In vitro Study of the Role of Human Neutrophil Enzymes on Root Caries Progression.

The role of the host immune system in caries progression is mainly speculative, and it is believed that it entails the enzymatic degradation of the dentin organic matrix. The aim of this study was to evaluate the proteolytic effect of human neutrophil enzymes on root caries progression. For this, specimens of bovine root dentin were divided into 4 groups (n = 30): caries (C), caries + neutrophils (C + N), no caries (Control), and no caries + neutrophils (Control + N). Streptococcus mutans biofilm (105 CFU/mL) was grown on the root surface to artificially induce root carious lesions (C and C + N groups). Specimens were then exposed to neutrophils (5 × 106 cells/mL) for 48 h (C + N and Control + N groups). Caries development and neutrophil exposures were repeated a 2nd and 3rd time. Caries depth (CD) and dentin demineralization (DD) were assessed by infiltration of rhodamine B using fluorescence microscopy. Collagen fibril ultrastructure was characterized under a polarized microscope with Picrosirius red staining. There were no significant differences (p > 0.05) in CD and DD between the C and C + N groups for 1, 2, and 3 caries-neutrophil exposures. Immature collagen was significantly less present in the carious groups (C, p = 0.003; C + N, p = 0.01) than in the noncarious groups in the most superficial 200 µm. We thus concluded that human neutrophil enzymes did not influence short-term root caries progression, and immature collagen fibrils were more susceptible to degradation during S. mutans-induced root caries progression.

Efficacy of Natural Collagen Crosslinkers on the Compromised Adhesive Bond Strength to NaOCl-treated Pulp Chamber Dentin.

PURPOSE: To evaluate the efficacy of natural collagen crosslinkers on compromised adhesive bond strength to NaOCl-treated pulp chamber dentin. MATERIALS AND METHODS: Mesial surfaces of the pulp chamber dentin of 120 extracted human molars were obtained. The dentin fragments were divided into six groups according to the protocols used: no treatment (negative control), sodium hypochlorite (NaOCl) for 30 min and final irrigation with 17% EDTA for 3 min (positive control). After treatment with NaOCl and EDTA, the dentin surfaces of the experimental groups were treated for 5 min with one of the following: grape seed extract (GSE), tannic acid (TA), green tea (GT), or n-acetyl cysteine (NAC). Half of the samples of each group were bonded with an etch-and-rinse (Single Bond; 3M Oral Care) and the other half using a self-etch (Scotchbond Universal; 3M Oral Care) adhesive. The restoration was completed with composite. The bonded specimens were sectioned to produce sticks and subjected to the microtensile bond strength test. Data were analyzed by two-way ANOVA and Tukey's HSD test (p < 0.05). RESULTS: Both adhesives had similar bond strengths (p > 0.05). The NaOCl-treated group had significantly lower bond strength than the negative control (p < 0.05). The application of NAC did not recover compromised bonding (p > 0.05). On the other hand, GSE, TA and GT had significant reversal effects of the bond strengths to NaOCl-treated dentin (p < 0.05). CONCLUSION: Compromised bonding of adhesives to NaOCl-treated dentin can be reversed by the application of either GSE, TA or GT.

Effect of thermocycling on roughness of nanofill, microfill and microhybrid composites.

OBJECTIVE: This study aimed to investigate the surface roughness of composite resins subjected to thermal cycles procedure. MATERIALS AND METHODS: Two microfill, four microhybrid and four nanofill composites were used. The surface roughness (Ra) was initially measured in a profilometer using a cut-off 0f 0.25 mm, after 3000 and 10,000 thermal cycles. Data were subjected to ANOVA and Fischer's test (α = 0.05). RESULTS: Overall, 3000 thermal cycles increased the surface roughness values for all materials and there was a trend in all groups to decrease the roughness after 10,000 thermal cycles. CONCLUSIONS: The composition of material, including the type of organic matrix, could be more relevant to roughness maintenance over time than the general behavior of composites based on particles fillers. The maintenance of smooth surface in resin-based composite restorations is totally dependent of organic composition of the material.

Effects of three restorative techniques in the bond strength and nanoleakage at gingival wall of Class II restorations subjected to simulated aging.

