02_D042_43796

8/13/2019 02_D042_43796

http://slidepdf.com/reader/full/02d04243796 1/12

DISSERTATION – SYNOPSIS

DR. NAMITH RAI

POST GRADUATE STUDENT

DEPARTMENT OF CONSERVATIVEDENTISTRY AND ENDODONTICS

A.J. INSTITUTE OF DENTAL SCIENCES

KUNTIKANA P.O,

NH-17

MANGALORE.-575004

BATCH 2013 - 16

8/13/2019 02_D042_43796


Rajiv Gandhi University of Health Sciences,

Bangalore.Karnataka

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. Name of the Candidate andAddress

(In block letters)

DR NAMITH RAI

FLAT NO – 603, ANAND APARTMENTS,

KARANGALPADY, KODIALBAIL,

MANGALORE-575003

KARNATAKA

2. Name of the Institution

A.J. INSTITUTE OF DENTAL SCIENCES,

MANGALORE.

3. Course of study and subject

MASTER OF DENTAL SURGERY-CONSERVATIVE

DENTISTRY AND ENDODONTICS

4. Date of admission of course 05/07/2013

5. Title of the topic: “EVALUATING THE EFFECT OF DIFFERENT CONDITIONING AGENTS

ON THE SHEAR BOND STRENGTH OF RESIN MODIFIED GLASS

IONOMERS”

8/13/2019 02_D042_43796


6. Brief resume of the intended work:

6.1 Need for the study:

Resin modified glass ionomer’s have several advantages compared to chemically cured glass ionom

cements. The advantages include command cure, ease of handling, improved physical properties a

esthetics. Resin modified glass ionomers have been marketed as direct restorative materials for class lesions as well as liners, bases and luting agents. The resin modified glass ionomers contain resins a

light activating compounds. Hence there are two distinct mechanisms of bonding of resin modifi

glass ionomers to tooth structure, a chemical bonding between anions of polyalkenoic acid chains acalcium ions in hydroxyapatite and micromechanical bond similar to that which occurs between dent bonding agents. Several conditioning agents have been evaluated to condition dentin prior to t

application of conventional glass ionomers and resin modified glass ionomers. These have main

included polyacrylic acid, citric acid, phosphoric acid and EDTA. Of late manufactures harecommended other conditioners to replace polyacrylic acid which includes ketac primer as one of t

conditioning agents. With the increased number of young patients coming with cervical erosion

utilization of resin modified glass ionomers is more common due to its several advantages of comma

cure and bonding equally well to both enamel and dentin. The need to improve the bonding efficacy resin modified glass ionomers by changing the conditioning liquids is essential. Bonding of res

modified glass ionomer which contains resin as one of its ingredients may not bond to the dentin substra

as efficiently as conventional glass ionomer, hence surface conditioning has an important role to createsubstrate that is suitable for both resin and glass ionomer cements.

8/13/2019 02_D042_43796


6.2Review of literature:

1. TA Imbery, A Namboodiri, A Duncan, R Amos, AM Best, PC Moon(2013) Evaluating dent

surface treatments for resin modified glass ionomer restorative materials Operative dentistry 3

4, 429-438. The purpose of this study was to evaluate the effect of six surface treatments on the shear bo

strength of the resin modified glass ionomer restorative materials to dentin. Occlusal surfaces

caries free third molars were reduced to expose only dentin. Surface treatments were smear lay

intact, cavity conditioner, EDTA, Ketac primer, self conditioner and etching with 35% phosphoracid followed by the application of optibond solo plus. Fujii II LC, Riva LC, Ketac Nano and Filt

Z250 were placed in copper band matrices 5mm in diameter and 2mm in height and were light cur

for 20 seconds. Specimens were stored in 100% humidity for 24 hours, after which they were placin de-ionized water for 24 hours at 37

0C. Then they tested under shear forces in an Instron univers

testing machine at a crosshead speed of 0.5mm/min. A two-way analysis was done. Acid etchin

followed by optibond solo plus provided highest bond strengths for al resin modified glass ionomer

