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Influence of a dental ceramic and a calcium aluminate cement on dental biofilm formation and gingival inflammatory response
Umeå University, Faculty of Medicine, Odontology.
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Dental restorative materials interact with their surrounding oral environment. Interaction factors can be release of toxic components and/or effects on biofilm formation and gingiva. In the end of the nineties, a calcium aluminate cement (CAC) was manufactured as a “bioceramic” alternative to resin composite. Dental ceramics are considered to be chemically stable and not to favour dental biofilm formation. Since the influence of aged, resin-bonded ceramic coverages is not fully investigated and the effect of CAC restorations on the dental biofilm formation and gingival response is unknown, those issues were evaluated in this thesis.

With or without oral hygiene, in clinical trials including cervical surfaces of CAC, and approximal surfaces of a leucite-reinforced bonded ceramic; biofilm growth, presence of caries-associated bacteria, clinical expressions of gingivitis, the amounts of gingival crevicular fluid (GCF) and its levels of IL-1α, IL-1β and IL-1 ra were investigated in comparison with resin composite and enamel. In addition, the unknown cytotoxic effect of specimens of CAC on fibroblasts was assessed in vitro.

With current oral hygiene a similar biofilm formation and gingival response, as evaluated, were observed at sites of CAC, resin composite and enamel. After ceased oral hygiene, more biofilm was assembled on CAC and on resin composite than on enamel. Neither with, nor without oral hygiene, biofilm formation, presence of caries-associated bacteria, clinical gingivitis and the levels of IL-1α, IL-1β and IL-1 ra differed between sites of ceramic, resin composite and enamel. Higher volumes of GCF were collected at ceramic sites compared to enamel. Fresh specimens of CAC showed the lowest cytotoxic effects on fibroblasts compared with three resin composites, zinc phosphate and glass ionomer cements.

In conclusion, the low cytotoxic effect of CAC and the limited increase in dental biofilm formation on that material compared with enamel suggest CAC to be a biocompatible dental material with respect to dental biofilm formation, presence of caries-associated microflora and gingival response. This finding, together with the observation that the influence of bonded ceramic on dental biofilm formation, caries-associated microflora and clinical gingivitis was not different from that of enamel, implicates for both CAC restorations and bonded ceramic that the need of oral hygiene and professional oral health care is not reduced.

Place, publisher, year, edition, pages
Umeå: Odontologi , 2007. , 61 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 98
Keyword [en]
cements, ceramics, cytotoxicity, dental biofilm, gingivitis, interleukin-1, oral hygiene, resin composite
Identifiers
URN: urn:nbn:se:umu:diva-1069ISBN: 91-7264.284-3 OAI: oai:DiVA.org:umu-1069DiVA: diva2:140094
Public defence
2007-04-20, Sal B, 1D, Tandläkarhögskolan, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2007-03-30 Created: 2007-03-30 Last updated: 2009-05-27Bibliographically approved
List of papers
1. Effect of a novel ceramic filling material on plaque formation and marginal gingiva.
Open this publication in new window or tab >>Effect of a novel ceramic filling material on plaque formation and marginal gingiva.
2002 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, no 6, 370-374 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this clinical investigation was to evaluate a novel ceramic (CF) filling material (DoxaDent) compared to resin composite (RC) and enamel in regard to plaque formation and gingival inflammation. The CF material is inorganic, non-metallic, and contains calcium aluminate, silicate, and water. To make intra-individual comparisons possible, each participant had at least one set of three test surfaces: two Class V restorations with subgingival cervical margins (one of the novel CF material and one of a hybrid RC) and one non-filled enamel surface (E). The amounts of plaque, gingival crevicular fluid, and clinical signs of gingival inflammation were intra-individually compared in 20 sets of the three test surfaces. In a cross-sectional study (CSS), the effect of oral hygiene on plaque formation and gingivitis around the surfaces was evaluated. In a following 10-day experimental gingivitis study (EGS), plaque formation and the induction of gingivitis during refrain from oral hygiene was compared. In the CSS, no significant differences were found between the surfaces in terms of amount of plaque and degree of gingival inflammation. At the end of the EGS the restorative materials showed a significantly higher amount of plaque (CF versus E, P = 0.014; RC versus E, P = 0.034), but no significant differences were found in degree of gingival inflammation. In condusion, the ceramic filling material was comparable to RC regarding plaque formation and gingival inflammation with customary oral hygiene. With neglected oral hygiene, significantly less plaque growth and a non-significant tendency toward lower amounts of gingival crevicular fluid were observed on enamel surfaces.

Identifiers
urn:nbn:se:umu:diva-17669 (URN)10.1080/000163502762667414 (DOI)12512888 (PubMedID)
Available from: 2007-11-15 Created: 2007-11-15 Last updated: 2017-12-14Bibliographically approved
2. Interleukin-1 levels in gingival crevicular fluid adjacent to restorations of calcium aluminate cement and resin composite.
Open this publication in new window or tab >>Interleukin-1 levels in gingival crevicular fluid adjacent to restorations of calcium aluminate cement and resin composite.
2005 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, no 5, 462-466 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this clinical study was to intra-individually compare Class V restorations of a calcium aluminate cement (CAC), resin composite and enamel with respect to the adjacent levels of interleukin (IL)-1alpha, IL-1beta and IL-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF). The hypothesis was that there are higher IL-1 levels adjacent to resin composite, compared with CAC and enamel. MATERIALS AND METHODS: In 15 subjects, at least one set of two Class V restorations with subgingival margins, one CAC and one universal hybrid resin composite, and one control surface of enamel were included. In a cross-sectional study and on days 0, 3 and 7 of an experimental gingivitis study, GCFs were collected with Periopaper for 30 s. The GCF concentrations of IL-1alpha, IL-1beta and IL-1ra were quantified with enzyme linked immunosorbent assays. RESULTS: Neither the cross-sectional study nor the experimental gingivitis study showed any significant differences in the levels of IL-1alpha, IL-1beta and IL-1ra between CAC, resin composite and enamel sites (p>0.05). In the cross-sectional study, low IL-1 concentrations were observed. The IL-1 levels increased significantly during the experimental gingivitis. CONCLUSION: Regardless of CAC or resin composite, the restorations per se did not affect the GCF levels of IL-1 and IL-1ra, neither at healthy gingiva, nor at initiation of plaque-related gingival inflammation.

