CHAPTER 2

This chapter discusses about the some of the literatures current today. It discussed
the principles, theories, properties, and uses behind the study.

2.1 Introduction

There are many reasons to tudy a problem of thermal stimuli propagation in dental
structures-like in the whole medicine, heat effects and heat transfer phenomena are of a
great importance in modern dentistry. Firstly, the analysis of the temperature distribution
could substantially help in diagnosis of many diseases. (Trikilis, et al. 1999) Secondly, the
temperature and temperature related effects are major risk in desruction of tooth
structures. (Toparli, et al. 2000)

2.2 Teeth sensitivity

A temperature ranging between 50 and 60 deg C, simulating a high-end intra-oral

temperature, is often used in thermocycling for testing in vitro dental materials (Ben-Amar
et al. 1986; Kanca 1988). However, there is a wide variation in the regimens used, the
high temperature ranging from 40 to 100 deg C (Gale & Darvell 1999).
Several studies on the range of intraoral temperatures obtained upon ingestion of
food or liquid suggested that the thermocycling regimens in the in vitro studies are
excessive (Longman & Pearson 1987; Michailesco et al. 1995; Youngson & Barclay
2000). Others showed that the temperature produced intra-orally during hot water
consumption may reach 67 deg C (Palmer et al. 1992) and even 77 deg C (Barclay et al.
2005).
Table 2-1 : Calculated Extreme Temperatures During Consumption of Hot
Beverage and Food
Temperature (deg. C) Hot beverage Hot food
Highest* 76. 3 53.6
Mean maximum** 46.4 +/- 7.5 41.6 +/- 4.3
Calculated extreme*** 61.4 50.2
* The highest temperature measured in one volunteer between the lower incisors
** The mean maximum temperatures +/- standard deviation recorded by each electrode for all
volunteers.
 *** The calculated extreme temperature obtained adding two standard deviations to the mean
maximum temperatures measured in vivo.
Source: Feuerstein, et al. 2007

2.3 Thermal Properties of the Materials

Wide temperature fluctuations occur in the oral cavity due to the ingestion of hot
or cold food and drink. In addition, more localized temperature increases may occur due
to the highly exothermic nature of the setting reaction for some dental materials. The
dental pulp is very sensitive to temperature change and in the healthy tooth is surrounded
by dentine and enamel, which are relatively good thermal insulators. It is important that
materials which are used to restore teeth should not only offer a similar degree of
insulation but also should not undergo a large temperature rise when setting in situ.
Another consequence of thermal change is dimensional change. Materials generally
expand when heated and contract when cooled. These dimensional changes may cause
serious problems for filling materials, particularly in the region of the tooth/restorative
interface. (John F. McCabe, 2008)

2.1.1 Thermal Conductivity of materials

Thermal conductivity is defined as the rate of heat flow per unit temperature
gradient. Thus, good conductors have high values of conductivity. Table 2.3 gives
values of thermal conductivity for some dental materials along with those for
enamel and dentine. It is clear that heat is conducted through metals and alloys
more readily than through polymers such as acrylic resin. The relatively high value
of conductivity for dental amalgam indicates that this material could not provide
satisfactory insulation of the pulp. For this reason, it is normal practice to use a
cavity base of a cement such as zinc phosphate which has a lower thermal
conductivity value.
Table 2-2 : Thermal conductivity values of some selected materials
 Source: Applied Dental Materials

Thermal conductivity is an equilibrium property and since most thermal

stimuli encountered in the mouth are transitory in nature the value of thermal
diffusivity may be of more practical use in predicting materials behavior.

2.4 Effectiveness of Thermocycling

Temperature changes used have rarely been substantiated with temperature
measurements made in vivo and vary considerably between reports. Justification and
standardization of regimen are required. However, the standard cyclic regimen defined
is: 35 °C (28 s), 15°C (2 s), 35°C (28 s), 45°C (2 s). No evidence of the number of cycles
likely to be experienced in vivo was found and this requires investigation, but a provisional
estimate of approximately 10 000 cycles per year is suggested. (Gale & Darvell, 1999).

2.4.1 Thermocycling for Microleakage Analysis

Microleakage studies are the most common method of detecting the causes that result in
bond failure along the tooth-restoration interface. Thermocycling is a widely acceptable
method used in in vitro microleakage studies. The question is about the validity and
clinical significance of the thermocycling method, since the temperatures used to stress
restorations may not be the real temperatures of cold and hot food/beverage tolerated by
patients (Pazinatto, Campos, Costa & Atta, 2003).
The figure below shows the results of the tests on the effect of the number of thermocycles
to microleakage. Five groups of flat dentin surfaces are shown. Group 1 did not go through
thermocycling. Group 2, 3, 4 and 5 have gone through 500, 1000, 2500, and 5000 cycles,
respectively. As shown in Figure 2-1, there is no definite difference or relation between
the number of thermocycles and the enlargement of microleakage.