2. DWBerzins, SAbey, MCCostache, CAWilkie and HW Roberts (2010) Resin modified gla

ionomer setting reaction competition Jour nal of dental research 89(1) 82-86.Resin modified glass ionomers set by atleast 2 mechanisms dependent upon reactant diffusion prior

gelation. Each reactions kinetics and setting mechanisms may rely on and /compete with the other.In this study investigation of resin modified glass ionomer setting reaction interactions usi

differential scanning calorimetry (DSC) by varying light cure initiation times. RMGIS was analyz

with isothermal and dynamic temperature scan DSC with light curing occurring immediately, at 5 10 minutes after mixing as well as without light activation. Results show that as time allowed for t

acid base reaction increased, the light activation polymerization exotherm decreased. Conversel

analysis of DSC data suggests that earlier light activation may limit the acid base reaction and resin a different structured material. During early RMGI development, acid base and ligh

polymerization reaction compete with and inhibit one another.

3. E Coutinho,YYoshida, SInoue, RFukuda, JSnauwaert, YNakayama,De Munck J,

Lambrechts, KSuzuki and Van Meerbeek B(2007) Gel phase formation at resin modified glaionomer / tooth interfaces Journal of dental research 86(7) 656-661.

Ionic bonding between polyalkenoic acid and hydroxyapatite may explain the excellent bondi

retention of glass ionomers in clinical trials.

This study has investigated the extent to which the self adhesiveness of resin modified glass ionome

can be attributed to this chemical bonding capacity. Therefore, the interaction of three RMGI’S w

tooth substrates was comprehensively characterized with electron and atomic force microsco

correlated with x-ray photoelectron spectroscopy (XPS). Interfacial ultra-structural analysis for tw

RMGI’s disclosed a shallow hybridization of hydroxyapatite-coated collagen, on which a submicr

gel phase was deposited through reaction of the polyalkenoic acid with calcium extracted from tdentin surface. One RMGI, however bonded to dentin without hybrid layer or gel pha

formation.XPS indicated that polycarboxylic acids included in the RMGI’S electrostatica

interacted with hydroxyapatite. It was concluded that the self adhesiveness of RMGI’S should

attributed to ionic bonding to hydroxyapatite around collagen and to micro-mechanical interlocki

for those RMGI’S that additionally hybridize dentin.

8/13/2019 02_D042_43796


4. E Coutinho,KVan landyut,J De Munck, APiotevin, YYoshida,

Inoue,MPnuemans,KSuzuki,PLambrechts and B Van Meerbeek (2006) Development of s

etch adhesive for resin modified glass ionomersJour nal of dental research 85(4) 349-353.

The favorable self-adhesiveness of resin modified glass ionomers might be even further improved

the time consuming and technically sensitive etch and rinse pre-treatment step with polyalkeno

acids could be avoided.

This study was undertaken to assess the effectiveness of an experimental self etch adhesive f

RMGI’S that does not need to be rinsed off. Ultrastructural analysis and micro-tensile bond streng

testing to enamel and dentin of RMGI restorative material and a RMGI adhesive were performed aft

four different surface pre-treatments : no conditioning, 25% polyalkenoic acid , an experimental se

etch adhesive , and 37.5% phosphoric acid followed by the experimental self etch adhesive. The u

of an experimental self etch adhesive increased the bond strength of RMGI’S, especially after

additional conditioning step. Interfacial analysis showed the formation of a thin hydroxyapat

containing hybr id layer. The self etch technique enhances the user friendliness of RMGI’S and lowe

their technique sensitivity, while maintaining desirable characteristics of the conventional etch a

rinse approach with polyalkenoic acids.

5. M Puemans, PKanumilli,J De Munck,K Van landyut, PLambrechts and B Van Meerbe

(2005) Clinical effectiveness of contemporary adhesives. A systemic review of current clinic

trialsDental materi als 21(9) 864-881.

The purpose of this study was to review current literature on the clinical effectiveness

contemporary adhesives when used to restore cervical non carious class V lesions. Restorati

retention in function of time was recorded in order to find out that if adhesives with a simplifi

application procedure are as clinically effective as conventional three step adhesives. Comparison

retention of class V adhesive restorations as a measure to determine clinical bonding effectiveness

adhesives revealed that glass ionomers most effectively and durably bond to tooth tissue. Three-st

etch and rinse adhesives and two-step self etch adhesives showed a clinically reliable and predictabgood clinical performance. The clinical effectiveness of two-step self-etch and rinse adhesives w

less favorable, while an inefficient clinical performance was noted for the one-step self et

adhesives. Although there is tendency towards adhesives with simplified application procedur

simplification so far appears to induce loss of effectiveness.

