Effect of different fabrication methods of occlusal devices on periradicular stress distribution: A photoelastic analysis.

STATEMENT OF PROBLEM: Investigations on the effectiveness of new methods for optimizing the fabrication of oral devices are lacking. PURPOSE: The purpose of this in vitro study was to evaluate stress distribution with photoelastic analysis in the periradicular area of teeth supporting occlusal devices fabricated by 5 different processes. MATERIAL AND METHODS: The occlusal devices were fabricated by vacuum thermoforming, heat-polymerized acrylic resin, chemical polymerized acrylic resin, 3-dimensional printing, and milling (computer-aided manufacturing). The devices were evaluated regarding initial fit, number of adjustments for passive fit, and stress distribution under 100-N and 400-N loads in the periradicular locations of posterior teeth. RESULTS: The 3-dimensional printing device did not require any adjustment for initial adaptation to the photoelastic model and presented a little friction with the model. The heat-polymerized acrylic resin device did not seat initially, requiring more sites of adjustment until passive adaptation. At 100-N and 400-N loads, the use of the computer-aided manufacturing occlusal device resulted in the lowest stresses in periradicular areas (0.744 and 1.583, respectively), and the 3-dimensional printing occlusal device produced the highest stresses with a 400-N load application (2.427). The lowest mean of fringe pattern was observed for the computer-aided manufacturing device, and the highest mean of fringe pattern was observed for the vacuum thermoforming device. CONCLUSIONS: The computer-aided design and computer-aided manufacturing milled occlusal device presented the best initial adaptation and transferred lower stresses to the periradicular areas than the other evaluated devices.

Resin composite adhesion to dentin using different curing lights and adhesive systems applied under electric current.

OBJECTIVES: To evaluate the effect of electric current application on the resin composite-tooth bond strength and hybrid layer of three adhesive systems light-cured by two light-curing units (LCUs). MATERIALS AND METHODS: Human molar teeth were distributed into 12 groups (n=6). Three adhesive systems were used: two-step etch-and-rinse (SB2; Adper Single Bond 2, 3M ESPE); two-step self-etch (CSE; Clearfil SE Bond, Kuraray); and one-step self-etch (SBU; Single Bond Universal, 3M ESPE) applied with (50µA) and without (control; conventional application) electric current, and light-cured with different LCUs. Resin composite blocks (Filtek Z350XT, 3M ESPE) were produced and cut into sticks (~1mm2) for microtensile bond strength (µTBS). Fracture patterns were analyzed on stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive, or mixed. Specimens were prepared for scanning electron microscope observation. The hybrid layer analysis was carried out using a confocal laser scanning microscopy (n=2). Data were submitted to three-way ANOVA followed by Tukey's post hoc test (α=0.05). RESULTS: The electric current increased the µTBS for all adhesive systems light-cured with single-emission peak and multiple-emission peak LCUs. Both LCUs presented similar µTBS values. CSE applied under electric current showed the highest µTBS mean values. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. CONCLUSIONS: The adhesive systems applied under electric current increased the bond strength using single-emission peak and multiple-emission peak LCUs. CLINICAL RELEVANCE: Electric current at 50µA applied throughout the dentin is a safe mode and results in better impregnation of the adhesive systems.

Oral Microbial Shift: Factors affecting the Microbiome and Prevention of Oral Disease.

