Journal of Dentistry, 6, No. 2,1978, pp. 95-l 19.

Printed in Great Brifain

Dental materials: 1976 literature

review
Part II
M. Braden, BSc, PhD, FlnstP, FPRI (Editor)
Dental School, London Hospital Medical College

D. Brown, 8%. Phd, MIM T. C. Tranter, 8s~. PhD

Dental Department, Guy’s Hospital, London Dental School, Welsh National School of Medicine,
Cardiff
E. C. Combe, MSc, PhD, CChem, FRIC
Department of Prosthetics, Turner Dental School, N. E. Waters, MSc, PhD, FlnstP
Manchester School of Dental Surgery, Royal Dental Hospital
of London
J.A.von Fraunhofer, MSc,PhD,CChem,FRIC,MIM
Eastman Dental Hospital, London D. F. Williams, 8s~. PhD, MIM
School of Dental Surgery, University of Liverpool
C. H. Lloyd, 8Sc. PhD
Department of Dental Prosthetics, Dental School A. D. Wilson, DSc, FRIC
and Hospital, Dundee Laboratory of the Government Chemist, London

C. Main, 13s~.PhD H. J. Wilson, PhD, DSc, FRIC

Dental School, Glasgow Department of Prosthetics, Birmingham Dental
School
M. Miller, 8s~. FRIC
School of Dental Surgery, University of Edinburgh

ABSTRACT
This paper, which is presented in two parts, reviews the work on dental materials published in 1976.
Included in Part I were sections on amalgam, casting alloys, denture base polymers, composite filling
materials, tissue conditioners and soft lining materials and fissure sealants. A review of the literature
relating to impression materials, dental ceramics, model and die materials, cements, dental implants and
dental biomechanics is presented in Part II.

INTRODUCTION
This review is the fourth in an annual series compiled by the Panel for Dental Materials
Studies in the United Kingdom, as a source of reference for work on dental
and is intended
materials published in 1976. It covers the introduction of new materials, the evaluation of
existing materials or their modification and developments in certain relevant techniques. A
basic list of 37 journals was surveyed by all the contributors, but each contributor was free
to include material from any other source.

IMPRESSION MATERIALS
The majority of papers continued to be concerned with accuracy of reproduction in elastic
impression materials. Bell et al. (1976) examined the effect of various ambient humidities on
the accuracy of elastomeric impression materials over periods of up to 72 hours. All showed
96 Journal of Dentistry, Vol. ~/NO. 2

shrinkage and loss in weight at low humidity. All gained weight at high humidity, but
whilst the polyether and silicone materials expanded, the polysulphides contracted. At 61
per cent relative humidity the polyether gained volume and weight, the silicone materials
and the organic hydroperoxide-cured polysulphide lost volume and weight and the lead-
dioxide-cured polysulphide shrank but gained weight. In general, the polyether was most
accurate at low humidities and the lead-cured polysulphide at high humidities. This work
confirms the known sensitivity of polyether to moisture but shows that it is accurate
provided that it is not submitted to high humidity as it would be if stored in a plastic bag It
also shows that the effect of humidity on elastomers is greater than might be expected, and
the different behaviour of the different types of elastomer shows how necessary it is for the
dentist to be well enough acquainted with his materials to be able to select the right one for
any given situation. In another study on accuracy Stauffer et al. (1976) examined six
elastic impression materials suitable for complete arch, fixed, partial dentures. They used a
metal master model with four abutment teeth for which they made a master partial denture,
and this was tried on stone casts from impressions of the master model. The fit was assessed
visually and the displacements of the teeth were measured. Their quantitative assessment is
interesting. Using one abutment as point of origin, the measured displacements of the
other three abutments were interpreted as displacement vectors, and the vectors for the three
abutments were added to give a ‘vector sum’ for each material. Deformation of the re-
production was defined as the surface area generated by rotation of the vector from the
reference direction. This means that inaccuracy was represented as a ‘surface of deformation’.
The vector diagram produced showed that polysulphides gave a small isotropic deformation,
hydrocolloids gave a larger displacement in the anteroposterior direction while the polyether
and silicone gave a lateral displacement, that of the silicone being larger. Reproducibility
calculated from the results was also best for the polysulphides. The casts with isotropic or
lateral displacement were the ones showing the best fit visually. These two papers confirm
numerous previous findings that lead-cured polysulphides are still the most accurate elastic
impression materials.
An aspect of impression accuracy which has been somewhat neglected is the deformation
due to unavoidable extension to fracture at interproximal spaces when an elastic impression
is withdrawn from the mouth. Using three different alginates Schwickerath (1976) measured
the distortion on four sides of a rectangle surrounding an impression of circular cross-section
which fractured on withdrawal. As would be expected, the side opposite the fracture, being
under compression, showed a decrease in dimension, while the other three sides showed an
increase which was largest in the line of the fracture. When the diameter of the model was
increased to give greater compression of the alginate layer in the undercut, deformations of
up to 10 per cent were found. In some cases it is better that the impression material should
fracture since the distortion may be considerably greater in a material which does not
fracture. This author also measured the contraction of elastomer at 36 “C and followed the
changes in air and in water at 23 “C for Impregum and Xantopren. Sawyer et al. (1976)
compared the accuracy of two alginates and one agar material with that of Impregum by
taking impressions of a die consisting of two posts cut MOD fashion and making seven
horizontal and twenty-one vertical measurements on each die stone cast. The mean
deviations of all these measurements ranged from -160 to + 76 for alginate, -11 to + 7
for agar and -8 to + 4 for Impregum, showing agar to be superior to a&ate. Duplication
variables using agar were studied by Goodall and Lewis (1976), who found that no serious
Braden et al.: Review of dental materials 97

deterioration was likely if the agar was stored for 14 days at the temperature recommended
by the manufacturer, so long as the vessel was sealed against loss of water. They concluded
that the effect of the amount of gel used warranted further study.
Accuracy cannot be guaranteed if an impression does not bond properly to the tray, and
Davis et al. (1976) tested the bonding properties of elastomer tray adhesives to acrylic
surfaces. The smoothest surfaces gave the best adhesion, but traces of wax reduced adhesion
markedly. They found that adhesives should be allowed to dry for at least 15 minutes to
give good bonding. Polyethers gave the strongest bond and silicones the weakest, and both
failed cohesively before bond failure.
The draft IS0 specification for alginate impression materials was followed by Schwandner
and Klijtzer (1976) who tested twenty-three brands. None passed all of the twenty-three
visual inspection tests. All passed the tests for strain in compression and permanent defor-
mation. The working and setting times agreed with those stated by the manufacturer in only
six materials. The consistency, detail reproduction and permanent deformation tests each
provide for three classes of material, but the results did not give a clear picture enabling such
a classification to be made. For instance the detail reproduction test put none of the
materials into class A, but on the other hand the permanent deformation test put none into
class C. Other comments on the tests were made by the authors and they concluded that
more work was needed on the specification.
Interest in rheological properties has been shown in two papers. Jorgensen (1976) has
described an apparatus designed for recording the elastic recovery of impression materials.
This is a cone and plate rheometer which exerts a torque on the material and then follows
the dimensional recovery, plotting strain against time using an angular displacement trans-
ducer. Meiners (1976) derived an equation relating streaming velocity, the rate of flow of an
impression paste through an annular space with parallel walls, to the applied pressure, and
he demonstrated graphically the effect of the width between the walls on the pressure/
velocity relation. The theory is to be applied to taking wash impressions.
Having observed that some impression materials produce more bubbles than others when
the same die stone is cast in tooth impressions, Lorren et al. (1976) measured contact
angles of die stone on various impression materials. Counting the bubbles on casts from
Impressions of an onlay preparation showed that the number of bubbles was directly related
to the contact angle. The results, which could have been anticipated from the relative
hydrophobic/hydrophilic nature of the impression materials, gave the order silicone,
polysulphide, polyether, hydrocolloid.
Present and possible future rubber impression materials were reviewed by Braden (1976),
particularly in regard to dimensional change during and after setting. He showed very clearly
the chemical differences between the four types of silicone rubber, of which two can be used
dentally, and he dealt with the dimensional behaviour of these and the other elastomers. He
then considered possible developments of new materials such as polyolefines and thiol-
terminated polyoxyalkalene glycols.

CERAMICS
Dental ceramics
The published information on dental ceramics is divisible into that concerning porcelain
itself and that relating to improvements in mechanical properties of porcelain restorations by
use of various forms of metal substrate.
98 Journal of Dentistry, Vol. ~/NO. 2