6. S Inoue, YAbey, Y Yoshida, JDe Munck, HSano, KSuzuki, PLambrechts and B Va

Meerbeek(2004) Effect of conditioner on bond strength of glass ionomer adhesive

dentin/enamel with and without smear layer interposition Operative dentistry 29(6) 685-692.

In this studythe effect of a polyalkenoic acid conditioner pretreatment on the bond strength of a gla

ionomer adhesive to tooth substrates with or without smear layer was evaluated.24 extracted hum

molars were obtained,resin composite was bonded to the surfaces using Fujibond LC with or witho

a polyalkenoic acid conditioner and subjected to micro-tensile bond strength testing, scanning electr

microscopy was used to determine failure. For dentin,smear layer coverage and conditioner treatme

did not reveal significant differences (range 20-29 Mpa). For enamel, smear layer coverage did n

affect micro-tensile bond strength whereas the use of conditioners significantly improved micr

tensile bond strength. Most dentin specimens failed mixed adhesive cohesively.

For enamel failure mostly occurred when no conditioner was used. Bonding to t

8/13/2019 02_D042_43796


glassionomeradhesive to dentin can achieved without the separate use of polyalkenoic ac

conditioner,even with the interposition of the smear layer. However,instrumented and no

instrumented enamel requires separate conditioning to provide sufficient micro-mechanical retention

7. K Yamamoto, HKojima,Tsutsumi and H Oguchi (2003) Effects of tooth conditioning agents

bond strength of a resin modified glass ionomer sealant to enamel journal of denti stry 31(1) 1

18.

The purpose of this study was to evaluate the effects of tooth conditioning agents on bond strength

resin modified glass ionomer sealant (FujiIII LC) to bovine enamel as well as on dissolution

calcium ions from the bovine enamel surfaces. The enamel surfaces of bovine lower incisors we

treated with 10 and 20% polyacrylic acid, 12% citric acid and 35% phosphoric acid for 20 second

FujiIIILC was applied to the etched enamel surfaces and the shear bond strength of each specim

was measured using an instron universal testing instrument. In specimens pretreated with distill

water 10% polyacrylic acid, 20% polyacrylic acid, 12% citric acid,35% phosphoric acid,the me

values of shear bond strength were 5.5,12.5,15.2,15.2and 15.1 MPa respectively.

The adhesion of a resin modified glass ionomer sealant to bovine enamel was significantly improv

by the use tooth conditioning agents. Especially, treatment of an enamel surface with 20% polyacry

acid results in good shear bond strength and relatively small degree of enamel erosion.

8. LA Miranda,PWeidlich,SMWSamueland M Maltz(2002) Fluoride release from restorati

materials coated with an adhesive Brazil ian dental journal 13(1) 39-43.

The purpose of this investigation was to evaluate if the presence of the adhesive,being part of t

hybrid layer composition,interfered with the fluoride released to tooth tissues. The restorati

materials studied were - Vitremer (3M), Heliomolar(Vivadent) and Z100(3M) using an adhesi

application (Scotch Bond Multipurpose Plus) (3M).

10 disks of each material were prepared - 5 were covered with the adhesive and 5 were not. The dis

were immersed in individual flasks containing artificial saliva which was changed daily. Fluorirelease was measured at days – 1,5,10,15,20 by a fluoride combined electrode(9609 BN-ORION

coupled to an ion analyzer(SA-720 Procyon). One-way ANOVA and the Student-Newman-Kuels t

were applied to compare the materials. The results showed that the use adhesive significantly reduc

the fluoride release of Vitremer and reduced fluoride release of Heliomolarto undetectable levels.

9. S Sano,TTakatsu,BCiucchi,JAHorner,WGMatthews and DH Pashley(1995) Nanoleakag

Leakage within the hybrid layer Operative dentistry 20(1) 18-25.

