The document summarizes a review article on the relevance of in vitro tests of adhesive and composite dental materials. It discusses how laboratory tests are conducted according to ISO standards to evaluate properties like depth of cure, flexural strength, water sorption and solubility. While such tests provide standardized physical property data, they do not replace clinical studies. Laboratory tests only partially correlate with clinical performance and cannot predict all potential problems. Both laboratory and long-term clinical studies are needed to fully assess new dental materials.
Comparative evaluation of treatment of noncarious cervical hypersensitivity b...DR.AJAY BABU GUTTI M.D.S
Comparative evaluation of treatment of noncarious
cervical hypersensitivity by a fluoride varnish, a
dentin bonding agent, and Er, Cr:YSGG laser: An
in vivo study JCD 2020
Preference of materials for posterior restorations: A cross-sectional study a...Premier Publishers
The aim of the study is to evaluate the preferences of materials for posterior restorations among Palestinian dentists and to assess whether postgraduate training or clinical experience had an influence on their material preferences. A cross-sectional study was carried out among 216 dentists in Palestine using an online survey, which consisted of closed questions asking about socio demographic variables, the level of specialization and time since graduation. It further probed into the preferences for posterior restorations through questions about the first choice of material, type of composite resin (if used), use of rubber dam and preferences for curing. It was observed that 66.2% of the dentists preferred using composite and 72.9% preferred nano-hybrid composite restorations over other types of composite material. However, the majority (88.4%) did not prefer using a rubber dam. There was no significant association between the time of clinical training or post-graduate training and their choices for the materials. The study reports that composite was the preferred material for posterior restoration among the Palestinian dentists, and nano-hybrid their preferred type of composite. However, these dentists seldom used rubber dam and their postgraduate training or time of training did not influence their choice of material
Comparative evaluation of treatment of noncarious cervical hypersensitivity b...DR.AJAY BABU GUTTI M.D.S
Comparative evaluation of treatment of noncarious
cervical hypersensitivity by a fluoride varnish, a
dentin bonding agent, and Er, Cr:YSGG laser: An
in vivo study JCD 2020
Preference of materials for posterior restorations: A cross-sectional study a...Premier Publishers
The aim of the study is to evaluate the preferences of materials for posterior restorations among Palestinian dentists and to assess whether postgraduate training or clinical experience had an influence on their material preferences. A cross-sectional study was carried out among 216 dentists in Palestine using an online survey, which consisted of closed questions asking about socio demographic variables, the level of specialization and time since graduation. It further probed into the preferences for posterior restorations through questions about the first choice of material, type of composite resin (if used), use of rubber dam and preferences for curing. It was observed that 66.2% of the dentists preferred using composite and 72.9% preferred nano-hybrid composite restorations over other types of composite material. However, the majority (88.4%) did not prefer using a rubber dam. There was no significant association between the time of clinical training or post-graduate training and their choices for the materials. The study reports that composite was the preferred material for posterior restoration among the Palestinian dentists, and nano-hybrid their preferred type of composite. However, these dentists seldom used rubber dam and their postgraduate training or time of training did not influence their choice of material
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
Cervical restorations were known as the least durable type of restoration. Therefore, it is important for clinician to identify the contributing factors that may lead to failure of the restorations. Objective: The purpose of this study was to compare the clinical performance in terms of type of restorative materials and the influence of clinical handling technique of non-carious cervical restorations. Materials and Methods: This cross-sectional study was carried out to patients with restorations on non-carious cervical lesions (NCCLs) at Universiti Sains Islam Malaysia dental clinic. The clinical performance of the restorations was evaluated using the ratings of the United States Public Health Service criteria and analyzed using the Pearson Chi-square.