Porcelain
A sudden realization that the dental industry was using radioactive fluorescers, in order to
obtain a degree of natural fluorescence in porcelain crowns and artificial teeth exposed to
ultraviolet light, brought a flurry of activity on both sides of the Atlantic. In a discussion on
the report of the National Radiological Protection Board on the notional hazard of fluorescers
with uranium compounds, the British Standards Institute (1976) reported that the highest
possible lifetime dose available from porcelain restorations containing such fluorescers was
only one-hundredth of the level at which significant pathological effects occur after acute
irradiation. They concluded that although these porcelains were safe for wearers, practitioners
and technicians, there should be no new production of materials containing radioactive
fluorescers after 30 June 1978, by which time a non-radioactive fluorescer should be
developed. This is probably just as well, as Wozniak et al. (1976) observed that porcelains
containing uranium and cerium additives do not fluoresce at the same wavelength as natural
teeth in ultraviolet light, many of them peaking in the green part of the visible spectrum.
To back up the BSI report, Weaver (1976) concluded that there is no health hazard to the
wearer of teeth containing these radioactive compounds because the low dosage of radiation
is blocked from the basal cell layer by the epithelial thickness of the mouth tissue.
Techniques used elsewhere have been applied to the problem of repairing in situ
porcelain restorations which have fractured or chipped. In one case they have been found
wanting, and in the other they offer a promising solution to a difficult problem. Jochen
and Caputo (1976) investigated various surface finishes on fractured porcelain teeth in an
attempt to bond composite resin to them. Although they reported that the use of a coarse
diamond burr gave the best retention, the repair was readily dislodged on testing. This was
not the case in the technique reported by Newburg and Pameijer (1976), who followed the
procedures recommended for the acid etching of enamel. After grinding, they cleaned the
surface of the porcelain with a 33 per cent solution of phosphoric acid, and after washing
and drying applied a 0.5 per cent silane bonding agent to the surface, To this they bonded an
ultraviolet-light-cured fissure sealant followed by an ultraviolet-light-cured composite resin.
After thermal cycling of the bond they observed that in all cases (as checked by applying
a shear force and observing the fracture by electron microscopy) bonding surpassed the
strength of the porcelain.
Ionic crowding in the surface of porcelain generates a compressive stress which increases
its resistance to fracture. However, Dunn and Reisbick (1976a) had to immerse completed
porcelain restorations in molten KNOa for up to 9 hours in order to obtain the threefold
increase in strength which they reported. They were unable to detect any optical changes in
the porcelain after this treatment.
In an investigation into how the firing conditions affect the density and strength of
porcelain, Meyer et aI. (1976) reported that whilst both opaque and gingivd porcelains
which were fired in a vacuum were more dense than those fired in air, there was no significant
difference in their tensile strength as determined in diametral compression.

Porcelain-metal composites
whilst one school of thought-Warpeha and Goodkind (1976)~was of the opinion that
the fracture resistance of porcelain-metal composites depends as much on metal design and
the correct manipulation of materials as on the bond strength itself, attention was still
b&g concentrated on m&hods of determining or expressing its contribution. Carter (1976)
Braden et el.: Review of dental materials 99

has extended the interpretation of his test, in which an enamelled metal plate is twisted until
fracture occurs, by relating the amount of enamel remaining to the efficacy of the bond.
Others (Caputo et al., 1976; Mackert et al., 1976) advocated a change in the testing pro-
cedure to duplicate more closely the clinical situation in order to test the reliability of such
composite structures and the importance of any differences.
Theoretical calculations by Asgar and Arfaei (1976) appear to provide an explanation of
the discrepancy between laboratory results and the clinical performance of porcelain-metal
restorations formed on noble and base metal SUbStrdteS. By comparing the moduli of each
material, they concluded that an equal force will cause two and a half times more Strain at
the porcelain-metal interface in a test rod cast from a noble metal than one cast from a base
metal.
A method of achieving an intimate bond between ceramics and cobalt-chromium implant
alloys was reported by Dunn and Reisbick (1976b). They developed a method of producing
a regular honeycomb surface in cobalt-chromium by controlled electrochemical etching. A
ceramic, applied by flame-spraying, entered the etch pits and solidified to produce a fully
retentive coating.
The possibility of substrate distortion was the subject of several reports. Rowe and Asgar
(1976) observed that noble metal alloys continued to shrink (as much as O-6 per cent in one
case) when subjected to repeated heating and cooling cycles, as in successive bakes of a
porcelain. Base metal alloys showed little or no change. A possible connection between this
shrinkage and bond strength is suggested by the report of Hamerink et al. (1976), who
observed differences in the bond strength between porcelain specimens which had been
subjected to either single or multiple firings. A practical method of preventing distortion of
multiple units during the firing of porcelain was presented by Presswood and Choate (1976),
who advocated the use of soldering or casting investment together with alumina firing pins to
create a stress-free tray to support all the component members.
The background to the development of the bonded alumina crown has now been revealed
by McLean and Seed (1976). It appears that many coating materials for platinum were
investigated and that tin, indium and zinc were considered to be possibilities. A detailed
study was undertaken on tin, which was itself tried on several substrates. A stable bond was
finally achieved using porcelain bonded to oxidized tin-coated platinum foil. The optimum
tin film thickness was determined experimentally to be in the range of 0.2-2~. In a follow-
up article on the twin-foil technique, McLean et al. (1976) provided practical details for
obtaining good bonds using either 0.025mm platinum foil for incisors or O.OS-mm foil
for cuspids, bicuspids and molars. A comparison of the economics of the twin-foil technique
and cast gold alloy/ceramic crowns is almost convincing.
The nature of the ceramo-metallic interface and its strength are of continued interest,
particularly as the increase in the price of gold has led to the introduction of base metal
alloys and alloys with low gold contents. Anusavice et al. (1976) and Lugassy (1976) have
shown that during firing of the ceramic the more reactive alloying elements in base metal
alloys diffuse towards the interface, where they oxidize, forming new mixed oxides which
replace the original surface oxide and control the adherence of the ceramic to the coping.
Interfacial failure of such crowns has been shown to be as low as 2 per cent (Lorey et al.,
1976). O’Brien et al. (1976) tested flat strips on to which ceramic had been fused to failure
in bonding. Interfacial failure occurred only with base metals, the bond between the noble
alloys and ceramic being intact after the latter had failed.
loo Journal of Dentistry, Vol. ~/NO, 2

Model, die and mould materials

The mechanical properties of models and dies are of great importance. Earnshaw (1976)
studied the effect of polymer impregnation on the properties of set porous gypsum. The
technique used was to immerse dry gypsum specimens in methyl methacrylate monomer
containing benzoyl peroxide initiator. After 10 minutes’ soaking at room temperature and
pressure, the specimens were wrapped in foil and heated at 70 “C for at least 6 hours. Such
procedures produced a significant increase in strength and abrasion resistance. The improve-
ment in properties of casts prepared from plaster was greater than that of stone. The
technique is suggested for the production of plaster study casts of greater durability.
Because of the brittle nature of gypsum, fracture of models can occur. Sanad et al. (1976)
suggested the use of cyanoacrylate adhesives for repair of dental stone. An aqueous poly-
acrylic acid solution was also effective if applied to the fracture surface of dried stone and
left for 4 minutes before reassembly of the broken fragments.
Kaiser and Nicholls (1976) studied stone casts prepared from aiginate impression
materials and found that thickness of impression material did not make a significant
difference to distortion of stone specimens. Teteruck et al. (1976) showed that only some
combinations of stone and alginate were compatible with each other.
The interaction between die stone and elastic impression materials has been reported by
Lorren et al. (1976) who measured contact angles on the assumption that a high contact
angle would be associated with a greater probability of entrapment of air bubbles. Silicones
had the highest contact angles (92-98”), and the order for the various materials was:
silicones > polysulphides > polyethers > hydrocolloids.
The dimensional accuracy of die materials was the subject of a report by Price et al. (1976).
A shrinkage of O-237 per cent was found for epoxy resin, whereas gypsum-based materials
were more accurate. Silver-plated dies showed a small dimensional loss.
In relation to mould materials, Vieira and Carvalho (1976) studied some factors
influencing the magnitude of hygroscopic expansion of a casting investment. They found
that this expansion was not the same for the material in different parts of the casting ring:
castings located near the crucible former shrank more than those located in the upper part
of the ring.

CEMENTS
The volume of literature on dental cements has shown no signs of declining but reports on
new formulations are a rarity. Base and root canal filling materials appear to be attracting
more attention. The majority of papers are devoted to the characterization of performance;
fortunately, there are definite signs that emphasis is shifting from laboratory testing to
clinical appraisals, simulated clinical evaluation and studies having direct clinical relevance.

Polycarboxylate cements
The polycarboxylate cements have continued to attract a considerable amount of research
interest. The word ‘chelation’ is still applied by some authors to describe both the mechanism
of the setting reaction and the nature of the adhesion between this type of cement and tooth
enamel. However, experimental proof of chelate formation has been lacking, and indeed,
infrared spectroscopic studies by Crisp, Prosser and Wilson (1976) indicated that the
binding of both Zn ‘+ and Ca2+ions to polyacrylate chains is purely ionic. Thus, the structure
Braden et al.: Review of dental materials 101

of the matrix is that of a salt-like gel and adhesion to enamel is by ionic interaction. Moser,
Broadbent et al. (1976) classified commercial zinc polycarboxylate cements into three
groups on the basis of thermal analytical studies. Two of the classes were related to the
MgO : ZnO ratio in the powder and the third to the type of polyacid used in the liquid.
Crisp, Prosser and Wilson (1976) showed, using infrared spectroscopy and NMR, that the
polyacid used is either the homopolymer of acrylic acid or the co-polymer of acrylic and
itaconic acids (see also Waters, 1977). The molecular weights (M,) of polyacrylic acids used
in commercial examples of this cement were shown by Bertenshaw and Coombe (1976) to
vary from 1.5000 to 50000.
A chemical study by Crisp, Lewis and Wilson (1976a) of the erosion of polycarboxylate
cement related the pattern of elution of metal ions to molecular structure. They found that
the rate of elution of Zn2+ and Mg2+ ions decreases with cement age, ultimately reaching a
constant value, a result explained by the progressive binding of cations to the polyanion as
the cement hardens. Magnesium ions are more easily hydrolysed than zinc ions, indicating
that they are less firmly bound to the polyanion chain. Zinc ions are apparently more strongly
bound to the polyanion when polyacrylic/itaconic acid is substituted for polyacrylic acid.
The lack of a common elution pattern for this type of cement makes the 24-hour test of
solubility of doubtful comparative value. Water is absorbed by these cements as the ionization
of the polyacid during setting creates a demand for water and is present in the matrix in at
least two forms.
@lo (1976) found the linear dimensional change during setting to be dependent on
cement brand, powder: liquid ratio and environmental humidity. Contraction was several
times greater when the relative humidity was 50 per cent as against 100 per cent. Maximum
and minimum changes recorded after 14 days were -6.1 and 0.6 per cent respectively.

