Effects of New Generation All-Ceramic and Provisional Materials on Fibroblast Cells.

PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxic and apoptotic effects of seven new-generation all-ceramic materials for CAD/CAM (Lava Ultimate [LU], VITA Mark II [VM], InCoris TZI [IC], IPS e.max CAD [EM], VITA Suprinity [VS], Cerasmart [CS], IPS Empress CAD [EC]) and six provisional materials (Protemp 4 [PT], Telio CAD [TC], CAD-Temp [CT], Telio Lab [TL], Temdent Classic [TD], Telio CS C&B [TS]) on L929 mouse fibroblast cells. MATERIALS AND METHODS: 24 disc-shaped specimens (∅ = 5 mm, h = 2 mm) were prepared from each test material. Medium extracts were collected at the 1st, 3rd, and 7th days for each group and tested using the L929 cell line. Cytotoxicity was evaluated using XTT assay, and apoptosis was determined by Annexin-V/PI staining. Data were analyzed using one-way ANOVA, Tukey's multiple comparison tests at a significance level of p < 0.05. RESULTS: The cell viability results among all-ceramic material groups after the 1st and 7th days of incubation periods showed statistically significant differences (p < 0.05). There were significant differences within the ceramic groups in different incubation periods regarding apoptosis rate (p < 0.05). Throughout the entire test period, LU and VM from the CAD/CAM all-ceramic materials and PT and TC from the provisional restoration materials showed cell viability higher than 90%. EC and TD showed the lowest cell viability and highest apoptosis rates in their own groups. For the provisional materials, there were significant differences in cell viability and apoptosis rate in all the incubation periods for each material (p < 0.05). CONCLUSIONS: Although some new-generation CAD/CAM and provisional restoration materials display slight cytotoxicity values, the results are still within the reliable range, and they can safely be used in clinical conditions.

Color change of CAD-CAM materials and composite resin cements after thermocycling.

STATEMENT OF PROBLEM: The color of resin cements and computer-aided-design and computer-aided-manufacturing (CAD-CAM) restorations may change with aging. PURPOSE: The purpose of this in vitro study was to analyze the influence of thermocycling on the color of CAD-CAM materials with underlying resin cement. MATERIAL AND METHODS: Seven different CAD-CAM materials, composite resins and glass-ceramics were cut into 0.7-mm and 1.2-mm thicknesses (n=10) and cemented with a dual-polymerizing resin cement, a light-polymerizing resin cement, and a preheated composite resin (N=420). Color values were measured by using spectrophotometry. Specimens were subjected to thermocycling (5°C and 55°C; 5000 cycles). The measured color difference (ΔE) data were analyzed by using descriptive statistics. Normality of data distribution was tested by using the Kolmogorov-Smirnov test. Three-way and 1-way ANOVA followed by the Scheffé post hoc test and unpaired 2-sample Student t test were computed to determine the significant differences among the tested parameters (α=.05). RESULTS: ΔE values were significantly influenced by the CAD-CAM material (ηp2=0.85, P<.001) and the resin composite cement (ηP2=0.03, P=.003) but were not influenced by thickness (P=.179). Significant interactions were present among thickness, cement, and CAD-CAM materials (P<.001). Vita Suprinity and GC Cerasmart showed significantly the lowest ΔE values (P<.001). The highest ΔE values were observed for IPS Empress CAD. The dual-polymerizing resin cement showed significantly lower ΔE values than the preheated composite resin (P=.003). CONCLUSIONS: Restoration materials and composite resin cement types used for cementation influence the amount of color change due to aging.

Cytotoxicity of Dental Implants: The Effects of Ultrastructural Elements.