Most microscopic studies involve quantitating the magnitude of movement of a tracer molecu

through a gap between restorative materials and the wall of cavity preparations. The prese

microscopic study examined the migration of silver nitrate into the interface between dentin and fidifferent dentin bonding agents used to restore class V cavities, in the absence of gap formatio

Several different leakage patterns were seen, but they all indicated leakage within the hybrid lay

when viewed by SEM. The ranking of microleakage from most to least was All-Bond 2>Superbo

C and B >Scotchbond Multipurpose>Clearfill liner bond system >Kuraray experimental system, K

200. To distinguish this special type of microleakage within the basal, porous region of the hybr

layer in the absence of gap formation, the term NANOLEAKAGE was proposed.

8/13/2019 02_D042_43796


7. Objectives of the study: The purpose of this in vitro study is to evaluate the effects of conditioniagents on the shear bond strength of resin modified glass ionomers to human dentin.

Materials and methods: 7.1 Source of data:120 Freshly extracted human premolars and molars will be collected from T

Department of Oral & Maxillofacial Surgery, A. J. Institute Of Dental Sciences & from private den

clinics in & around Mangalore, adhering to CDC infection control protocols global.

Exclusion criteria : Cracked tooth , caries affected tooth

7.2 Methodology :

120Recently extracted, caries free premolars and molars will be cleaned of debris and disinfected in a

0.5% solution of sodium hypochlorite and sterile water for 30 minutes. The occlusal surface of each too

will be reduced using conventional model trimmer with water to produce the dentin surface. The surface

is not treated with any other abrasive papers or discs.

EXPERIMENTAL GROUPS

GROUP I LIQUID OF GLASS IONOMER

Sub group I Tooth will be conditioned with Liquid of glass ionomer and restored with Fuji II LC(

Sub group II Tooth will be conditioned withLiquid of glass ionomer and restored with Ketac Nano

Sub group III Tooth will be conditioned with Liquid of glass ionomer and restoredwithVitremer (10

GROUP II KETAC PRIMER

Sub group I Tooth will be conditioned with Ketac primer and restored with Fuji II LC(10)

Sub group II Tooth will be conditioned withKetac primer and restored with Ketac Nano(10)

Sub group III Tooth will be conditioned with Ketac primer and restoredwithVitremer(10)

GROUP III EDTA 17%

Sub group I Tooth will be conditioned with EDTA 17% and restoredwith Fuji II LC(10)

Sub group II Tooth will be conditioned with EDTA 17% and restored with Ketac Nano(10)

Sub group III Tooth will be conditioned with EDTA 17%and restored with Vitremer (10)

CONTROL GROUP

GROUP IV INTACT SMEAR LAYER WITHOUT CONDITIONING

Sub group I Intact smear layer will be restored with Fuji II LC(10)

Sub group II Intact smear layer will be restored with Ketac Nano(10)

Sub group III Intact smear layer will be restored with Vitremer(10)

Conditioning agents will be applied as per manufacturer’s instructions. Copper band matrices 5mm in

diameter and 2mm in height will be held on the dentin surface by grasping with cotton forceps to hold th band steady. Then resin modified glass ionomer cement is triturated and mixed according to the

manufacturer’s instructions using finger pressure to compress the restorative materials against dentin.

Then the specimens will be light cured for 20 seconds with an intensity of 500mW/cm2

, 10 specimenswill be made of each group. Excess restorative material will be removed from matrix band dentininterface with a sharp no.25 bard parker blade. Samples will be stored for 48 hrs prior testing, Initially f

24 hrs in 100% humidity at 37oC and then placed in37

0C de-ionized water for 24hrs. Samples will be

shear tested with Instron universal testing machine with a crosshead speed of 0.5 mm/min. A shearing b beveled to a 1mm thick contact surface area will be placed at the junction of dentin and copper band

matrix. The load required for the failure will be recorded in pounds and converted to megapascals.

Statistical analysis :

Collected data will be analyzed by ANOVA and TUKEYS TEST.

8/13/2019 02_D042_43796


7.3. Does the study require any investigations or interventions to be conducted on patients or other

humans or animals? If so, please describe briefly. Not applicable

7.4. Has the ethical clearance been obtained from your institution in case of 7.3? Yes obtained from the ethical clearance committee of A.J INSTITUTE OF MEDICALSCIENCES,MANGALORE.