Analyzing Adhesion of Epoxy/Steel Interlayer in Scratch TestIJERA Editor
The aim of this paper is to investigate use of an experimental technique to determine which parameters effects
on the interfacial durability performance of adhesive on the metallic adherends as zinc plated mild steel (S235)
by using Taguchi method. The experimental layout has been used four scratch force parameters using the L16
(41x23) orthogonal array. The statistical methods of signal to noise ratio (SNR) and the analysis of variance
(ANOVA) were applied to examine effects of surface treatment, adhesive type, blade angle and thickness on
scratch force and scratch energy. Besides, the surface analysis was carried out the morphological modifications
as well as to perform elemental analyses of the pre-treated surfaces. Results of this study indicate that the
thickness and surface treatment are main parameters influencing scratch force (by 52.4% and 19.9%) and
scratch energy (by 44.0 % and 25.6%), respectively.
Evaluation of Microleakage and Microgap of Two Different Internal Implant–Abu...Dr. Anuj S Parihar
Aim: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant–abutment associations.
Materials and methods: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram’s stain and biochemical reactions were used for identification of colonies.
Results: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 μm and was 10.4 μm in group II. The disparity among the two groups was found
to be significant (p < 0.05).
Conclusion: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
Cervical restorations were known as the least durable type of restoration. Therefore, it is important for clinician to identify the contributing factors that may lead to failure of the restorations. Objective: The purpose of this study was to compare the clinical performance in terms of type of restorative materials and the influence of clinical handling technique of non-carious cervical restorations. Materials and Methods: This cross-sectional study was carried out to patients with restorations on non-carious cervical lesions (NCCLs) at Universiti Sains Islam Malaysia dental clinic. The clinical performance of the restorations was evaluated using the ratings of the United States Public Health Service criteria and analyzed using the Pearson Chi-square.
Analyzing Adhesion of Epoxy/Steel Interlayer in Scratch TestIJERA Editor
The aim of this paper is to investigate use of an experimental technique to determine which parameters effects
on the interfacial durability performance of adhesive on the metallic adherends as zinc plated mild steel (S235)
by using Taguchi method. The experimental layout has been used four scratch force parameters using the L16
(41x23) orthogonal array. The statistical methods of signal to noise ratio (SNR) and the analysis of variance
(ANOVA) were applied to examine effects of surface treatment, adhesive type, blade angle and thickness on
scratch force and scratch energy. Besides, the surface analysis was carried out the morphological modifications
as well as to perform elemental analyses of the pre-treated surfaces. Results of this study indicate that the
thickness and surface treatment are main parameters influencing scratch force (by 52.4% and 19.9%) and
scratch energy (by 44.0 % and 25.6%), respectively.
Evaluation of Microleakage and Microgap of Two Different Internal Implant–Abu...Dr. Anuj S Parihar
Aim: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant–abutment associations.
Materials and methods: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram’s stain and biochemical reactions were used for identification of colonies.
Results: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 μm and was 10.4 μm in group II. The disparity among the two groups was found
to be significant (p < 0.05).
Conclusion: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Replantation in dentistry / /certified fixed orthodontic courses by Indian de...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Objective: The aims of this study isto evaluate the inter-premolar width changes in the mandible using three different commercial orthodontic arch wires. Subjects and methods: Thirty patients including both males and females have been allocated in this study. Three orthodontic wires including NiTi, copper NiTi, and Beta-Titanium wires had been used. A special observational technique including cbct had been used to make an evaluation for the inter-premolar width before and after the aligning stage. Results: The results showed a highly significant increase in post-treatment inter premolar width in CNA and NITI groups; compared to Cu NITI group; with highly significant statistical difference (p < 0.01 respectively). Conclusion: The present study showed that there is a high significant increase in the inter-premolar width in the mandible, when comparing the wires in the groups (NiTi, CNA, and copper niti). Also, the gender of the patient does not seem to have an impact of the gender on post-treatment efficacy of each wire.
The black box of orthodontic research is now in its second edition. This book is considered as a reference for orthodontic professionals who look for validation
and optimization of their basic knowledge, experience and updated research concerning
the orthodontic field.