PURPOSE: In this in vitro study, the purpose was to assess the cytotoxicity profiles of seven commercial dental implant materials by using cell culture methods on an osteoblastic cell line. MATERIALS AND METHODS: The microstructure of seven commercial dental implants (each given a letter code) was investigated via scanning electron microscopy and energy-dispersive x-ray analysis. Medium extracts were collected on the first and fifth days for each group and tested using MC3T3-E1 cell line. Cytotoxicity was evaluated with Xcelligance System and XTT reagent, and apoptosis was determined by Annexin-V staining. One-way analysis of variance (ANOVA) and Tukey's multiple range tests were used for statistical analyses. In all tests, P was set as .05. RESULTS: ANOVA results disclosed that Ti (P = .001), Na (P = .001), Ca (P = .019), Al (P = .024), and P (P = .020) amounts were significantly different between test materials. Cytotoxicity and apoptosis analyses revealed that implant materials (C) and (E) were the materials with the lowest cell vitality and the highest apoptosis rates among the test materials. Phosphorus was the only element that presented the highest amount in C and E (14.23% and 12.29%, respectively) compared with the other implant materials tested. (F) and (G) had favorable results for all experiments. CONCLUSION: The results suggest that pure dental implant materials with a lower number of additional elements may possess fewer cytotoxic effects than the other implant materials tested in this study.

Radiopacity of Luting Cements as a Potential Factor in Peri-implantitis: An In Vitro Comparative Study.

The aim of this study was to establish the radiopacity of cements used in implant-retained fixed partial dentures with respect to implant material, enamel, and dentin. A sample of 10 specimens of 13 different cements, implants, enamel, and dentin were prepared. Radiographs of the specimens and aluminum step wedges were acquired. Mean gray values of specimens were measured using digital imaging software. Kolmogorov-Smirnov and Shapiro-Wilk normality tests and independent t test were used (P = .05). Implantlink Semi, Premier, and Dentotemp had the lowest radiopacity values; GC FujiTemp LT, Multilink Implant, Poly-F Plus, Cavex-Temporary, and Panavia SA showed the highest. Within the limitations of the study, cements containing zinc oxide and ytterbium-trifluoride can be recommended for cementation of implant-retained restorations.

Glass-ceramics bonding in geriatric patients: comparison with young teeth.

OBJECTIVE: The aim of the study was to assess whether in geriatric patients, the shear bond strength (SBS) of glass-ceramics differed when compared to young controls. BACKGROUND: In the need of aesthetic restorations for geriatric patients, reliable bonding of glass-ceramics should be accomplished; however, glass-ceramics bonding on aged tooth structures is still unclear. MATERIALS AND METHODS: Sixty extracted molars from young and geriatric patients [18-25 (Y), and 65-80 (O)] were cut buccolingually to prepare enamel (E) and dentin (D) surfaces. Both surfaces were randomly divided into three groups according to the resin cements: Variolink II (V); Superbond (S); and Clearfil Esthetic Cement (C) (n = 10). Disc-shaped glass-ceramics (IPS E-max Press) (n = 120) were prepared. Specimens were bonded and subjected to thermocycling. SBS test was performed using a universal testing machine (0.5 mm/min). After debonding, the surfaces were examined using stereomicroscope and scanning electron microscope. Data were statistically analysed with Kolmogorov-Smirnov, Levene, anova and Bonferroni tests (p = 0.05). RESULTS: There were no significant differences between the old and young teeth surfaces. V showed the highest SBS [MPa(SD)] on both enamel and dentin [36.7 (6.5) (YE), 23.2 (13.2) (YD), 32.1 (16.2) (OE), 25.5 (8.6) (OD), respectively]. Significant differences were observed between resin cements (p < 0.05). The failure types were 43% adhesive between tooth and cement, 48% mix, 9% adhesive between cement and ceramic, regardless of cement type. CONCLUSION: In geriatric patients, the shear bond strength of glass-ceramics did not differ when compared to that of young controls. On the dentin surface, etch-rinse resin cements appear to be more appropriate for glass-ceramics bonding.

Oral health-related quality of life among institutionalized patients after dental rehabilitation.

