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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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Incubation

Mitis Salivarius agar : candle jar

Rogosa agar: anaerobicgas jar


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3. Identification of bacterial strains

i. Culture characteristics

Primary identification by colony

morphology


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ii. Microscopic examination

S. mutans lactobacilli


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iii.Further identification of streptococcal

colonies was done by biochemicalreactions:

1. Catalase Test


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2. Sugar Fermentation Tests

mannitol sorbitol

raffinose

fermentation tests

for verification of S. mutans

negative positive


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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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A. Agar Diffusion Inhibitory test

The agar diffusion inhibitory test was

performed on days 1, 2, 4, 6 and 8


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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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The density of bacterial

suspension was adjusted

and standardized to that

of 0.5 MacFarland

Turbidity Standard


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Each plate contained:

3 disks of the tested

materials

one negative control

one positive control


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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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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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The fluoride content was determined

by means of an ion specific electrode


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Following calibration Ion specific electrode

Reference electrode

Temperature electrode


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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

)


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)


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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