Cracked teeth have long presented a diagnostic challenge. Previous investigators have considered possible predictive factors, many of which revolve around the tooth’s restorative characteristics. Few have investigated the restorative status of teeth with cracks extending into the pulp chamber. The purpose of this investigation was to determine the prevalence of the different types of restorations present in intrapulpally cracked teeth and determine any other restorative factors that may aid in predicting the presence or extent of an intrapulpal crack. Intrapulpally cracked molars requiring endodontic therapy at the VCU Graduate Endodontic Practice were included in this study. For each tooth, the type of restorative material present and surfaces involved were recorded. The Restoration Volume Proportion (RVP) was calculated to accurately quantify the size of the restoration present. Pulpal and periapical diagnoses, and intrapulpal crack classification were also recorded. Chi squared analysis and logistic regression were used to determine any significant associations. This study included 43 teeth. The study population was 65% female and the average age was 56. Of the various restoration types evaluated, 73% of teeth presented with amalgams, 12% with composites. Class I restorations were 61% of the sample. The most frequently occurring restoration size by volume was a “small” restoration. The most commonly involved teeth were the maxillary 1st molar and mandibular 2nd molar. A significant association was found between restoration size and crack classification suggesting that teeth with larger restorations had a higher incidence of coronal cracks while those with smaller restorations had a higher incidence of radicular cracks. Restoration classification and pulpal walls involved were also significantly associated suggesting that Class II restorations were most frequently associated with cracks involving a single pulpal wall while Class I restorations were evenly associated with one and two wall cracks. Other significant associations were found between tooth type and pulpal walls involved and between restoration surfaces and pulpal wall classification. This study found several significant associations between restoration characteristics and intrapulpal cracks. Further research may continue to reveal how a tooth’s restorative status may influence its risk for the presence of an intrapulpal crack.

THE BOND STREGTH OF ADHESIVE RESIN CEMENT: TIME DIFFERENTIAL BETWEEN CEMENTATION AND FINISHING OF CAST DOWEL-CORES By Purnima Joan Shahani, D.D.S., M.S.A Thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.Virginia Commonwealth University, 2003Major Director: Peter C. Moon, M.S., PhDDirector of VCU Dental Biomaterials LaboratoryThis study compared the retention of cast dowel-cores cemented with Panavia® 21 subjected to immediate versus delayed high-speed finishing. Conventionally, finishing is delayed for 24 hours to one week to allow for optimal setting and ultimate strength of the cement. Forty-five recently extracted human maxillary canines were used. Teeth were divided among 3 groups: a control group (n=15, no finishing), an immediate finishing group (n=15, high-speed cutting of the cores performed five minutes after cementation) and a delayed finishing group (n=15, high-speed finishing performed 48 hours post-cementation). Tensile load to failure was applied using an Instron® at a crosshead speed of 0.05 inches/minute. A statistical test of equivalence was performed. The average retention force associated with failure after immediate finishing was not found to be inferior to delayed finishing failure force. In fact, post-hoc comparisons indicated that immediate finishing has statistically significant greater mean retentive force when compared to this force for delayed finishing at p = 0.00001.

Statement of Problem. Resin-based cements have become increasingly more popular for the cementation of prefabricated endodontic dowels due to their superior retention. The manufacturer of Panavia F 2.0 suggests that the product be stored under refrigerated conditions while not in use, however, there is no literature to support such a rationale. It is possible that these storage/use temperature cycling events may have a deleterious effect on the retention of prefabricated endodontic dowels. Purpose. The purpose of this in-vitro study was to investigate the retention of Panavia F 2.0 used to lute prefabricated endodontic dowels after the Panavia F 2.0 system has been kept under different storage conditions. Material and Methods. Sixty-four extracted human central incisors were selected to undergo root canal therapy and dowel retention testing. Four separate Panavia F 2.0 cement systems were placed under 4 different storage conditions for a period of 6 months, until retention testing was initiated. In the first group, the Panavia F 2.0 was stored under the manufacturer's suggested refrigerated conditions, at a constant temperature of 40°F. In the second group, the Panavia F 2.0 was stored under a constant 90°F temperature. In the third group, the Panavia F 2.0 was stored under room temperature conditions of 70°F. The fourth group attempted to mimic clinical usage conditions with the Panavia F 2.0 being cycled from refrigeration at 40°F for 22 hours/day to 2 hours/day of room temperature at 70°F 5 days per week for the duration of the 6-month storage condition period. Results. Stress values were analyzed using 1-way ANOVA. A Tukey's HSD multiple comparison analysis of the dowel retention strengths indicated that the group stored at 90°F resulted in the lowest retention. This group was significantly lower than all other groups' retention strength (p Conclusions. Within the limitations of this study, the storage of Panavia F 2.0 at either room temperature or cycling between refrigeration and room temperature yields similar dowel retention values. However, the storage of Panavia F 2.0 at temperatures of 90°F for prolonged periods causes poor dowel retention. Clinical Implications The results of this study do not support the necessity of storing Panavia F 2.0 under refrigerated conditions between clinical uses, if used within six months. However, the storage of the Panavia F 2.0 cementation system at temperatures of 90°F for prolonged periods will affect dowel retention and is therefore not advisable.