AIM: The aim of the present study was to determine the changes in oral health-related quality of life before and 3 months after dental rehabilitation among geriatric patients residing in a state-owned nursing home, using the General Oral Health Assessment Index (GOHAI). METHODS: Data from 40 patients were collected through the administration of a structured questionnaire, as well as from medical records and intraoral examinations. Sociodemographic and behavioral variables, and denture use/length of use were recorded. The GOHAI questionnaire was completed before and 3 months after dental rehabilitation by the same examiner. Normality of the GOHAI scores was examined with the Kolmogorov-Smirnov test. Data were analyzed using descriptive statistics, t-tests, one-way ancova and ancova (P < 0.05). RESULTS: The study sample included 32 men (80%) and eight women (20%) with a mean age of 72.75 years. Mean GOHAI scores increased from 41.275 (low) to 53.100 (moderate) 3 months after dental rehabilitation (t = 1.42, P < 0.001, r = 0.86). Patients with poor oral hygiene (P = 0.000), those who had been using dentures (P = 0.000) and patients younger than 70 years-of-age (P = 0.03) provided higher GOHAI scores after dental rehabilitation. GOHAI scores before and after dental rehabilitation were not influenced by sociodemographic and behavioral variables (P > 0.05). The after treatment GOHAI scores, which were corrected according to gender and age, showed no significant differences regarding the education level, income, behavioral variables, use of dentures, oral hygiene status and presence of systemic diseases (F = 0.62, P = 0.69). CONCLUSIONS: Dental rehabilitation of institutionalized geriatric patients resulted in a significant improvement in GOHAI scores, indicating an improvement in oral health-related quality of life after receiving proper dental care.

Cytotoxicity of dentin bonding agents.

This study sought to evaluate the cytotoxicity of 5 dentin bonding agents (Admira Bond, Adper Single Bond Plus, Clearfil SE Bond, Clearfil S3 Bond, and Heliobond) by XTT assay using human gingival fibroblast cells. Samples of dentin bonding agents were prepared on a black 96-well microplate, and the cytotoxicity of each bonding material was measured every 24 hours for 7 days, then on Days 14, 21, and 28. One-way ANOVA and Bonferroni post hoc tests were used for statistical analyses. All 5 materials were evaluated as severely cytotoxic (P < 0.001) on the first day, with cell viabilities ranging from 6% to 24%. All the bonding agents showed severe cytotoxicity with viability results <10%. With the exception of Adper Single Bond Plus, toxicity continued to Day 28 for all compounds. The utmost care must be considered during the clinical utilization of dentin bonding agents to keep them within the area of restoration and prevent their contact with adjacent tissues.

Effects of surface-finishing protocols on the roughness, color change, and translucency of different ceramic systems.

STATEMENT OF PROBLEM: Surface-finishing protocols have a mechanical impact on ceramic surfaces that could eventually affect surface topography and light scattering. An optimum protocol is needed to avoid damaging the optical properties of ceramics. PURPOSE: The purpose of this study was to determine the effects of different surface-finishing protocols on the surface roughness, color change, and translucency of ceramic and metal ceramic restorations. MATERIAL AND METHODS: Standardized disk-shaped specimens (1.5 × 10 mm, n=128) were fabricated from 3 different ceramic core materials (aluminum oxide [Al2O3]-AL, zirconium oxide [ZrO2]-ZR, lithium disilicate [Li2Si2O5]-LIT), veneered (V) with dentin ceramics (n=32 per group), and placed in the following groups: ALV, ZRV, and LITV. The metal ceramic group acted as the control (n=32). Four different surface-finishing methods were tested. Airborne-particle abrasion with 50 µm Al2O3, polishing with adjustment kit, polishing with adjustment kit plus diamond polishing paste, and autoglazing (n=8 subgroup) were applied on the veneering ceramics. The specimens were analyzed with a profilometer for surface roughness, and color change and translucency were measured with a clinical spectrophotometer. Statistical analyses were performed with 1-way ANOVA and the Tukey honest significant difference tests (α=.05). RESULTS: Specimens treated with the airborne particle abrasion method showed significantly higher mean profilometer for surface roughness values in all groups (P<.05). The polishing with adjustment kit and autoglazing methods revealed statistically similar surface roughness values in all groups (P>.05). With the diamond polishing paste method, lower surface roughness values were achieved in the ZRV and metal ceramic groups acted as the control groups. Different surface-finishing methods affected the color change of the ceramic systems, except for ZRV. Surface-finishing protocols significantly affected the translucency values of the ALV, LITV, and metal ceramic groups (P<.05). CONCLUSIONS: No single surface-finishing protocol can be recommended to obtain the smoothest surface and the least color change without affecting translucency for the ceramics tested. The airborne-particle abrasion protocol created rougher surfaces and decreased translucency, and color change in zirconia was not affected by the finishing protocols.

