Effect of high irradiance and short exposure times on the depth of cure of six bulk-fill resin composites.

This study examined the effect of high irradiance and short exposure times on the depth of cure of six resin-based composites (RBCs). Bluephase PowerCure and the Valo X light-curing units (LCUs) were used to photocure bulk-fill RBCs for their recommended exposure times: Admira Fusion x-tra (AFX/20s), Aura Bulk Fill (ABF/20s), Filtek One Bulk Fill (FOB/20s), Opus Bulk Fill APS (OBF/30s), Tetric EvoCeram Bulk Fill (TEC/10s) and Tetric PowerFill (TPF/10s). In addition, all bulk-fill RBCs were tested for depth of cure with one short 3 s exposure time from the Bluephase PowerCure or the Valo X in the Xtra Power mode. The RBCs (n = 10 per RBC) were inserted into a 4 mm diameter metal mold and covered by a polyester strip before being photocured. After 24 h of storage, uncured RBC was scraped away to determine the depth of cure of the RBCs. None of the RBCs achieved a 4 mm depth of cure. The depth of cure of TEC and TPF was unaffected by the exposure times (recommended or short) when using the Valo X. The depth of cure of AFX/20s, AFX/Xtra Power, ABF/Xtra Power, FOB/Xtra Power, and OBF/30s RBCs was greater when using Valo X compared to the Bluephase PowerCure. It was concluded that short exposure times can reduce depth of cure and should only be used for some RBCs.

Effect of a calcium silicate cement and experimental glass ionomer cements containing calcium orthophosphate particles on demineralized dentin.

OBJECTIVE: The study aims to evaluate the effect of a glass ionomer cement (GIC; Fuji 9 Gold Label, GC) with added calcium orthophosphate particles and a calcium silicate cement (CSC; Biodentine, Septodont) regarding ion release, degradation in water, mineral content, and mechanical properties of demineralized dentin samples. METHODS: GIC, GIC + 5% DCPD (dicalcium phosphate dihydrate), GIC + 15% DCPD, GIC + 5% ß-TCP (tricalcium phosphate), GIC + 15% ß-TCP (by mass), and CSC were evaluated for Ca2+/Sr2+/F- release in water for 56 days. Cement mass loss was evaluated after 7-day immersion in water. Partially demineralized dentin disks were kept in contact with materials while immersed in simulated body fluid (SBF) at 37 °C for 56 days. The "mineral-to-matrix ratio" (MMR) was determined by ATR-FTIR spectroscopy. Dentin hardness and elastic modulus were obtained by nanoindentation. Samples were observed under scanning and transmission electron microscopy. Data were analyzed by ANOVA/Tukey test (α = 0.05). RESULTS: Ca2+ release from CSC and GIC (µg/cm2) were 4737.0 ± 735.9 and 13.6 ± 1.6, respectively. In relation to the unmodified GIC, the addition of DCPD or ß-TCP increased ion release (p < 0.001). Only the dentin disks in contact with CSC presented higher MMR (p < 0.05) and mechanical properties than those restored with a resin composite used as control (p < 0.05). Mass loss was similar for GIC and CSC; however, the addition of DCPD or ß-TCP increased GIC degradation (p < 0.05). CONCLUSION: Despite the increase in ion release, the additional Ca2+ sources did not impart remineralizing capability to GIC. Both unmodified GIC and CSC showed similar degradation in water. CLINICAL RELEVANCE: CSC was able to promote dentin remineralization.

Effect of multi-layer applications of self-etch universal bonding agents on the adhesion of resin composite to enamel.