OBJECTIVE: To evaluate the effects of simulated aging in bond strength and nanoleakage of class II restorations using three different restorative techniques. MATERIALS AND METHODS: Class II preparations (n = 12) were restored using: FS - composite resin Filtek Supreme Plus (3M/ESPE); RMGIC + FS - resin-modified glass ionomer cement Vitrebond Plus (3M/ESPE) + FS; and FFS + FS - flowable composite resin Filtek Supreme Plus Flowable (3M ESPE) + FS. The teeth were assigned into two groups: Control and Simulated Aging - Thermal/Mechanical cycling (3,000 cycles, 20-80 °C/500,000 cycles, 50 N). From each tooth, two slabs were assessed to microtensile bond strength test (µTBS) (MPa), and two slabs were prepared for nanoleakage assessment, calculated as penetration along the restoration margin considering the penetration length (%) and as the area of silver nitrate particle deposition (µm(2)). Data were analyzed by two-way analysis of variance (ANOVA) followed by Tukey's post hoc test (p < 0.05). RESULTS: FS presented the highest µTBS to dentin (22.39 ± 7.55 MPa) after simulated aging, while the presence of flowable resin significantly decreased µTBS (14.53 ± 11.65 MPa) when compared to no aging condition. Both control and aging groups of RMGIC + FS presented the highest values of silver nitrate penetration (89.90 ± 16.31 % and 97.14 ± 5.76 %) and deposition area (33.05 ± 12.49 and 28.08 ± 9.76 µm(2)). Nanoleakage was not affected by simulated aging. CONCLUSIONS: FS presented higher bond strength and lower nanoleakage and was not affected by simulated aging. Use of flowable resin compromised the bond strength after simulated aging. CLINICAL RELEVANCE: The use of an intermediate layer did not improve the dentin bond strength neither reduced nanoleakage at the gingival margins of class II restorations under simulated aging conditions.

Effect of dentin surface modification on the microtensile bond strength of self-adhesive resin cements.

PURPOSE: To explore the potential to modify human dentin surface as a means of improving the microtensile bond strength (µTBS) of resin cement to dentin. MATERIALS AND METHODS: Sound human molars were collected, and their occlusal surfaces were ground flat to expose polished dentin. Indirect composite resin cylinders were cemented to the teeth with RelyX Unicem or G-Cem self-adhesive cements following dentin surface treatments: 6.5% grape-seed extract, 5% glutaraldehyde, or 25% polyacrylic acid and control (no pretreatment). After 24 hours, the teeth were sectioned into beams to produce a cross-sectional area of 1.0 mm(2). Specimens of each group (n = 25) were individually mounted on a jig and placed on a tensile testing machine. A tensile force was applied to failure at a 1 mm/min crosshead speed. RESULTS: The use of polyacrylic acid on dentin prior to cementation with RelyX Unicem resulted in a statistically significant increase in µTBS compared to the control group (p= 0.0282). Polyacrylic acid (p= 0.0016) or glutaraldehyde (p= 0.0043) resulted in a statistically significant increase in µTBS of G-Cem to dentin when compared to the control group. Treatment with grape-seed extract did not result in a statistically significant increase in µTBS for either cement (p > 0.05). CONCLUSIONS: Priming dentin surfaces prior to the use of self-adhesive resin cements may be a promising means of improving µTBS. In addition, it was concluded that the results of this study are material dependent as well as being dependent of the type of dentin primer.

Changes in the stiffness of demineralized dentin following application of tooth whitening agents.

OBJECTIVE: The purpose of this study was to evaluate the effect of the bleaching agents on the elastic modulus of bovine demineralized dentin matrix (EMDM). MATERIALS AND METHODS: Eighty-five slices were obtained from 17 bovine teeth. The slices were divided randomly into five experimental groups (n = 17): unbleached control group (CG), 4% hydrogen peroxide (HP4), 4% hydrogen peroxide + 0.05% Ca (HP4 + Ca), 7.5% hydrogen peroxide + ACP (HP7.5) and 10% carbamide peroxide (CP10). The HP4, HP4 + Ca and CP10 groups were treated with the bleaching agents for 8 h/day (14 days), while the samples of HP7.5 group were exposed to bleaching agent for 30 min twice a day (14 days). The CG was kept in 100% humidity. After bleaching treatments, the enamel of the samples was removed and 85 dentin beams (0.5 × 1.7 × 7.0 mm) were prepared. Afterwards, the beams were immersed in 10% phosphoric acid solution (5 h) and rinsed with water (10 min). The beams were tested after 24 h, 7 and 14 days of storage in distilled water, using three-point bend method. Data were statistically analyzed using ANOVA and Fisher's test. RESULTS: All bleaching treatments reduced the EMDM. After 14 days post-bleaching, the EMDM increased for HP4 and HP4+Ca groups. CONCLUSIONS: The use of bleaching agents promoted a decrease in EMDM, which indicates that the bleaching treatment interacts with the dentin organic matrix. The EMDM measurement for the specimens of the 7.5% hydrogen peroxide group that were immersed in water at 14 days post-bleaching did not recover the EMDM values when compared to the control group.