Cytotoxicity of hard and soft denture lining materials.

The cytotoxicity of nine soft and hard lining materials (Mollosil Plus, Ufi Gel SC, Visco-gel, Molloplast-B, GC Tissue Conditioner, Vertex Rapid Simplified, GC Reline Hard, Vertex Self-Curing, Ufi Gel hard C) was evaluated using human gingival fibroblasts (HGFs). Twelve disk samples per lining material were prepared and incubated for 24, 48, 72, and 96 h. Cytotoxicity of each lining material's extract on cultured HGFs was measured using XTT assay. Data were analyzed using one-way ANOVA, post hoc Dunnett's T3 and Bonferroni tests at a significance level of p<0.05. At all incubation periods, all the hard lining materials (Vertex-SC, GC Reline Hard, Vertex-RS, and Ufi Gel hard C) showed cell viability higher than 90%. Among the soft lining materials, although there were no significant differences in cell viability among the different incubation periods for each lining material (p>0.05), autopolymerized acrylic-based GC Tissue Conditioner showed significantly lower cell viability than the other soft lining materials at each incubation period. Among the hard lining materials, there were no significant differences both among the materials and across all incubation periods for each lining material (p>0.05). In conclusion, all soft and hard liners exhibited good biocompatibility regardless of incubation time, except for GC Tissue Conditioner.

Influence of two desensitizer agents on the microleakage of adhesively luted ceramic inlays.

OBJECTIVES: The purpose of this study was to evaluate the effects of two different desensitizers (Hemaseal & Cide and Aqua Prep F) on the microleakage of ceramic inlay restorations luted with adhesive resin cement. METHODS: Cylindrical Class V cavities were prepared on the buccal surfaces of thirty extracted human third molars. One of the desensitizers (either Hemaseal&Cide, Advantage Dental Products Inc. or Aqua-Prep F, Bisco) was applied to the cavities. Ten samples were used as controls. Ceramic inlays were fabricated using the heat-pressed glass ceramic technique (IPS Empress II). Inlay restorations were luted using adhesive cement (Variolink II, Ivoclar-Vivadent). The restorations were properly finished, stored in distilled water at 37°C for 24 h and subjected to 1000 thermal cycles. The microleakage scores were examined using a stereomicroscope at the 30x magnification after each sample was stained with 0.5% basic fuchsin. The data were analyzed using Kruskall Wallis and Mann Whitney U tests (P=0.05). RESULTS: Aqua-Prep F samples showed significantly higher microleakage scores at the enamel margins than did the Hemaseal & Cide and control groups (P<.05). Hemaseal & Cide application led to less microleakage than the other groups both at the enamel and dentin margins (P<.05). CONCLUSIONS: Hemaseal & Cide desensitizer decreased the microleakage process at the enamel and dentin margins of inlay restorations luted with adhesive luting cement, while Aqua-Prep F increased the leakage scores at the enamel margins.

Influence of fluoride- or triclosan-based desensitizing agents on adhesion of resin cements to dentin.