To evaluate the effect of adhesive coats application on the enamel microtensile bond strength (µTBS) of universal adhesives, morphological etching pattern and their chemical interaction with hydroxyapatite (HA). Two universal adhesives were investigated: Scotchbond Universal (SBU, 3 M) and Prime&Bond Universal (PBU, Dentsply). The adhesives were applied in self-etching mode on bovine enamel (n = 8) in one (1L), two (2L) or three coats (3L) and light-cured as per manufacturers' instructions. As controls adhesives were applied to etched enamel (H3PO4-37% phosphoric acid). Bonded specimens were cut into sticks that were stored in deionized water for 24 h or 6 months prior to µTBS testing. Two-way ANOVA and Tukey's test were used for statistical analysis of bond strength with α = 5%. For morphological SEM analysis, enamel surfaces were treated as aforementioned and immediately rinsed with acetone. The intensity of monomer-calcium salt formation from each treatment was measured via infrared spectroscopy (ATR-FTIR). All treatments presented no significant reduction on µTBS after aging (p > 0.05). However, SBU attained highest µTBS when applied in 3L. PBU showed higher µTBS when applied to H3PO4 etched enamel than 1L or 2L. Etching pattern was enhanced by 3L application, particularly with PBU. Chemical interaction was notably higher for SBU than PBU, with no relevant differences with more layers or prior H3PO4-etching. The application of three adhesive coats of universal adhesives in self-etch mode using may enhance the bonding performance and etching pattern to enamel, surpassing the H3PO4-etched enamel bond for SBU. The chemical interaction with calcium from enamel is not affected by number of coats or prior phosphoric acid etching.

Effect of toothbrushing on surface roughness, gloss, and topography of polished and glazed ultra-translucent zirconia.

PURPOSE: This study evaluated the effect of toothbrushing cycles on surface roughness (Ra), gloss (GU), and morphology of two zirconia finishing and polishing protocols. MATERIALS AND METHODS: An ultra-translucent zirconia disc was sectioned into rectangular plates (12 mm × 7 mm × 3 mm) and divided into two groups according to the polishing and finishing system used (diamond rubber abrasive/DRA or glazing/GLA). Bovine enamel (BEN) plates with the same dimensions were used as a Control. Specimens of zirconia and enamel were analyzed for Ra and GU (n = 11) and surface morphology by scanning electron microscopy (n = 3) before toothbrushing (baseline) and after 15,000 and 30,000 toothbrushing cycles. Ra and GU data were analyzed by ANOVA two-way and post-hoc Tukey's test (α = 0.05), while the surface morphology was analyzed qualitatively. RESULTS: The Ra decreased significantly after 30,000 toothbrushing cycles for DRA and GLA zirconia ceramics. DRA showed a higher GU at the baseline, after 15,000 and 30,000 toothbrushing cycles than GLA and BEN. Toothbrushing polished the zirconia, creating a smooth surface, while no changes were observed for BEN. CONCLUSIONS: The increase in toothbrushing cycles (30,000) changed the surface roughness of DRA and GLA zirconia ceramics. DRA zirconia presented the highest GU, which did not change with toothbrushing.

Synthesis of silver core-shell nanoparticles and their influence on an experimental resin endodontic sealer: An in vitro analysis.

AIM: To avoid root canal recontamination and endodontic treatment failure, endodontic sealers with antibacterial activity could be an alternative. Silver nanoparticles have antibacterial activity and this study aimed to synthesize Ag@SiO2 nanoparticles, incorporate them into an experimental endodontic resin sealer and evaluate their influence on physicochemical and biological properties. METHODOLOGY: Ag@SiO2 nanoparticles were produced using the sol-gel process, based on the Stöber method. The particles were characterized in terms of their chemical structure by Fourier transform-infrared spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TGA), UV-Vis spectral analysis, scanning electron microscopy, and transmission electron microscopy, where the particle morphology and diameter were analysed. A dual-cured experimental endodontic resin sealer was formulated using 70 wt% UDMA, 15 wt% GDMA, and 15 wt% BisEMA. The photoinitiators were added separately in two pastes. The Ag@SiO2 nanoparticles were incorporated into the endodontic sealer at the concentrations of 2.5 wt%, 5 wt%, and 10 wt%, and a control group without nanoparticles was also formulated. The endodontic sealers were evaluated for their flow, film thickness, degree of conversion, softening in solvent, radiopacity, cytotoxicity and antibacterial activity immediately and after 9 months in water storage. RESULTS: Silver was detected in the chemical characterization of Ag@SiO2 that presented a spheric regular shape and average 683.51 nm ± 93.58 diameter. Sealers presented adequate flow and film thickness while radiopacity values were below the ones required by ISO 6876. All groups underwent softening after immersion in a solvent. The 10 wt% groups showed a higher loss of subsurface hardness (∆KHN%). No reduction in cell viability was observed. Enterococcus faecalis viability in biofilm was reduced in 10 wt% groups after 24 h and 9 months. CONCLUSION: The addition of 10 wt% Ag@SiO2 reduced E. faecalis viability at immediate and longitudinal analysis while maintaining the physicochemical properties of developed sealers.

