Physical, mechanical and antibacterial properties of the orthodontic adhesive doped with S-TiO2.

Orthodontic adhesive doped with sulfur-modified TiO2 promotes antibacterial effect. The objective of the study was to characterize the physical, mechanical and antibacterial properties of the orthodontic bracket adhesive, doped with modified titanium dioxide nanoparticles. Sulfur-doped TiO2 was synthetized and morphological topography was analyzed with TEM and SEM imaging. The catalytic performance during the degradation of rhodamine B was assessed. Nanomaterial was added at four concentration (1, 3, 6, and 10 wt%) to a commercial orthodontic adhesive. The shear bond strength and microhardness of a resin-based orthodontic adhesive containing S-TiO2 were evaluated. The inhibitory effect of the pure and doped adhesives against Escherichia coli and Streptococcus mutans was examined. As the results, the highest antimicrobial activity and good adhesive properties were noticed for light-cured orthodontic adhesive doped with 3% of S-TiO2. In this case, orthodontic adhesives with strong and long-lasting bactericidal properties can be created through the incorporation of modified TiO2 without negatively influencing microhardnesses, and bonding ability. White spot lesion and demineralization, which occurs very often in patients during orthodontic treatment, can be therefore minimized.

Influence of luting strategies on dentin bond performance of self-adhesive resin luting cement in combination with a universal adhesive.

OBJECTIVES: This study aimed to evaluate the dentin bond performance of various resin luting cement (RLC) systems combined with universal adhesives in different luting strategies. MATERIALS AND METHODS: Three self-adhesive resin luting cements (SRLCs) were used with universal adhesives as primers. Twelve specimens per group were prepared to measure shear bond strength (SBS) under distinct luting strategies in etch-&-rinse and self-etch modes. Regarding luting strategies, the bonded specimens were categorized into four groups based on tooth primer application and the curing mode of the SRLC paste: (i) with light irradiation of the tooth primer (wL) + dual-cure mode (DC) of the SRLC paste, (ii) wL + self-cure mode (SC) of the SRLC paste, (iii) without light irradiation of the tooth primer (woL) + DC mode of the SRLC paste, and (iv) woL + SC mode of the SRLC paste. Specimens were also subjected to different storage conditions: 24 h in water (baseline condition) and 10,000 cycles of thermal cycling. RESULTS: Luting strategy, storage condition, and SRLC system type significantly influenced dentin SBS values in both etching modes. Notably, certain SRLCs exhibited significantly higher dentin SBS when the primer was light-irradiated compared with no primer irradiation. CONCLUSION: Most SRLCs demonstrated higher dentin bond strength with light-irradiated primers, suggesting potential enhancement of dentin bond performance via primer light irradiation.

Historical Perspectives on the Use Plastic-Based Cements in Endodontics and Prosthodontics: Part 1 - Oxychlorides.

Oxychloride of zinc was used for years to treat teeth by different approaches and procedures. The success of material usage depended on how well the procedures were conducted and largely on the mix of the material. This article aims to review the evolutionary history of this material with a view to its clinical uses, properties, procedures, applications, and successes when used in the management of decayed tooth structure. Perspectives proffered within focus cover 110 years from 1850 to 1960."Who has not mentally asked the question, as he has taxed himself and his patient to almost complete exhaustion in some dental operation of unusual magnitude or length, Is there not some way either to prevent this destruction of tissue or to restore these organs when attacked, unattended by the severe mental and physical strain upon the operator, and the shrinking, dread, and suffering to the patient which the present general practice and teaching involve?…If the profession would avert this evil, observation must be extended and accurate; new remedies must be sought and applied; investigation by experiment made popular, and the employment of other than mere mechanical remedies encouraged."

Historical Perspectives and Comparisons on the Use Plastic-Based Cements in Endodontics and Prosthodontics: Part 2 - Oxyphosphates.

Oxyphosphate of zinc was used for years to treat teeth by different approaches and procedures. Like oxychloride of zinc, success of the material depended on how well the procedures were conducted and largely on the mix of the material. This article aims to review the evolutionary history of this material with a view to its clinical uses, properties, procedures, applications, and successes when used in the management of decayed tooth structure and rebuilding of teeth. Perspectives proffered within focus cover 110 years from 1850 to 1960.

