DISSERTATION - SYNOPSIS

DR RAJAT SAREEN

POST GRADUATE STUDENT

DEPARTMENT OF CONSERVATIVEDENTISTRY

AND ENDODONTICS

A.J. INSTITUTE OF DENTAL SCIENCES, KUNTIKANA,

MANGALORE.

BATCH 2011-2012

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / Name of the Candidate
And Address
(in block letters) / RAJAT SAREEN
20-L MODEL TOWN
JALANDHAR CITY
PUNJAB
2. / Name of the institution / A.J. INSTITUTE OF DENTAL SCIENCES,
N.H-17, KUNTIKANA,
MANGALORE-575004
3. / Course of study and subject / MASTER OF DENTAL SURGERY, CONSERVATIVE DENTISTRY AND ENDODONTICS.
4. / Date of admission to course / 21-04-2011
5. / Title of the topic: / PROTECTIVE EFFECT OF RESIN COATING ON THE MICROLEAKAGE OF CLASS V RESTORATIONS FOLLOWING TREATMENT WITH CABAMIDE PEROXIDE IN VITRO
6. / Brief resume of the intended work:
6.1 Need for the study: Tooth bleaching has turned into a popular treatment in dentistry. Amongst all the bleaching techniques, Nightguard Vital bleaching (a/c as “at home bleaching”) has been considered to be the safest, most cost effective, patient pleasing method for improving the appearance. Long term bleaching has inevitably led to an increased potential for broad exposure of restorative materials to bleaching agent. Crim has reported an increase in microleakage at the dentin margins of class V resin composite restorations following exposure to home bleaching agents. However recent studies show that bleaching had no influence on the microleakage of Class V tooth colored restorations. Apart from microleakage, other detrimental effects of bleaching on both restorative materials and tooth-hard tissues have been reported.
Although the effects of bleaching on tooth-colored restorative materials is still controversial ,in some cases, replacement of the restoration after tooth bleaching is advised due to poor post treatment color match and the degraded properties of the restorative material. During the procedure, bleaching induced effects such as increased microleakage, might lead to series of clinical problems such as bacterial accumulation, staining and pulp damage.
Literature demonstrates the protective effects of resin varnish against bleaching agents. Resin coating is considered to be beneficial in reducing marginal staining and enhancing marginal integrity.Resin coating could potentially eliminate the effects of bleaching agents on the microleakage of tooth colored restorative materials. However till date, relatively little information is available .Therefore this in-vitro intends to evaluate the effects of resin coating on the bleaching of dental restorative materials.
6.2 Review of literature:
1.  H Yu, Q Li, T Attin, Y Wang. Protective Effect Of Resin Coating On the Microleakage Of Class V Restorations Following Treatment with Carbamide Peroxide In Vitro. Operative Dentistry 2010;35(6):634 – 640.
This in-vitro study evaluated the effects of resin coating on the bleaching of dental materials. Under the limitations of this study, the conclusions drawn were that there was significant cervical microleakage of Resin Modified Glass Ionomer Cement and Conventional Glass Ionomer Cement after bleaching with 10 % Carbamide peroxide gel.
2.  H Yu, X Pan , Y Lin Q Lin, M Hussain , Y Wang. Effects of Carbamide Peroxide on the staining susceptibility of tooth colored restorative materials. Operative Dentistry 2009;34(1): 72-82
This study investigated the effects of an at-home bleaching gel containing 15% carbamide peroxide on the susceptibility of tooth colored restorative materials to different staining solutions. The results of this in-vitro study were that 15% carbamide peroxide bleaching had an effect on the staining susceptibility of the restorative materials, effects of bleaching agents on the color change of esthetic restoratives were material-dependent, 15% Carbamide peroxide had a significant erosion effect on the surface of compomer and Glass ionomer cement and resin composite had a better color stability than compomer and Glass ionomer cement.
3.  M Khorouschi, SR Fardashtaki.Effect of light activatedbleaching on the microleakage of class V tooth colored restoration. Operative Dentistry 2009;34(5):565-570
This study evaluated the effect of plasma arc bleaching on the microleakage of Class V restorations restored with resin composite, compomer and Resin modified Glass ionomer cement. Plasma arc bleaching did not significantly affect the microleakage of existing tooth – colored restorations restored with Z100 resin composite, F2000compomer and Vitremer resin modified glass ionomer cement.
4.  BM Owens, WW Johnson. Effect of single step adhesive on the marginal permeability of class V resin composites.Operative dentistry 2007;31(2):67-72
This in-vitro study evaluated the coronal and apical marginal microleakage of four self – etch, seventh generation adhesive systems with results showing no significant differences at the coronal compared to the apical margins of the four adhesive systems and control tested.
5.  A. RuyaYazici, AsliKeles,DuyguTuncer, MeserretBaseren.Effect of pre-restorative home bleaching on microleakageof self etchadhesives.JEsthetRestor Dent 2010;22(3):186-193
This study evaluated the prerestorative home – bleaching affected microleakage of resin composite restorations bonded with etch-and –rinse and self –etch adhesives. Results indicated that prerestortive home-bleaching had an adverse effect on microleakage of Single Bond(SB) and Adper Easy Bond(EO).
6.  BA Matis, MA Cochran, G Eckert. Review of the effectiveness of various tooth whitening systems. Operative dentistry 2009;34(2): 230-235
This review compares nine published studies conducted at the Indiana University School Of Dentistry. Twenty-five products in four different systems were evaluated using the TrubyteBioform Color ordered shade guide and a Chroma meter.Dentist prescribed overnight bleaching method was shown to be the most effective method of bleaching.
6.3 Objectives of the study:
Literature reveals that Carbamide peroxide treatment increased the microleakage of class V conventional tooth colored restorations.Therefore, this in-vitro study aims to evaluate the effects of resin coating on the bleaching of restorative materials such as Conventional Glass Ionomer cement,Resin modified Glass Ionomer Cement, Compomer and Composites.
.
7 / Material and methods:
7.1 Source of data:
Sixty four freshly extracted molar teeth will be collected, not less than one month from the start of the experiment, from the Department of Oral and Maxillofacial Surgery, A.J. Institute of Dental Sciences and from private dental clinics in Mangalore and surrounding areas and to be stored and surfaced adhering to CDC infection control protocols global
7.2 Methods of collection of data(including sampling procedure, if any)
Selection of Teeth:
Sixty four freshly extracted molar teeth which will be stored, surfaced and grouped randomly into four experimental groups consisting of sixteen teeth in each group and four subgroups would be there in each main group consisting of four teeth in each of subgroups. Cracked and carious teeth will be excluded from the study.