The effect of dentin pretreatment on the microtensile bond strength of self-adhesive resin cements.

STATEMENT OF PROBLEM: Self-adhesive cements have lower bond strength than conventional resin cements that rely on the application of etch-and-rinse adhesive systems. PURPOSE: The purpose of this study was to evaluate the effect of tannic and polyacrylic acid on the microtensile bond strength of self-adhesive resin cements to dentin. MATERIAL AND METHODS: Eighteen molar crowns were flattened to expose dentin and divided into 3 groups according to the dentin pretreatment: (1) control, without surface treatment; (2) 25% polyacrylic acid solution (Ketac Conditioner); (3) 20% tannic acid. Composite resin (Tescera) blocks were luted to dentin surfaces using 2 self-adhesive resin cements (RelyX Unicem or Maxcem Elite) (n=3). All specimens were stored in distilled water for 24 hours, sectioned into beams (1 mm(2)), and tested to failure using a microtensile method at a crosshead speed of 1 mm/min. The data were statistically analyzed using 2-way ANOVA and Fisher's PLSD tests (α=.05). RESULTS: The polyacrylic acid significantly improved the microtensile bond strength of RelyX Unicem (14.92 ±4.94 MPa) when compared to the control group (8.35 ±1.99 MPa) and tannic acid treatment (8.38 ±2.67 MPa) (P<.001). Dentin surface treatment did not affect the microtensile bond strength of Maxcem Elite cemented groups (control, 8.45 ±3.21 MPa; polyacrylic acid, 9.53 ±9.95 MPa; tannic acid, 6.89 ±4.45 MPa). CONCLUSIONS: Dentin pretreatment with polyacrylic acid improved the microtensile bond strength of RelyX Unicem.

Effect of a new irrigant solution containing glycolic acid on smear layer removal and chemical/mechanical properties of dentin.

The objective of this study was to evaluate the effects of glycolic acid (GA) (with pH 1.2 and 5) and ethylenediaminetetraacetic acid (EDTA) on the chemical and mechanical properties of dentin to investigate the potential use of GA as final irrigant in the root canal therapy. Specifically, changes in microhardness, smear layer removal, erosion, mineral content distribution, apatite/collagen ratio and flexural strength of mineralized dentin treated with GA were assessed. Saline solution was used as a negative control. Knoop microhardness (KHN) was measured on the root canal lumen of root segments. Dentin beams were used for 3-point flexural strength (σ) test. Scanning electron microscopy (SEM) images of root sections were obtained for evaluation of smear layer removal and dentin erosion on root segments and energy dispersive X-ray spectroscopy (EDS) was used for mineral content distribution. The apatite/collagen ratio (A/C) in dentin powder were examined by Fourier transform infrared (FTIR) spectroscopy. KHN, σ and A/C results were statistically analyzed with ANOVA and Tukey tests (α = 0.05). Smear layer and dentin erosion scores were analyzed with Kruskal-Wallis and Dunn tests (α = 0.05). Root dentin treated with EDTA and GA presented similar KHN regardless of the pH (p > 0.05). However, KHN was significantly reduced in EDTA and GA groups when compared to control group (p<0.001). GA showed the same ability to remove the smear layer and to cause dentin erosion as EDTA. EDS results showed that the GA and EDTA solutions did not alter the dentin mineral content distribution. The apatite/collagen ratio reduced with all irrigant solution and was the lowest with GA pH 5 (p<0.001), while σ was not significantly affected by the experimental solutions (p = 0.559). It can be concluded that GA has similar ability to remove the smear layer than EDTA. GA does not affect negatively the chemical/mechanical properties and it does not increase dentin erosion. The use of GA with low pH seems to promote less change in collagen/apatite ratio, but further studies are needed to establish an ideal clinical protocol. Therefore, this study supports the potential use of GA as an alternative final irrigation solution for root canal preparation.