The continuing development in orthodontic materials and mechanics led researchers
from different countries to employ their efforts and capabilities to investigate any relation
between these and their use in orthodontic treatment. Running multiple studies scenarios
for different populations, needs to be organized and ranked according to article type and
methodology incorporated to simplify the process of referencing and validating each
orthodontic procedure used.
For this, it was my honorable opportunity to give a hand in this issue. For most orthodontic
subjects encountered daily in practice, the most leading results, statements and conclusions
of concern mentioned in literature will be documented in order of publishing time.
Considering theses, beside focusing on the mentioned reference, will give orthodontists
the whole picture of the stroy.
It should be stated here that more focus on the leading orthodontic journals will be
noticed. Any valuable notes for the purpose of improving the way the book is presented
for audience will be of our great appreciation.
Raed H. Alrbata
Healing of Periapical Bone Lesion After Periradicular Surgery And Graft Place...QUESTJOURNAL
Objectives: 1.To clinically evaluate the healing process following periapical surgery with Chitra granules 2.To radiographically evaluate healing, following periapical surgery with Chitra granules. 3.To compare the bone healing in the study group, clinically and radiographically following the modalities of treatment, with that of the control group (without graft). Materials: 1.Chitra hydroxyapatite granules. 2. Gutta-percha — for root canal obturation by lateral condensation. 3. High Copper amalgam used as retrofilling materials. To evaluate healing after periapical surgery using Chitra granules, 22 patients were selected from out patient section of Department of Conservative Dentistry and Endodontics, Govt. Dental College, Kozhikode,based on clinical and radiographical evaluation. The study group consisted of 13 males and 9 females. All were of the age group 15-35 years. After selection they were randomly divided into two groups A and B. In group A the Chitra granule were placed in the bony defect and in group B the defect were left as such after surgery. Results: Clinical parameters showed better early symptom free condition in group A compared to group B. But data found statistically insignificant (t-7.27,df-1.8, P >0.05). Radiographical evaluation data analysis showed statistically significant difference among group A and group B. Conclusion: Biocompatible Chitra granule not only obliterates the cavity but act as a scaffold for bone growth and prevent scar tissue formation.It is osteoconductive. In comparison to the conventional periapical surgery, the placement of Chitra granules facilitates bone regeneration more easily. The material is found to be very cost effective, easily available, easy to manipulate and involves least complication to both clinicians and patients.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
3. Introduction
The article we are about to discuss is
entitled:
“Relevance of In Vitro Tests of Adhesive
and Composite Dental Materials”.
Accepted for publication in the Swiss
Journal, “Schweiz Monatsschr
Zahnmed”, on 11th January, 2011.
4. Authors
The study was done by:
1. Siegward D. Heintze,
R&D, Head of Preclinical Research,
Ivoclar Vivadent AG, Schaan,
Liechtenstein
2. Brigitte Zimmerli,
Department of Preventive, Restorative
and Pediatric Dentistry,
School of Dental Medicine,
University of Bern
6. Aim of the Study
The study was a review in 3 parts (this being part
1), that was aimed at examining literature available
on studies on relevance of laboratory testing of
composites and adhesives and approval
requirements for composite materials.
The investigators compared the in vivo and in vitro
literature data and discussed the relevance of in
vitro analyses.
They also presented the standardized ISO
protocols, with a focus on the evaluation of
physical parameters.
7. Materials and Methods
A review of approval requirements of the
medical device directive and CE
certification, and the ISO test regulations
for dental materials was done.
Information was obtained from a study by
Schorn (1994), and from the ISO
Standardization Documents of
1997,1998, and 2010.
8. Materials and Methods
An electronic literature search was then
conducted in the databank PubMed.
The articles evaluated were selected using
the following keywords:
1. “composite restoration”,
2. “survival rate and composite”, and
3. “composite restoration” combined with:
a) “flexural strength”,
b) “depth of cure”,
c) “color stability”,
d) “water sorption”,
e) “solubility”,
f) “radiopacity”, and
g) “biocompatibility”.