Effect of desensitizers on the bond strength of resin cements to dentin was evaluated. Intact premolars (N = 90) were embedded in polymethyl methacrylate; dentin surfaces were exposed, and they were randomly divided into two main groups of cements (Duolink (D), Variolink II (V); n = 45 per group) and then into three desensitizer subgroups (n = 15 per subgroup). Teeth in controls (C) were treated according to cements' adhesion protocols; the other two groups received either fluoride- [Aqua-Prep F (F)] or triclosan-based [Seal&Protect (T)] desensitizers. Ceramic disks (Empress 2) were adhered; specimens were thermocycled (×5,000 cycles, 5-55 ± 1°C, dwell time 30 s) and subjected to shear bond strength test (MPa ± SD) in a universal testing machine (crosshead speed 1 mm/min). Failure types were classified using scanning electron microscope. For V, application of both desensitizers (29.6 ± 7.8 and 22.8 ± 2.8 for F and T, respectively) did not present significantly different results than that of the VC (21.2 ± 2.3; p > 0.05, one-way ANOVA). In D, F (20.6 ± 2.4) showed significantly higher results (p < 0.05) than those in T (16.1 ± 3.9) and DC group (15.2 ± 2.3). V showed significantly higher results than D (p < 0.05, Bonferroni). F and T did not negatively affect the bond strength results with D and V. Adhesive failures were more frequent with both T (84%) and F (66%) in D; cohesive failures in the cement (88%) were more commonly observed with F in V. Both F and T desensitizers can be safely used prior to final cementation but F in combination with V seems to be more reliable, considering both the bond strength and the failure types.

Bond strength of different dentin bonding systems to fluorotic enamel.

PURPOSE: The effect of three different bonding strategies on the shear bond strength of a resin composite to fluorotic enamel surfaces was investigated. MATERIALS AND METHODS: Thirty-six noncarious extracted human molars with fluorosis and 36 without fluorosis were scraped clean from any remaining tissue, and then were divided into three subgroups according to the tested dentin bonding systems. The resin composite was bonded to the teeth using three different adhesive systems: Peak LC Bond with an etch-and-rinse technique (Ultradent Products), Peak LC Bond with a self-etching technique using Peak SE Primer (Ultradent Products), and Xeno V (Dentsply Caulk) using a one-bottle self-etching technique. Following the photopolymerization of the resin composites, thermocycling was performed 5000 times. Shear bond strengths were tested using the Shimadzu Universal Testing Machine until failure. The analysis of the fractured enamel surfaces was performed using an optical microscope (Nikon ECLIPSE ME 600) at 10X and 1000X magnification, and the images were analyzed with an image analyzer (LUCIA 4.21). The data obtained were analyzed with two-way ANOVA and the Bonferroni test at a significance level of p < 0.05. RESULTS: Mean shear bond strengths in MPa of the groups were: Peak LC Bond, self-etching, on fluorotic enamel 13.23 +/- 2.58 and on nonfluorotic enamel 17.81 +/- 2.90; Peak LC Bond, etch-and-rinse, on fluorotic enamel 16.77 +/- 2.32 and on nonfluorotic enamel 21.13 +/- 2.74; one-bottle self-etching Xeno V on fluorotic enamel 10.79 +/- 2.14 and on nonfluorotic enamel 14.58 +/- 2.99. CONCLUSION: Fluorosis adversely affected the bonding performance of all the bonding systems to enamel. The use of the etch-and-rinse dentin bonding technique produced higher bond strengths of the resin composite tested to fluorotic and nonfluorotic enamel compared to both self-etching techniques.

Bond strength of glass-ceramics on the fluorosed enamel surfaces.