Influence of provisional cementation on the stability of adhesively bonded resin-based composite crowns.

PURPOSE: To investigate the influence of temporary cementation and subsequent bonding on the durability during in-vitro aging-simulation and fracture force of resin-based composite crowns. METHODS: Identical molar crowns (n=48, n=8 per group) were milled from resin-based composites and temporarily cemented and finally bonded to human molars. To simulate temporary application, crowns were cemented either with zinc-oxide-eugenol-cement (Tempbond) or with eugenol free zinc-oxide-cement (Tempbond NE). For a first simulation of a long-term provisional clinical application, thermal cycling, and mechanical loading (TCML 2 x 600 x 5°C-55°C, 2 minutes each cycle, distilled water, 240,000 cycles at 50N) was performed. After TCML all crowns were removed, cleaned, and luted either by using etch-and-rinse technique (Vococid, Futurabond U, Bifix QM) or a self-adhesive (Bifix SE) cementation system. A second thermal cycling and mechanical loading (TCML 2 x3,000 x 5°C/55°C, 2 minutes each cycle, distilled water, 1.2 x 106 at 50N) was accomplished to simulate 5 years of clinical application. To assess the survival of the crowns, the failure rates during TCML were documented. As controls, crowns were included without prior provisional cementation. After TCML all crowns were loaded to failure. Failure was categorized as fracture of the crown and partial loosening of the crown. RESULTS: All crowns survived both TCML procedures without any failures. The fracture values after TCML varied between 3,538.0 ± 1,041.2 N and 4,612.0 ± 801.5 N without significant (P= 0.146) differences between the individual groups. No correlation was found between fracture force and type of provisional cementation (zinc-oxide-eugenol vs. zinc-oxide: Pearson: -0.063/P= 0.672) or type of bonding (adhesive vs. self-adhesive: Pearson: -0.151/ P= 0.307). No different failure pattern was observed between the tested systems. CLINICAL SIGNIFICANCE: Regardless of the type of temporary cementation, there was no effect on the in-vitro performance or strength of the final permanently bonded crowns. Resin-based crowns might be bonded with adhesive or self-adhesive systems even after previous temporary cementation.

The influence of neutral MDP-Na salt on dentin bond performance and remineralization potential of etch-&-rinse adhesive.

OBJECTIVES: To investigate the effect of neutral 10-methacryloyloxydecyl dihydrogen phosphate salt (MDP-Na) on the dentin bond strength and remineralization potential of etch-&-rinse adhesive. METHODS: Two experimental etch-&-rinse adhesives were formulated by incorporating 0 wt% (E0) or 20 wt% (E20) neutral MDP-Na into a basic primer. A commercial adhesive, Adper Single Bond 2 (SB, 3 M ESPE), served as the control. Sixty prepared teeth were randomly allocated into three groups (n = 20) and bonded using either one of the experimental adhesives or SB. Following 24 h of water storage, the bonded specimens were sectioned into resin-dentin sticks, with four resin-dentin sticks obtained from each tooth for microtensile bond strength (MTBS) test. Half of the sticks from each group were immediately subjected to tensile loading using a microtensile tester at a crosshead speed of 1 mm/min, while the other half underwent tensile loading after 6-month incubation in artificial saliva (AS). The degree of conversion (DC) of both the control and experimental adhesives (n = 6 in each group) and the adsorption properties of MDP-Na on the dentin organic matrix (n = 5 in each group) were determined using Fourier-transform infrared spectrometry. Furthermore, the effectiveness of neutral MDP-Na in promoting the mineralization of two-dimensional collagen fibrils and the adhesive-dentin interface was explored using transmission electron microscopy and selected-area electron diffraction. Two- and one-way ANOVA was employed to assess the impact of adhesive type and water storage on dentin bond strength and the DC (α = 0.05). RESULTS: The addition of MDP-Na into the primer increased both the short- and long-term MTBS of the experimental adhesives (p = 0.00). No difference was noted in the DC between the control, E0 and E20 groups (p = 0.366). The MDP-Na remained absorbed on the demineralized dentin even after thorough rinsing. The intra- and extra-fibrillar mineralization of the two-dimensional collagen fibril and dentin bond hybrid layer was confirmed by transmission electron microscopy and selected-area electron diffraction when the primer was added with MDP-Na. CONCLUSIONS: The use of neutral MDP-Na results in high-quality hybrid layer that increase the dentin bond strength of etch-&-rinse adhesive and provides the adhesive with remineralizing capability. This approach may represent a suitable bonding strategy for improving the dentin bond strength and durability of etch-&-rinse adhesive.

Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Dentinal Tubule Occluding Efficacy Of Er: YAG Laser And Universal Adhesive Loaded With Nano-Carbonated Apatite.

ER:YAG laser and experimental resin-based dental adhesive loaded with functionalized carbonated apatite filler were used in this study to evaluate the dentin interaction in terms of penetration and occlusion of the dentinal tubules aiding in the control of dentin hypersensitivity (DH). Spheroidal Carbonated apatite nanoparticles (N-CAP), with an average size of 20±5 nm diameter, were synthesized, characterized, and incorporated in a universal adhesive "All Bond Universal, Bisco, USA", in (2% weight) concentration. Er:YAG laser "Lightwalker, FOTONA, EU" was adjusted to an energy output of 40mJ/ pulse and pulse repetition of 10 Hz for 10 seconds. Dentin specimens were prepared from the buccal surface of 75 extracted sound human molars. The specimens were randomly divided into five groups (n=15) according to the surface treatment: Group (L): Laser only; Group (LB): Laser in combination with adhesive; Group (LBN): Laser in combination with adhesive loaded with N-CAP; Group (B): adhesive only; and Group (BN): adhesive loaded with N-CAP. Depth of penetration and occlusion of the dentinal tubules were assessed using Environmental Scanning Electron Microscope Examination (ESEM). One-way ANOVA was used to compare groups, followed by a pairwise test for multiple comparisons (α=0.05). Groups (LB), and (LBN) showed the highest mean of dentinal tubules' penetration, with a non-significant difference between them. In contrast, the specimens treated with laser only (L) showed the most minor penetration. The employment of ER-YAG laser irradiation with the adhesive loaded with N-CAP was evaluated to be effective in penetrating and occluding the opened dentinal tubules.

Effect of bioceramic intracanal medication on the dentinal bond strength of bioceramic cements: an ex-vivo study.

Background: The present study evaluated the effect of a bioceramic intracanal medicament (Bio-C Temp) on the push-out bond strength of bioceramic cements. Methods: Forty-eight human single-canaled premolars were prepared and randomly divided into three groups: Group (A) received no intracanal medicament; Group (B) calcium hydroxide (CH); and Group (C) Bio-C Temp. After medicament removal, the roots were sectioned transversely. The slices in each group were separated into two subgroups (n = 16): in Subgroup (1), mineral trioxide aggregate (MTA) was placed, and in Subgroup (2) Bio-C Repair. Push-out bond strength was determined using a universal testing machine, applying a constant compressive force on the cement until bond failure. The failure mode was also evaluated. Data were analyzed using the Chi-square test and two-way ANOVA followed by Tukey's post hoc tests. The level of significance was set at 5%. Results: The pushout bond strength of Bio-C Repair was significantly higher than that of MTA irrespective of intracanal medication (p = 0.005). The placement of Bio-C Temp was associated with significantly lower bond strength (p = 0.002, p = 0.001). Conclusion: Bio-C Repair showed better bond strength compared to MTA, irrespective of intracanal medication. Bio-C Temp intracanal medicament, however, decreased the bond strength of both these cements.

Effect of Acetylsalicylic Acid on Biological Properties of Novel Cement Based on Calcium Phosphate Doped with Ions of Strontium, Copper, and Zinc.