Long-term Evaluation of Dentin Matrix Stability and Gelatinolytic Activity after Dentin Pretreatment with Caffeic Acid Phenethyl Ester.

PURPOSE: To investigate the long-term effect of 0.05% or 0.1% caffeic acid phenethyl ester (CAPE) on dentin matrix stability and hybrid layer stability, using an etch-and-rinse (Adper Scotchbond Multipurpose/ASB) or a self-etch adhesive (Clearfil SE Bond/CSE). MATERIALS AND METHODS: Dentin matrix specimens were assigned to five groups: 0.05% or 0.1% CAPE, green tea (GT), and the controls distilled water (DW) and dimethyl sulfoxide (DMSO). Following immersion of specimens for 1 h, modulus of elasticity (ME) and dentin mass change (MG) were determined at 3 post-treatment time points: immediately afterwards and at 3 and 6 months. Collagen solubilization (CS) was estimated by hydroxyproline (HYP) quantification. Resin-dentin interfaces with both adhesives were assessed with in situ zymography tests to evaluate gelatinolytic activity (GA). The dentin pretreatments were actively applied for 60 s. The sealing ability of aged resin-bonded slices was assessed by nanoleakage tests. RESULTS: GT increased immediate ME, which decreased significantly after 3 months (p < 0.0001). The CAPE groups did not differ from the control groups. GT provided a significant increase in dentin matrix mass after treatment (p < 0.0001). No significant differences regarding MG were observed for CAPE 0.1%, CAPE 0.05%, DW, and DMSO groups after 3 and 6 months. Cumulative HYP release revealed that CAPE groups and GT were statistically similar to DW and DMSO; the GT group exhibited statistically significantly less HYP release than did CAPE groups (p = 0.0073). Treatment with 0.05% or 0.1% CAPE presented lower GA when applied to ASB before acid conditioning (p < 0.05), but no differences were detected when the CAPE groups were applied to CSE. CAPE at 0.1% significantly reduced nanoleakage for CSE, and 0.05% CAPE with CSE presented levels of nanoleakage similar to those of the CSE control group. CONCLUSION: CAPE at 0.05% or 0.01% did not influence ME, MG, or CS, but reduced GA when applied to ASB before acid conditioning. CAPE at 0.1% with CSE promoted adhesive layer integrity.

Long-term nanomechanical properties and gelatinolytic activity of titanium tetrafluoride-treated adhesive dentin interface.

OBJECTIVE: This study investigated the effects of dentin pretreatment with 2.5% titanium tetrafluoride (TiF4) on nanomechanical properties, and the in situ gelatinolytic activity of the dentin-resin interface, for up to 6 months. METHODS: Twenty-four human teeth were prepared by exposing occlusal flat dentin surfaces, and were randomly assigned to experimental groups, according to application or non-application of a TiF4 pretreatment, and to the adhesive systems (Clearfil SE Bond or Scotchbond Universal). Resin composite (Filtek Supreme Ultra) was built up incrementally on the teeth in all the groups. Then, the specimens were sectioned and randomly selected for evaluation at 24h, 3 months and 6 months of storage time. The reduced modulus of elasticity (Er) and the nanohardness of the underlying dentin, as well as the hybrid layer and the adhesive layer were measured using a nanoindenter. Gelatinolytic activity at the dentin-resin interfaces was assessed by in situ zymography using quenched fluorescein-conjugated gelatin at 24h and 6 months. Statistical analyses were performed with ANOVA and Tukey's tests. RESULTS: There were no differences in Er and nanohardness values between adhesives systems and pretreatment (p=0.1250). In situ zymography showed significantly higher gelatinolytic activity after 6 months for all the experimental groups (p=0.0004), but no differences between the adhesive systems (p=0.7708) and the surface pretreatment (p=0.4877). SIGNIFICANCE: Dentin pretreatment with 2.5% TiF4 followed by self-etching adhesive systems did not influence nanomechanical properties or gelatinolytic activity of the adhesive-dentin interface layers, over time.

Glycolic acid as the final irrigant in endodontics: Mechanical and cytotoxic effects.