BACKGROUND: Recently, oral microbiome has gained popularity among scientists. Microorganisms are no longer considered as disease-producing pathogens, rather they are now considered as partners of human in maintaining health. Since ancient times, changes in our lifestyle have affected our microbiome and the balance with their human host has been perturbed. The present review includes the description about factors affecting oral microbiome and establishing symbiosis with the human host so that they contribute in maintaining health rather than eliciting diseases. MATERIALS AND METHODS: A comprehensive literature search was performed on databases such as Google Scholar, PubMed and Medline until April 2015. First, articles were selected on the basis of their titles and then abstracts were screened and unwanted articles were excluded. Articles obtained from all the databases were checked and duplicate articles were removed. Articles obtained from various databases: PubMed = 35, Google Scholar=8. Out of these 43 articles, total 29 articles were finally selected for this review. RESULTS: The published literature suggests that the modern oral microbiome is less biodiverse, and possess more pathogenic bacterial species and lesser beneficial bacteria. The possible factors mainly responsible for this shift in microbiome were found to be change in diet, industrial revolution and indiscriminate use of antibiotics. CONCLUSION: Various changes in lifestyles have affected oral microbiome adversely and perturb the symbiosis between the microbiome and their hosts. The present oral microbiome is found to be less diverse and more pathogenic. The present review may be helpful in understanding the relationship between the microbiome and their human hosts so that microbiome contributes in maintaining healthy state of the body.

Oral Paleomicrobiology: Study of Ancient Oral Microbiome.

BACKGROUND: Paleomicrobiology is a special branch of micropaleontology concerned with the study of bacterial fossils. We have used the term 'oral paleomicrobiology', as in this review we have focused on the ancient oral microflora. Recently, dental calculus and dental pulp have been identified as rich sources of ancient microbial DNA. Study of this ancient genetic material opens a new door to the ancient world. This review gives an overview of history of ancient DNA research, various techniques of analyzing ancient DNA in dental calculus and dental pulp, and the implications of the oral paleomicrobiology. MATERIALS AND METHODS: A comprehensive literature search was performed in the following databases-pubmed, medline and google scholar for studies published before 10 April, 2015. The following keywords were used- 'ancient DNA', 'ancient oral flora, 'oral paleomicrobiology' and 'oral microbiome', '16S rRNA sequencing'. To obtain additional data, a manual search was performed using the reference lists of selected articles. RESULT: As a result of literature search, 27 articles were found in pubmed, 12 in google scholar and one in medline. Eight more articles were selected from the reference list of selected articles. CONCLUSION: The combination of microbiology and paleontology has brought a revolution in the study of human evolution and microbial communities. The naturally well-preserved samples of microbial DNA from dental pulp and microbial colonies trapped in dental calculus are a potential source of microbial genetic material, which will prove invaluable in resolving mysteries of the past. This may be a beginning of a new era of oral paleomicrobiology, which will contribute in our studies about prevention of disease by establishing symbiosis between human beings and their microbiome.

Histological Evaluation of Allium sativum Oil as a New Medicament for Pulp Treatment of Permanent Teeth.

OBJECTIVE: The objective of this study was to evaluate the histo pathology effects of two medicaments Allium sativum oil and formocresol on the remaining pulp tissue of the permanent teething children. MATERIALS AND METHODS: A total of 18 premolars were included in this study. Two sound premolars were extracted and subjected to histological examination to show the normal pulp tissue. Pulpo tomy procedure was performed in the rest of the remaining 16 premolars; half of them using Allium sativum oil and the rest of the tested premolars were medicated using formocresol and all were sealed with suitable restoration. Then, premolars extracted at variable intervals (48 hours, 2 weeks, 1 month, 2 months), stained using hemotoxylin and eosin etain (H&E) and prepared for histopathology examination. RESULTS: Histological evaluation seemed far more promising for Allium sativum oil than formocresol. Histological evaluation revealed that teeth treated with Allium sativa oil showed infammatory changes that had been resolved in the end of the study. On the contrary, the severe chronic infammation of pulp tissue accompanied with formocresol eventually produced pulp necrosis with or without fibrosis. In addition, pulp calcification was evidenced in certain cases. CONCLUSION: Allium sativum oil is a biocompatible material that is compatible with vital human pulp tissue. It offers a good healing potential, leaving the remaining pulp tissue healthy and functioning.

Malignant transformation of calcifying cystic odontogenic tumour - a review of literature.