Glass-ionomer cements
The effect of incorporating chelating agents in glass-ionomer cement systems was studied by
Wilson, Crisp and Ferner (1976). Tartaric acid was found to be particularly effective in
sharpening set. Its action was attributed to the enhancement of the extraction of cations
from the glass powder, the withholding of cations from the polyanion chain, thus preventing
premature ion-binding and loss of working time and the formation of a binuclear metal/
tartaric acid complex which acted as a flexible bridging unit between polyanion chains.
The compressive strength and hardness of glass-ionomer cements have been found by
Crisp, Lewis and Wilson (1976b) to increase continually over a period of 1 year. Compressive
strengths approaching 400 N/mm2 were attained for cements stored in paraffin. Crisp, Lewis
and Wilson (1976~) concluded that glass-ionomer cements used for fillings should be mixed
at the highest powder: liquid ratio compatible with adequate working properties in order to
obtain rapid hardening rates, high strength and maximal resistance to moisture contamina-
tion.
Jenkins (1976) compared the bond strengths of a glass-ionomer cement to that of an
acid-etched resin system and concluded that whereas the latter is preferable under
conditions of high loading the former offers certain advantages where there is low loading
on extensive areas of exposed dentine. The biological compatibility of the glass-ionomer
cement was assessed in vitro (cell culture) and in vivo (monkey teeth) by Dahl and Trbnstad
(1976). The in vitro studies indicated that although there was some toxic effect from the
freshly prepared cement there was none when the cement had fully hardened. The g-day
102 Journal of Dentistry, Vol. ~/NO. 2

in vivo study showed that, unlike the dental silicate cement, the glass-ionomer cement was
welI tolerated by pulp. A 2-year clinical trial by Williams and Winters (1976) indicated that
the glass-ionomer cement ASPA II is as effective as the two best resins in preventing the
initiation of pit and fissure caries. These workers suggested that its cariostatic effect is due
in part to the release of fluoride.

Phosphate-bonded dental cements

Only two papers could be found which were devoted solely to the zinc phosphate cement,
and none was found for the silicate cement. This state of affairs reflects the decline in
importance of the latter type of cement.
A specification solubihty test for zinc phosphate cements has been devised by Wilson,
Abel and Lewis (1976) for small specimens. It employs a calorimetric method to determine
eluted phosphate and the results correlated well with those obtained using the classic test for
‘solubility and disintegration’. Extraction of phosphate was found to be pH-dependent, with
a minimum at a pH of 5, indicating the need to use buffered solutions.
Abramovich et al. (1976) studied the corrosion of enamel by zinc phosphate cement
using scanning electron microscopy. These workers found that lesions were effected within
the first few minutes after the application of the cement to the enamel surface. They con-
sidered that the irregular shape of these lesions would harbour caries-producing debris.
Kendzior et al. (1976) confirmed early observations on the effect of cold temperature
mixing on the properties of zinc phosphate cement, i.e. at low temperatures more powder
can be incorporated in the liquid, working time is increased and setting time decreased.

Base materials
Bryant and Wing (1976a) studied the rate of development of strength in base materials used
beneath dental amalgam. Under in vitro conditions most materials had reached a state of
clinical set within 5 minutes, and the early strength (at 7 minutes) of the various cements
could be ranked thus: zinc phosphate cement > zinc oxide/eugenol cement > calcium
hydroxide cement. Subsequently, all the cements, with the exception of the zinc oxide/
eugenol, continued to gain strength as they aged in water. The zinc oxide/eugenol cement first
increased in strength to a maximum and thereafter weakened considerably. Bryant and Wing
(1976b) also found that the important manipulative variable affecting cement strength is
the powder : liquid ratio, temperature variation having little effect. In a third paper (Bryant
and Wing, 1976~) they concluded from a simulated clinical appraisal of a number of base
materials including zinc phosphate cement, various types of zinc oxide/eugenol cement and
calcium hydroxide, that all were capable of withstanding amalgam condensation loads
provided that they had reached a state of ‘clinical set’.
Farah et al. (1976) examined the effect of cement base type on the stresses and de-
flections induced in composite resins by external forces. Deflections were highest when the
composite resin was supported by a calcium hydroxide liner of low modulus. Lowest values
of induced stress were observed with a base of zinc polycarboxylate cement, which had a
modulus intermediate between those of a zinc oxide/eugenol and a zinc phosphate cement.

Root canal cements

Root canal cements are materials which vary widely in chemical composition and properties.
At present there seems little rationale in their formulations and there are no standards, or
Braden et et.: Review of dental materials 103

indeed clinical indications, to aid the development of these materials along scientific lines. It
is understood that the International Standards Organization Technical Committee for
Dentistry (IS0 TC/106) has recently formed a group of experts to study this matter.
Grossman (1976) examined twelve varieties of root canal cement for particle size, flow,
setting time, adhesion and peripheral leakage. Values obtained varied widely. For example,
setting time varied from 1 to 40 hours. The chemical complexity and variety of these
compositions makes a summary difficult and the reader is referred to the original paper for
details. McComb and Smith (1976) compared the physical properties of polycarboxylate-
based and conventional root canal sealers. The polycarboxylate formulations were shown
to have definite advantages: higher strength and greater adhesion to dentine.

Physical properties of dental cements

Powers et al. (1976) reported values for the compressive strength, tensile strength and
modulus of elasticity of five dental cement types used as luting agents. A zinc phosphate
cement gave the highest values for compressive strength and modulus, while a polycarboxylate
cement gave the highest tensile strength. A non-eugenol/zinc oxide cement had the poorest
mechanical properties.
Paddon and Wilson (1976) found that the stress relaxation properties of the dental
silicate, zinc polycarboxylate and glass-ionomer cements are markedly different. The dental
silicate cement is at all times a highly rigid material with a high modulus and minimal
plastic response-characteristics related to the three-dimensional structure of its matrix. In
contrast the zinc polycarboxylate cement retains its markedly plastic characteristics,
suggesting that the ionic cross-links are labile. The glass-ionomer cement shows an inter-
mediate behaviour. At first it resembles the polycarboxylate cement, but on ageing its
rigidity and modulus approach that of a dental silicate cement.
The test for compressive strength has been statistically examined by Wilson (1976a)
using a zinc oxide/eugenol cement. The distribution of strength values was found to be
negatively skewed, but removal of outlying results using statistical techniques converted the
distribution to a normal one. Whereas crosshead speed was found to have little effect, the
geometry of the test specimen was important and recorded strength values were found to
decrease as the length: diameter ratio was increased.
Tibbetts et al. (1976) measured the thermal diffusion through amalgam and cement bases
both in vitro and in vivo. These workers found that all cement bases reduced thermal
diffusion. The zinc oxide/eugenol cement base proved to be the best thermal insulator,
whereas the zinc phosphate cement base was the poorest. A calcium hydroxide base showed
intermediate properties.
Wilson (1976b) discussed the meaning and limitations of the specification test for
‘solubility and disintegration’. While the test is an essential screening test for some dental
cements, it has a limited clinical predictive value. Valid comparisons of clinical excellence.
cannot be made. The test measures soluble reaction intermediates and so relates to hardening
rate and early vulnerability to aqueous attack. The true erosion of dental cements is
obscured by the atypical period of the test, which is carried out while the cement is still
hardening, together with the restriction of the test media to water alone. The test is
not valid for zinc oxide/eugenol cements since one of the products of decomposition,
zinc hydroxide, is insoluble and the other, eugenol, is volatile, and thus neither is accounted
for.
104 Journal of Dentistry, Vol. ~/NO. 2

Jacobsen (1976) has proposed a new method for evaluating the working time of restora-
tive materials baaed on their adaptation when inserted in an artificial cavity. Interestingly,
deterioration in adaptation was observed even when the materials could still be manipulated.
Jacobsen and Kahn (1976) applied the Williams parallel plate plastometer to restorative
materials and constructed strength/time curves.
Grajower et al. (1976) found that there is interaction between cavity liners and com-
posite resins placed in freshly extracted teeth. The cavity liners studied included zinc oxide/
eugenol cement and various zinc oxide and calcium hydroxide compositions.

Adhesion and marginal leakage

The adhesive behaviour of dental cements continues to attract much attention, an
indication of the great interest shown in adhesive dental materials. The effect of varnishing
on the bond strength between various dental cements and dentine was studied by Chan and
Horton (1976). The bond strength between polycarboxylate cement and dentine, which was
several times greater than that of other dental cements, was, not surprisingly, dramatically
reduced when a varnish layer was interposed. The effect on the bonding of zinc phosphate
and zinc oxide/eugenol with 2-ethoxybenzoic acid cements was small, whereas that of a
zinc oxide/eugenol cement was actually improved by varnishing. Causton et al. (1976)
found that the bond strength of polycarboxylate cements can be improved by pretreatment
of dentine with a calcifying saline solution containing tricalcium diorthophosphate and
sodium fluoride, adjusted to a pH of 7.4. However, these workers indicated that the
improvement effected was not permanent, a point which has been the subject of discussion
(Beech, 1976). Garton et al. (1976) showed that the bond strengths of both glass-ionomer
and carboxylate cements to dentine can be improved by a l-minute application of a special
mineralizing solution.
Sadowsky and Retief (1976) found that the polycarboxylate cement is far more
effective than the zinc phosphate and silicophosphate cements for the direct attachment of
steel orthodontic bands to teeth. However, several workers (Moser, Dowling et al., 1976;
Reynolds and Fraunhofer, 1976; Sadowsky and Retief, 1976) indicated that acid-etched
resins are superior even to the polycarboxylate cement for this purpose.
Saito et al. (1976) found that the adhesive strength of the polycarboxylate cement to each
dental casting alloy tested was much .greater than for the zinc phosphate cement. Poly-
carboxylate cement was found to form stronger bonds with chemically active alloys than the
precious metal alloys. Results were ranked in decreasing order, thus: Cu alloy = Ni-Cr alloy >
Ag-Sn-Zn ahoy > Ag-Pd alloy > Au alloy (type III).
Andrews and Hembree (1976) made an in vitro evaluation of the marginal leakage of
inlay cements using a 45Ca radioactive isotope. Inlays seated with polycarboxylate and zinc
phosphate cements showed less marginal leakage over 3-6 months than with a zinc oxide/
eugenol/2-ethoxybenzoic acid cement, although initially all three cements exhibited the
same leakage.