The aim of this study was to investigate the effects of glycolic acid (GA) on the microhardness, roughness, dentin mineral content distribution; smear layer removal and cytotoxicity. One hundred human teeth were randomly divided into six groups: distilled water (control group), 17% EDTA, 10% citric acid (CA), 5% GA, 10% GA, and, 17% GA. Microhardness and roughness were measured in the canal lumen. Scanning electron microscopy (SEM) images (2000×) for smear layer removal evaluation; energy dispersive X-ray spectroscopy (EDS) for chemical analysis. Cell viability assay was made on fibroblast cells. The lowest microhardness and higher roughness were observed for 17% GA. GA showed the ability to remove the smear layer to a similar level as EDTA and CA, with no statistical difference between the concentrations used. GA and CA were cytotoxic in a dose-dependent manner. GA showed potential as an endodontic agent for final irrigation in root canal terapies.

Importance of the hybrid layer on the bond strength of restorations subjected to cyclic loading.

The present study evaluated the long-term microtensile bond strength of collagen-depleted dentin followed by cyclic loading. Bovine flat, midcoronal dentin received one of the following surface treatments: acid-etch or acid-etched + 5% NaOCl for 2 min. The teeth were restored with Single Bond, Scotchbond Multi-purpose, One-Step Plus, or All-Bond 2 adhesive systems. Half of the specimens were randomly assigned to receive 200,000 cycles (50 N force). Teeth were sectioned into 1 x 1 mm thick slices and stored for 24 h, 1 month, 3 months, or 6 months. Specimens were subjected to tensile testing after elapsed storage time. Samples were analyzed by three-way ANOVA and Fisher's PLSD (p < 0.05). The results showed that the deproteinized groups without cyclic loading presented lower bond strength when compared with the control group, but the difference was only statistically significant for Single Bond and All-Bond 2 (p < 0.05). All adhesives presented a decrease in bond strength over time, regardless of the dentin treatment. When cyclic loaded, the decrease in bond strength for the deproteinized group was even greater when compared with the control group (p < 0.05). The results suggest that the hybrid layer is important as a stress-buffering layer when loading is applied, and thus the presence of collagen is essential.

The effect of load cycling on nanoleakage of deproteinized resin/dentin interfaces as a function of time.

OBJECTIVES: To evaluate the effects of cyclic loading on nanoleakage as a function of time at resin-dentin interfaces with and without removal of collagen. METHODS: Bovine flat mid-coronal dentin received one of the following surface treatments: (1) acid-etch or (2) acid etched+5% NaOCl for 2m. The teeth were then bonded with Single Bond (3M ESPE), Scotchbond Multi-Purpose (3M ESPE), One-Step Plus (Bisco) or All-Bond 2 (Bisco) adhesive systems and restored with Z250 composite. Half of the bonded teeth were randomly assigned to receive 200,000 cycles of loading at 50 N. Teeth were sectioned into 1 mm x 1 mm thick slices and stored in distilled water for 24h and 6 months. After water storage, beams were prepared for nanoleakage evaluation and observed under the SEM. Data were statistically analyzed using three-way ANOVA and Fisher's PLSD test (p<0.05). RESULTS: Use of NaOCl did not affect nanoleakage at the interface of all adhesive systems (p>0.05) when compared to their respective controls. After 6 months of immersion in water, except for One Step Plus, collagen-depleted groups and control groups presented similar leakage values. After cyclic loading, the deproteinized group revealed a higher degree of silver nitrate deposits when compared to the control group (p<0.05). All four adhesive systems presented a high degree of silver nitrate deposits after 6 months of water storage. SIGNIFICANCE: The hybrid layer is important as a stress-absorbing layer and it may not represent the weak link for initiation of the nanoleakage phenomenon.

In vitro remineralization effects of grape seed extract on artificial root caries.

Grape seed extract (GSE) contains proanthocyanidins (PA), which has been reported to strengthen collagen-based tissues by increasing collagen cross-links. We used an in vitro pH-cycling model to evaluate the effect of GSE on the remineralization of artificial root caries. Sound human teeth fragments obtained from the cervical portion of the root were stored in a demineralization solution for 96 h at 37 degrees C to induce artificial root caries lesions. The fragments were then divided into three treatment groups including: 6.5% GSE, 1,000 ppm fluoride (NaF), and a control (no treatment). The demineralized samples were pH-cycled through treatment solutions, acidic buffer and neutral buffer for 8 days at 6 cycles per day. The samples were subsequently evaluated using a microhardness tester, polarized light microscopy (PLM) and confocal laser scanning microscopy (CLSM). Data were analyzed using ANOVA and Fisher's tests (p<0.05). GSE and fluoride significantly increased the microhardness of the lesions (p<0.05) when compared to a control group. PLM data revealed a significantly thicker mineral precipitation band on the surface layer of the GSE-treated lesions when compared to the other groups (p>0.05), which was confirmed by CLSM. We concluded that grape seed extract positively affects the demineralization and/or remineralization processes of artificial root caries lesions, most likely through a different mechanism than that of fluoride. Grape seed extract may be a promising natural agent for non-invasive root caries therapy.