9. Findings
The majority of the dental literature consists of
results from laboratory tests, as this is much
faster and less labor-intensive than collecting
clinical data.
The proportion of published clinical prospective
studies compared to all other published studies
in four international English-language dental
journals from 2003 to 2008 ranged between 2%
and 23%.
11. Clinical Studies on Composite Use Based on
Laboratory Recommendations
Whereas laboratory studies can be very useful
in providing recommendations on how dentists
should use composite materials in their daily
clinical routine, it was noted that some
recommendations do not supercede other
simpler techniques.
For example, Demarco et al. (2007) used
translucent wedges and transparent matrices
in placement of proximal composite
restorations on one group of patients, and
metallic matrices and wooden wedges on
another.
12. Clinical Studies on Composite Use
A 4 year follow up study by Demarco et al. (2010)
showed no significant differences (p > 0.05),
between the two matrix and wedge systems.
Comparing 4-year to baseline results, the quality of
marginal adaptation, marginal staining and
roughness, decreased for both metallic and
translucent matrices, while color match, occlusal
contacts, and proximal contacts, decreased in
quality for translucent matrices (p < 0.001).
Although the matrix and wedge systems evaluated
showed similar clinical performance, there was
clinical quality loss after 4 years, with most of the
restorations being still acceptable, and no
intervention was necessary.
13. Clinical Studies on Composite Use
Other clinical studies such as these on:
a) “selective” bonding versus “total” bonding (Baratieri & Ritter
2001, Brunthaler et al. 2003),
b) “with softstart polymerization” versus “without softstart
polymerization” (Chan et al. 2008),
c) “incremental placement” vs. “bulk placement” of composites,
(Sarrett et al. 2006),
showed no significant differences between
either of the proposed alternatives, after years
of labour intensive research.
It is for this reason that it was questioned how
much relevant information in-vitro tests of
dental materials really provide in terms of
clinical suitability.
14. Requirements for a Composite
Material
Today, most composites are sold as
universal composites, i. e., the material is
suitable for every indication and size of
direct restoration.
Hence, the composites must fulfill a broad
spectrum of handling and load-bearing
requirements due to the demands placed
on it by the oral environment and
mastication.
15. Requirements for a Composite Material
Mjör (2007) highlighted the following as the
major requirements for a composite fillings:
i. Handling properties of the material: High viscosity,
packability, not sticking to instruments, flowability and
polishability.
ii. Esthetics of the material: The composite restoration
should not be visible at a social, speaking distance.
iii. Longevity of the placed filling: Flexural strength, fracture
strength, surface hardness, water sorption, solubility,
polymerization shrinkage and shrinkage force.
The skill and experience of the dentist, and
patient-related factors, such as caries activity
and parafunctions, also influence the longevity
16. Standardization Organizations
Most of the materials used in dentistry are subject
to the Medical Device Directive 93/42 (Schorn
1994), valid Europewide.
The CE mark (Communautées Européennes)
means that the product corresponds to the basic
requirements of the guidelines and harmonized
standards.
The American Dental Association (ADA) has
guidelines for the awarding of a Seal of
Acceptance.
The FDA (in the USA) and ISO (internationally) also
have standards that must be adhered to by
17. Laboratory Tests
Results must be reproducible.
Parameters which influence the test results must be
known.
The coefficient of variation, that is, the ratio of the
standard deviation to the mean, should be under
20%.
Devices used for testing must be suitable (proven
and documented)and may have to be calibrated
before performing the test or measurement.
- (FDA 1978)
Lab results make a test internally valid; clinical
19. Depth of Cure
Determines how thick the composite layer
can be and still attains adequate
conversion.
In the test, composite is placed in the hole
(6 mm long 4 mm) of a stainless steel
mould and polymerized.
The ISO standard specifies a minimum of
1.5 mm (ISO 2009a).