Effect of thickness of CAD/CAM materials on light transmission and resin cement polymerization using a blue light-emitting diode light-curing unit.

OBJECTIVE: Evaluate the effect of thickness of high-translucency (HT) CAD/CAM materials on irradiance and beam profile from a blue light-emitting diode light-curing unit (LCU) and on the degree of conversion (DC) and maximum polymerization rate (Rpmax ) of a light-cured resin cement (LCC). MATERIAL AND METHODS: The direct output from the LCU, the light transmission and irradiance ratio (IR) through one conventional composite and nine HT CAD/CAM materials (0.5, 1.0, 1.5, or 2.0-mm thick; n = 5) were measured with a integrating sphere coupled to a spectrometer. The light beam was assessed with a beam profiler camera. The DC at 600 s and the Rpmax of one LCC was determined using a Fourier transform infrared spectrometer (n = 5). Data were analyzed by ANOVA followed by Tukey's tests, and Dunnett's test was also used for irradiance data (α = 0.05). RESULTS: A significant decrease in irradiance through all materials occurred as thickness increased. Thin CAD/CAM materials improved light homogeneity, which decreased with the increase in thickness. The DC of the LCC directly exposed to light was the same as when exposed to 45%, 25%, 15%, or 5% IRs. Rpmax decreased with the decrease in IR. CONCLUSIONS: Although the HT CAD/CAM materials reduced the irradiance from the LCU, minor effects were observed in the LCC's DC. CLINICAL SIGNIFICANCE: Despite the light attenuation of blue light through different CAD/CAM materials that were up to 2-mm thick, the degree of conversion of one brand of light-cured resin cement was clinically acceptable when the LCU was used for 30 s.

Effect of thickness and CAD-CAM material on fatigue resistance of endodontically treated molars restored with occlusal veneers.

PURPOSE: To evaluate the influence of the thickness and type of computer-aided design and computer-aided manufacturing (CAD-CAM) material on the fatigue resistance and failure mode of endodontically treated teeth (ETT) restored with occlusal veneers (OV). MATERIALS AND METHODS: Seventy-five (N = 75) ETT were restored with Herculite XRV in the endodontic access. Five experimental groups (n = 15) were tested. Four groups had two different thicknesses (0.6-0.7 mm or 1.4-1.6 mm) and two different CAD-CAM materials: zirconia-reinforced lithium-silicate (LS/Celtra Duo) and composite resin (RC/Cerasmart). The fifth group (control) did not have occlusal veneers. All the specimens were subjected to accelerated fatigue (5 Hz frequency) with an occlusal load increasing up to 1800 N and 131,000 cycles. The number of cycles was recorded when the machine stopped or at the completion of the test. Fatigue resistance was analyzed using the Kaplan-Meier survival test (95% significance level, log-rank post hoc pairwise comparisons). The samples were categorized according to failure mode. The CAD-CAM materials were examined through scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). RESULTS: No differences were found between the thicknesses, regardless of the type of the CAD-CAM material. The thick LS OV outperformed the RC and control groups. The thin RC OV and control groups showed a higher percentage of repairable and possibly repairable failures than the other groups. LS was more homogeneous under SEM, and the EDS analysis detected Si and Zr, but not Li. CONCLUSIONS: A larger thickness did not improve the resistance of the CAD-CAM materials. Thick LS showed a higher cumulative survival rate to fatigue than the RC and control groups. The direct composite alone (control) survived similarly to the experimental groups, except for the thick LS.