This study aimed to compare the biological properties of newly synthesized cements based on calcium phosphate with a commercially used cement, mineral trioxide aggregate (MTA). Strontium (Sr)-, Copper (Cu)-, and Zinc (Zn)-doped hydroxyapatite (miHAp) powder was obtained through hydrothermal synthesis and characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy dispersive X-ray spectrometry (EDX). Calcium phosphate cement (CPC) was produced by mixing miHAp powder with a 20 wt.% citric acid solution, followed by the assessment of its compressive strength, setting time, and in vitro bioactivity. Acetylsalicylic acid (ASA) was added to the CPC, resulting in CPCA. Biological tests were conducted on CPC, CPCA, and MTA. The biocompatibility of the cement extracts was evaluated in vitro using human dental pulp stem cells (hDPSCs) and in vivo using a zebrafish model. Antibiofilm and antimicrobial effect (quantified by CFUs/mL) were assessed against Streptococcus mutans and Lactobacillus rhamnosus. None of the tested materials showed toxicity, while CPCA even increased hDPSCs proliferation. CPCA showed a better safety profile than MTA and CPC, and no toxic or immunomodulatory effects on the zebrafish model. CPCA exhibited similar antibiofilm effects against S. mutans and L. rhamnosus to MTA.

Apoptotic effects of biodentine, calcium-enriched mixture (CEM) cement, ferric sulfate, and mineral trioxide aggregate (MTA) on human mesenchymal stem cells isolated from the human pulp of exfoliated deciduous teeth.

BACKGROUND: Preservation of primary teeth in children is highly important. Pulpotomy is a commonly performed treatment procedure for primary teeth with extensive caries. Thus, biocompatibility of pulpotomy agents is highly important. Biodentine, calcium enriched mixture (CEM) cement, ferric sulfate, and mineral trioxide aggregate (MTA) Angelus are commonly used for this purpose. Thus, this study aimed to assess the apoptotic effects of Biodentine, CEM cement, ferric sulfate, and MTA on stem cells isolated from the human pulp of exfoliated deciduous teeth. METHODS: In this in-vitro, experimental study, stem cells isolated from the human pulp of exfoliated deciduous teeth were exposed to three different concentrations of Biodentine, CEM cement, ferric sulfate, and MTA for different time periods. The cytotoxicity of the materials was evaluated by flow cytometry using the annexin propidium iodide (PI) kit. Data were analyzed by ANOVA and Tukey's test at P<0.05 level of significance. RESULTS: All four tested materials induced significantly greater apoptosis compared with the control group. The difference in cell apoptosis caused by the first concentration of ferric sulfate and MTA was not significant at 24 hours. In other comparisons, the cytotoxicity of ferric sulfate was significantly lower than that of other materials. Biodentine showed higher cytotoxicity than MTA at first; but this difference faded over time. The cytotoxicity of CEM cement was comparable to that of MTA. The highest cell viability was noted at 24 hours in presence of the minimum concentration of ferric sulfate. The lowest cell viability was noted at 72 hours in presence of the maximum concentration of CEM cement. CONCLUSIONS: In comparison with other materials, ferric sulfate showed minimum cytotoxicity; the cytotoxicity of the three cements was comparable. It appears that the concentration of ferric sulfate and the composition of cements are responsible for different levels of cytotoxicity.

Engineering Interfacial Integrity with Hydrolytic-Resistant, Self-Reinforcing Dentin Adhesive.

The leading cause of composite restoration failure is secondary caries, and although caries is a multifactorial problem, weak, damage-prone adhesives play a pivotal role in the high susceptibility of composite restorations to secondary caries. Our group has developed synthetic resins that capitalize on free-radical polymerization and sol-gel reactions to provide dental adhesives with enhanced properties. The resins contain γ-methacryloxypropyltrimethoxysilane (MPS) as the Si-based compound. This study investigated the properties of methacrylate-based resins containing methacryloxymethyltrimethoxysilane (MMeS) as a short-chain alternative. The degree of conversion (DC), polymerization kinetics, water sorption, mechanical properties, and leachates of MMeS- and MPS-resins with 55 and 30 wt% BisGMA-crosslinker were determined. The formulations were used as model adhesives, and the adhesive/dentin (a/d) interfaces were analyzed using chemometrics-assisted micro-Raman spectroscopy. The properties of the 55 wt% formulations were comparable. In the 30 wt% BisGMA formulations, the MMeS-resin exhibited faster polymerization, lower DC, reduced leachates, and increased storage and loss moduli, glass transition (Tg), crosslink density, and heterogeneity. The spectroscopic results indicated a comparable spatial distribution of resin, mineralized, and demineralized dentin across the a/d interfaces. The hydrolytically stable experimental short-chain-silane-monomer dental adhesive provides enhanced mechanical properties through autonomous strengthening and offers a promising strategy for the development of restorative dental materials with extended service life.