20. Depth of Cure
Method of determining depth of cure are either
by scooping the unpolymerized portion with a
plastic spatula, and the remaining composite
thickness measured and divided by two, or by
measuring the Vickers hardness of the top and
bottom of specimens of different thicknesses.
A material qualifies as completely cured when
the surface hardness of the bottom is at least
80% of that of the top.
Tsai et al. 2004 showed that this value
correlates well with half the depth of cure test
as specified in the ISO standard.
23. Factors Affecting Depth of Cure
1) The transparency of the composite.
2) The power density of the polymerization
unit, the duration of irradiation.
3) The distance between the emission window
of the light probe and the composite to be
polymerized.
(Krämer et al. 2008)
24. Factors Affecting Depth of Cure
Ernst et al. (2004), showed that in Class II
cavities with deep proximal boxes reaching
into the dentin, the first increment of
composite at the gingival floor must be
irradiated with a device providing 560
mW/cm2 for at least 40 s.
If a unit emitting 1200 mW/cm2 is used, 20 s
of polymerization suffices to completely
harden the material.
25. Factors Affecting Depth of Cure
The gingival part of Class II restorations has
been evaluated as a critical area for the
formation of secondary caries; about 80% of all
secondary caries forms there and only 20% at
the occlusal margin (Mjör 1998).
Moreover, marginal discoloration is found much
more frequently in this area than elsewhere
(Wilson et al. 2006).
The reason for this has been attributed to
inadequate conversion of composite in the
gingival part of Class II restorations.
26. Secondary caries (arrow) at the distal gingival floor of a Class II
composite restoration in a premolar.
27. Factors Affecting Depth of Cure
Inadequate maintenance and monitoring of the
power density of light-curing units in private
practices.
In a field test of 301 dental offices in Germany,
26% of the units emitted less than the minimum
required power density of 400 mW/cm2 (Ernst
et al. 2006, Rueggeberg et al. 1994).
48% of the light probes exhibited defects or
composite residuals were stuck to them (Ernst
et al. 2006).
28. The direct clinical relevance of the depth of cure test remains questionable, not
least because access for polymerization in the oral cavity is difficult and the light
probe usually does not come into direct contact with the restoration surface.
Polymerization is often
performed by an assistant,
which can lead to further
imprecision in curing.
29. Factors Affecting Depth of Cure
Closer to our set-up, a recent study
examined 83 light curing units in private and
public dental clinics in Nairobi, Kenya.
Age of a light curing unit was shown to bear
a significant influence on the light
intensity of the curing units - there being a
decrease in light intensity output with
increase
in age of the units (Alasow 2010).
30. Sensitivity to Ambient Light
The clinical relevance of this test lies in the
information about how long the dentist can
handle the material before the ambient light
cures it.
The ISO standard stipulates a handling time of
at least one minute.
In the clinical situation, premature
polymerization of restorative composites (as
opposed to luting composites) is usually not a
problem if the operator is experienced.
31. Sensitivity to Ambient Light
Composites with long handling time also tend
to have a longer polymerization time, since
the curing reaction is considerably delayed
through the given composition of initiators and
inhibitors (Ilie & Hickel 2006).
In the test, appr. 30 mg of test material is
illuminated for 60 s under predetermined
conditions (8000 lux ― 1000) with a UV filter.
The material is then compressed between two
glass plates to a thin film which may not
exhibit any inhomogeneities due to premature
polymerization.
32. Flexural Strength
Is a measure of the fracture resistance of a material.
For restorative materials in occlusion bearing areas,
the ISO standard demands a flexural strength of at
least 80 MPa.
Composite materials with a flexural strength less
than this minimum standard sowed increased
fractures in clinical studies.
On the basis of this, Solitaire(Heraeus Kulzer), had
to be improved to a better product after clinical
studies showed fractures in the area of the marginal
ridge and margins after only 2 years ((Ernst et al.
