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A COMPARATIVE STUDYOF THE ANTIBACTERIAL
EFFECT OF SOMEFLUORIDE RELEASING
RESTORATIVEMATERIALS
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Success or failure of a restorative
material depends , to a great extent, on
its ability to resist secondary caries andmicroleakage
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Secondary or recurrent caries is found
at the interface of tooth and restoration
and is, in general, a result of :
The persisting bacterial
presence Lack of a thoroughly
hermetic seal between
the filling and the cavitywalls
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In an attempt to decrease the effect
of microleakage increased emphasishas been placed on developing
restorative materials with anticariogenic
properties
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The anticariogenic effects of
fluoride has prompted the inclusion
of fluoride into a host of dental
materials such as GIC, resin
composites and their hybrids
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1. Investigate and compare the antibacterial
activity of some fluoride releasing
restorative materials at different time
intervals
2. Measure and compare the fluoride releaseof the restorative materials at the same
time intervals
3. Correlate between fluoride release andantibacterial activity
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I. MaterialsI.1. Restorative Materials
Tetric Ceram Vitremer
Dyract
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II. METHODS
II.1. Specimen Preparation:
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45 Disk specimens
Vitremer15
Dyract15
TetricCeram
15
SM5
Fl5
Lact5
SM5
Fl5
Lact5
SM5
Fl5
Lact5
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II.2. Microbiological Study
2. Processing the samples
Mitis Salivarius Bacitracin Agar Rogosa Agar
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II.2. Microbiological Study
Incubation
Mitis Salivarius agar : candle jar
Rogosa agar: anaerobicgas jar
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II.2. Microbiological Study
3. Identification of bacterial strains
i. Culture characteristics
Primary identification by colony
morphology
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II.2. Microbiological Study
3. Identification of bacterial strains
ii. Microscopic examination
S. mutans lactobacilli
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II.2. Microbiological Study
3. Identification of bacterial strains
iii.Further identification of streptococcal
colonies was done by biochemicalreactions:
1. Catalase Test
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II.2. Microbiological Study
2. Sugar Fermentation Tests
mannitol sorbitol
raffinose
fermentation tests
for verification of S. mutans
negative positive
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory testPrior to each test day,
each of the strains was
subcultured on blood agar
to ensure the use of pure
non contaminated strains
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory test
The agar diffusion inhibitory test was
performed on days 1, 2, 4, 6 and 8
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory test
On the tested days, three to five colonies
of the pure strains of each organism
tested were emulsified in 3-4 ml of sterile
saline.
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory test
The density of bacterial
suspension was adjusted
and standardized to that
of 0.5 MacFarland
Turbidity Standard
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory test
Each plate contained:
3 disks of the tested
materials
one negative control
one positive control
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory test
This procedure was repeated for each of
the 10 plates (5 plates of each strain)
The bacterial plates with the specimen
disks were then incubated in their optimalgrowth conditions for 24 hrs
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II.2. Microbiological Study
A. Agar Diffusion Inhibitory test
The diameter of the zones of microbial
inhibition was measured in millimeters by
a ruler
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II.3 Fluoride release
Five specimen disks of each
material were soaked in 10ml
distilled water
Specimens were removed daily,
and transferred into another tube
filled with 10ml of distilled water
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II.3 Fluoride release
The fluoride content was determined
by means of an ion specific electrode
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II.3 Fluoride release
Following calibration Ion specific electrode
Reference electrode
Temperature electrode
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II.3 Fluoride release
The results were displayed on the upperpart of the liquid crystal display (LCD) in
fluoride (F) concentration and expressed
in ppm
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II.4 Statistical Analysis
Data were collected, tabulated and
statistically analyzed using one-wayANOVA and paired t-test
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Dyract and Tetric
Ceram did not exhibit
any antibacterial effect
against both
streptococci and
lactobacilli at anytested time period
Vitremer, showed no
inhibitory effect onboth strains of
bacteria on days 1
and 2
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Streptococci
0
5
10
15
20
25
30
35
Diffusionzonediam(mm)
Day 1 Day 2 Day 4 Day 6 Day 8
Dyract
Tetric
Vitremer
Control
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Lactobacilli
0
5
10
15
20
25
30
35
Diffu
sionzone
(mm
)
Day 1 Day 2 Day 4 Day 6 Day 8
Dyract
Tetric
Vitrem
Contro
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Fluoride Release
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
Fluo
ride(ppm)
Day 1 Day 2 Day 4 Day 6 Day 8
Dyract
Tetric
Vitremer
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1. Out of the three tested materials, the
RMGI (Vitremer) was the only onecapable of producing an inhibitory
effect on both S. mutans and
Lactobacilli.2. The RMGI (Vitremer) was capable of
releasing a significant amount of
fluoride during the first two days ofthe experiment but not to a level that
suppresses bacterial activity.
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3.Although Dyract could release a
detectable amount of fluoride on day 1,it was not able to exhibit antibacterial
activity.
4. Tetric Ceram was not capable ofreleasing fluoride or exhibiting any
antibacterial activity.
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5. The delayed antibacterial activity ofVitremer may be attributed to the
release of other substances rather
than fluoride.
6. There was no correlation found
between fluoride release and
antibacterial activity of the restorativematerials during the first week after
curing.
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Prof. Dr. Mohammed M. Abd El Mohsen
Professor of Operative Dentistry
Faculty of Oral and Dental MedicineCairo University
Dr. Ola Mohammed Ibrahim Fahmy
Assistant Professor of Operative DentistryFaculty of Oral and Dental Medicine
Cairo University
Dr. Eman Ezzat WalyLecturer in Microbiology Department
Faculty of Medicine
Cairo University
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