Effects of exercise therapy on painful temporomandibular disorders.

Temporomandibular disorders (TMD) are common chronic musculoskeletal pain conditions among orofacial pain. Painful TMD condition such as myalgia and arthralgia can be managed by exercise therapy. However, as it is hard to access actual effect of each modality that is included in an exercise therapy programme due to multiple choice of the management modality, their efficacy remains controversial. Therefore, this review focused on the effects of exercise therapy for the management of painful TMD. The aims of this review were to summarise the effects of exercise therapy for major symptoms of painful TMD and to establish a guideline for the management of painful TMD, resulting in higher quality and reliability of dental treatment. In this review, exercise modalities are clearly defined as follows: mobilisation exercise, muscle strengthening exercise (resistance training), coordination exercise and postural exercise. Furthermore, pain intensity and range of movements were focused as outcome parameters in this review. Mobilisation exercise including manual therapy, passive jaw mobilisation with oral appliances and voluntary jaw exercise appeared to be a promising option for painful TMD conditions such as myalgia and arthralgia. This review addressed not only the effects of exercise therapy on various clinical conditions of painful TMD shown in the past, but also an urgent need for consensus among dentists and clinicians in terms of the management of each condition, as well as terminology.

Bonding effectiveness and multi-interfacial characterization of two direct buildup resin core systems bonded to post-space dentin.

OBJECTIVES: The aim of the present study was to evaluate the bonding effectiveness of two resin core buildup systems using conventional methods in the field of adhesive dentistry and a new non-destructive method. MATERIALS AND METHODS: Twenty-four single-rooted human teeth were built up with dual-cure one-step self-etch adhesive and composite systems (SY1: Clearfil DC bond and Clearfil DC core automix, SY2: Clearfil bond SE one and Clearfil DC core automix one). The prepared samples were sectioned into approximately 1 × 1-mm-thick beams and subjected to micro-tensile bond strength (µTBS) testing (n = 24). The fractured beams after µTBS testing were analyzed by SEM and energy-dispersive X-ray (EDX) spectrometry. The three teeth filled with each resin core system were sectioned and embedded in epoxy resin to observe the dentin-bonding interface under TEM (n = 6). Moreover, three of each resin core-filled teeth without any processing were examined using µCT (n = 6). RESULTS: Two-way ANOVA revealed that the two factors "root region" (p < 0.001, F = 15.22) and "system" (SY1 < SY2; p < 0.001, F = 22.52) had a significant influence. The µTBS gradually decreased from the coronal side to the apical side of the root canal. Morphological evaluation revealed that SY2 was superior in terms of resin curing at the apical side. µCT non-destructive evaluation clearly revealed gap formation in SY1. CONCLUSION: SY2, which included a new light-independent catalyst, showed better bonding effectiveness and adhesive interface to dentin compared to that of SY1. CLINICAL RELEVANCE: The new catalyst, which is activated by contact with adhesive and resin composite, can be used for resin core buildup restorations.

Allergic reaction to titanium-made fixed dental restorations: A clinical report .

From the mid 1980s (approximately 10 years after titanium was first used as a medical metal), reports of suspected Ti sensitization began to emerge. In the present report,a 33-year-old Japanese woman presented with pruritus of the fingers and a specific reaction to mercury, nickel, and silver on lymphocyte stimulation testing (LST).Her condition improved after 17 restorations containing Hg or Ag were removed.Titanium and composite resin, both of which had no reaction on LST, were used in replacements of the intraoral restoration after the pruritus improved; however, cervical eczema emerged after 9 months, and repeat LST showed a specific reaction to Ti. The eczema improved after removal of the titanium. It is therefore likely that Ti allergy provoked the eczema. This report suggests that clinicians should be aware of the possibility of a titanium allergy from a dental restoration.

Effect of filler contents on the bond strength of CAD/CAM resin crowns: New resin primer versus conventional silane agents.