Colorimetric evaluation after in-office tooth bleaching with violet LED: 6- and 12-month follow-ups of a randomized clinical trial.

OBJECTIVES: To evaluate the long-term outcomes of in-office bleaching with violet LED light (LED) alone or combined with carbamide (CP) or hydrogen (HP) peroxides. METHODS: Volunteers of a previous short-term study were recalled for 6- and 12-month follow-ups, according to the following interventions (n = 18/group): LED, CP, LED/CP, HP, and LED/HP. The objective color (ΔEab, ΔE00) and whiteness index (ΔWID) changes were calculated applying the CIELab coordinates' values obtained using a spectrophotometer. A visual shade guide determined the tooth's subjective color change (ΔSGU). Data were submitted to one-way ANOVA or Welch's ANOVA, following appropriate post hoc tests (α = 5%). RESULTS: The LED and CP groups exhibited the lowest ΔEab, ΔE00, and ΔSGU (p < 0.05), but the LED group displayed a significantly lower ΔWID. After 12 months, the LED/CP group presented a higher ΔEab and ΔE00 than the CP group (p < 0.05). ΔEab, ΔE00, ΔSGU, or ΔWID means did not differ statistically between the LED/CP and HP groups. The LED/HP group presented a higher ΔE00 than the HP group, regardless of the time. CONCLUSIONS: The bleaching efficacy of LED alone was significantly lower compared to the LED/CP and HP-containing protocols. After 12 months, the LED/CP and HP groups did not differ in bleaching efficacy. LED irradiation only increased the objective color change of bleaching gels. CLINICAL RELEVANCE: LED alone promoted a long-term perceptible bleaching, but not compatible with that of high-concentrated HP. The bleaching outcomes of violet irradiation to 37% CP were maintained over time, with LED/CP demonstrating comparable results to HP even after 12 months. NATIONAL CLINICAL TRIALS REGISTRY (REBEC): RBR-5t6bd9.

Characterization and effectiveness of a violet LED light for in-office whitening.

OBJECTIVES: This study characterized a violet LED light (V-LED; bright max whitening) tooth whitening device and evaluated its efficacy on stained enamel compared to hydrogen peroxide (HP). MATERIALS AND METHODS: Characterization of the V-LED beam profile was performed using a laser beam-profiler. The irradiance was measured throughout an exposure cycle at 0- and 8-mm distances using an integrating sphere and a spectral radiometer. Bovine enamel/dentin blocks stained with black tea (BT), cigarette smoke (CS), or without staining (CONT) were subjected to V-LED or 40% HP (n = 10/group). Color parameters (ΔL, Δa, Δb, and ΔE00) were measured using a digital spectrophotometer. Light transmission was estimated through 1-mm-thick bovine enamel slices (n = 5). ΔL, Δb, ΔE00, and irradiance were analyzed by two-way ANOVAs and Tukey's tests, Δa by Kruskal-Wallis and Mann-Whitney tests, and light transmission by t-test (α = 5%). RESULTS: Heterogeneous beam distribution was observed for the emitting V-LED chips. After 20 sequential exposures, irradiance levels were reduced 25-50%, regardless of the distance from V-LED. Localized irradiance values were statistically different between beam locations and different distances from the target. V-LED produced lower ΔE00, ΔL, Δa, and Δb values than HP for CONT and BT, with no differences for CS. Light transmittance decreased approximately 98% through 1-mm thick enamel. CONCLUSIONS: V-LED irradiance was heterogeneous and decreased throughout the exposure cycles and was also greatly reduced with increasing tip distance. V-LED produced a significantly lower whitening effect on BT and control teeth. CLINICAL RELEVANCE: This study contributes to the knowledge of V-LED and its clinical use.