Calcifying cystic odontogenic tumour (CCOT) has been classified as an odontogenic tumour. Ghost cell odontogenic carcinoma (GCOC) is the malignant counterpart of CCOT. This paper aims to review the literature regarding malignant transformation of CCOT. A literature search was done via the National Library of Medicine PubMed interface, searching for articles relating to malignant transformation of CCOT. From these articles, references were obtained, and from their references lists, pertinent secondary references were also identified and acquired. After reviewing the literature, we found 26 cases of GCOC which developed from CCOT. Malignant transformation of CCOT was seen more commonly in the maxilla. Histologically, changes such as increased nuclear/cytoplasmic ratio, atypical mitotic figures have been reported after malignant transformation. Immunohistochemical analysis has shown an increased expression of ki-67 and p53 in tumour cells. Malignant transformation of CCOT, although rare, mostly takes place in recurrent and long standing cases.

Differences in tooth shade value according to age, gender and skin color: A pilot study.

PURPOSE OF THE STUDY: The purpose was to investigate the differences in tooth shade value according to age, gender and skin color among a sample of the local population in Bengaluru, India. METHODOLOGY: The study comprised 100 subjects belonging to both gender between the age groups of 16 years to 55 years. Tooth shade values of permanent maxillary left or right central incisors were recorded using the Vitapan 3D-Master shade guide. Skin color was matched using the Radiance compact makeup shades as a guide. RESULTS: Chi-square statistical test demonstrated that younger subjects have lighter tooth shade values. No statistically significant differences were recorded in tooth shade value according to gender or skin color. CONCLUSION: Within the limitations of the current study, it can be concluded that tooth shade value is significantly influenced by age. Gender and skin color appear not to have a significant relation to tooth shade value.

Association of Body Mass Index and Chronology of Tooth Eruption in Children visiting a Dental Hospital in UAE: A Cross-sectional Study.

The objective of this research was to investigate the relationship between body mass index (BMI) and the mean age at which permanent teeth erupt in school-going children. Materials and Method: This cross-sectional study at RAK College of Dental Sciences, UAE, involved 89 children aged 6-14 years. Erupted teeth in the mouth were included. Statistical analysis, including t-tests, ANOVA, and Kruskal-Wallis, was conducted using SPSS version 29, with a significance threshold set at p < 0.05. Results: Out of 89 children (41 girls and 48 boys) in the study, 56.17 % had normal weight, 20.22 % were overweight, 17.97 % were underweight, and 5.6 % were obese. Female children generally experienced earlier permanent tooth eruption than males. Additionally, there was an observed trend of earlier tooth eruption with increasing weight or BMI. Underweight children notably displayed a delayed mean age of tooth eruption. Conclusion: This study demonstrates a notable correlation between BMI and the mean age at which permanent teeth erupt in school-going children aged 6 to 14 years who visited our dental hospital. To establish a more precise understanding of the connection between BMI and dental development, we recommend conducting further longitudinal studies involving multiple centers. Clinical Significance: Monitoring a child's BMI is crucial for assessing dental health and planning tailored treatment for those aged 6 to 14. Understanding the BMI's connection to permanent tooth eruption timing allows dental professionals to identify trends in early or delayed development. This enables them to customize treatment strategies, promoting a precise and personalized approach for better oral health outcomes in this age group.

New adhesive protocol improves shear bond strength of Polyetherketoneketone (PEKK).