Purpose This study aims to evaluate the effects of resin primers containing methyl methacrylate (MMA) and silane agent on the bonding effectiveness of indirect resin composite blocks with three different filler contents.Methods A commercially available computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite block and two experimental resin composite blocks with different filler contents were alumina-blasted and two surface treatments (primer and silane agent) were applied. The resin cement was built up, and the micro-tensile bond strength (µTBS) was measured after 24 hours, 1 month or 3 months of water storage (n = 24 per group). The fracture surfaces after µTBS measurements and resin block/cement interface were observed by scanning electron microscopy (SEM).Results The primer treatment group showed a significantly higher bond strength than the silane group only in F0 (filler content 0 wt%) group (P < 0.001). In the primer group, F0 and F41 (filler content 41 wt%) groups showed significantly higher bond strengths than F82 (filler content 82 wt%) group (P < 0.001). In contrast, in the silane group, F41 group showed significantly higher bond strength than F0 and F82 groups (P < 0.001), and F82 group showed significantly higher bond strength than F0 group (P < 0.001). SEM revealed that the matrix resin was partially destroyed on the fracture surface of the primer group, and an uneven interface surface was observed compared with that of the silane group.Conclusions MMA-containing primers showed higher bonding effectiveness to CAD/CAM resin composite blocks than the silane treatment.

Mechanism of dentin hardness measurements using a dentin hardness measuring device with a light-emitting diode.

Significance: Managing caries is imperative in a rapidly aging society. Current diagnoses use qualitative indices. However, a quantitative evaluation of hardness in a clinical setting may lead to more accurate diagnoses. Previously, hardness meter using indenter with light for tooth monitoring (HAMILTOM) was developed to quantitatively measure tooth hardness. Herein, the physical interpretation of dentin hardness measured using HAMILTOM and the dentin hardness measurement mechanism are discussed. Aim: This study evaluates the mechanism of dentin hardness measurements using HAMILTOM physically and compare the invasiveness to dentin by HAMILTOM with those using a dental probe for palpation. Approach: Eleven bovine dentin samples were used to create caries models. HAMILTOM measured the dark areas, and its indentations were observed using scanning electron microscopy. Also, its invasiveness was evaluated by comparing the results with those from dental probe palpation. Results: The indentation areas were smaller than the dark areas in HAMILTOM, which may be due to exuded water from the dentin sample and the elastic recovery of dentin sample. Additionally, the dental probe indentation was deeper than the HAMILTOM indentations. Conclusions: The results demonstrate that the indentation areas were smaller than the dark areas measured by HAMILTOM, which might contain the influence of exuded water and the deformation of dentin sample. Also, HAMILTOM is less invasive than dental probe palpation. In the future, HAMILTOM may become a standard hardness measuring method to diagnose root caries.

Advanced statistical analyses to reduce inconsistencies in bond strength data focused on donor factors: A six-factor analysis using linear mixed and nonlinear regression models.

PURPOSE: This study aimed to investigate the effects of the age and sex of tooth donors on dentin bond strength. METHODS: A total of 38 extracted teeth (12 male and 26 female donors; age range: 17-82 years) were used in this study. In addition to donor age and sex, four other microtensile bond strength (µTBS) test specimen factors were evaluated: dentin position, bonding area, presence of voids at the interface, and computed tomography (CT) values of dentin. The µTBS was measured immediately (24 h) and 6 months after storage in water. After the µTBS testing, linear mixed and nonlinear regression models were used to analyze the effects of these factors on the µTBS data. RESULTS: The results from the linear mixed model revealed that the bonding area (P = 0.02), presence of voids at the interface (P = 0.04), and storage time (P < 0.001) significantly affected bond strength. In contrast, no correlation was observed between the µ TBS and dentin position (P = 0.08) or sex (P = 0.07). The results of the nonlinear regression model with robust variance-covariance estimators revealed that age significantly affected bond strength (P < 0.001). In addition, a significant positive correlation was found between µTBS and age (P < 0.001), with nonlinearity (P = 0.002). However, no correlation was observed between the µTBS and CT values (P = 0.69) without nonlinearity (P = 0.39). CONCLUSIONS: These findings suggest that bond strength increases with age until 60 years but not afterward.

Potential smear layer interference with bonding of self-etching adhesives to dentin.