Clinical studies
Clinical studies on dental cements are still, regrettably, all too few. Thus, the durability and
toxicity of the various dental cements remain a subject for debate.
Some studies on the reaction of pulp towards various dental cements have been reported.
Although zinc oxide/eugenol cements are widely supposed to be bland, recent experimental
Braden et al.: Review of dental materials 105

evidence throws some doubt on this assumption. Brannstrom and Nyborg (1976) found
that this cement causes inflammation of pulpal tissues as evidenced by the presence of
exudate cells. An observed reduction in the odontoblast layer was attributed to the dehydrat-
ing effect of this cement, but PIant and Jones (1976a, b) did not support this conclusion.
Brannstrom and Nyborg concluded that zinc oxide/eugenol cement might cause more
damage to the pulp than zinc phosphate cement. Paterson (1976) also considered that
zinc oxide/eugenol cement is suspect, and has found necrosis in pulp adjacent to the cement.
Of the other materials examined for pulp capping, zinc oxide plus water gave excellent results,
the polycarboxylate cements were intermediate in their effect on tissue while calcium
hydroxide yielded poor results.
Only two studies relating to the clinical evaluation of performance could be found.
Silvey and Myers (1976), in a 7-year clinical study of luting agents, were unable to find any
significant difference in the success rate between zinc oxide/eugenol and zinc phosphate
cements. Laband (1976) made a clinical evaluation of a root canal cement containing para-
formaldehyde and concluded that it has a useful place in endodontic therapy.

MISCELLANEOUS
Corrosion
Reports on corrosion in dental materials published in 1976 can be broadly divided into
studies involving dental amalgams, and work concerned with base metal alloys for implant
use. Electrochemical studies in vitro form the bulk of the published work, but animal and
tissue culture investigations have also been reported.

Corrosion in implant materials

Williams (1976) presented a comprehensive review of corrosion of implant materials,
including discussions of the degradation of polymeric and ceramic implant materials. The
section on metals and alloys dealt with 316 stainless steel, cobalt-chromium alloys, titanium
and its alloys and platinum metals. Here, Williams reviewed reports of corrosion in clinical
practice and experimental electrochemical techniques such as anodic polarization, and
described the mechanisms of implaht corrosion for the various alloys. The effects of corrosion
on tissues were also discussed. A wide range of implant polymers-plastics, fibres and
elastomers-were reviewed, and the degradation mechanisms such as hydrolysis and enzy-
mic action were discussed. Intentionally, ‘biodegradable’ polymers were included. The
last section reviewed ceramics, bioglasses and various forms of carbon used in implants.
Sutow et al. (1976) reported on an in vitro investigation of anodic polarization and
capacitance behaviour of 316-L stainless steel in Ringer’s solution. This group found that
the behaviour of cold-rolled and annealed specimens was independent of pH and PO? in the
physiological range used. The passive film of annealed material was found to be much more
stable than of cold-rolled material, but the high breakdown potentials observed for the
former (800-950 mV SCE) were sensitive to surface preparation methods.
Lemons et al. (1976) carried out a preliminary study of an animal model system for the
investigation of the effects on tissue of metallic corrosion products formed in vivo. An
externally applied potential was used to accelerate the corrosion of a chosen implant alloy
over a period of 2-3 weeks. Tissue reactions adjacent to the alloy showed fibrous tissue
capsules and metallic corrosion product contamination. Alloys studied included 3 16-L
stainless steel, cobalt-chromium and a titanium alloy.
106 Journal of Dentistry, Vol. ~/NO. 2

Amalgam corrosion
Marek et al. (1976) reported on a basic study of corrosion in the major dental amalgam
phases: 7 (Ag-Sn), y1 (Ag-Hg-Sn) and rz (Sn-Hg). Samples were prepared by electro-
plating mercury on AgsSn, to avoid the usual variations in preparation of amalgam, and a
scanning electron microscope examination of the crystals of each phase was carried out
before and after potentiostatically controlled exposure in artificial saliva. While simple
immersion had little effect, contact with gold was found to increase the probability of
corrosion of the ‘y2 phase. In conditions simulating those which exist in crevices and pores
(high acidity, high chloride concentration) the y2 phase was found to deteriorate rapidly,
and the y1 phase suffered morphological change.
Darvell (1976) has described in detail the design and construction of a quantitative
microphotometer system used to study surface changes occurring during the corrosion
of dental amalgam. A photometer was incorporated in the image beam of a microscope to
allow changes in scattering or absorption of light to be measured on small areas. The
application of the technique was demonstrated with a series of curves of reflectivity/time
for dental amalgam in orthophosphate solutions of differing pH.
Wang Chen and Greener (1976a) measured the effect of anodic polarization on the
tensile strength of a conventional amalgam (Aristaloy) and a high copper amalgam
(Dispersalloy). Conventional tensile testing using axial tensile loading revealed a 27 per cent
reduction in strength for the polarized Aristaloy. This was attributed to the anodic
corrosion of the r2 phase, observed at the sample surface after polarization. The strength of
the Dispersalloy amalgam was unchanged. Diametral compression testing, in which tensile
failure is initiated in the bulk of the sample, did not show any significant difference in
strength between unpolarized and polarized samples of either amalgam. Wang Chen and
Greener argued that since marginal breakdown of restorations probably occurs by tensile
failure initiated at the corrosion-weakened surface, the axial tensile test is more realistic
than the diametral test described in the ADA specification No. 1.
The same authors (Wang Chen and Greener, 1976b) presented a calculation predicting
rapid marginal breakdown due to galvanic corrosion when an Aristaloy restoration contacts
a Dispersalloy amalgam, and warned against such amalgdmv placements.
Goldschmidt et al. (1976) reported on the cytotoxic effects of amalgam corrosion
products upon human gingival fibroblasts and HeLa cells grown in culture. Concentrations of
Hg2+ and A$ ions as low as 1U6 -1tT4M were shown to be capable of causing cellular injury,
while the stannous ion showed little cytotoxic potential. The authors suggested that
periodontal inflammation and breakdown could be related to the release of corrosion
products from amalgam restorations adjacent to the tissue.
Zardiackas et al. (1976) reported on a method for improving the electrochemical
stability of conventional amalgam restorations by ‘selective interfacial amalgamation’. A
silver suspension used as a cavity liner reacted with mercury expressed during condensation
to form a restoration with the more noble y1 phase adjacent to the tooth structure.
Corrosion resistance in vitro was far superior to that of unlined restorations.

Dental implants
In a year in which very few new developments in dental implants were reported, the most
interesting and instructive paper was the review by Grenoble and Voss (1976). The various
types of implant were described and the clinical and experimental materials discussed. It
Braden et el.: Review of dental materials 107

was concluded thdt the success rate of subperiosteal implants functioning routinely for more
than 5 years is approximately 90 per cent and that the functional success of endodontic pin
stabilizers is also good. Although most of the early endosseous implants functimed for dY
short periods of time, recent usage appears to be considerably more effective.
These conclusions seem very fair in relation to other reports. Barker (1976), whilst
stating that their indiscriminate and general use is not advocated, suggested that endosseous
pins and blade implants do have some indications. In discussing anatomical considerations,
he recommended that all implants should remain intraosseous throughout their length
subgingivdlly or subapically, which makes mandatory the avoidance of cavities such as the
antrum and nose, Like Grenoble and Voss, Barker argued that these devices need far more
evaluation.
Smithloff and Fritz (1976) evaluated 33 blade implants in 23 patients for durations up
to 60 months. They concluded that blade implantation does represent a technically feasible
procedure and implants can be maintained in the mouth for up to 5 years, although some
degree of bony breakdown will be seen in the majority of patients by this time. This break-
down was almost exclusively located at the neck of the implant, and was thought to be due
to the lack of attachment at the epithelial-implant interface. The need for good oral hygiene
was emphasized. Unfortunately, as in many papers of this type, the matend used for the
implants was not mentioned. The necessity of good oral hygiene was also emphasized by
Bodine et al. (1976) who discussed the long term success of subperiosteal implants.
Furthermore, it was again stressed that every penetration of the oral mucosa by an implant
should be regarded as a potential source of inflammation with resulting epithelial extension.
In an experimental study in beagle dogs, Gourley et al. (1976) found 40 out of 44 titanium
endosteal implants well tolerated clinically, radiographically and histologically at 2 years,
although none was placed in occlusion. Areas of radiolucency were noted in the bone around
the neck and shoulders of many implants at 6 months, but there were no progressive changes
after this time.
As usual much attention has been given to the search for alternative materials for dental
implants. Greenberg and Kamel (1976) described the properties of an alumina/polyacrylic
acid composite which can be made with a controlled porosity. Hodosh et al. (1976)
reported further work with their acrylic-based tooth replica implants, describing a porous
polymethacrylate/vitreous carbon material which has been used in 15 patients. All implants
demonstrated firmness, stability and good periodontal health. The epithelial attachments
were reported to be comparable to those around natural teeth, and radiography showed
negligible bone loss.
Petersen, Klawitter et al. (1976) used alumina for implants, placed in dogs, in which the
roots were porous. All 43 implants failed because of bacterial invasion of the bony socket,
the 7-p pores of the crown part being sufficiently large for the penetration of bacteria.
Petersen, Pennel et al. (1976b) achieved much better results with porous coated cobalt-
chromium implants. About one-third of these implants failed immediately, but 84 per cent
of the remainder were judged successful. A detailed study of porous dental implants in
miniature swine was reported by Karagianes et al. (1976). Implants made of porous titanium
alloy and of porous alumina were observed over periods up to 1 year. With the ceramic,
bone ingrowth was impeded by the lack of adequate interconnecting porosity, and when the
porosity was increased the ceramic strength was inadequate so that it was not possible to
get satisfactory initial Stability. This highlights the difficulty with porous ceramics. The
108 Journal of Dentistry, Vol. ~/NO. 2