OBJECTIVES: Effect of different adhesive luting systems on the shear bond strength of IPS Empress 2 ceramic restorations to fluorosed enamel surface was investigated. METHODS: Forty-eight ceramic discs (2 mm x 3 mm; IPS Empress 2) were fabricated. Twenty-four non-carious extracted human molar teeth with fluorosis and 24 without fluorosis were cleaned with pumice using a plastic brush and then they were divided into two main groups. The IPS Empress 2 ceramic discs were luted to the teeth of four subgroups with two different adhesive luting systems, Variolink 2/Excite DSC (etch-and-rinse) and Clearfil Esthetic Cement/ED Primer II (self-etch), thermocycling was performed 5000 times. Shear bond strengths were tested using Shimadzu Universal Testing Machine until failure. An optical microscope and image analyzer were used at 10x and 1000x magnification to analyze the surfaces for adhesive, cohesive and mixed failure percentages. Data was analyzed with one-way ANOVA and Tukey test at a significance level of p<0.05. RESULTS: Mean shear bond strength data of the groups in MPa were; Variolink 2/Excite DSC on fluorosed enamel: 18.3+/-3.08, Variolink 2/Excite DSC on non-fluorosed enamel: 18.79+/-2.65, Clearfil Esthetic Cement/ED Primer II on fluorosed enamel: 8.43+/-2.45, Clearfil Esthetic Cement/ED Primer II on non-fluorosed enamel: 13.53+/-1.68. Mixed failure was the most prevalent type of failure in moderate fluorosed and non-fluorosed teeth with etch-and-rinse dentin bonding system, and in fluorosed teeth with self-etch dentin bonding system. CONCLUSIONS: The use of an etch-and-rinse adhesive luting procedure produced higher bond strengths of glass-ceramics bonded to fluorosed and non-fluorosed enamel surfaces than the self-etch bonding system.

Evaluation of metal bond strength to dentin and enamel using different adhesives and surface treatments.

Because adherence of base metal alloys is important for the long-term clinical success of adhesive fixed partial dentures, it has been necessary to improve adhesion to metal substrate by using different surface treatments. This study used different surface conditioning methods and two different luting resins to evaluate the shear bond strength of base metal alloys to dentin and enamel. Sixty noncarious freshly extracted human teeth were mounted in a plastic holder filled with autopolymerized acrylic resin. After the roots were removed and 30 flat enamel and 30 flat dentin surfaces were exposed, the specimens were divided randomly into two main luting cement groups. Sixty nickel chromium (NiCr) metal specimens were fabricated and subjected to three different surface conditioning procedures: sandblasting with 50 microm aluminum oxide, tribochemical silica coating, and a combination of the two. Scanning electron mircoscopy (SEM) evaluations revealed mainly cohesive failures. Self-cure adhesive resulted in higher bond strengths to dental substrates. Higher bond strengths were achieved through a combination of sandblasting and tribochemical silica coating; however, further clinical research is required. A surface treatment that combines sandblasting with tribochemical silica coating can achieve a more effective bond for adhesive restorations with metal substrates.

Multidisciplinary treatment approach of Morquio syndrome (Mucopolysaccharidosis Type IVA).

Morquio syndrome (mucopolysaccharidosis type IVA) is an autosomal recessive disorder caused by the accumulation of mucopolysaccharides in lysosomes because of the deficiency of N-acetylgalactosamine-6-sulphate sulphatase. Patients with Morquio syndrome often need orthodontic treatment. This study demonstrates the correction of malocclusion by orthodontic treatment and the improvement of the masticatory function by prosthodontic treatment in a male patient affected by Morquio syndrome. Labial inclinations of mandibular and maxillary anterior teeth were corrected, and spaces necessary for prosthodontic restorations were preserved. After this procedure, the restorations were made, and Hawley appliances were used in both jaws for retention. Patient satisfaction and an acceptable occlusal relationship were achieved by following an optimal treatment plan when considering the general status of the patient with Morquio syndrome.

Comparison of the hardness and microbiologic adherence of four permanent denture soft liners.

Resilient denture linings cannot be used for extended periods due to the loss of softness and the adhesion of microorganisms on their surfaces. This study investigated the hardness and microbiologic adherence of four permanent soft denture lining materials. In addition, the adherence of Candida albicans and Staphylococcus aureus was studied in vitro by quantitative culture method and scanning electron microscopy (SEM). Surface properties of the materials also were observed with SEM. The hardness of all materials increased throughout the study. Molloplast-B was the most adequate permanent soft lining material for clinical use under these laboratory conditions.

Effect of an antibacterial adhesive on the bond strength of three different luting resin composites.