PURPOSE: To evaluate the effect of smear-layer interposition on the bonding effectiveness of self-etching adhesives with different etching potential. MATERIALS AND METHODS: Bur-cut dentin specimens were obtained from 25 human molars after preparation of the dentin surface with a medium-grit diamond bur (bur-cut). An additional 25 molars were fractured at the midcoronal dentin to create a smear-layer-free surface (smear-free dentin). The prepared teeth were assigned to 5 groups, according to the adhesive to be applied: a strong one-step self-etching adhesive (PLP, Adper Prompt L-Pop, 3M ESPE, pH = 0.8); two ultra-mild one-step self-etching adhesives (C3S, Clearfil Tri-S Bond, Kuraray, pH = 2.7; AEB, Adper Easy Bond, 3M ESPE; pH = 2.7 ); as the self-etching control, a mild two-step self-etching adhesive (CSE, Clearfil SE Bond, Kuraray, pH of primer = 1.9); and as the etch-and-rinse control, a three-step etch-and-rinse adhesive (OFL, Optibond FL, Kerr). After composite buildups were made, all specimens were stored in distilled water (24 h/37°C) prior to microtensile bond strength testing (µTBS). The failure mode was determined with a stereomicroscope at 50X magnification. Representative µTBS specimens were processed for analysis in a Feg-SEM. The Kruskal-Wallis test was performed to determine statistical differences (p < 0.05). RESULTS: Except for the strong one-step self-etching adhesive, all other self-etching adhesives (mild and ultramild) revealed a significantly lower bond strength to bur-cut dentin than to smear-free dentin. The etch-and-rinse adhesive presented the highest µTBS, which was not significantly different when bonded to bur-cut or smear-free dentin. Fracture analysis demonstrated a prevalence of adhesive failures for the self-etching adhesives, while OFL revealed more mixed failures. SEM revealed that smear debris remained part of the adhesive interfacial complex produced by the ultra-mild one-step self-etching adhesive C3S when applied on bur-cut dentin. CONCLUSION: Smear debris interferes with the interaction of mild and ultra-mild self-etching adhesives with dentin.

Hydrolytic stability of three-step etch-and-rinse adhesives in occlusal class-I cavities.

OBJECTIVES: A dental adhesive without small and hydrophilic monomers such as 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) would be beneficial in order to avoid contact allergies. However, these monomers are important to increase infiltration and polymerization of the adhesive. Therefore, the purpose of this study was to evaluate the bonding effectiveness and bond durability of a more hydrophobic and biocompatible adhesive as compared to a conventional three-step etch-and-rinse adhesive. METHODS: Sixteen non-carious human third molars were used to determine the micro-tensile bond strength testing (µTBS) and interfacial ultrastructure by transmission electron microscopy (TEM) of the more hydrophobic cmf adhesive system (Saremco) adhesive as compared to the control OptiBond FL (Kerr). RESULTS: The more hydrophobic and biocompatible three-step etch-and-rinse adhesive was able to produce a reasonable short-time bonding effectiveness. In the long term, the collagen fibrils in the hybrid layer were not effectively protected and were prone to hydrolytic degradation. As a result, long-term bonding effectiveness of this novel adhesive was very low. CONCLUSIONS: Application of a more hydrophobic adhesive without altering the application procedure considerably results in a reduced durability of the created bond CLINICAL RELEVANCE: Omitting small and hydrophilic components from the adhesive formulation may impair the durability of your composite restoration.

Demonstration of an optical dentin hardness measuring device using bovine dentin with different demineralization times.

Significance: The increase in root caries is a serious problem as society ages. Root caries is diagnosed by inspection and palpation, which are qualitative. A method to objectively and quantitatively evaluate the progress of root caries in a clinical setting is strongly desired. The root caries could be diagnosed by measuring hardness because dentin becomes softer as the caries progresses. Vickers hardness has been customarily used as an indicator of tooth hardness. However, this method cannot be used to in vivo teeth because the teeth must be dried prior to measurement to make the indentation. A hardness meter using an indenter with light for tooth monitoring (HAMILTOM) is proposed as an optical device. HAMILTOM could measure hardness of teeth in wet condition as a dark area while applying a load to dentins without drying. Therefore, HAMILTOM may realize hardness measurements of in vivo teeth in a clinical setting quantitatively. Aim: The aim of our study is to demonstrate the optical dentin hardness measuring device HAMILTOM using bovine dentin with different demineralization times and to evaluate the correlation between the dark areas measured by HAMILTOM and the Vickers hardness measured by the Vickers hardness tester. Approach: The samples were 20 bovine dentins. They were demineralized by a lactic acid solution with different times and divided into groups 1 and 2 of 10 samples each. In both groups, the dark areas and Vickers hardness were measured for each sample. Group 1 was used to obtain a calibration curve to calculate Vickers hardness from the dark area. Group 2 was used to validate the calibration curve obtained from the dentin samples of group 1. Results: The areas appearing black without a total internal reflection of the indenter measured by HAMILTOM increased as the demineralization time increased. Additionally, the Vickers hardness of group 2 calculated by the dark areas of group 2 and the calibration curve obtained in group 1 and the Vickers hardness of group 2 measured by the Vickers hardness tester were strongly correlated with a determination coefficient of 0.99. Conclusions: The results demonstrate that HAMILTOM may be a suitable alternative to the conventional method. Unlike the conventional method, which cannot be used for in vivo teeth, HAMILTOM holds potential to quantitatively evaluate the progress of caries in in vivo teeth.

Four-year clinical evaluation of CAD/CAM indirect resin composite premolar crowns using 3D digital data: Discovering the causes of debonding.

PURPOSE: To analyze the causes of debonding of computer-aided design/computer-aided manufacturing (CAD/CAM) indirect resin composite premolar crowns with a focus on the morphological factors of the crown and abutment teeth. METHODS: The clinical courses of 109 CAD/CAM indirect resin composite crowns were observed, and the patients' background characteristics, crown locations, luting methods, types of abutments, distal-most/non-distal-most molars, and types of resin blocks were confirmed. To investigate the influence of the morphology of the crown and abutment teeth, the 1) vertical dimension of the abutment teeth, 2) taper, and 3) thickness of the crown occlusal surface during events were measured from the three-dimensional digital data. The Kaplan-Meier method and multivariable Cox proportional hazard model were used for the statistical analyses. The nonlinearity of the effect of each comparison factor was included in the model. RESULTS: Complications included 21 debonding cases, two crown fractures, five root fractures, and two core debondings. The cumulative no-debonding and no-crown-fracture rate over 1423 days (3 years and 11 months) was 77.4%. The multivariable Cox regression analysis revealed that the abutment teeth type of tooth (first or second premolar) (P = 0.02) and luting materials (P < 0.01) significantly influenced the debonding frequency. All morphological factors (1-3) significantly influenced the debonding. The hazard ratios and nonlinear graph indicated that the crown thickness was less effective than the vertical dimension and taper. CONCLUSION: The combination analysis of clinical outcomes and 3D digital data revealed that preparation of the abutment is important for avoiding crown debonding.

Effect of tooth temperature on the dentin bonding durability of a self-curing adhesives: The discrepancy between the laboratory setting and inside the mouth.

A two-bottle self-curing universal adhesive (Tokuyama Universal Bond; Tokuyama Dental) that does not require a long waiting time or light curing after application of the bonding material has been developed. This study aimed to evaluate the influence of tooth and adhesive temperature during the bonding procedure on the effectiveness of dentin bonding. The results showed that the tooth temperature affected the effectiveness of the dentin bonding; therefore, to determine the precise bonding ability in the laboratory, the temperature of the tooth must be raised until it is the same as that of the oral cavity. In addition, the temperature of the material did not affect bonding effectiveness; this result confirms that it does not matter whether the refrigerated product is used soon after its removal from the refrigerator or after it reaches room temperature in the clinic.

Does the bonding effectiveness of a fiber post/resin composite benefit from mechanical or chemical treatment? Seven methods for saliva-contaminated surfaces.

PURPOSE: This study examined four cleaning methods and three chemical treatments for artificial saliva-contaminated fiber posts in terms of bonding durability to resin composite core materials. METHODS: Non-contaminated fiber posts (Tokuyama FR Post, Tokuyama Dental) and those contaminated (GC Fiber Post, GC) with artificial saliva (Saliveht Aerosol, Teijin Pharma) were used. Washing and drying (WD), alcohol cleaning (AlC), H3PO4 etching (P/WD), alumina blasting (B/D) for decontamination and silanization (Clearfil Ceramic Primer Plus, Kuraray Noritake Dental, Si), resin priming (HC Primer, Shofu, MMA), and bonding resin application (Clearfil Universal Bond Quick, Kuraray Noritake Dental, BR) for chemical treatment were performed. The treated fiber post was planted inside a cylindrical tube and filled with resin composite (DC Core Automix ONE, Kuraray Noritake Dental). The specimen was sectioned, and a push-out test was performed after 24 h, 1 month, and 3 months. The fracture surface was observed using a scanning electron microscope (SEM). RESULTS: Adhesion between the non-contaminated fiber post and resin composite did not improve by silanization and decreased by alumina blasting. SEM observations revealed a fractured glass fiber by alumina blasting. Saliva contamination decreased the bond strength between the fiber post and resin composite; however, recovery was achieved by WD, Alc, P/WD, and B/D. Compared to Si, BR (P = 0.009) was effective in restraining the long-term durability of bonding, whereas MMA (P = 0.99) was not. CONCLUSION: The application of bonding resin after alcohol cleaning is the most convenient and effective clinical procedure for fiber post surface treatment.