Effect of extended light activation and increment thickness on physical properties of conventional and bulk-filled resin-based composites.

OBJECTIVES: To evaluate the biaxial flexural strength (BFS), flexural modulus (BFM), and Knoop microhardness (KHN) of incremental and bulk-filled resin-based composites (RBCs) using extended curing exposure times. MATERIALS AND METHODS: Disc specimens (n = 8; 6-mm diameter) were fabricated using three stacked molds (0.5-mm thick for the top and bottom molds, and a 1-mm-thick center mold for the conventional and 3-mm thick for the bulk-fill RBCs). Conventional (Tetric EvoCeram/TCE and Filtek Z250/FIZ) and bulk-fill RBCs (Tetric EvoCeram Bulk Fill/TBF and Filtek One Bulk Fill Restorative/FOB) were evaluated. The stacked RBC-filled molds were light-cured for (1) the manufacturer-recommended exposure (MRE) duration; (2) 50%, and (3) 100% extension of the MRE. The BFS, BFM, and KHN of the top and bottom discs were measured. BFS and BFM were analyzed by three-way ANOVA (material*curing time*depth) and Tukey's post hoc (α = 0.05). KHN was analyzed by two-way ANOVA (curing time*depth) and Tukey's post hoc (α = 0.05). RESULTS: Extending the exposure duration did not change the BFS and BFM on the top of the RBCs, but the BFS and KHN increased at the bottom of bulk-fill RBCs. For the conventional RBCs, TCE showed the highest increase on BFS at the bottom, going from 53.6 MPa at T1 to 69.9 at T3. Among the bulk-fill RBCs, FOB presented the highest increase on the bottom BFS (T1: 101.0 ± 19.9 MPa, T3: 147.6 ± 12.9 MPa). For all RBCs and exposure times, BFS and KHN were lower at the bottom. Only FIZ and FOB reached a bottom-to-top hardness ratio of 80%, at T3 and T2. CONCLUSION: A significant increase on the BFS and KHN on the bottom of bulk-fill RBCs can be observed when the time of exposure to the curing light is double the MRE. However, extended exposure does not eliminate differences on the BFS and KHN between the shallow and deep regions of RBCs. TCE and TBF failed to reach an acceptable B/T hardness ratio at all evaluated exposure times. CLINICAL RELEVANCE: Mechanical properties of RBCs can be affected by insufficient polymerization, specially at deeper regions of the increment. Therefore, clinicians should consider applying twice the MRE to curing-light to polymerize the maximal increment thickness of bulk-fill RBCs.

Effect of erosive challenge with HCl on restorative materials.

OBJECTIVE: Investigate the effect of erosive challenge with hydrochloric acid (HCl) on the surface of five different restorative materials. MATERIAL AND METHODS: Ten plates of five restorative materials (Admira Fusion, Activa BioActive-Restorative, Charisma, Equia Forte HT Fil/EF, Filtek Universal Restorative/FU) were obtained. Half of the plate surfaces was covered with an adhesive tape, creating a control area, and the other side was submitted to the HCl (0.06 M HCl; pH 1.2; at 37 °C; for 30 h). Plates with control and HCl-treated areas were analyzed regarding the surface roughness (Sa), roughness profile (Rv), surface loss (SL), microhardness (MI), and gloss (GL) (n = 10). Surface morphology was analyzed by SEM and chemical elements were identified by EDX (n = 5). Data were evaluated by ANOVA and Tukey's test (α = 0.05). RESULTS: Most materials were not affected by HCl. FU showed the lowest Sa and Rv, and the highest GL after HCl. On the other hand, EF presented the highest Sa, Rv, and SL, and the lowest GL. The MI of materials was not changed after HCl. Topographical and chemical alterations were observed after HCl only for EF. CONCLUSIONS: The composites showed minor surface changes after HCl, which was not observed for the glass ionomer cement (EF). FU presented the best performance regarding the parameters evaluated. CLINICAL RELEVANCE: The effects of erosive challenge with HCl on composites were minimal, while the glass ionomer cements might not be indicated as restorative material for patients with gastroesophageal reflux disease.