A microtomographic and histopathological evaluation of dental cements as late-stage peri-implant complication in a rat model.

Cement mediated peri-implantitis accounts for 1.9-75% of dental implant failures associated with peri-implant diseases. This study evaluated the biological impact of dental cements on osseointegrated implants using Lewis rats. Twenty-two rats were distributed into 6 groups: negative control (NC) soft diet (SD), and hard diet (HD); positive control SD and HD (n = 3); Implant + bio-ceramic Cement (BC) SD and HD which included contralateral Sham sites (n = 5). Titanium implants were placed on either side of the maxillae and allowed to heal for 14 days. Later, both sides of experimental groups underwent a re-entry surgery to simulate clinical cementation. The right side received 0.60 mg of BC. At 14 days post cement application, maxillae were harvested for clinical, microtomographic, and histological evaluations. Clinical and microtomographic evaluations indicated evidence of extensive inflammation and circumferential bone resorption around BC implants in comparison to NC. Histology revealed cement particles surrounded by inflammatory infiltrate in the implant area accompanied by biofilm for SD groups. Both sides of BC indicated intensive bone resorption accompanied by signs of osteolysis when compared to NC. Cemented groups depicted significantly lower bone to implant contact when compared to NC. In conclusion, residual cement extravasation negatively impacted osseointegrated implants after re-entry surgeries.

Assessment of the Efficacy and Bond Strength of Different Dentin-bonding Agents with Adhesives on Primary Teeth: An In Vitro Study.

AIM: The purpose of this study was to evaluate the effectiveness and strength of three various dentin-bonding agents used with adhesives on primary teeth. MATERIALS AND METHODS: The study used 80 recently extracted, healthy human maxillary anterior primary teeth that had undergone physiologic resorption, or over-retention. Teeth were cut to expose a flat dentin surface at a depth of 1.5 mm. All samples were divided into four groups (20 samples in each group) as follows: Group I-Control group, Group II-Primary teeth bonding with 6th-generation bonding agent, Group III-Primary teeth bonding with 7th-generation bonding agent, Group IV-Primary teeth bonding with 8th-generation bonding agent. All of the samples' dentinal surfaces were covered with composite resin using a Teflon mold after adhesive had been applied. A universal testing machine (INSTRON) was used to assess the shear bond strength. Data were collected and statistically analyzed. RESULTS: The maximum mean shear bond strength was found in 8th-generation bonding agent (30.76 ± 0.16), followed by 7th-generation bonding agent (26.08 ± 0.21), 6th-generation bonding agent (25.32 ± 0.06), and control group (6.18 ± 0.09). Statistically significant difference was found between the three different bonding agents (p < 0.001). CONCLUSION: On conclusion, the 8th-generation bonding agent demonstrated a greater shear bond strength to dentin than the 7th and 6th-generation bonding agent. CLINICAL SIGNIFICANCE: The emergence of different bonding techniques to the market improves the durability and quality of restorations. An effective bonding to the tooth would also reduce bacterial penetration, marginal microleakage, possibility of pulpal inflammation preserve tooth structure, and postoperative sensitivity by allowing less cavity preparation. How to cite this article: Alqarni AS, Al Ghwainem A. Assessment of the Efficacy and Bond Strength of Different Dentin-bonding Agents with Adhesives on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):342-345.

Impact of acid and laser etching of enamel on microleakage in different adhesive systems.