titanium implants were more successful, the bone-implant union retaining integrity under
high and low masticatory stresses. The design of the implant was very critical, however, for
in truncated cone-shaped devices the gingival inflammation, alveolar bone resorption and
epithelial invagination were severe. Slender transgingival posts were less susceptible to
calculus accumulation and resulted in a more satisfactory gingival and subgingival response.
Since the tissue reponse to endosseous dental implants is clearly controlled by the nature
of the implant surface, there have been several attempts at coating implants with, hopefully,
biocompatible materials. Cranin and Rabkin (1976) coated the root part of their implants
with zirconia and reported 7 out of 8 cases in dogs to be satisfactory at 30 weeks. The
polytetrafluoroethylene-carbon composite Proplast was investigated as a surface coating on
endosteal implants, used in primates, by Svare et al. (1976), but found not to have any
beneficial effect on stability.
Two materials of considerable promise are carbon and bioglass. The former has been
much discussed in recent years in the context of dental implants, as reviewed by Grenoble
and Voss (1976). The biocompatibility of vitreous carbon has been confirmed by Kafrawy
et al. (1976), who did note, however, a tendency for some of the implant beds to fill up
with bone, resulting in partial or total extrusion of the implants from the bone. A preliminary
report of the use of bioglass for natural tooth implants was published by Stanley et al.
(1976). Several different bioglasses (for example, 45 per cent SiOs, 24.5 per cent CaO,
24.5 per cent NasO, 6 per cent PsOs) were investigated in a 6-month screening study.
These materials have been designed to elicit osteogenesis at the implant-tissue interface, not
to be just biologically acceptable. Although only 25 per cent of the implants were retained
in the baboons after 6 months, the material was held to be promising, in some cases an
apparently true periodontal membrane with properly orientated Sharpey’s fibres being
evident.
The design and biomechanical aspects of dental implants have again been considered.
Wolfson et al. (1976) discussed the load-bearing capacity of alumina endosseous implants,
while Weinstein et al. (1976) have performed a finite element stress analysis of porous-rooted
dental implants. Kydd and Daly (1976) also discussed the effect of stress on the bone
response to titanium dental implants. Pugh et al. (1976) have designed a new implant
specifically for use with a cement for stabilization. The mechanical properties of these
implants, as placed in post-mortem steer specimens were described. It was stated that this
new design should eliminate most of the problems associated with endosteal blade implants,
although there does not seem to be adequate justification for this claim.
Finally, there have been several papers dealing with specific implant applications.
Williams et al. (1976) reviewed implants used in mandibular replacement, and Kratochvil
et al. (1976) described experimental work in Macaca mukztta monkeys in which the
successful rehabilitation of grossly deficient mandibles was achieved with combined
subperiosteal implants and bone grafts. The use of mucosal inserts for denture retention on
the atrophic alveolar ridge was described by Babbush (1976), and the rebuilding of the
deficient edentulous alveolar ridge with porous ceramic implants by Pedersen (1976).
The metallic implant literature for 1976 concentrates on two clinically important aspects:
the attachment and retention of the implant by the tissues and the biocompatibility of the
ahoy. Porous surfaces suitable for the ingrowth of soft tissue have been produced by flame-
spraying alumina on to a cobalt-chromium alloy base (Dunn and Reisbick, 1976) or a 316
stainless steel base (Baldwin and MacKenzie, 1976). Unfortunately, the pore size in both
Braden et el.: Review of dental materials 109

cases was too small to accept hard tissue. Retention of the ceramic coat was achieved by
electrolytically roughening the metal surface before spraying. Fuys et al. (1976) demon-
strated the flexibility of a powder metallurgy approach in producing porous metal implants.
Whilst it may be possible to increase the pore size for bone ingrowth but at the same time
retaining adequate mechanical strength by adjustment of the processing parameters, the
biocompatibility of the nickel alloy used must be examined.
Whilst in vitro (Solar et al., 1976) and in vivo studies (Lemons et al., 1976) have shown
that the corrosion resistance of the titanium alloy in particular is excellent in body fluids,
Gristina et al. (1976) pointed out that the effect on bacterial growth should also be
considered. Alloys apparently inert to the body may have a profound bacteriotoxic effect,
reducing the incidence of septicaemia around the implant, and it may well be advisable to
incorporate antimicrobial substances into otherwise inert strong implants.

Dental biomechanics
Mastica tory forces and mandibular movement
An attempt to measure the ability of human subjects to estimate the intensity of their biting
forces when using different conditions of perceptual reference has been reported by
Hannam (1976). It was concluded that the results obtained suggested that the bite force
discriminatory ability of the subjects was improved if they received a reference level before
each test rather than attempt to retain a concept of a scale of biting forces determined
before the start of a series of 50 biting force tests.
The stresses developed in teeth when premature occlusal contacts occur have been
investigated using a photoelastic technique by Mehta et al. (1976).
Jaw movement during the open-close-clench cycle was recorded by McCall et al. (1976)
using a Hall-effect generator and a small permanent magnet f=ed to opposing incisor teeth.
A computer program was used to provide a graphic display of jaw-closing velocity as a
function ofjaw position. It is claimed that the results obtained show that temporomandibular
joint dysfunction which can be successfully treated by accepted occlusal therapy is indicated
by a large root mean square error between the actual experimental data of a given patient
and the parabolic curve computed to be the best fit to the experimental data.
Whereas the measurements of McCall et al. were in a vertical plane only, the apparatus of
Lemmer and his colleagues, which utilized a similar transducer system, allowed measure-
ments of jaw movement to be recorded in the three conventional anatomical planes-
sagittal, coronal and horizontal-from a single reference point. The use of the apparatus
and its capabilities were discussed in one paper (Lemmer et al., 1976a), which also described
the movement of a point on the jaw as recorded in two dimensions in each of the three
planes. A second paper (Lewin et al., 1976) indicated how integration of these movements
in three dimensions with time may be carried out with the apparatus.
McCoy et al. (1976) described a method whereby mandibular movement recording data
engraved on plastic blocks by the technique described by Lee (1969) may be photographed
and the information transferred to a computer memory.
The reliability of the radiographic procedure, tracing apparatus and tracing technique
during cineradiographic recording of temporomandibular joint movements was assessed by
Saxby and Franks (1976). A range of variation of 0.46-0.8 mm between anatomical and
radiographic measurements of mandibular condyles was found, which is in reasonable
agreement with the findings of Bergstedt and Wictorin (1971). Results obtained using a
110 Journal of Dentistry, Vol. ~/NO. 2

mechanical simulator suggested that the cineradiographic record showed a wider separation
of paths of opening and closing than actuahy existed.
A method of measuring volumetric variation in the meatus acusticus externus caused by
mandibular movement was detailed by Van Willigen (1976). It was suggested that this
technique offers a method of analysing mandibular movement without causing discomfort
to the patient.
An electronic technique which enables muscle activity, the sound of tooth contact, the
force between opposing teeth and mandibular displacement to be recorded at the same
time on a single chart during mastication was reported by,Atkinson (1976). It was deduced
that tooth contact initiates a latent-silent period in the masseter and temporalis which occurs
before movement is arrested in the final intercuspal position. It was also suggested that the
kinetic energy of the mandible on closing is reduced during this period and finally absorbed
by the crushing of food. The hypothesis was advanced that mastication is controlled by a
central clock mechanism.

Stress analysis studies of dental implants and of the effects of osteo-ectomy

The load-bearing capacity of alumina endosseous implants, surgically placed in the mandibles
of rhesus monkeys, to which gold crowns had been fitted after functioning for 95 and 179
days was examined by Wolfson et al. (1976). Bone implant compatibility was found by
histological examination to be excellent. For the 6 out of 10 implants which were successful
the average load value to produce plastic deformation was 57 kg.
A two-dimensional plane, finite element stress analysis of $orous-rooted dental implants
was presented by Weinstein et al. (1976). The results were compared with data obtained on
actual implanted specimens. The selection of the material properties of the interface in the
analysis was shown to be highly important.
The nature of the mode of attachment that exists between a titanium alloy (6 per cent
Al, 4 per cent Va) threaded implant of conical shape and alveolar bone was examined in dog
mandibles by Kydd and Daly (1976). Five months after insertion the implants were subjected
to a torque applied by means of a special dynamometer. The results indicated a frictiona
interaction rather than an adhesion breakdown.
The stress concentration in .the simulated alveolus at the apex of a plane photoelastic
model of a second premolar retained by a metal pin was investigated by Gambrel1 and Allen
(1976). Stress concentration factors are reported for three different pin positions and five
different angles of the coronal force. Not unexpectedly, the stress at the apex is reduced
when the implant is held by a pin, and, as pointed out by the authors, whether the reduction
of stress at the apex and the creation of stress at the pin is of physiological benefit is a
question which has yet to be answered.
The biomechanical effects of osseous surgery carried out in periodontal treatment were
simulated on dried human mandibles to which miniaturized strain gauges were attached by
Vogan and Knoell (1976). Both occlusal and lateral loads were applied to the teeth before
and after osteo-ectomy. After osteo-ectomy strains were nearly double the value for the
normal condition and were greatest for lateral loads.