2001; Krämer et al. 2005).
33. Water Sorption and Solubility
Weight of specimen after water sorption, minus
weight after re-drying the specimen should yield
value of less than 40 μg/mm3.
Water sorption tests according to the ISO
standard yielded 27 μg/mm3 for Admira and 12
μg/mm3 for Tetric Ceram (Janda et al. 2007),
both lower than the ISO limit and therefore
suitable for clinical use.
Admira and Tetric Ceram did not differ
significantly in the 5-year clinical comparison
34. Shade and Color Stability
No electronic devices are used to measure
color, despite the fact that all other
parameters are standardized.
Nevertheless, the human eye is still
considered to yield the most highly
reproducible color assessment; electronic
devices exhibit a certain degree of
imprecision (Hugo et al. 2005).
35. Radiopacity
Radiopacity is set by comparison to an aluminum
standard.
It is an example of the suboptimal limits set by the
ISO standards.
The minimum value of 100%Al is too low for clinical
use.
A composite material must have a radiopacity of at
least 200%Al to be distinguishable from dental hard
tissues (Espelid et al. 1991).
This shows that although the test protocol is clinically
36. The restorations exhibit different radiopacities. Note that the mesial
restoration at tooth 27 is barely distinguishable from the dental hard
38. Result Discrepancies between Testing
Laboratories
Values differing by 10–15% of the mean lie
within the range of variation of the test and
are determined by the material, the test
methods, and the manual fabrication of the
specimens.
Deviations greater than this, can however
arise for one reason or another (Huysmans
et al. 1996).
39. Conclusion
A great advantage of standardized testing is
that the values obtained in different institutes
can be compared to each other.
The in vitro tests provide physical values
that are of crucial importance for assessing
the clinical suitability of the materials.
40. Conclusion
The standardized laboratory tests are
important for the first material analysis.
As opposed to other test methods, they
correlate well in part with the clinical data.
Laboratory tests do not replace clinical tests,
but they do increase the safety of the
patients who participate in controlled studies
of the new materials.
41. Conclusion
Despite laboratory tests being carried out,
unexpected problems in clinical use,
problems which could not be anticipated in
the laboratory tests., still arise.
This is especially valid for innovative
material concepts for which no analogous
comparisons to existent systems can be
drawn.
For this reason, clinical studies of
appropriate duration are still important.
43. CRITICAL ANALYSIS OF THE
ARTICLE: Title
RELEVANCE OF IN VITRO
TESTS OF ADHESIVE AND
COMPOSITE DENTAL
MATERIALS
Specific
Measurable?
Accurate
Realistic
45. CRITICAL ANALYSIS OF THE
ARTICLE: Objectives
Clear & unambiguous
However, the adhesive component of the
study was probably not exhaustively
tackled.
Dwelled more on composite filling
materials as opposed to luting cements.
Biocompatibility? Should have been
tackled more too.
46. CRITICAL ANALYSIS OF THE
ARTICLE: Methodology
Guidelines and test methods for composite
materials reviewed.
Electronic literature search was conducted
in the databank PubMed.
Bias?
47. CRITICAL ANALYSIS OF THE
ARTICLE: Discussion and
Conclusion
Good citation of literature
Proper inferences drawn
Need to augment laboratory studies
with clinical studies emphasised.
49. References
1. Heintze SD, Zimmerli B. Relevance of in vitro tests of
adhesive and composite dental materials, a review in 3
parts. Part 1: Approval requirements and standardized
testing of composite materials according to ISO
specifications. Schweiz Monatsschr Zahnmed
2011;121(9):804-16.
2. Demarco FF, Pereira-Cenci T, André DA. Effects of metallic
or translucent matrices for Class II composite restorations:
4-year clinical follow-up findings. Clin Oral Invest (2011)
15:39-47.
3. Alasow KB. Efficiency of light curing units in Dental clinics
in Nairobi, Kenya. (2010)