• Restorative Dentistry and Endodontics
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• v.27 no.2
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• pp.142-149
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• 2002

Low-viscosity composite resins may produce better sealed margins than stiffer compositions (KempScholte and Davidson, 1988: Crim, 1989). Plowable composites have been recommended for use in Class V cavities but it is also controversial because of its high rates of shrinkage. On the other hand, in the study comparing elastic moduli and leakage, the microfill had the least leakage (Rundle et at. 1997) Furthermore, in the 1996 survey of the Reality Editorial Team, microfills were the clear choice for abfraction lesions. The purpose of this study was to evaluate the microleakage of 6 compostite resins (2 hybrids, 2 microfills, and 2 flowable composites) with and without load cycling. Notch-shaped Class V cavities were prepared on buccal surface of 180 extracted human upper premolars on cementum margin. The teeth were randomly divided into non-load cycling group (group 1) and load cycling group (group 2) of 90 teeth each. The experimental teeth of each group were randomly divided into 6 subgroups of 15 samples. All preparations were etched, and Single bond was applied. Preparations were restored with the following materials (n=15) : hybrid composite resin [Z250(3M Dental Products Inc. St. Paul, USA), Denfil(Vericom, Ahnyang, Korea)], microfill [Heliomolar RO(Vivadent, Schaan, Liechtenstein), Micronew(Bisco Inc. Schaumburg, IL, USA)], and flowable composite［AeliteFlo(Bisco Inc. Schaumburg, IL, USA), Revolution(Kerr Corp. Orange, CA, USA)]. Teeth of group 2 were subjected to occlusal load (100N for 50,000 cycles) using chewing simulator(MTS 858 Mini Bionix II system, MTS Systems Corp. Minn. USA). All samples were coated with nail polish 1mm short of the restoration, placed in 2％ methylene blue for 24 hours, and sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed for microleakage on a sclale of 0 (no leakage) to 3 (3/3 of wall). Results were statistically analyzed by Kruscal-Wallis One way analysis, Mann-Whitney U-test, and Student-Newmann-Keuls method. (p = 0.05) Results : 1. There was significantly less microleage in enamel margins than dentinal margins of all groups (p＜0.05) 2. There was no significant between six composite resin in enamel margin of group 1. 3. In dentin margin of group 1, flowable composite had more microleakage than others but not of significant differences. 4. there was no significant difference between six composite resin in enamel margin of group 2. 5. In dentin margin of group 2, the microleakage were R＞A =H=M＞D＞Z. But there was no significant differences. 6. In enamel margins, load cycling did not affect the marginal microleakage in significant degree. 7. In enamel margins, load cycling did affect the marginal microleakage only in Revolution. (p＜0.05).

• Restorative Dentistry and Endodontics
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• v.26 no.4
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• pp.332-340
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• 2001

Flowable composite resin has lower filler content, increased flow, and lower modules of elasticity. It is suggested that flowable composite resin can be bonded to the tooth structure intimately and absorb or dissipate the stress. Therefore, it may be advantageous to use flowable composite resin for the base material of class II restoration and for the class V restoraton. The purpose of this study was to evaluate the microleakage and shear bond strength of four flowable composite resins (Aeliteflo, Flow-It, Revolution, Ultraseal XT Plus) compared to Z100 using Scotchbond Multi Purpose dentin bonding system. To evaluate the microleakage, notch-shaped class V cavities were prepared on buccal and lingual surfaces of 80 extracted human premolars and molars on cementum margin. The teeth were randomly divided into non-thermocycling group (group 1) and thermocycling group (group 2) of 40 teeth each. The experimental teeth of each group were randomly divided onto five subgroups of eight samples (sixteen surfaces). The Scotchbond Multi-Purpose and composite resin were applied for each group following the manufacturer's instructions. the teeth of group 2 were thermocycled five hundred times between 5$^{\circ}C$ and 55$^{\circ}C$. The teeth of group 2 were placed in 2% methylene blue dye for 24 hours, then rinsed with tab water. The specimens were embedded in clear resin, and sectioned longitudinally with a diamond saw. The dye penetration on each of the specimen were observed with a stereomicioscope at $\times$20 magnification. To evaluate the shear bond strength, 60 teeth were divided into five groups of twelve teeth each. The experimental teeth were ground horizontally below the dentinoenamel junction, so that no enamel remained. After applying Scotchbond Multi-Purpose on the dentin surface, composite resin was applied in the shape of cylinder. The cylinder was 4mm in diameter and 2mm in thickness. Shear bond strength was measured using Instron with a cross-head speed of 0.5mm/min. After shear bond strength measurement, mode of failure was evaluated with a stereomicroscope at $\times$30 magnification. All data were statistically analyzed by One Way ANOVA and Student-Newman-Keuls method. The correlation between microleakage and shear bond strength was analyzed by linear regression. The results of this study were as follows ; 1. In non-thermocycling group, the leakage value of Z100 was significantly lower than those of flowable composite resins at the enamel and dentin margin, margin, except that Revolution showed the lower leakage value than that of Z100 at the dentin margin (p<0.05). 2. In thermocycling group, the leakage values of Z100 and Ultraseal XT Plus were lower than those of other subgroup at the enamel and dentin margin, except that Flow-It showed the lower leakage value than that of Ultraseal XT Plus at the dentin margin (p<0.05). 3. The leakage value of Z100 and Ultraseal XT Plus in thermocycling group were not higher than that in non-thermocycling group at the enamel margin. The leakage value of Z100 in thermocycling group was not higher than that in non-thermocycling group at the dentin margin (p<0.05). 4. As for the shear bond strength measurement, there were no statistically significant differences among groups (p<0.05). The shear bond strengths given in descending order were as follows: Z100(16.81$\pm$2.98 MPa), Flow-It(14.8$\pm$4.43 MPa), Aeliteflo(14.34$\pm$3.69 MPa), Revolution(13.46$\pm$4.23 MPa), Ultraseal XT Plus(12.83$\pm$3.16 MPa). 5. Failure modes of all specimens were adhesive failures. 6. There was no correlation between microleakage and shear bond strength.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.21-26
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• 2001

Purpose : This study was peformed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. Materials and Methods : From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients $(90\%)$ and lumpectomy or excisional biopsy for 10 patients $(8.3\%)$. Forty six patients $(38\%)$ received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the sternal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Results : Cosmetic score was excellent or good in $76\%$ (91/120), fair in $19\%$ (23/120) and poor in $5\%$ (6/120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (N0 versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0.0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conclusion : Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary node metastasis and treated with less extensive surgery without chemotherapy.