Identifiers
urn:nbn:se:umu:diva-17173 (URN)10.1111/j.1600-051X.2005.00698.x (DOI)15842260 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2017-12-14Bibliographically approved
3. Cytotoxicity of a calcium aluminate cement in comparison with other dental cements and resin-based materials.
Open this publication in new window or tab >>Cytotoxicity of a calcium aluminate cement in comparison with other dental cements and resin-based materials.
Show others...
2006 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 1, 1-8 p.Article in journal (Refereed) Published
Keyword
Aluminum Compounds/*toxicity, Analysis of Variance, Animals, Calcium Compounds/*toxicity, Composite Resins/toxicity, Dental Cements/*toxicity, Dental Restoration; Permanent/methods, Flow Cytometry, Glass Ionomer Cements/toxicity, L Cells (Cell Line)/drug effects, Mice, Resin Cements/toxicity, Zinc Phosphate Cement/toxicity
Identifiers
urn:nbn:se:umu:diva-9069 (URN)10.1080/00016350500279568 (DOI)16428175 (PubMedID)
Available from: 2008-02-28 Created: 2008-02-28 Last updated: 2017-12-14Bibliographically approved
4. Mutans streptococci and lactobacilli in plaque on a leucite-reinforced dental ceramic and on a calcium aluminate cement.
Open this publication in new window or tab >>Mutans streptococci and lactobacilli in plaque on a leucite-reinforced dental ceramic and on a calcium aluminate cement.
2006 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 10, no 3, 175-180 p.Article in journal (Refereed) Published
Abstract [en]

In this in vivo study, the proportions of mutans streptococci and lactobacilli in plaque were examined (1) on proximal surfaces of bonded, leucite-reinforced ceramic crowns and (2) on class V restorations of calcium aluminate cement (CAC). The examined proportions were intraindividually compared with those of resin composite and enamel. Mutans streptococci and lactobacilli in samples from plaque that was accumulated for 10 days on the following surfaces were determined by cultivation on blood agar plates and species-selective plates: (1) proximal leucite-reinforced ceramic crown, class II composite and enamel (n=11); and (2) class V restoration of CAC and composite, and enamel (n=17). Mutans streptococci and lactobacilli in the samples were distributed in three groups: 0, >0-1, and >1% of total bacteria. The surfaces with detected mutans streptococci were similarly distributed between the materials and enamel. The highest proportion of mutans streptococci and lactobacilli were observed on ceramic followed by composite and enamel. A higher proportion of lactobacilli, but not of mutans streptococci, was detected on enamel compared to CAC and composite. However, no significant differences were found between the surfaces. Conclusively, the materials investigated did not show different relative proportions of mutans streptococci and lactobacilli in plaque, compared to enamel.

National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-17034 (URN)10.1007/s00784-006-0045-4 (DOI)16642391 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2017-12-14Bibliographically approved
5. Dental biofilm, gingivitis and interleukin-1 adjacent to approximal sites of a bonded ceramic.
Open this publication in new window or tab >>Dental biofilm, gingivitis and interleukin-1 adjacent to approximal sites of a bonded ceramic.
2007 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, no 12, 1062-1067 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to investigate in vivo the influence of aged, resin-bonded, ceramic restorations on approximal dental biofilm formation and gingival inflammatory response, associated with and without customary oral hygiene. Material and Methods: In a cross-sectional and in a 10-day experimental gingivitis study, Quigley-Hein plaque index, gingival index (GI), crevicular fluid and its levels of interleukin (IL)-1alpha, -1beta and receptor antagonist were measured at appoximal surfaces of leucite-reinforced bonded ceramic coverages, resin composite restorations and enamel and compared intra-individually in 17 participants. Results: No differences were found between the ceramic, composite and enamel regarding plaque index, GI, levels of IL-1alpha, -1beta and the receptor antagonist. Throughout, higher crevicular fluid amounts were observed at ceramic sites compared with the enamel (p<0.05). In the experimental gingivitis, plaque index, GI, crevicular fluid and its IL-1alpha levels increased significantly. Conclusion: The need for optimal oral hygiene and professional preventive oral health care does not seem to be reduced with regard to approximal surfaces of aged, resin-bonded, leucite-reinforced ceramic restorations in comparison with those of a hybrid, resin composite and enamel.

Identifiers
urn:nbn:se:umu:diva-17671 (URN)10.1111/j.1600-051X.2007.01146.x (DOI)17941884 (PubMedID)
Available from: 2007-11-15 Created: 2007-11-15 Last updated: 2017-12-14Bibliographically approved

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