Figure 2-1: Mean Values of Microleakage

The enlargement of microleakage does not depend on the number of thermocycles the
material is subjected to. However, thermocycling does affect the size of microleakage on
dentin surfaces.

2.4.2 Impact of Thermocycling on Dislodgement Force

One of the most crucial reasons for the failure of endodontically treated teeth is the
leakage of applied endodontic materials, which is indicated as a failure in obstructing the
communications between root canal structure and its nearby tissues. Good sealing
property has been introduced as a prominent characteristic of an ideal root-end filling and
repair material which can guarantee its longevity and increase the success rate at the
end.
The means and standard deviations of push bond-strengths of both thermocycled and
non-thermocycled white mineral trioxide aggregate cement are shown in the figure below.
 Figure 2-2: Bond Strength Values of Endodontic Cements
Groups 1, 3, and 5 are endodontic cements which are untreated. Groups 2, 4, and 6 have
gone through thermocycling of 500 cycles at 5°C to 55°C. As shown on the figure above,
the bond strength of the endodontic cements, namely white mineral trioxide aggregate
cement and bioaggregate, depreciates as it is subjected to thermocycling.

2.4.3 Effects of thermal cycling regimens

Various aspects of a thermal cycling regimen have been tested experimentally.

The dependent variable was often some measure of tracer penetration. Comparison of
cycled and uncycled specimens, temperature range, number of temperatures in the cycle,
number of cycles, dwell times and whether the cycles were in tracer have all been made.
Gage and Clark used an artificial saliva during thermal cycling. (Gale & Darvell, 1998)

2.4.4 Usefulness of thermo cycling machine

It is to be noted that there is no concrete evidence that failures in practice occur

because of thermal stresses, notwithstanding the theoretical expectation. However, the
distinction must be made between the equivalent static stress test (i.e., increase steadily
until collapse occurs) and fatigue failure, where repeated loading to a stress below the
static strength occurs. A less severe test would in fact improve discrimination of this point,
so long as stresses were below those which would cause immediate collapse. Equally, it
has never been determined whether it is the time at temperature (i.e., cumulative duration
under stress), as opposed to true fatigue, that is the relevant factor. In other words,
whether failure occurs due to flow in one or other of the layers in the bonded structure is
unknown. This must be dependent on the glass transition temperatures of those bonded
components (which do not appear to have been determined). Such flow would lead to
collapse in a truly static test at a stress below the ordinary static strength. Cycling tests
cannot of themselves discriminate these issues, and failure to allow for them might
account in part for the inconsistency of test results so far reported. The test outcome
clearly depends on the stress generated and the failure mechanism. (Gale & Darvell,
1998)

2.5 Water Bath Design

The temperature achieved in the bath depends on a) the size of the bath to be
heated b) its surface area for heat loss c) the room temperature and d) the amount of hot
water that is being added by the circuit. The volume of hot wate (Haranath, 1963)r
reaching the bath depends again a) on the volume of water getting heated, and b) on the
intensity of heat applied. (Haranath, 1963)

2.6 Electric Immersion Heaters

The thermocycling machine to be built requires two water baths – the cold bath and the
hot bath. For the heating of the hot water bath, an electric immersion heater is planned to
be used. As for the electric immersion heater, the efficiency raises a question as to
whether it would be optimal for a thermocycling machine.
Electric immersion heaters are easier to use compared to other heaters available in the
market. The design takes up only a little space on the fluid it will heat. However, when
heating, the uniformity of the temperature throughout the fluid it is inconsistent. These
heaters take more power consumption due to heat loss (Pullissery, 2017).
The results of a study with regards to the heat distribution of electrical immersion
heaters are shown below. The heater is made up of copper alloy heating coil and a
copper thermostat. It is submerged to a fluid of pure water.

Table 2-3 Heat Distribution of Heater

Parts Heat Rate (W)
Coil 1 4030.5
Coil 2 4028.4
Coil 3 4004.87
Boiler Walls 5.66
Heater Thread 471.6
Source: Reduction of Heat Loss for an Immersion Heater by Pullissery, 2017

As shown in Table 2-3, the main heat loss is found on the heater head. As a solution,
the gap inside the heater head should be designed with insulations. The best placement
of the heater is to sink the heating coils to the water as much as possible.