OBJECTIVE: Inert surface of Polyetherketoneketone (PEKK) jeopardizes resin bonding. This study aimed to present a new adhesive protocol to improve PEKK bonding. METHODS: A total of 360 PEKK blocks were milled, polished (maximum roughness of 0.20 µm), and randomly assigned to groups. The new protocol was applied (n = 36) and compared to conventional treatments (no treatment; sandblasting (110-µm Al2O3 and silica); no adhesive; Visiolink (Bredent); and PEKKbond (AnaxDent)) (n = 36). For the new protocol, the surface was blasted (110 µm Al2O3 and 96% isopropyl alcohol at 60 psi), followed by 96% isopropyl alcohol washing, and air drying. PEKKbond was applied (dried for 3 min at 77 °C), followed by Visiolink (dried for 3 min at 60 °C); both light-cured for 3 min (800 mW/cm2). Preopaque (GC Europe) and Opaque (AnaxDent) were applied and light-cured (5 min). Morphological topography was analyzed, and flowable gingiva-colored composite (AnaxGum, AnaxDent) was bonded. All specimens were aged for 24 h and thermocycled (5000 cycles, 5-55 °C). Shear bond strength (SBS) was measured (MPa) and data were analyzed by two-way ANOVA, Tukey, and Weibull moduli estimation (α = 0.05). RESULTS: The highest SBS values were found in the new protocol (p < 0.05), regardless of aging. Thermocycling reduced SBS (p < 0.05), while Al2O3 and PEKKbond produced higher SBS values than silica and Visiolink, respectively (p < 0.05). SIGNIFICANCE: The new protocol strongly improves PEKK adhesiveness, and this can reflect in the longevity of prostheses.

Bond Strength and Surface Roughness of Two Ceramics After Metal Bracket Debonding.

Objective: The aims of this study were to compare the bond strength between metallic brackets and two different glass ceramics and to evaluate the ceramic surface roughness after different finishing protocols. Methods: The surface roughness of lithium disilicate and resin matrix ceramic samples was measured (initial). All samples were treated with hydrofluoric acid and silane and bonded to metallic brackets with orthodontic cement adhesive. Shear bond strength tests were performed using a universal testing machine (n=12). The surface roughness was measured again (intermediate, n=6) after removing the remaining cement adhesive from the ceramic surfaces with a diamond or 24-blade bur after polishing the ceramic surfaces (final, n=6). Results: The resin matrix ceramic had the highest bond strength. The rotatory instrument used for the removal of cement adhesive did not affect the surface roughness of the resin matrix ceramic or lithium disilicate (p=0.985 and p=0.504, respectively), but did affect the evaluation time (p<0.001) for both restorative materials. The intermediate roughness was the highest. For the resin matrix ceramic, polishing promoted a final surface roughness similar to the initial condition; however, changes in the surface shape of this ceramic could be visibly observed when using a 24-blade bur. Conclusion: The bond strength of metallic brackets bonded on resin-matrix ceramics is higher than bonding on lithium disilicate. The use of diamond burs for the removal of the remaining adhesive from the resin matrix ceramics is highly recommended.

Physical analysis of an acrylic resin modified by metal and ceramic nanoparticles.

BACKGROUND: Nanoparticles (NPs) have gained significant attention in various fields due to their unique properties and potential applications. Polymethyl methacrylate (PMMA) is an acrylic resin widely used in dentistry and medicine. However, the effect of different types of NP fillers on the physical properties of PMMA-based resins has not been thoroughly explored in the literature. OBJECTIVES: The present study aimed to evaluate the effects of 3 different types of NP fillers on the physical properties of an experimental PMMA-based resin as a function of the NP content and concentration. MATERIAL AND METHODS: Ten groups (n = 10) were designed. The specimens were composed of an acrylic resin, silicon dioxide (SiO2), cerium dioxide (CeO2), and titanium dioxide (TiO2) at the following ratios (wt%): group 1 (G1) - control; group 2 (G2) - 0.5% SiO2; group 3 (G3) - 1% SiO2; group 4 (G4) - 3% SiO2; group 5 (G5) - 0.5% CeO2; group 6 (G6) - 1% CeO2; group 7 (G7) - 3% CeO2; group 8 (G8) - 0.5% TiO2; group 9 (G9) - 1% TiO2; and group 10 (G10) - 3% TiO2. Transmission electron microscopy (TEM) was used to assess the quality of NP dispersion. Thermal stability was assessed with thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The effects of the abovementioned NPs on the properties of the resin were evaluated using the Archimedes principle for density, the Vickers hardness (VH) test and the impact strength (IS) test. Data analysis employed the oneand two-way analysis of variance (ANOVA), followed by Duncan's post hoc test at a significance level of 0.05. RESULTS: Transmission electron microscopy showed partial NP dispersion. All types of NPs enhanced the mechanical properties of the acrylic resin except for IS, which was similar to that of the control group. Among the types of NPs, irrespective of the weight percentage, CeO2 showed higher thermal stability and higher IS for 0.5 wt% and 1 wt% as compared to other groups, as well as the highest values of density at 0.5 wt%, 1 wt% and 3 wt%. Titanium oxide at 1 wt% presented a higher VH as compared to other groups. The fracture pattern was the same for all groups. CONCLUSIONS: Incorporating the tested NPs into the acrylic resin resulted in enhanced physical properties, primarily attributed to a lower NP content.

Post-fatigue fracture load, stress concentration and mechanical properties of feldspathic, leucite- and lithium disilicate-reinforced glass ceramics.

Objective: To evaluate the mechanical properties of different CAD/CAM ceramic systems and the post-fatigue fracture and stress distribution when used as cemented crowns. Materials and methods: Sixty (60) CAD/CAM monolithic crowns were milled using three different ceramic materials (FD - Feldspathic [Vita Mark II]), LE - Leucite-based ceramic [IPS Empress CAD] and LD - Lithium Disilicate [IPS e.max CAD]) and adhesively cemented on resin composite dyes. Specimens were stored in distillated water (37 °C) for 7 days. After, half of the crowns were submitted to immediate fracture load test while the other half was submitted to fatigue cycling. The average cement layer of approximately 80 µm was assessed using scanning electron microscopy (SEM). The average thickness was used in the three-dimensional (3D) Finite Element Analysis (FEA). For each ceramic material, the density, Poisson ratio, shear modulus, Young modulus, fracture toughness, and true hardness were assessed (n = 3). The data was used to assess the Maximum Principal Stress throughout 3D-FEA according to each material during load to fail and post-fatigue. Data were submitted to two-way ANOVA and Tukey test (α = 0.05). Results: LD showed the highest compression load, density, shear modulus, Young modulus, fracture toughness and true hardness values. While LE presented the lowest mechanical properties values. There is no difference in the Poisson ratio between the evaluated ceramics. Conclusion: LD was susceptible to aging process but presented stronger physicomechanical properties, showing the highest post-fatigue fracture load and highest stress magnitude.

Effect of the Combination of Restorative Material and the Etching Protocol in Enamel Microleakage in Class II Cavities after Thermocycling.

This study is aimed at evaluating the marginal microleakage of bulk-fill class II restorations after thermocycling. Thirty-two human third molars received class II cavities prepared on mesial and distal faces. The cavities were bonded according to the adhesive protocol (total or self-etching). The cavities were then restored with composite and divided into 8 groups based on the composite combination: layering technique with Filtek Z350XT (G1 and G5), first layer with Filtek Z350 XT Flowable Restorative and then Filtek Z350XT (G2 and G6), bulk-fill technique with Filtek One Bulk Fill (G3 and G7), and first layer with Filtek One Bulk Fill Flow and Filtek Z350 XT (G4 and G8). The restorations were then subjected to thermocycling (2000 cycles, 5°C and 55°C, dwell time of 30 s). After aging, the restored teeth were immersed in methylene blue for 48 hours. The restorations (n = 32) were sectioned in the middle (two sections). The microleakage results were analyzed by two-way ANOVA followed by Tukey's post hoc test (α = 0.05). The groups did not differ statistically from each other in terms of marginal microleakage (p = 0.295). It can be concluded that there is no difference in the percentage of microleakage between conventional and bulk-fill resins on both consistencies, as well as there is also no statistically significant difference when the adhesive system is used in a conventional or self-etching mode.

Expression of p21 is dependent on or independent of p53 in carcinoma ex pleomorphic adenoma (undifferentiated and adenocarcinoma types).

Our study is aimed to characterize alteration in the immunohistochemical expression of p21 and p53 in normal tissue of the salivary gland surrounding carcinoma arising in pleomorphic adenoma, and the tumor cells of carcinoma arising in pleomorphic adenoma as well as to identify whether the induction of expression p21 is dependent on or independent of p53 in carcinoma arising in pleomorphic adenoma. A selected series of 27 cases of carcinoma ex pleomorphic adenoma (undifferentiated and adenocarcinoma types) was examined. The results showed that p21 and p53 expression was negative in the most components of normal tissue of the salivary gland surrounding carcinoma arising in pleomorphic adenoma. p21 was strongly expressed in carcinoma cells in 9 (33.3%) cases out of 27. p53 was strongly expressed in carcinoma cells in 10 (37%) cases out of 27. Also a co-expression of p21 and p53 showed negative nuclear staining in 9 cases, while 8 cases expressed positive staining. p21 expressed negative nuclear staining in 4 cases but p53 expressed positive staining in the same cases. p21 expressed positive nuclear staining in 6 cases but p53 expressed negative nuclear staining in the same cases. Our data suggest that inactivation of p53 and p21 may play an important role in the evolution of carcinoma ex pleomorphic adenoma. Also p21 behaves as dependent on or independent of p53 in carcinoma arising in pleomorphic adenoma.

Improving the bonding stability between resin cements and zirconia-based ceramic using different surface treatments.

PURPOSE: To evaluate the effects of airborne-particle abrasion with alumina particles or silicamodified alumina particles on the bond strength between zirconia and conventional MDP-based (Ph; Panavia F 2.0, Kuraray) or self-adhesive (SA; RelyX U200, 3M ESPE) resin cements. MATERIALS AND METHODS: Five surface treatments were evaluated: C = no surface treatment; AB = airborne-particle abrasion with alumina particles (BIO-ART Dental Supplies and Equipment); ABP = AB combined with MDP-based primer (Alloy Primer, Kuraray); SS = airborne-particle abrasion with silica-modified alumina particles (CoJet, 3M ESPE) combined with silane (RelyX Ceramic Primer, 3M ESPE); and SSP = SS combined with MDP-based primer. The surface roughness (Ra) of the airborne particle-abraded samples (n = 5) was measured by a contact profilometer (Mitutoyo Surftest SJ-401, Mitutoyo). Cylinders of the resin cements tested were bonded to the surface-treated zirconia. The microshear test was performed by the application of a load with a wire loop parallel to the adhesive interface until debonding of the resin cement cylinders. The microshear bond strength (µSBS) of the samples was measured before and after being subjected to thermocycling (TC; 5°C to 55°C, 60 seconds dwell time for 3,000 cycles; MSCT, Marcelo Nucci). One-way (Ra) and two-way (µSBS) analysis of variance followed by Tukey post hoc test (α = .05) were used. RESULTS: The SS (Ph: 12.6 MPa; Ph-TC: 6.37 MPa; SA: 11.8 MPa; SA-TC: 9.37) and SSP (Ph: 10.4 MPa; Ph-TC: 5.82 MPa; SA: 10.4 MPa; SA-TC: 10.0) surface treatments produced the highest surface roughness values (P < .001). The SS samples achieved the highest immediate bond strength for both resin cements. However, after TC, SA resin cement associated with any surface treatment produced the highest bond strength values. CONCLUSION: The self-adhesive resin cement promoted higher and more stable bond strength values when associated with a surface roughening method.

Bond strength of self-adhesive resin cement to dentin using different adhesion protocols.