Development of dental inspection method: Nondestructive evaluation of an adhesive interface by ACTIVE acoustic emission.

PURPOSE: This study aims to confirm the usefulness of active acoustic emission (Active AE) for reproducible and non-invasive generation of physical external force which is required for conventional AE. METHODS: Experiment 1: A root dentin-resin adhesive interface was observed. The post space was filled with a dual-cure resin composite core material with and without adhesive. The vibration characteristics of the data obtained from the time-frequency analysis were evaluated. Experiment 2: A crown-abutment tooth adhesive interface was observed. Adhesive resin cement was used for luting the crown and adhesion states in the same specimen over time were analyzed with three measurements: at trial-fitting, immediately after luting, and 2 weeks after luting. Data were subjected to time-frequency analysis and relationships between amplitude (indicating loudness) and frequency (indicating the sound component) were analyzed. RESULTS: Experiment 1: Time-frequency analysis confirmed multiple peak frequencies for each specimen without adhesive and monomodal peak frequency in all specimens using adhesive. Experiment 2: Two weeks after luting, all specimens showed a single major peak except one which showed multiple weak peaks. The three-dimensional visualization of time-frequency analysis revealed one specimen with multiple weak peaks while all others displayed a single, low-amplitude band at 2 weeks after luting. CONCLUSION: The state of the adhesive interface can be evaluated using active AE. This basic technique may prove useful to evaluate changes in the adhesive interface of prostheses over time.

Development of novel measurement method for consistency of resin cements.

The aim of this study was to develop a new method to evaluate the consistency of resin cements by modeling the operation of setting a crown. First, the weight of the resin cements and the inner surface area of the crown were measured to configure the conditions for consistency evaluation using a model abutment tooth and a model crown. As the evaluation method, a 200 mm2 contact surface area of a glass plate was placed on top of 30.0 mg of resin cement paste, and a pressure of 10.0 N was applied to the glass plate. When the paste was spread over the entire bottom surface of the glass plate, it was designated a "Pass". A "Pass" result was obtained for all resin cements tested and a "Fail" result for all resin composites, indicating the usefulness of the new method for assessing cement flowability when setting a crown.

Novel testing method to evaluate the mechanical strength of self-adhesive resin cements with reflection of cement thickness.

This study aimed to propose an evaluation method for testing the mechanical strength of film-formed self-adhesive resin cements (SARCs) while reflecting cement layer thickness. Three commercially available dual-cure type SARCs were used for tensile and shear tests using specimens with varying thicknesses (0.05, 0.2, and 0.4 mm). There were no significant differences in tensile strengths among the various specimen thicknesses. In the shear test, there was a significant decrease in the strength with a reduction in specimen thickness. Stress distribution and fracture patterns were analyzed using in silico nonlinear dynamic finite element analysis. Finite element analysis demonstrated that stress distribution on the specimen surface was homogeneous even with different thicknesses in the tensile test, whereas it was inhomogeneous and induced different fracture patterns on the 0.05-mm-thick specimen in the shear test. These results suggest that the tensile test is useful for testing the mechanical strength of film-formed SARCs.

Combination of a silane coupling agent and resin primer reinforces bonding effectiveness to a CAD/CAM indirect resin composite block.

The effects of silanization and resin primer application on CAD/CAM indirect resin composite block bonding were investigated. KATANA AVENCIA P blocks (Kuraray Noritake Dental) were treated with a silane coupling agent and/or a resin primer. The contact angles (CAs) of resin primer were observed before and after silanization. Panavia V5 (Kuraray Noritake Dental) was built after each treatment. Bond strengths were measured, and the interface was analyzed by energy dispersive X-ray spectroscopy (EDS). The CA showed that silane treatment improved the wettability of the resin primer to the resin block. The combination treatment of the silane and resin primer showed significantly higher bond strength than no treatment, only in the silanization or resin primer group (p<0.001 each). EDS analysis showed that the resin primer penetrated both cement and block sides. The combination of the silane and resin primer improved bonding effectiveness between the resin block and resin cement.

Back to the multi-step adhesive system: A next-generation two-step system with hydrophobic bonding agent improves bonding effectiveness.