2.7 Refrigerant to be Used in the Cold-Water Bath

Freon™ 134a was introduced as a replacement for chlorofluorocarbons (CFCs) in

many applications. CFCs, which were developed over 60 years ago, have many unique
properties. They are low in toxicity, nonflammable, noncorrosive and compatible with
other materials. In addition, they offer the thermodynamic and physical properties that
make them ideal for a variety of uses. CFCs are used as refrigerants; as blowing agents
in the manufacture of insulation, packaging and cushioning foams; as cleaning agents for
metal and electronic components; and in many other applications. However, the stability
of these compounds, coupled with their chlorine content, has linked them to depletion of
the earth’s protective ozone layer. As a result, Chemours has phased out production of
CFCs and introduced environmentally acceptable alternatives, such as
hydrofluorocarbon (HFC) 134a. (Chemours, 2018)

Freon™ 134a can be used to replace CFC-11, CFC-12, and HCFC-142b in many
thermoplastic foam applications. Freon™ 134a can be used as a replacement for CFC-
12 and HCFC141b in thermoset foams. HFC-134a features properties that are
advantageous for high value-in-use products and meets the requirements of
safety/environmental issues. Freon™ 134a is nonflammable, has negligible
photochemical reactivity, and low vapor thermal conductivity.

Table 2.1 : R134a Properties

2.8 Definition of Terminologies

 Chlorofluorocarbon (CFC) – Refrigerants thought too contribute to the depletion of

the ozone layer.
 Compressor- A vapor pump that pumps vapor from one pressure level to a higher-
pressure level.
 Condenser- Component in a refrigeration system that transfers heat from the
system by condensing refrigerant.
 Cooling coils- part of the system that is used for heat transfer(cooling).
 Dental thermocycling machine – machine used for testing materials that is
submerged in water baths.
 Electric immersion heaters- machine use to heat water bath.
 Endodontic material – use to obturate the root canal system of teeth when the pulp
tissue has been destroyed either as a consequence of trauma or subsequent to
tooth decay involving the pulp and infection of the pulp tissue.
 Evaporator- component in a refrigeration system that absorbs heat into the system
and evaporates liquid refrigerant.
 Exothermic nature- reaction that releases energy from the system to its
surrounding, usually in form of heat, but also in a form of light, electricity, or sound.
  Final element- device that directly controls the value of the manipulated variable
of the control loop.
 FreonTM 134a- refrigerant that has low in toxicity, nonflammable, noncorrosive and
compatible with other material.
 Heating coils- part of the system that is used for heat transfer(heating).
 In vitro - test made outside the human body.
 In vivo - test made inside the human body.
 Microleakage- diffusion of bacteria, oral, fluids, ions, and molecules into the tooth
and filling material interface.
 Power regulator- system designed to automatically maintain a constant voltage
level.
 Transmitter- equipment used to generate and transmit electromagnetic waves
carrying messages or signals.
 Thermal conductivity - define as the rate of heat flow per unit temperature gradient.
 Thermal cycling regimens – procedures for laboratory testing of dental
restorations.

Journal

 Osnat Feuerstein, e. a. (2008). Clinical Oral Implants Research. Temperature changes in dental
implants following exposure to hot substances in an ex vivo model, 629-633.

 Trikilis N., Rawlinson A., Walsh T.F., Peridontal probing depth and subgingival temperature in
smokers and no-smokers, J. Clin Periodontol., 1999
  Toparli M, Gokay N., Aksoy T., An investigation of temperature and stress distribution on restores
maxillary second premolar tooth using three-dimensional finite element method, J Oral Rehabil.,
2000
 Pazinatto, Flávia Bittencourt, Campos, Bruno Barbosa, Costa, Leonardo César, & Atta, Maria
Teresa. (2003). Effect of the number of thermocycles on microleakage of resin composite
restorations. Pesquisa Odontológica Brasileira, 17(4), 337-341.
 Mohammad Ali Saghiri, Armen Asatourian, Franklin Garcia-Godoy, James L. Gutmann, and
Nader Sheibani, “The Impact of Thermocycling Process on the Dislodgement Force of Different
Endodontic Cements,” BioMed Research International, vol. 2013, Article ID 317185, 6 pages,
2013.

References
Dhankhar, P. (2012). International Journal of Science and Research. A Study on Refrigerants, 1212-1220.

Gale, M. S., & Darvell, B. W. (1998). Journal of Dentistry 27. Thermal cycling procedures for laboratory
testing of dental restoration, 89-99.

Haranath, P. (1963). A Simple Construction of Water Baths, 267-269.

John F. McCabe, a. A. (2008). Applied Dental Materials 9th Edition. Oxford: Blackwell Publishing Ltd.

Osnat Feuerstein, e. a. (2008). Clinical Oral Implants Research. Temperature changes in dental implants
following exposure to hot substances in an ex vivo model, 629-633.

Pullisery, M. (2017). Reduction of Heat Loss for an Immersion Heater. Halmstad.