This study aimed to evaluate the microleakage of light-cured and self-cured adhesives on enamel surfaces selectively etched with Er, Cr: YSGG laser or 35% phosphoric acid. A total of 60 class V cavities were prepared 1 mm above the cemento-enamel junction (CEJ). The specimens were randomly divided into six groups. Group 1: Clearfil SE Bond with no conditioning, Group 2: Tokuyama Universal Bond with no conditioning, Group 3: Clearfil SE Bond conditioned with 35% phosphoric acid, Group 4: Tokuyama Universal Bond conditioned with 35% phosphoric acid, Group 5: Clearfil SE Bond conditioned with Er, Cr: YSGG laser and Group 6: Tokuyama Universal Bond conditioned with Er, Cr: YSGG laser. Microleakage was evaluated qualitatively (visually) and quantitatively (ImageJ). The data were analyzed using IBM SPSS V23 and submitted to Kruskal-Wallis and Wilcoxon tests. The significance level was set at p < 0.05. In all evaluation methods, the microleakage scores exhibit significant differences (p*<0.001). Group 1 and Group 3 exhibited similar and lower microleakage values than the Group 5. In the occlusal margin, the microleakage values were similar in Group 2, Group 4, and Group 6, whereas in the gingival margin Group 4 showed significantly lower leakage compared to Group 2. Regardless of the etching protocols and adhesive systems used, less microleakage was observed on the occlusal surface than on the gingival surface. Phosphoric acid etching provides better results than laser etching for enamel surface treatment on both occlusal and gingival surfaces.

Removal efficiency of a fast setting pozzalan-based bioactive cement: a micro CT study.

AIM: The aim of this study was to evaluate the removal efficiency of PRMTA and ECMPremixed applied to the coronal third according to the RET by UI and to examine the effect of different solutions on material removal. MATERIALS AND METHODS: 40 permanent upper central teeth were used to simulate immature teeth. The samples were irrigated with 1.5% NaOCl and calcium hydroxide was placed. Samples were incubated in PBS. Then irrigation was done with 17% EDTA, the samples were randomly divided into 2 groups (n = 20):Group 1: PRMTA, Group 2: ECM Premixed. The materials were placed in the samples. Then the samples were scanned with micro-CT. Materials were removed by UI. Micro-CT scan of the samples was performed. Each material group was divided into 2 subgroups (n = 10): Group1 was MTAD, group2 was irrigated with 10% CA; then micro-CT was performed. Obtained images were positioned in DataViewer and analyzed with CTAn. The obtained data were statistically analyzed in IBM SPSS 25. The significance level was determined as 5%. RESULTS: There was no significant difference between the initial volumes of the materials (p > 0.05). The amount of the remaining material after UI was significantly higher in the PRMTA (0.7471%) group compared to the ECM Premixed (0.0093%). There was no significant difference in terms of remaining material after irrigation with MTAD and CA in both groups (p > 0.05). CONCLUSION: A great deal of the materials were removed by UI under the operation microscope. ECM Premixed was removed more effectively compared to the PRMTA. And, acidic solutions did not provide any additional benefit in material removal.

Elective full pulpotomy in mature permanent teeth diagnosed with symptomatic irreversible pulpitis: a two years retrospective study.

AIM: To investigate the outcome of elective full pulpotomy, using calcium silicate-based cements (CSBC), after 2 years, in symptomatic mature permanent teeth with carious lesions, diagnosed as irreversible pulpitis, and analyse the capacity of Wolters et al. (2017) classification to predict the likelihood of treatment failure. METHODS: The treatment records of 56 patients with symptomatic mature teeth with carious lesions, diagnosed as irreversible pulpitis and treated by elective full pulpotomy, using CSBCs as pulp capping materials, were reviewed. Thirteen teeth were excluded. The remaining 43 teeth were evaluated retrospectively at 24 months. Fisher`s exact test with the Lancaster's mid-P adjustment was used to assess different outcomes amongst the diagnostic categories. RESULTS: Four of the cases failed before 24 months and required root canal treatment (RCT). Overall success rate at 2 years was 90.7% (39 of 43). An inverse, but non-significant, correlation was observed between the severity of pulpitis according to the Wolters classification and the treatment success rate (p > 0.05). The type of CSBC used was associated to the success rate (OR = 10.5; 95% C.I. = 0.5 - 207.4; p = 0.027), being 82% with Endosequence and 100% with Biodentine. Postoperative pain associated significantly to lower success rate (66.7%) (Odds ratio = 8.0; 95% C.I. = 0.7 - 95.9; p = 0.047). CONCLUSIONS: Elective full pulpotomy using a CSBC was a successful choice for the treatment of mature permanent teeth with symptoms indicative of irreversible pulpitis. There were no significant differences between the success rate of mild, moderate and severe pulpitis. Postoperative pain could be considered a risk marker for failure of full pulpotomy. The term "irreversible pulpitis" should be re-signified to indicate the need for access to the pulp chamber, rather than an indication for extraction or RCT.