8/13/2019 02_D042_43796


7.5INVESTIGATION DESIGN

120 Freshly extracted human molars and premolars will be disinfected, stored and surfaced as

per CDC protocol.

Occlusal surfaces will be reduced to expose only dentin, conditioning agents will be applied as

per manufacturer’s instructions.

Copper band matrices 5mm in diameter and 2mm in height will be held on the dentin surface

by grasping with cotton forceps to hold the band steady.

EXPERIMENTAL GROUPS CONTROL GROUP

GROUP I

LIQUID OF GLASS

IONOMER

Fuji II LC (10)

Ketac

Nano(10)

Vitremer(10)

GROUP II

KETAC PRIMER

Fuji II LC (10)

Ketac

Nano(10)

Vitremer(10)

GROUP III

EDTA: 17%

Fuji II LC (10)

Ketac

Nano(10)

Vitremer(10)

GROUP IV

INTACT SMEAR

LAYER

Fuji II LC (10)

Ketac

Nano(10)

Vitremer(10)

8/13/2019 02_D042_43796


Resin modified glass ionomers will be placed in copper band matrices. Triturated and mixedaccording to the manufacturer’s instructions using finger pressure to compress the restorative

materials against dentin and will be light cured for 20 seconds (500Mw/cm2).

Excess restorative material will be removed from the matrix band dentine interface with a sharp No

25 Bard Parker blade.

Samples will be stored for 48 hours prior to testing, initially for 24 hours in 100 % humidity at 37 C

and then placed in 370C de-ionized water for 24 hours.

Then will be tested under shear forces in an INSTRON UNIVERSAL TESTING machine at a

crosshead speed of 0.5 mm /min. A shearing bar beveled to a 1mm thick contact surface area will be

placed at the junction of dentine and copper band matrix.

The load required for the failure will be recorded in pounds and converted to megapascals.

Statistical analysis will be done using TUKEYS and

ANOVA test.

8/13/2019 02_D042_43796


8. List of references:

Imbery TA, Namboodiri A,Duncan A, Amos R, Best AM, Moon PC (2013) Evaluating

dentin surface treatments for resin modified glass ionomer restorative materials Operative

dentistry 38-4, 429-438.

Berzins DW,Abey S,Costache MC, Willkie CA and Roberts HW(2010) Resin modified gla

ionomer setting reaction competition Journal of dental research 89(1) 82-86.

CoutinhoE,Yoshida Y,Inoue S,Fukuda R,Snauwaert J, Nakayama Y, De Mun

J,Lambrechts P,Suzuki K and Van Meerbeek B(2007) Gel phase formation at resin modifi

glass ionomer/tooth interfaces Journal of dental research 86(7) 656-661.

Coutinho E,Van landyut K, De Munck J, PiotevinA,Yoshida Y, Inoue S,Pnuemans M,Suzu

K,Lambrechts P and Van Meerbeek B(2006) Development of self etch adhesive for res

modified glass ionomersJour nal of dental research 85(4) 349-353.

Puemans M,Kanumilli P,De Munck J,Van landyut K,Lambrechts P and Van Meerbeek

(2005) Clinical effectiveness of contemporary adhesives. A systemic review of curre

clinical trialsDental materi als 21(9) 864-881.

Inoue S,Abe Y,Yoshida Y, De Munck J,Sano H,Suzuki K,Lambrechts P and Van Meerbe

B (2004) Effect of conditioner on bond strength of glass ionomer adhesive to dentin/enam

with and without smear layer interpositionOperative dentistr y 29(6) 685-692.

Yamamoto K,Kojima H,Tsutsumi and Oguchi H(2003) Effects of tooth conditioning agen

on bond strength of a resin modified glass ionomersealent to enamel Journal of dentis

31(1) 13-18.

Miranda LA, Weidlich P,Samuel SMW and Maltz M (2002) Fluoride release fro

restorative materials coated with an adhesive Brazil ian dental journal 13(1) 39-43.

Sano S,Takatsu T,Ciucchi B,Horner JA,Matthews WG and Pashley DH (199

Nanoleakage: Leakage within the hybrid layer Operative dentistry 20(1) 18-25.

8/13/2019 02_D042_43796


02_D042_43796

Documents

Transcript of 02_D042_43796