BACKGROUND: The treatment of dentin before the use of self-adhesive cements is still a crucial point to achieve the best bond strength values. The objective of this study was to evaluate the bond strength between dentin and composite resin using different adhesion strategies with self-adhesive resin cement. MATERIAL AND METHODS: Forty healthy third human molars were randomly divided into 4 groups (n = 10): CA (control); application of self-adhesive cement (Rely X U200, 3M ESPE), AD + CA: only application of conventional adhesive (Adper Single Bond 2, 3M ESPE) + self-adhesive cement, AC + AD + CA; conditioning with 37% phosphoric acid for 15 seconds + application of conventional adhesive + self-adhesive cement and AC + CA; conditioning with 37% phosphoric acid for 15s + self-adhesive cement. Blocks made of composite resin (Z250 XT, 3M ESPE) were cemented over dentin. The samples were stored for 24h in distilled water at 37ºC and then were sectioned on a metallographic cutter to obtain tooth picks with approximately 1.0 mm2 in cross section. A universal testing machine was used with a speed of 0.5 mm/min to test the microtensile bond strength,. The fracture patterns were classified as adhesive, cohesive and mixed failures. The data (MPa) were analyzed statistically by One-way ANOVA and Holm-Sidak test (α=5%). RESULTS: The AC + AD + CA and AC + CA groups had the highest averages, while the CA and AD + CA groups had the lowest bond strength values. Adhesive failure was prevalent in all groups. CONCLUSIONS: Conditioning with 37% phosphoric acid for 15s increases the adhesion of the self-adhesive resin cement to the dentin, regardless of the use of dental adhesive system. Key words:Resin cement, microtensile bond strength, acid conditioning.

Mechanical Properties of Experimental Composites with Different Photoinitiator.

OBJECTIVE: The effect of different photoinitiators on mechanical properties of experimental composites was evaluated. MATERIALS AND METHODS: Resin composites were formulated by using a blend of bisphenol A-glycidyl and triethylene glycol (50/50 wt%) dimethacrylate monomers, and 65 wt% of barium aluminium silicate and silica filler particles. Photoinitiators used were 0.2% camphorquinone (CQ) and 0.8% co-initiator (DMAEMA); 0.2% phenyl-propanedione and 0.8% DMAEMA; 0.1% CQ + 0.1% phenyl propanedione and 0.8% DMAEMA; 0.42% mono(acyl)phosphine oxide (MAPO); and 0.5% bis(acyl)phosphine oxide (BAPO). Specimens (n = 10) were light cured by using a multiple-emission peak light-emitting diode for 20 seconds at 1,200 mW/cm2 of irradiance and Knoop hardness and plasticization, depth of cure, flexural strength, and elastic modulus were evaluated. Data were statiscally analyzed at significance level of α = 5%. RESULTS: Experimental composites containing MAPO and BAPO photoinitiators showed the highest values of flexural strength, elastic modulus, top surface hardness, and lower hardness reduction caused by alcohol compared with CQ. Composites containing CQ and PPD showed similar results, except for depth of cure and hardness of bottom surface. CONCLUSION: BAPO and MAPO showed higher flexural strength, elastic modulus, hardness on top surface, and lower polymer plasticization to CQ.

Tooth Discoloration Using Calcium Silicate-Based Cements For Simulated Revascularization in Vitro.

The endodontic revascularization may be an alternative treatment for necrotic immature teeth, however, several treatment steps may cause tooth discoloration. This study evaluated the use of three calcium silicate-based cements with different radiopacifying agents on the color alteration (∆E) of extracted premolars after simulation of revascularization. Forty single rooted extracted premolars were shaped with #1-6 gates Glidden drills, rinsed with sodium hypochlorite, and filled with fresh human blood. Three calcium silicate-based cements with different radiopacifying agents (bismuth oxide - CSBi, calcium tungstate - CSW, and zirconium oxide - CSZr) were applied over the blood clot (n=10). The control group received the application of a temporary zinc oxide-based cement (TFZn) (n=10). ∆E was measured with a spectrophotometer, using the L*a*b* color system of the International Commission on Illumination (CIELab), in different times: prior to the preparation of the access cavity (t0); right after treatment (t1); and after one (t2), two (t3), three (t4) and four (t5) months. The tooth site for color evaluation was standardized by silicon matrix, the color reading was performed 3 times per tooth, and the teeth were stored in 37º water between evaluations. ∆E, whiteness (WID index) and yellowness (b*) were evaluated. Data were subjected to one-way ANOVA and repeated measures ANOVA, followed by Tukey's post hoc test (α=0.05). All groups were similar in ∆E1 (t0-t1). The ∆E was the lowest and constant in the control group. In all evaluation times, CSBi presented the highest ∆E (p<0.01). CSW and CSZr were similar in all evaluated times and presented intermediate ∆E values. WID index from CSBi and CSW presented more distancing from 'white' reference. CSBi presented the greatest decrease in yellowness (b* value). The cement containing bismuth oxide presented the highest color alteration values. All tested calcium silicate-based cements presented clinically perceptible discoloration. Calcium tungstate and zirconium oxide may be used as alternative radiopacifiers to decrease tooth discoloration after endodontic tooth revascularization.

Adhesive systems applied to dentin substrate under electric current: systematic review.

OBJECTIVES: The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current. MATERIALS AND METHODS: The first search strategy was based on data available at PubMed, LILACS, Scielo, Scopus, and Cochrane Library, using a combination of descriptors such as "dentin bond agents OR adhesive system AND electric current OR electrobond" or "dentin bonding agents OR dentin bonding agent application OR adhesive system AND electric current OR electrobond", with no limit regarding the publication year. The second search strategy was based on the articles' references found previously. An additional search strategy was applied that concerned the proposed theme in the SBU-UNICAMP (Unicamp's Library System Institutional Repository). RESULTS: Twelve studies published between 2006 and 2020 were found. The analyses of the selected studies showed that the use of electric current during adhesive systems application on dentin, whether conventional or self-conditioning, increases resinous monomer infiltration in the dentin substrate, which improves the hybridization processes and the bond strength of the restorative material to dentin. CONCLUSIONS: Despite the favorable results related to the use of this technique, there is still no specific protocol for the application of adhesive systems under electric current.

Effect of Cement Layer Thickness on the Immediate and Long-Term Bond Strength and Residual Stress between Lithium Disilicate Glass-Ceramic and Human Dentin.

This study tested whether three different cement layer thicknesses (60, 120 and 180 µm) would provide the same bonding capacity between adhesively luted lithium disilicate and human dentin. Ceramic blocks were cut to 20 blocks with a low-speed diamond saw under cooling water and were then cemented to human flat dentin with an adhesive protocol. The assembly was sectioned into 1 mm2 cross-section beams composed of ceramic/cement/dentin. Cement layer thickness was measured, and three groups were formed. Half of the samples were immediately tested to evaluate the short-term bond strength and the other half were submitted to an aging simulation. The microtensile test was performed in a universal testing machine, and the bond strength (MPa) was calculated. The fractured specimens were examined under stereomicroscopy. Applying the finite element method, the residual stress of polymerization shrinkage according to cement layer thickness was also calculated using first principal stress as analysis criteria. Kruskal-Wallis tests showed that the ''cement layer thickness'' factor significantly influenced the bond strength results for the aged samples (p = 0.028); however, no statistically significant difference was found between the immediately tested groups (p = 0.569). The higher the cement layer thickness, the higher the residual stress generated at the adhesive interface due to cement polymerization shrinkage. In conclusion, the cement layer thickness does not affect the immediate bond strength in lithium disilicate restorations; however, thinner cement layers are most stable in the short term, showing constant bond strength and lower residual stress.