Biological interaction, esthetics, handling, and loss rate of temporary luting cements - a clinical single-blind randomized controlled trial.

OBJECTIVES: To evaluate three temporary luting cements in terms of their restoration loss rates, biological interactions, esthetic properties, and handling characteristics. MATERIALS AND METHODS: 75 adults requiring fixed prosthodontics voluntarily participated in a single-blind, randomized controlled trial. After preparation, temporary restorations were luted with a randomly selected temporary luting cement (either Provicol QM Plus (PQP), Bifix Temp (BT), or Provicol QM Aesthetic (PQA)). Clinical examinations were performed one to two weeks after cementation. The following criteria were evaluated: tooth vitality, percussion, hypersensitivity, gingival bleeding, odor formation, esthetics, cement handling, removability, cleanability, and retention loss. Antagonistic teeth served as controls. Statistical analysis was performed using the paired t-test, one-way ANOVA, Pearson's chi-square and Fisher's exact test, where appropriate. RESULTS: The overall loss rate of temporary restorations was 16.0%, showing no cement-specific differences. Postoperative hypersensitivity occurred in 8% of cases regardless of cement type. Esthetic impairment was reported by 31% of the PQP-fixed restorations, compared with 4.0% and 4.2% of the BT and PQA-bonded restorations. Cement application was reported to be easy in 100% of cases, excess removal in 88-96%, depending on the cement used. CONCLUSIONS: The choice of luting material affects the esthetic appearance of a temporary restoration and should be considered, particularly in restorations in esthetically demanding areas. No significant differences between the cements were identified regarding biocompatibility, handling, and loss rate. CLINICAL RELEVANCE: Translucent cements can help to reduce color interferences, resulting in a more appealing appearance of the temporary restoration.

Efficacy of root-end filling techniques using premixed putty type bioceramic cements: an ex vivo study.

OBJECTIVES: Currently, premixed putty-type bioceramic cements (PPBCs) have become popular materials for root-end fillings. This study investigated three root-end filling techniques using PPBCs and calcium silicate-based sealers including EDTA pretreatment. MATERIALS AND METHODS: Ninety root segments were prepared and standardized with an artificial fin and lateral canal, and assigned to three groups (n = 30). Root-end fillings were placed using BC-RRM Putty alone (Group PA), injection of BC sealer followed by BC-RRM Putty (Lid Technique: Group LT) or BC-RRM Putty with BC sealer coating (Deep putty packing technique: Group DP). Half of each group was pretreated with 17% EDTA. The radiographic images of the specimens were assessed by five graders and push-out bond strength tests were conducted. The data were analyzed with a general linear model including two-way ANOVA and chi-square test at a significance level of 5%. RESULTS: DP approach demonstrated significantly higher bond strength than LT (P < 0.05). However, there was no statistically significant difference in bond strength between PA and either DP or LT. EDTA pretreatment had no significant effect on push-out bond strength. Radiographically, for the main canal, PA and DP scored significantly higher than LT. In the fin, PA scored significantly higher than others (P < 0.05). CONCLUSION: Our study highlights variations in root-end filling techniques. Injecting a bulk of bioceramic sealer before the placement of PPBCs may reduce bond strength and radiopacity. The application of PPBCs alone or in the deep putty technique demonstrates potential for favorable outcomes. EDTA pretreatment did not enhance bond-strength. CLINICAL RELEVANCE: Careful selection and application of bioceramic materials and techniques in root-end fillings may influence the outcome of endodontic root-end surgery. When PPBCs and calcium silicate-based sealers are used together for root-end fillings, sealer followed by deep putty application may offer improved bond strength and radiographic fill compared to the lid technique.

Investigation of mechanical properties, remineralization, antibacterial effect, and cellular toxicity of composite orthodontic adhesive combined with silver-containing nanostructured bioactive glass.

BACKGROUND: The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength. METHODS: nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA. RESULTS: The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX). CONCLUSION: Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength.