In dental research, restorative materials have been regularly subjected to alternating in vitro thermal stress in investigations since the 1950s, in order to simulate in vivo alternating temperature stress and to artificially stress them in vitro. The provocation temperature is mostly 5 degrees C for cold provocation, and 55 degrees C for hot provocation. These temperatures are determined quite arbitrarily based on very few examinations in vivo. Extensive temperature data for the approximal space of teeth, which is decisive for the success of fillings adhesively attached to dentin, has so far not been addressed. The objective of this study was to examine the interproximal temperature characteristics created in the space of all teeth in vivo with thermal alternating stress, and therefore to validate the in vitro standardized thermal alternating stress of 5-55 degrees C. Fifteen study participants with healthy teeth were used to determine the temperature in each inter-dental space, resulting from hot/cold provocation in the upper and lower jaw, from the central incisor to the second molars. This was performed by a thermal element (cable sensor GTF 300, Greisinger Electronic GmbH, Regenstauf, Germany). The temperature sensor was attached with dental floss into the interproximal space and the temperature was recorded by the computer. The participants in the pilot test had to state when they were able to sip an 85 degrees C hot drink. That particular temperature value was taken for hot provocation as maximum temperature reference. Cold ice water (0 degrees C) was used for cold provocation as minimum temperature reference. The respective recordings with a total of 14 measurements for each individual were performed simultaneously in the upper and lower jaw. The study participants were to start with hot provocation, followed by cold provocation. This cycle was repeated at least once with an individual dwell time. The highest recorded approximal space temperature was 52.8 degrees C in the lower jaw, between the first and the second premolar. The lowest temperature of 13.7 degrees C was recorded in two participants in the upper jaw, between the 1st and 2nd incisor, and between the two central incisors. The mean of the maximum temperatures was 43.8+/-3.7 degrees C, and the mean of the minimum temperatures 24.2+/-4.6 degrees C. The mean initial temperature was 35.2+/-1.3 degrees C. None of the recordings reached either the upper threshold (55 degrees C) or the lower threshold (5 degrees C). This study showed that the actual thermal stress in the interproximal space of teeth is slightly lower than the one used in in vitro examinations. For class II cavities, most of the alternating temperature stress limits selected at 5-55 degrees C cover the actually occurring temperature interval quite well.

The aim of the study was to evaluate the clinical performance of the nanofiller resin composite Filtek Supreme (3M ESPE) vs the conventional fine hybrid resin composite Tetric Ceram (Ivoclar Vivadent) in stress-bearing posterior cavities. In accordance with a split mouth study design, 50 patients (35.7+/-11.3 years) received at least one pair of Filtek Supreme and Tetric Ceram restorations in each of two comparable class II cavities. To obtain comparability, the adhesive Scotchbond 1 was used for all the restorations. After 2 years, the restorations (total number 112) were scored according to the Ryge criteria. After 2 years (recall rate 100%), the results (%) of the Ryge evaluation for the two groups Filtek Supreme/Tetric Ceram were marginal adaptation: Alfa 96/96, Bravo 2/2, Charlie 2/0, and Delta 0/2; anatomic form: Alfa 98/98, Bravo 0/0, and Charlie 2/2; secondary caries: Alfa 100/100 and Bravo 0/0; marginal discoloration: Alfa 98/100, Bravo 2/0, and Charlie 0/0; surface: Romeo 95/95, Sierra 4/4, Tango 0/0, and Victor 2/2; and color match: Oscar 46/57, Alfa 50/39, Bravo 2/4, and Charlie 2/0. One Tetric Ceram and one Filtek Supreme restoration showed fractures that needed restorative intervention. No severe postoperative sensitivities were reported within the observation period. All restored teeth remained vital; the integrity of all the teeth was scored Alfa. After 2 years, no statistically significant differences (Wilcoxon-Mann-Whitney test) was found between the two restorative materials investigated. Therefore, Filtek Supreme, based on a new nanofiller technology, has proved efficaciousness for clinical use in stress-bearing posterior cavities.

The aim of the study was to evaluate the clinical performance of a packable fine hybrid dental composite (Prodigy Condensable) and the influence of the additional application of a flowable resin composite (Revolution, SDS Kerr) layer on marginal integrity after 2 years in stress-bearing posterior cavities according to the Ryge criteria. In 50 patients (40.5+/-17.5 years of age), 116 class II fillings (metal matrix system, glass ionomer-cement-base in 36%, rubberdam isolation in 70%) were placed, with at least two restorations per patient. The adhesive Optibond Solo Plus was used for all the restorations. In one of the two fillings in each patient, an additional layer of the flowable composite Revolution was applied in the entire cavity and separately light-cured. Baseline scores have been rated Alfa in > or =95% and Bravo in <5%. After 2 years, the results [%] of the Ryge evaluation for the two groups with/without the additional use of Revolution were: (1) Marginal Adaptation: Alfa:78/70, Bravo:16/27, Charlie:0/0, Delta:6/4; (2) Anatomic Form: Alfa:89/95, Bravo:6/2, Charlie:6/4; (3) Secondary Caries: Alfa:98/100, Bravo:2/0; (4) Marginal Discoloration: Alfa:76/68, Bravo:24/32, Charlie:0/0; (5) Surface: Alfa:90/91, Bravo:4/5, Charlie:0/0, Delta:6/4; (6) Color Match: Oscar:56/57, Alfa:44/39, Bravo:0/4, Charlie:0/0. Within the observation period (recall rate: 95%), three restorations out of 116 at baseline fractured, one restoration showed a secondary caries, one tooth received endodontic treatment, and all other restored teeth remained vital. After 2 years, no statistically significant difference (Chi-square test) in the overall survival rate between the group with the additional use of Revolution (92.8%) and that without Revolution (94.6%) was found. The combined survival rate for both groups together was 93.7% of clinically acceptable restorations.

Immediately after bonding, less microleakage was observed around the base of metal brackets on human than bovine teeth. These marginal gaps were, however, superficial in both groups, none of them involving deep penetration of dye under the bracket base.