Orthodontic appliances and stress analysis studies

The load-extension characteristics of alastik modules and the effect of altering the rate of
loading were examined by Kovatch et al. (1976). The rate of decay of load with time for a
Braden et el.: Review of dental materials 111

given extension was found to be slower, the slower the initial stretching of the module, a
result which is in accordance with the expected behaviour of polymeric materials of this
type.
Errors involved in recording tooth movement during growth by various techniques have
been discussed by Isaacson et al. (1976), who concluded that the method advocated by
Bjijrk (1963) is the only one capable of precision. This procedure involves the placement of
three tantalum implants in the maxilla and three implants in the mandible.
The problem of defining a centre of rotation when a tooth is subject to both vertical and
transverse movements was considered by Hurd and Nikolai (1976), who suggested that the
centre of rotation should be the point on the long axis line experiencing the least displace-
ment. On this hypothetical basis a method of locating the centre of rotation has been
described.
The force system set up in adjacent teeth when a misaligned tooth is tied in to a passive
plain arch was examined using simple models by Waters (1976a). The main conclusion was
that the stiffness of the span to which the misaligned tooth is attached increases as teeth are
tied in successively either side but that the load-deflection characteristics are not generally
affected by extra restraints after the first two on either side. The force-displacement
characteristics of an idealized multiple loop arch to both vertical and horizontal displacement
have also been derived from simple beam theory (Waters 1976b). The analysis presented was
shown to be in good agreement with measurements made on model appliances. The
influence of the length and width of the loops on the deflection characteristics of both
modes of displacement was discussed.
A preliminary report on the changes in physical properties induced by a heat treatment
with a typical 18/8 stainless steel wire and a heat-treatable wire of cobalt-chromium-nickel
alloy was given by Waters et al. (1976). The flexural rigidity, elastic properties after forming
over a wide strain range, resistance to failure in bending and elastic recovery after a heat
treatment were examined. The optimal heat treatments were found to be 400-450 ‘C and
475-525 “C for the 18/8 stainless steel and cobalt-chromium-nickel alloy respectively.
These optima were unchanged for heat treatment times between 1 and 16 minutes.

Stress analysis of various restorativ? techniques

The finite element technique of stress analysis was applied by Yettram et al. (1976) to the
stress distribution produced by the occlusal loading of the crowns of natural and restored
teeth. Principal stress patterns for single and two point loading were given, and it was shown
that the masticatory forces tended to flow around the enamel cap, leaving the dentine core
relatively lightly stressed. A similar effect was shown to occur with a cast gold full crown,
which has a similar Young’s modulus to enamel. When a low modulus material (acrylic resin)
was used for the crown, considerably more of the occlusal load was shown to pass through
the coronal dentine.
Using an axisymmetric model of a first molar with a Class I cavity Farah et al. (1976)
investigated the stresses developed in the cement base and in the overlying composite
restoration when the model was loaded occlusally. Deflections in the composite were
greatest when it was supported by a base with a low modulus. The maximum tensile stress
occurring in the composite for a load of 45 kg was 12 MN/m2, whereas the tensile strength
of most composites is 30-40 MN/m2. It was suggested that ideally the liner should have the
same modulus of elasticity as the composite material.
112 Journal of Dentistry, Vol. ~/NO. 2

An investigation by Newburg and Pameijer (1976) compared the traditional technique of

cemented cast metal post and core restorations with a simpler procedure in which pins and/
or posts and composite resin materials were used to restore endodontically treated teeth.
The different post and core systems were subjected to tensile, shear and torque forces. It was
concluded that the procedure in which composite resins are used with threaded pins and/or
posts in the root canal is reliable, but that the technique in which the post and core unit is
made from a composite resin alone without additional retention is the least retentive
system and the use of this technique should be discouraged.

Complete dentures
Tissue pressures developed under complete maxillary dentures for a variety of masticatory
and non-masticator-y conditions were reported by Cutright et al. (1976). In this study four
pressure transducers capable of measuring both positive and negative pressures over a range
of 500 mm Hg with a sensitivity of 1 mm Hg were placed in the anterior and posterior palatal
regions and over the left and right ridges respectively. In general the pressures recorded
during any activity such as chewing or swallowing varied from region to region but a
positive pressure was usually followed by a negative pressure at the same site. Interestingly,
non-masticatory activities produced as large or larger pressures than masticator-y activities.
A useful paper by Kelsey et al. (1976) discussed the validity of various methods used to
record pressures against tissues under complete dentures and described a diaphragm
pressure transducer and its calibration which should be capable of giving quantitative results.
Sixteen references dating back to Black’s gnathodynamometer experiments are supplied.
A comparison between the tooth loadings which recur with the canine and group
function type of occlusions has been presented by McAdam (1976).

Removable partial dentures

Von Ludwig (1976a) using inductive pressure and motion recorders, examined the influence
of framework stability, saddle extension and type and location of anchorage on the
distribution of load between the saddle and abutment teeth for three different free-end
saddle dentures. In a further paper (von Ludwig, 1976b) the method was applied to an
upper and to a lower denture with short bilateral free-end saddles.

Clasps
The rationale, application, advantages and disadvantages of the mesial rest-I-bar concept
developed by Kratochvil (1963) was discussed by Demer (1976), who concluded that when
used properly it is an excellent design for free-end saddle partial dentures.
The stress distribution within circumferential clasps with and without tapered arms was
analysed by Morris et al. (1976), using elasticity theory and a photoelastic technique. The
conclusion drawn from their results by the authors, namely that a tapered clasp is likely
to be more prone than an untapered clasp to eventual fatigue failure, is contrary to previous
work and current teaching, and resulted because the authors have assumed a comparison
should be made under a fixed load rather than under a condition of a specific deflection.
Braden et el.: Review of dental materials 113

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McLean J. W., Kedge M. I. and Hubbard J. R. (1976) The bonded alumina crown. 2-Con-
struction using the twin-foil technique. Amt. Dent. J. 21, 262-268.
McLean J. W. and Seed I. R. (1976) The bonded alumina crown. 1-The bonding of platinum
to aluminous dental porcelain using tin oxide coatings. Amt. Dent. J. 21, 119- 127.
Meyer J. M., O’Brien W. J. and Yu C. U. (1976) Sintering of dental porcelain enamels. J.
Dent. Res. 55, 696-699.
Newburg R. and Pameijer C. H. (1976) Silane bonding of composite resin to porcelain. J.
Dent. Res. 55, B187.
O’Brien W. J., Seluk L. W., Fan P. L. et al. (1976) Classification of porcelain’ enamel inter-
facial fractures. J. Dent. Res. Special Issue B, abstr. 506.
Presswood R. G. and Choate J. E. (1976) Stress-free support for multiple-unit frames for
the application of porcelain. J. Prosthet. Dent. 35, 585-587.
Rowe A. and Asgar K. (1976) Thermal study of porcelain substrate metals. J. Dent. Res. 55,
B188.
Warpeha W. S. and Goodkind R. J. (1976) Design and technique variables affecting fracture
resistance of metal-ceramic restorations. J. Prosthet. Dent. 35, 291-297.
Weaver J. N. (1976) Alpha and beta absorbed doses from uranium in porcelain teeth. J. Dent.
Res. 55, B187.
Wozniak W. T., Moore B. K. and Smith E. (1976) Fluorescence spectra of dental porcelains:
comparisons with natural teeth. J. Dent. Res. 55, B186.

Model, die and mould materials

Earnshaw R. (1976) Improvement in the properties of gypsum casts by polymer impreg-
nation, Amt. Dent. J. 21, 160-164.
Kaiser D. A. and Nicholls J. I. (1976) A study of distortion and surface hardness of improved
artificial stone casts. J. Prosthet. Dent. 36, 373-381.
Lorren R. A., Salter D. J. and Fairhurst C. W. (1976) Contact angles of die stone on impress-
ion materials. J. Prosthet. Dent. 36, 176- 180.
Price W. R., Chai L., Eames W. B. et al. (1976) Dimensional accuracy and detail reproduction
of several die materials. J. Dent. Res. 55, p. B235, abstr. 694.
Sanad M. E. E., Combe E. C. and Grant A. A. (1976) Repair of gypsum models. J. Dent. Res.
55, p. Dl45, abstr. 1.59.
Teteruck W. R., Johnson L. N. and Plotzke 0. B. (1976) Alginate and dental stone com-
patibility. J. Dent. Res. 55, p. B233, abstr. 688.
Vieira D. F. and Carvalho J. A. (1976) Hygroscopic expansion in the upper and lower parts
of the casting ring. J. Prosthet. Dent. 36, 18 1- 185.