Effect of long-term water storage on etch-and-rinse and self-etching resin-dentin bond strengths.

This study sought to evaluate the long-term bond strength of etch-and-rinse and self-etch adhesive systems to dentin after one year of water storage. Crown fragments from the buccal surface of extracted bovine incisors were ground flat to expose dentin surfaces. Four etch-and-rinse and two self-etch bonding agents were used according to manufacturers' instructions. Bonded specimens were stored in water for either 24 hours or one year at 37 delete C. After elapsed storage times, specimens were tested for shear bond strength (SBS) at 0.5 mm/min. Data were analyzed by ANOVA and Tukey's tests (p < 0.05). Both evaluated factors (adhesive system and storage time) and their interactions were statistically significant. Single Bond produced the highest SBS regardless of the water degradation period. One-year water storage reduced the SBS of Prime & Bond NT and One-Up Bond F significantly; the other adhesives performed similarly. Long-term bond strengths of etch-and-rinse and self-etch adhesive systems are susceptible to hygroscopic and hydrolytic effects to varying extents, depending on their chemistry and structure. The presence of monomers with different properties might induce preferential degradation of specific adhesive polymer systems.

Centrifugal partition chromatography enables selective enrichment of trimeric and tetrameric proanthocyanidins for biomaterial development.

Proanthocyanidins (PACs) find wide applications for human use including food, cosmetics, dietary supplements, and pharmaceuticals. The chemical complexity associated with PACs has triggered the development of various chromatographic techniques, with countercurrent separation (CCS) gaining in popularity. This study applied the recently developed DESIGNER (Depletion and Enrichment of Select Ingredients Generating Normalized Extract Resources) approach for the selective enrichment of trimeric and tetrameric PACs using centrifugal partition chromatography (CPC). This CPC method aims at developing PAC based biomaterials, particularly for their application in restoring and repairing dental hard tissue. A general separation scheme beginning with the depletion of polymeric PACs, followed by the removal of monomeric flavan-3-ols and a final enrichment step produced PAC trimer and tetramer enriched fractions. A successful application of this separation scheme is demonstrated for four polyphenol rich plant sources: grape seeds, pine bark, cinnamon bark, and cocoa seeds. Minor modifications to the generic DESIGNER CCS method were sufficient to accommodate the varying chemical complexities of the individual source materials. The step-wise enrichment of PAC trimers and tetramers was monitored using normal phase TLC and Diol-HPLC-UV analyses. CPC proved to be a reliable tool for the selective enrichment of medium size oligomeric PACs (OPACs). This method plays a key role in the development of dental biomaterials considering its reliability and reproducibility, as well as its scale-up capabilities for possible larger-scale manufacturing.

Comparison of different polishing methods on the surface roughness of microhybrid, microfill, and nanofill composite resins.

AIM: The aim of the present study was to evaluate the effect of different polishing methods on the surface roughness of resin-based composites subjected to a thermocycling procedure. METHODS: A total of 192 specimens were divided into 24 groups, according to composite materials (Filtek Z250, Point 4, Renamel Nanofill, Filtek Supreme Plus, Renamel Microfill, and Premise) and finishing and polishing systems (Sof-Lex Pop On, Super Snap, Flexidisc, and Flexidisc+Enamelize). The specimens were subjected to thermocycling (5000 cycles). RESULTS: Filtek Supreme Plus showed the lowest surface roughness values before thermocycling. After thermocycling, Filtek Supreme Plus continued to have the lowest surface roughness, with a statistically-significant difference for the other materials. After thermocycling, there was no statistically-significant difference among all the polishing techniques studied. CONCLUSIONS: The thermocycling was concluded as being able to change composite resins' surface roughness, whereas different finishing and polishing methods did not result in surface roughness changes after thermocycling.