OBJECTIVES: Effect of a dentin adhesive system containing antibacterial monomer-MDPB (Clearfil Protect Bond) on the shear bond strength of all-ceramic-IPS Empress 2 restorations luted with three different dual-polymerizing systems (Variolink 2, RelyX ARC and Panavia F 2.0) to dentin was investigated. METHODS: One hundred and eight all-ceramic discs (2 x 3mm; IPS Empress 2) were fabricated and ultrasonically cleaned. The buccal surfaces of 108 non-carious extracted human premolars were flattened to expose dentin and subsequently polished with 600-grit wet silicon carbide paper. Three dual-polymerizing luting systems had test groups and control groups consisting of 18 samples each. For the test groups Clearfil Protect Bond was applied to the exposed dentin surfaces. Control groups received the original bonding procedures of each adhesive system. After the all-ceramic samples were luted to the teeth, thermocycling was performed 5000 times. Shear bond strengths were tested using Shimadzu Universal Testing Machine until failure. Analysis of fractured dentin surfaces were performed using Optical Microscope at x10 and x1000 magnifications and the images were analyzed with Image Analyzer. Data was analyzed with one-way ANOVA and Bonferroni test at a significance level of p<0.05. RESULTS: Mean shear bond strength data of the groups in MPa were; Variolink: 20.45+/-4.75, Variolink+Clearfil Protect Bond:29.32+/-2.37, RelyX ARC:18.82+/-3.19, RelyX ARC+Clearfil Protect Bond:25.58+/-4.05, Panavia F 2.0:17.11+/-2.98, Panavia F 2.0+Clearfil Protect Bond:24.40+/-7.46. Application of the antibacterial adhesive increased the shear bond strengths of all three dual-polymerizing systems to dentin (p=0.00). The surface analysis showed that most of the specimens showed the adhesive failure mode between the dentin and the composite luting agent interface. CONCLUSION: The antibacterial adhesive system Clearfil Protect Bond can be safely used to prevent the potential risk of complications resulting from bacterial activity regardless of affecting the bond strength of IPS Empress 2 restorations luted with the dual-polimerizing systems used in this study.

Effects of dentin disinfectants on the shear bond strength of all-ceramics to dentin.

This study investigated the effect of dentin disinfectants on the shear bond strength of all-ceramic restorations luted with two different dual-polymerizing systems to dentin. Dentin disinfectants chlorhexidine gluconate-based Concepsis and benzalkonium chloride-based Tubulicid Red were applied in combination with Variolink 2 and Resilute. The buccal surfaces of non-carious extracted human premolars were flattened to expose dentin and subsequently polished with 600-grit wet silicon carbide paper. Each dual-polymerizing luting system had two test groups and a control group. Dentin from the test groups was first treated with dentin disinfectants, then the all-ceramic restorations were luted with dual polymerizing systems. The dentin without disinfectant application and ceramic restoration was used as a control. After the all-ceramic samples were luted to all treated surfaces, the specimens were thermocycled and tested for shear bond strength until failure. Analysis of the fractured dentin surfaces was performed using Optical Microscope-Nikon ECLIPSE ME 600 (Nikon Co, Tokyo, Japan) at between 10x and 1000x magnifications and the images were analyzed with Image Analyzer LUCIA 4.21 (Nikon Co). The data were analyzed with one-way ANOVA and Duncan test at a significance level of p<0.05. Application of the two dentin disinfectants increased the shear bond strength of both the Variolink 2 and Resilute systems, but this increase was statistically significant only in Tubulicid Red treated specimens (p<0.05). Surface analysis showed that all the specimens showed the adhesive failure mode between the dentin and composite luting agent interface.

Multidisciplinary approach to restoring anterior maxillary partial edentulous area using an IPS Empress 2 fixed partial denture: a clinical report.

Esthetics is a major concern during restoration of anterior partial edentulous areas. All-ceramic fixed partial dentures may provide better esthetics and biocompatibility in the restoration of anterior teeth. This clinic report describes a multidisciplinary approach and treatment procedures with an IPS Empress 2 fixed partial denture to restore missing anterior teeth.