Cements
Abramovich A., Macchi R. L. and Ribas L. M. (1976) Enamel corrosion produced by zinc
phosphate dental cement. J. Dent. Res. 55, 107-l 14.
Andrews T. S. and Hembree J. H. (1976) In viva evaluation of marginal leakage of 4 inlay
cements. J. Prosthet. Dent. 35, 532-537.
Beech D. R. (1976) ‘Effect of calcifying fluid on bonding of cements and composites to
dentine in vitro’. (Letter to the Editor.) Br. Dent. J. 141, 69.
Bertenshaw B. W. and Combe E. C. (1976) Studies on polycarboxylates and related cements.
J. Dent. 4, 87-90.
Brannstrom M. and Nyborg H. (1976) Pulp reaction to a temporary zinc oxide/eugenol
cement, J. Prosthet. Dent. 35, 185-191.
Bryant R. W. and Wing G. (1976a) The rate of development cbf strength in base forming
materials for dental amalgam. Amt. Dent. J. 21, 153- 159.
Braden et el.: Review of dental materials 115

Bryant R. W. and Wing G. (1976b) The effects of manipulative variables on base forming
materials for amalgam restorations. Aust. Dent. J. 21, 21 l-216.
Bryant R. W. and Wing G. (1976~) A simulated clinical appraisal of base materials for
amalgam restorations. Aust. Dent. J. 21, 322-326.
Causton B. E., Samara-Wickrama and Johnson N. W. (1976) Improved bond strengths of
polycarboxylate cements and composite restoratives to dentine by pretreatment with
calcifying fluids in vitro. Br. Dent. J. 140, 339-342.
Chan K. C. and Horton D. J. (1976) The effect of varnish on dentinal bond strength of five
dental cements. J. Prosthet. Dent. 35,403-406.
Crisp S., Lewis B. G. and Wilson A. D. (1976a) Zinc polycarboxylate cements. A chemical
study of erosion and its relationship to molecular structure. J. Dent. Res. 55, 299-308.
Crisp S., Lewis B. G. and Wilson A. D. (1976b) Characterization of glass-ionomer cements.
1. Long term hardness and compressive strength. J. Dent. 4, 162- 166.
Crisp S., Lewis B. G. and Wilson A. D. (1976~) Characterization of glass-ionomer cements.
2. Effect of the powder: liquid ratio on the physical properties. J. Dent. 4, 287-290.
Crisp S., Prosser H. J. and Wilson A. D. (1976) An infra-red spectroscopic study of cement
formation between metal oxides and aqueous solutions of poly(acrylic acid). J. Mater.
Sci. 11, 36-48.
Dahl B. L. and Tronstad L. (1976) Biological tests of an experimental glass (silica poly-
acrylate) ionomer cement. J. Oral Rehabil. 3, 19-24.
Farah J. W., Powers J. M., Dennison 3. B. et al. (1976) Effects of cement bases on the
stresses and deflections in composite restorations. J. Dent. Res. 55, 115-120.
Garton B., Levine R. S. and Beech D. R. (1976) A clinically viable technique for improving
adhesion of polyacrylate cements to dentine. J. Dent. Res. 55, p. D135, abstr. 117.
Grajower R., Hirschfield Z. and Zalkind M. (1976) Observations on cavity liners for comp-
osite resin restorations. J. Prosthet. Dent. 36, 265-273.
Grossman L. I. (1976) Physical properties of root canal cements. J. Endont. 2, 166- 175.
Jacobsen P. H. (1976) Working time of polymeric restorative materials. J. Dent. Res. 55,
244-251.
Jacobsen P. H. and Kahn K. L. (1976) Shear strength of setting restorative materials. J. Dent.
Res. 55, p. D144, abstr. 153.
Jenkins C. B. G. (1976) A comparison of bond strengths of glass-ionomer cements and an
acid etch resin system. J. Dent. Res. 55, p. D134, abstr. 116.
Kendzior G. M., Leinfelder K. F. and Hershey H. G. (1976) The effect of cold temperature
mixing on the properties of zinc phosphate cement. Angle Orthod. 46, 345-350.
Laband P. ( 1976) Clinical evaluation of a root canal cement that contains paraformaldehyde.
J. Am. Dent. Assoc. 93, 583-585.
McComb D. and Smith D. C. (1976) Comparison of the physical properties of poly-
carboxylate-based and conventional root canal sealers. J. Endodont. 2, 228-235.
Moser J. B., Broadbent J. M., Combe E. C. et al. (1976) Some carboxylate cements. Br. Dent.
J. 141, 379-382.
Moser J. B., Dowling D. B., Greener E. H. et al. (1976b) Adhesion of orthodontic cements to
human enamel. J. Dent. Res. 55,411-418..
@lo G. (1976) Linear dimensional changes during setting of two polycarboxylates cements.
J. Oral Rehabil. 3, 161-166.
Paddon J. M. and Wilson A. D. (1976) Stress relaxation studies on dental cements. J. Dent.
4, 183-189.
Paterson R. C. (1976) The reaction of the rat molar pulp to various materials. Br. Dent. J.
140,93-96.
116 Journal of Dentistry, Vol. ~/NO. 2

Plant C. G. and Jones D. W. (1976a) The damaging effects of restorative materials. Part 1.
Physical and chemical properties. Br. Dent. J. 140, 373-377.
Plant C. G. and Jones D. W. (1976b) The damaging effects of restorative materials. Part 2.
Pulpal effects related to physical and chemical properties. Br. Dent. J. 140, 406-412.
Powers J. M., Farah J. W. and Craig R. G. (1976) Modulus of elasticity and strength properties
of dental cements. J. Am. Dent. Assoc. 92, 588-591.
Sadowsky P. L. and Retief D. H. (1976) A comparative study of some dental cements used
in orthodontics. Angle Orthod. 46, 17 1- 18 1.
Saito C., Sakai Y., Node H. and Fusayama T. (1976) Adhesion of polycarboxylatecements
to dental casting alloys. J. Prosthet. Dent. 35, 543-548.
Silvey R. G. and Myers G. E. (1976) Clinical studies of dental cements, V. Recall evaluation
of restorations cemented with zinc oxide eugenol and zinc phosphate. J. Dent. Rex 55,
289-291.
Tibbets V. R., Schnell R. J., Schwartz M. L. et al. (1976) Thermal diffusion through amalgam
and cement bases. J. Dent. Res. 55,441-451.
Waters N. E. (ed.) (1977) Dental materials: 1975 literature review. J. Dent. 5, l-3 1.
Williams B. and Winter G. B. (1976) Fissure sealants, a 2-year clinical trial. Br. Dent. J. 141,
15-18.
Wilson A, D. (1976a) Examination of the test for compressive strength applied to zinc oxide
eugenol cement. J. Dent. Res. 55, 142-147.
Wilson A. D. (1976b) Specification test for the solubility and disintegration of dental
cements: a critical evaluation of its meaning. J. Dent. Res. 55, 721-729.
Wilson A. D., Abel G. and Lewis B. G. (1976) The ‘solubility and disintegration’ test for zinc
phosphate dental cements: the use of small specimens. J. Dent. 4, 28-32.
Wilson A. D., Crisp S. and Ferner A. J. (1976) Reactions in glass ionomer cements: IV.
Effect of chelating co-monomers on setting behaviour. J. Dent. Rex 55,489-495.
Corrosion in implant materials
Lemons J. E., Nieman K. M. W. and Weiss A. B. (1976) Biocompatibility studies on surgical
grade titanium, cobalt and iron-base alloys; J. Biomed. Mater. Res. Symp. 7, 549.
Sutow E. J., Pollack S. R. and Korostoff E. (1976) An in vitro investigation of the anodic
polarisation and capacitance behaviour of 316-L stainless steel. J. Biomed. Mater. Res.
10, 671.
Williams D. F. (1976) Corrosion of implant materials. In: Huggins R. A. (ed.) AnnuaZ Review
of Materials Science, Vol. 6. Palo Alto, Calif., Annual Reviews, p. 237.
Amalgam corrosion
Darvell B. W. (1976) A quantitative microphotometer system. Surface Technol. 4, 95.
Goldschmidt P. R., Cogen R. B. and Taubman S. B. (1976) Effects of amalgam corrosion
products on human cells. J. Periodont. Res. 11, 108.
Marek M., Hochman R. F. and Okabe T. (1976) In vitro corrosion of dental amalgam
phases. J. Biomed. Mater. Res. 10, 789.
Wang Chen C. P. and Greener E. H. (1976a) The effect of anodic polarisation on the tensile
strength of dental amalgam. J. Oral Rehabil. 3, 323.
Wang Chen C. P. and Greener E. H. (1976b) A calculation relating galvanism and marginal
breakdown. J. Biomed. Mater. Res. 10, 971.
&r&&as L. D., Stoner G. E. and Smith F. K. (1976) Dental amalgam stabilisation by
selective interfacial amalgamation. Biomat. Med. Dev. Artif. Organs 4, 1%.
Dental implants
Babbush C. A. (1976) Mucosal inserts: a technique for the atrophic alveolar ridge. J. oral
Surg. 34, 517-521.
Braden et et.: Review of dental materials 117