Purpose: To compare the in-vitro shear bond strengths of a new paste-paste formulation of resin-modified glass-ionomer cement (Rm-GIC) to an exising powder-liquid formulation. The study will test the hypothesis that the new paste-paste formulation of Rm-GIC (Fuji-Cem ™, GC Corp, Tokyo, Japan) has the same bond strength as an existing popular powder-liquid formulation of Rm-GIC (Rely-X ™ Luting Cement, 3M, St. Paul, MN)Materials and Methods: A total of 33 human molars were sectioned parallel to the occlusal surface to expose mid-coronal dentin and mounted parallel to the bond shearing device on the universal testing machine (Instron). For Group I samples (Rely-X, n=15), the powder and liquid were measured and adjusted to achieve a ratio of 1.6 and mixed for 30 seconds as recommended by the manufacturer. For Group II (Fuji-Cem, n=18), the paste-paste was expressed from the paste-dispenser provided by the manufacturer and mixed for 10 seconds as recommended. After testing, the teeth from group II were bonded on a different site with the same material but mixed for 20 seconds (n=18). To ensure a uniform flow and bond surface area, the mixed cement was syringed into a cylindrical mould (diameter 2.38mm, height 2mm) and allowed to set under constant force. All samples were subjected to fracture by shear loading on a universal testing machine (Instron) at a uniform crosshead speed of .02" per minute and expressed as MPa. Values were analyzed at the pResults: Wilcoxon rank sums test showed significantly higher shear bond strength values for Rely-X compared to Fuji-Cem mixed both at 10 seconds and 20 seconds. Mixing for 20 seconds resulted in stronger bonds for Fuji-Cem compared to 10 seconds, but was still significantly lower than Rely-X.Conclusions: Within the limitations of the study, the Rely-X powder-liquid formula shows a significantly stronger dentin shear bond strength when compared to the new paste-paste formula of resin-modified glass ionomer cement, Fuji-Cem.

Statement of problem. Clinicians have used disinfection materials to remove surface contaminants during cavity preparation. It has been postulated that disinfection materials may negatively affect shear bond strength of restorative materials. If so, large numbers of restorations may be predestined for early failure with the use of a disinfection protocol.Purpose. To determine whether there is a difference in the bond strength between dentin and composite resin with a 3-step disinfection technique compared to a conventional bonding technique without the additional disinfection protocol.Material and Methods. Sixty human molar teeth were sectioned parallel to the occlusal surface to expose mid-coronal dentin and mounted parallel to a bond shearing device on a universal testing machine (Instron) and randomly divided into 2 groups. In Group I (n=30), specimens were treated with chlorhexidine, tubulicid red, and sodium hypochlorite before dentin bonding, following the manufacturer's instructions for All Bond 2. In Group II (n=30), specimens were treated only with the bonding protocol of All Bond 2. To ensure a uniform bond surface area, core paste was syringed into a cylindrical mold (diameter 2.38mm, height 2.00mm) that was in contact with the dentin bonding surface of each specimen, and allowed to set under constant force. All specimens were subjected to fracture by shear loading in a universal testing machine (Instron) at a uniform crosshead speed of 0.02 inch per minute and expressed as MPa. Statistical analysis, using nonpaired student's t-test, was performed. Results. A statistically-significant higher shear bond strength was found for the 3-step disinfection group (mean shear bond strength, 25.3; STD, 4.6) compared to the conventional bonding group (mean shear bond strength, 20.5, STD, 3.4) (PConclusions. The 3-step disinfection technique group showed a significantly stronger dentin shear bond strength compared to the conventional bonding technique without disinfection.