Application of crosslinkers to dentin collagen enhances the ultimate tensile strength.

The stabilization of dentin collagen with biocompatible crosslinking agents may be of clinical importance to improve dentin bond strength. The present study aimed to evaluate the effect of three collagen crosslinking agents on the ultimate tensile strength (UTS) of undemineralized and demineralized dentin. Ten freshly extracted sound molars were sectioned into 0.5 x 0.5 mm2 thick beams. The beams were either demineralized or kept undemineralized. Then, specimens were subdivided into four groups according to treatments--PBS solution (control), 5% glutaraldehyde (GD), 0.5% proanthocyanidin PBS solution (PA), and 0.625% genipin PBS solution (GE). Specimens were kept in their respective solutions for either 4 or 40 h. To assess UTS, specimens were subjected to tensile forces at a crosshead speed of 1 mm/min. Statistical analysis was performed using two-way ANOVA and Fisher's PLSD test (p < 0.05). Statistically significant increases in UTS were observed for demineralized dentin after PA and GE dentin treatment, when compared with those of the control group. Dentin treated with GD showed no statistically significant differences in UTS when compared with that the control. Undemineralized dentin revealed no significant differences as compared to that of the control, regardless of the collagen crosslinkers. The application of two naturally occurring crosslinkers, i.e., PA and GE, to dentin collagen significantly improves UTS, indicating its potential value in restorative dentistry.

Clinical assessment of postoperative sensitivity in posterior composite restorations.

This incidence of postoperative sensitivity was evaluated in resin-based posterior restorations. Two hundred and ninety-two direct restorations were evaluated in premolars and molars. A total of 143 Class I and 149 Class II restorations (MO/OD and MOD) were placed in patients ranging in age from 30 to 50 years. After the cavity preparations were completed, a rubber dam was placed, and the preparations were restored using a total-etch system (Prime & Bond NT) and a resin-based restorative material (TPH Spectrum). The patients were contacted after 24 hours and 7, 30 and 90 days postoperatively and questioned regarding the presence of sensitivity and the stimuli that triggered that sensitivity. The Chi-square and Fisher's Exact Test were used for statistical analysis. Evaluation at 24 hours after restorative treatment revealed statistically significant differences among the types of cavity preparations restored and the occurrence of postoperative sensitivity (p = 0.0003), with a higher frequency of sensitivity in Class II MOD restorations (26%), followed by Class II MO/DO (15%) and Class I restorations (5%). At 7, 30 and 90 days after restorative treatment, there was a decrease in the occurrence of sensitivity for all groups. The percentage of sensitivity among the groups was not significantly different. This study shows that the occurrence of sensitivity is correlated with the complexity of the restoration.

The effects of endodontic substances and naturally reducing agents on the bond strength of epoxy resin-based sealer to root dentin.

AIM: To evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine (CHX), and two naturally derived reducing agents on the bond strength of epoxy resin-based sealer to root dentin. MATERIALS AND METHODS: A total of 60 single-rooted human teeth were prepared using ProTaper (Dentsply Tulsa Dental Specialties, Johnson City, TN, USA) and an irrigation protocol including 5% NaOCl or 2% CHX gel, and ethylenediaminetetraacetic acid (EDTA), for smear layer removal. The following subgroups (n = 10) were also assessed according to the naturally derived reducing agent used: no agent (control group); grape seed extract (GSE); and green tea. Root canals were filled with gutta-percha and AH Plus (Dentsply DeTrey, Konstanz, Germany). Bond strength was measured using the push-out test, and statistical analyses were performed using ANOVA; failure patterns (modes) were classified as adhesive, cohesive, or mixed. The types of failure modes were evaluated using the Chi-squared test at α =0.05. RESULTS: The irrigation protocols demonstrated similar bond strength values (P > 0.05). However, the Chi-squared test revealed significant differences in failure mode among the groups (P < 0.05). An increase in the incidence of adhesive failures was observed for the NaOCl and EDTA groups. The other groups demonstrated a prevalence of mixed and cohesive failures. CONCLUSION: The irrigation protocols and use of naturally derived reducing agents had no effect on the bond strength of the resin-based sealer to dentin; however, improvement was evident in the adhesion quality of AH Plus to NaOCl-treated root dentin, due to the prevalence of cohesive failure.