This study evaluated the bonding effectiveness of a newly developed two-step hydrophobic bonding material. Three groups using different bonding systems were compared: BZF group, using the new bonding system (BZF-29; GC, Tokyo, Japan); GPB group, using a one-step bonding system (G-Premio Bond; GC); and SE2 group, using a two-step bonding system (CLEARFIL SE Bond 2; Kuraray Noritake Dental, Tokyo, Japan). Microtensile bond strength (µTBS) was measured after storage in water for 24 h, 3 months and 6 months (n=25/group). Fracture surfaces were observed under scanning electron microscopy. The BZF group showed significantly higher µTBS than the other groups (p<0.001). Dominant failure patterns were cohesive failure for the BZF group (48-84%), mixed failure for the SE2 group (48-60%) and interface failure between adhesive and resin composite for the GPB group (48-52%). The hydrophobicity of the BZF-29 bonding system improves the long-term bonding effectiveness between adhesive and resin composite.

Critical review about two myths in fixed dental prostheses: Full-Coverage vs. Resin-Bonded, non-Cantilever vs. Cantilever.

The purpose of this review was to assess the literature regarding four types of fixed dental prostheses (FDPs)/resin-bonded FDPs (RBFDPs) to provide clinicians with a comparative overview of two myths: "RBFDPs are easy to debond in patients' mouths" and "cantilever RBFDPs still have some clinical problems, especially in terms of overloading the abutment teeth and being easy to debond". A total of 782 papers were identified, 753 of which were judged unsuitable and thus excluded, leaving a total of 29 articles for inclusion in this review. The results indicated that 1) Two-retainer RBFDPs achieve clinical results comparable to full-coverage three-unit FDPs; 2) Cantilever RBFDPs show excellent long-term clinical outcomes (especially in incisor teeth) compared with other FDPs; 3) RBFDPs typically show less catastrophic failure than conventional FDPs, rebonding should be considered when debonding occurs; and 4) Cantilever RBFDPs can be recommended as defect replacement prostheses for maxillary lateral incisors and mandibular incisor teeth. Scientific field: Prosthodontics, Adhesive dentistry, Esthetic dentistry.

Development of dental inspection method: nondestructive evaluation of a dentin-adhesive interface by acoustic emission.

Purpose The state of adhesion between root dentin and a resin composite core material was inspected using acoustic emission (AE).Methods A total of 14 human incisors and premolars were used to prepare "no-adhesive group" and "adhesive group" specimens. For "adhesive group" specimens, a bonding agent was applied to root canal dentin. The entire post space was subsequently filled with a resin composite for both specimen groups. The prepared specimens were fixed onto a jig on which an AE sensor was installed. A zirconia ball was used for the impact test, and a vibration wave generated by the collision was measured by the system using an AE sensor. The obtained data were subjected to time-frequency analysis using analysis software (LabVIEW), and the relationship between the amplitude indicating the loudness and the frequency indicating the sound component was analyzed.Results Zirconia-ball collision tests using AE revealed differences between the groups with respect to the waveform of vibration waves transmitted to the root dentin through the root dentin-resin interface. The time-frequency analysis of the obtained data confirmed that multiple peaks were observed for each specimen in the no-adhesive group, whereas a single characteristic vibration peak was observed for all specimens in the adhesive group.Conclusions The state of the adhesive interface was successfully evaluated by AE. This demonstration is expected to lead to the development of a device that can detect problems at the bonding interface between the prostheses and tooth substances.

Status of decontamination methods after using dentin adhesion inhibitors on indirect restorations: An integrative review of 19 publications.

The purpose of this review was to assess the literature regarding the decontamination of resin cement before the luting procedure in order to provide clinicians with a comparative overview of decontamination effects. A total of 19 articles were selected for inclusion in this review. The results indicated that bonding effectiveness is reduced due to residual adhesion inhibitors such as saliva, blood, hemostatic agents, and temporary/provisional cement. Self-etching and self-adhesive systems tend to be more negatively affected by adhesion inhibitors than do etch and rinse systems. Cleaning with an ultrasonic scaler or rotating brush have demonstrated conflicting effects in several studies. Some studies have reported that phosphoric acid has negative effects and recommend mild acid for decontamination. The application of phosphoric acid followed by sodium hypochlorite has been shown to help avoid negative effects. Alumina blasting has been investigated as a mechanical cleaning method in a relatively large number of experiments, most of which have confirmed its effectiveness. An intraoral cleaner containing functional monomers that has become commercially available in recent years is a promising method in clinical practice because it can easily and effectively remove temporary adhesive material. In addition, adhesion inhibitors can be easily removed from resin-coated dentin surfaces.