Purpose: To evaluate the tensile strength properties of Rx Naturelle Plus and Option (high-palladium) alloys on soldered connectors under simulated preceramic and postceramic soldering conditions. Materials and methods: Eighty cylindrical castings were fabricated (40 using Rx Naturelle Plus alloy and 40 using Option alloy). The 40 castings for each alloy were subdivided into 2 groups of 20 each. In the first group, castings for each alloy were randomly paired and soldered with SMG2 solder to produce 10 preceramic test connector specimens for each alloy. In the second group, castings were similarly paired and soldered with 490 fine solder to produce 10 postceramic test connector specimens for each alloy. Each solder connector was subjected to tensile force until failure using an Instron testing machine. Statistical analysis using a Wilcoxon Rank Sums Test was performed.Results: No significant difference was found between the mean connector strength for Rx Naturelle Plus preceramic solder (mean tensile failure stress, 50,000 Psi; STD, 11,250) compared to Option preceramic solder (mean tensile failure stress, 59,700.4 Psi; STD, 16,350) (p= 0.1202). However, the connector strength for Rx Naturelle Plus postceramic solder (mean tensile failure stress, 37,800 Psi; STD, 32,450) was significantly lower than the Option postceramic solder (mean tensile failure stress, 45,300 Psi; STD, 17,550) (p= 0.0407). Not only did Rx Naturelle Plus postceramic solder connectors show evidence of lower strength, but also an increased variation among specimens.Conclusions: Rx Naturelle Plus solder connectors provided better strength with the preceramic are opposed with the postceramic connectors. For postsolder connectors, Rx Naturelle Plus alloy had less acceptable strength and a wider variation, suggesting it is more technique sensitive than Option alloy connectors.

AbstractAN IN-VITRO COMPARISON OF THE RETENTION OF PREFABRICATED PARALLEL-SIDED VENTED TITANIUM POSTS CEMENTED WITH THREE DIFFERENT DUAL-POLYMERIZABLE RESIN CEMENTSBy Maha M. El-Sayed, B.D.S., D.M.D.A Thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University.Virginia Commonwealth University, 2003Thesis Director: David R. Burns, D.M.D. Associate Professor and Program DirectorGraduate ProsthodonticsDepartment of ProsthodonticsPurpose: The purpose of this in-vitro study was to compare the retentive strength of an autopolymerizing resin cement to three dual-polymerizable resin cements when used to cement paraposts without light activation and to relate diametral tensile stress and hardness as a measure of the degree of polymerization to the retentive strength of the different dual-polymerizable resin cements. Material and methods: 60 human extracted premolar teeth were endodontically-treated and randomly divided into 4 test groups (n=15). Parapost XP posts (size 5) were cemented using Panavia 21(control), Panavia F, RelyX Unicem and Linkmax resin cements. The latter three cements were dual-polymerizable and were not light-activated, and the control cement was autopolymerizable. Also, 140 resin cement samples were fabricated for diametral tensile stress and Knoop hardness testing. Each test had 70 samples, 10 of each of the following groups: Panavia 21, Panavia F light-activated, Panavia F autopolymerized, RelyX Unicem light-activated, RelyX Unicem autopolymerized, Linkmax light-activated, Linkmax autopolymerized. Post retention, diametral tensile stress and surface hardness tests were performed 1 week after sample fabrication or post cementation.Results: ANOVA and Tukey-Kramer statistical analysis revealed significant differences among the test groups for the three tests. Conclusions: Within the limitations of this in vitro study, tested dual-polymerization resin cements had similar or superior parapost retention to the control autopolymerizing resin cement without photoactivation. Dual-polymerizable resin cements had improved diametral tensile stress and surface hardness when light-activated than when autopolymerized. No correlation was observed between surface hardness and diametral tensile stress or between the tested physical properties of the resin cements and their retentive qualities