Methodology:
One hundred twenty eight cavities will be prepared on the buccal and palatal/lingual surfaces of the sixty four freshly extracted molars which were randomly devided into four main groups(thirty two class v restorations in each main group).In each tooth, the buccal and lingual/palatal cavities were randomly restored with four restorative materials such as conventional glass-ionomer cement, resin modified glass-ionomer cement, compomer and composites. These were further submitted to four subgroups randomly(n=8) bleached with resin coating(group BC);bleached without resin coating(group B);immersed in artificial saliva with resin coating(group SC);immersed in artificial saliva without resin coating(group S).Then thermocycing done and soaked in 0.5% basic fuchsin dye for 24 hours. Then teeth were rinsed, dried, and sectioned to be viewed under stereomicroscope for investigation.
7.3 Does the study require any investigations or interventions to be
conducted on patients or other humans or animals? If so, please
describe briefly.
Not applicable
7.4 Has ethical clearance been obtained from your institution in case
of 7.3?
YES
INVESTIGATION DESIGN













The teeth were further subdivide into four sub groups in each one of these main subgroups. 8 restorations falls in each subgroup by this process. Before bleaching root of each tooth was sealed with epoxy resin.10% carbamide peroxide to be used for 28 days for bleaching.




Microleakage was assessed by dye penetration at the occlusal and gingival surface of the teeth and statistically analysed by Kruskal Wallis Test and Mann Whitney ‘U’ Test.

8. / List of references:
1  H Yu, Q Li, T Attin, Y Wang. Protective Effect Of Resin Coating On the Microleakage Of Class V Restorations Following Treatment with Carbamide Peroxide In Vitro. Operative Dentistry 2010;35(6):634 – 640.
2  H Yu, X Pan, Y Lin Q Lin, M Hussain, Y Wang. Effects of Carbamide Peroxide on the staining susceptibility of tooth colored restorative materials. Operative Dentistry 2009;34(1): 72-82
3  M Khorouschi, SR Fardashtaki. Effect of light activated bleaching on the microleakage of class V tooth colored restoration. Operative Dentistry 2009;34(5):565-570
4  BM Owens, WW Johnson. Effect of single step adhesive on the marginal permeability of class V resin composites. Operative dentistry 2007;31(2):67-72
5  A. RuyaYazici, AsliKeles, DuyguTuncer, MeserretBaseren. Effect of pre-restorative home bleaching on microleakage of self etchadhesives.JEsthetRestor Dent 2010;22(3):186-193
6  BA Matis, MA Cochran, G Eckert. Review of the effectiveness of various tooth whitening systems. Operative dentistry 2009;34(2): 230-235
9. / Signature of candidate
10. / Remarks of the guide:
11. / Name & Designation of
(in block letters):
11.1 Guide: / DR B. SURESHCHANDRA
PRINCIPAL & PROFESSOR ,
DEPARTMENT OF CONSERVATIVE DENTISTRY AND ENDODONTICS
11.2 Signature:
11.3 Co-Guide (if any)
11.4 Signature:
11.5 Head of Department / DR RAJARAM NAIK
PROFESSOR & HOD,
DEPARTMENT OF CONSERVATIVE DENTISTRY AND ENDODONTICS.
11.6 Signature
12. / 12.1 Remarks of the Chairman &
Principal:
12.2 Signature