Baldwin C. M. and Mackenzie J. D. (1976) Flame sprayed alumina on stainless steel for
possible prosthetic applications. J. Biomed. Mater. Res. 10, 445-453.
Barker B. C. W. (1976) Anatomical considerations when using endodontic endosseous pins
and blade implants. Aust. Dent. J. 21, 299-307.
Bodine R. L., Melrose R. J. and Grenoble D. E. (1976) Long term implant denture histology.
J. Prosthet. Dent. 35, 665-673.
Cranin A. N. and Rabkin M. R. (1976) Zirconia coated dental endosteal implants in dogs. J.
Dent. Res. 55, B195.
Dunn B. and Reisbick M. H. (1976) Adherence of ceramic coatings to Co-Cr structures. J.
Dent. Rex 55, 328-332.
Fuys R. A., Craig R. G. and Asgar K. (1976) Physical properties of a nickel base alloy
prepared by isostatic pressing of a powdered metal. J. Oral Rehabil. 3, 15 1- 160.
Gourley I. M., Richards L. W. and Cordy P. R. (1976) Titanium endosteal dental implants
in the mandibles of beagle dogs. J. Prosthet. Dent. 36, 550-566.
Greenberg A. R. and Kamel I. (1976) Polymer-ceramic composite for tooth root implants.
J. Biomed. Mater. Res. 10, 777-788.
Grenoble D. E. and Voss R. (1976) Materials and design for implant dentistry. Biomat. Med.
Dev. Artif: Organs 4, 133-169.
Gristina A. G., Robere G. D., Shoji H. et al. (1976) An in vitro study of the bacterial re-
sponse to inert and reactive materials. J. Biomed. Mater. Res. 10, 273-28 1.
Hodosh M., Shklar G. and Povar M. (1976) Syntactic porous polymethacrylate-vitreous
carbon tooth replica implants as abutments for fixed partial dentures. J. Prosthet. Dent.
36,676-684.
Kafrawy A. H. E., Boone M. E., Dickey D. M. et al. (1976) Reactions to vitreous carbon
implants. J. Dent. Res. 55, p. B197.
Karagianes M. T., Westerman R. E., Rasmussen J. J. et al. (1976) Development and evaluation
of porous dental implants in miniature swine. J. Dent. Res. 55, 85-94.
Kratochvil F. J., Boyne P. J. and Pump R. L. (1976) Rehabilitation of grossly deficient
mandibles with combined subperiosteal implants and bone grafts. J. Prosthet. Dent. 35,
452-461.
Kydd W. L. and Daly C. H. (1976) Bone response to titanium implants and mechanical
stress. J. Prosthet. Dent. 35, 567-572.
Lemons J. E., Niemann K. M. W. and Weiss A. B. (1976) Biocompatibility of surgical grade
titanium, cobalt and iron base alloys. J. Biomed. Mater. Res. 10, 549-553.
Pedersen K. N. (1976) Rebuilding of deficient edentulous alveolar ridge with porous
ceramic implants. Int. J. Oral Surg. 5, 133- 141.
Petersen L. J., Klawitter J. J., Weinstein A. M. et al. (1976) Clinical evaluation of porous
rooted alumina ceramic dental implants. J. Dent. Res. 55, B243.
Petersen L. J., Pennel B. M., McKinney R. V. et al. (1976) Clinical and histological
evaluation of porous coated cobalt chromium prosthetic teeth. J. Dent.. Res. 55, B 197.
Pugh J., Weiss C., Weiss F. et al. (1976) Design and biomechanical evaluation of a cementable
endosteal blade implant. J. Biomed. Mater. Res. Symp. 7, 751-758.
Smithloff M. and Fritz M. E. (1976) The use of blade implants in a selected population of
partially edentulous adults. J. Periodontol. 47, 19-24.
Solar R. J., Pollack S. R. and Korostoff E. (1976) Corrosion resistance of a Ti 6 Al 4 V alloy
in Ringer’s solution with selected amino acids. J. Dent. Res. Special Issue B, abstr. 130.
Stanley H. R., Hench L., Going R. et al. (1976) The implantation of natural tooth form
bioglasses in baboons. Oral Surg. 42, 339-356.
Svare C. W., Glick P. L., Lavelle W. E. et al. (1976) One year study of Proplast-coated
endosteal implants in primates. J. Dent. Res. 55, p. B196.
118 Journal of Dentistry, Vol. 6/ No. 2

Weinstein A. M., Klawitter J. J., Anand S. et al. (1976) Stress analysis of porous-rooted
dental implants. J. Dent. Res. 55, 772-717.
Williams E. O., Pare1 S. M. and Drane J. B. (1976) Mandibular replacement; a review of
embedded implants. J. Prosthet. Dent. 35, 207-210.
Wolfson S. H., Svare C. W. and Weber D. (1976) Load bearing capacity of functioning
alumina dental endosseous implants. J. Dent. Res. 55, 22-29.
Masticatory forces and mandibular movement
Atkinson H. F. (1976) Research into mastication. Aust. Dent. J. 21, 23-24.
Bergstedt A. and Wictorin L. (1971) The influence of the angle of projection on the linear
error in craniolateral radiography of the temporomandibular joint. Acta Odontol. Stand.
29, 3-16.
Hannam A. G. (1976) The regulation of the jaw bite force in man. Arch. Oral Biol. 21,
641-644.
Lee R. L. (1969) Jaw movements engraved in solid plastic for articulator controls. Part I.
Recording apparatus. J. Prosthet. Dent. 22, 209-224.
Lemmer J., Lewin A. and Van Rensburg L. B. (1976) The measurement of jaw movement.
Part I. J. Prosthet. Dent. 36, 211-218.
Lewin A., Lemmer J. and Van Rensburg L. B. (1976) The measurement of jaw movement.
Part II. J. Prosthet. Dent. 36, 312-318.
McCall W. D., Bailey J. 0. and Ash M. M. (1976) A quantitative measure of mandibular
joint dysfunction: phase plane modelling of jaw movement in man. Arch. Oral BioZ. 21,
685-689.
McCoy R. B., Shryock E. F. and Lundeen H. C. (1976) A method of transferring mandibular
movement data to computer storage. J. Prosthet. Dent. 36, 5 11-516.
Mehta N. R., Roeber F. W., Haddad A. W. et al. (1976) Stresses created by occlusal prema-
turities in a new photo-elastic model system. J. Am. Dent. Assoc. 93, 334-341.
Saxby M. S. and Franks A. S. T. (1976) Assessment of reliability of cineradiographic re-
cording of temporomandibular joint movements. J. Oral Rehabil. 3, 279-292.
Van Willigen J. (1976) Some morphological aspects of the meatus acusticus externus in
connection with mandibular movements. J. Oral Rehabil. 3, 299-304.

Stress analysis studies of dental implants and of the effects of osteo-ectomy

Grambrell S. C. and Allen J. M. (1976) Stress concentrations at the apex of pinned, im-
planted teeth. J. Dent. Res. 55, 59-65.
Kydd W. L. and Daly C. M. (1976) Bone-titanium implant response to mechanical stress. J.
Prosthet. Dent. 35, 567-571.
Vogan W. I. and Knoell A. C. (1976) The biomechanical effects of simulated osseous surgery.
J. Periodont. Rex 11, 360-367.
Weinstein A. M., Klawitter J. J., Anand S. C. et al. (1976) Stress analysis of porous rooted
dental implants. J. Dent. Res. 55, 772-777.
Wolfson S. H., Snare C. W. and Weber D. (1976) Load-bearing capacity of functioning
alumina dental endosseous implants. J. Dent. Res. 55, 22-29.

Orthodontic appliances and stress analysis studies

Bjork A. (1963) Variation in the growth pattern of the human mandible: longitudinal radio-
graphic study by the implant method. J. Dent. Res. 42,400-411.
Hurd J. J. and Nikolai R. J. (1976) Centers of rotation for combined vertical and transverse
tooth movements. Am. J. Orthod. 70, 551-558.
Isaacson R. J., Worms F. W. and Speidel T. M. (1976) Measurement of tooth movement. Am.
J. Orthod. 70, 290-303.
Braden et el.: Review of dental materials 119

Kovatch J. S., Lautenschlager E. P., Apfel D. A. et al. (1976) Load-extension-time behaviour

of orthodontic alastiks. J. Dent. Res. 55, 783-786.
Waters N. E. (1976a) The mechanics of plain and looped arches: Part 1. Br. J. Orthod. 3,
75-78.
Waters N. E. (1976b) The mechanics of plain and looped arches: Part 2. Br. J. Orthod. 3,
161-167.
Waters N. E., Houston W. J. B. and Stephens C. D. (1976) The heat treatment of wires: a
preliminary report. Br. J. Orthod. 3, 217-222.

Stress analysis of various restorative techniques

Farah J. W., Powers J. M., Dennison J. B. et al. (1976) Effects of cement bases in the stresses
and deflections in composite restorations. J. Dent. Res. 55, 115- 120.
Newburg R. E. and Pameijer C. H. (1976) Retentive properties of post and core systems. J.
Prosthet. Dent. 36, 636-643.
Yettram A. L., Wright K. W. J. and Pickard H. M. (1976) Finite element stress analysis of
the crowns of normal and restored teeth. J. Dent. Rex 55, 1004-1011.

Complete dentures
Cutright D. E., Brudvik J. S., Gay W. D. et al. (1976) Tissure pressure under complete
maxillary dentures. J. Prosthet. Dent. 35, 160-170.
Kelsey C. C., Reid F. D. and Coplowitz J. A. (1976) A method of measuring pressures
against tissues supporting functioning complete dentures. J. Prosthet. Dent. 35, 376-383.
McAdam D. B. (1976) Tooth loading and cuspal guidance in canine and group function
occlusions. J. Prosthet. Dent. 35, 283-290.

Removable partial dentures

Von Ludwig P. (1976a) Kinematik und Belastungverteilung abgestiitzter Freiendprothesen.
I. Einflub der Geriiststabilitat auf die Sattelkinematik und die Belastung des zahnlosen
Prothesenlagers. Dtsch. Zahnaerztl. Z. 31, 547-552.
Von Ludwig P. (1976b) Kinematik und Belastungverteilung abgestiitzter Freiendprothesen.
II. Einflub des Ortes und der Abstiitzung auf die Sattelkinematik und die Belastungs-
verteilung Pfeiler-zahnloses Prothesenlager. Dtsch. Zahnaerztl. Z. 3 1, 6 12-6 15.

Clasps
Demer W. J. (1976) An analysis of mesial rest-I-bar clasp designs. J. Prosthet. Dent. 36,
243-253.
Kratochvil F. J. (1963) Influence of occlusal rest portion and clasp design on movement of
abutment teeth. J. Prosthet. Dent. 13, 114-123.
Morris H., Farah J. W., Craig R. G. et al. (1976) Stress distribution within circumferential
clasp arms. J. Oral Rehabil. 3. 387-394.