Effects of shades of a multilayered zirconia on light transmission, monomer conversion, and bond strength of resin cement.

OBJECTIVE: To evaluate the influence of shades of a multilayered zirconia on light transmission, resin cement degree of conversion, and shear bond strength of resin cement. MATERIALS AND METHODS: The light transmission through opaque (OPQ) and translucent (TNS) regions of Katana UTML zirconia (Kuraray Noritake Dental) were evaluated for using a spectroradiometer (n = 5). Degree of conversion of dual-cure resin cement (Panavia V5, Kuraray Noritake Dental) was measured after light-activation through OPQ or TNS regions and direct exposure. Composition of the zirconia was analyzed with energy dispersive x-ray spectroscopy (EDS). Shear bond strength (SBS) was evaluated on the OPQ and TNS regions after 24 h and 1 year from specimen preparation (n = 15). RESULTS: The OPQ region produced higher irradiance loss (95.1%) than TNS one (92.9%), and lower degree of conversion (52.4%) than TNS (71.2%) at 24 h post-light activation. EDS analysis did not show differences on the microstructure of the OPQ and TNS regions. There were no significant differences on the SBS between zirconia regions. For both zirconia regions, a significant reduction on the SBS occurred after aging, being 31.7% for OPQ and 38% for TNS. CONCLUSION: Both OPQ and TNS regions affected the light transmission through the multilayered zirconia. The OPQ region yielded the highest light attenuation and the lowest degree of conversion of resin cement. Different regions of the zirconia did not influence the SBS. Clinical significance Although opaque and translucent regions of the multilayered zirconia reduced the light transmission from LED curing unit and the degree of conversion of resin cement, the regions did not affect the resin cement adhesion.

Effect of argon plasma on repair bond strength using nanofilled and microhybrid composites.

OBJECTIVES: To evaluate the effect of atmospheric pressure plasma (PLA), sandblasting (SAN), silanization (SIL) and hydrophobic bonding resin (HBR) on the micro-shear bond strength (MSBS) of fresh nanofilled (NF) or microhybrid (MH) composites to water-aged nanofilled composite. MATERIALS AND METHODS: NF plates were fabricated and stored in distilled water for 4 months. The aged plates were assigned to the groups (n = 6): 1- untreated; 2- SAN + SIL + HBR; 3- HBR; 4- PLA + HBR; 5- SAN + HBR; 6- SAN + PLA + HBR; and 7- PLA. Two fresh composite cylinders were constructed on each plate with NF or MH composites and tested after 24 h or 1 year of water-storage, using the MSBS testing. Data were analyzed by three-way ANOVA and Tukey test (α = 0.05). RESULTS: NF yielded better outcomes than MH at 24 h, which was not observed at 1 year. HBR showed the highest MSBS results, while untreated and PLA groups yielded the lowest one. MSBS reduced for all groups after 1 year. CONCLUSIONS: Only HBR can obtain good MSBS results, while PLA alone was not beneficial. After 1 year, a reduction in repair MSBS was observed and the type of composite did not influence the results. CLINICAL RELEVANCE: The repair technique can be simplified with the use of only an adhesive and macromechanical retentions in the old composite, regardless the type of fresh composite.

Surface treatments on CAD/CAM glass-ceramics: Influence on roughness, topography, and bond strength.

OBJECTIVE: To evaluate the influence of surface treatment on roughness (SA), topography, and shear bond strength (SBS) of computer-aided designer and manufacture (CAD/CAM) zirconia-reinforced lithium silicate (ZLS) and feldspathic (FEL) glass-ceramics. MATERIALS AND METHODS: FEL and ZLS specimens were submitted to 5% or 10% hydrofluoric acid (HF) or self-etching ceramic primer (MEP) and different application times (20, 40, and 60 s), or to sandblasting (Control, 20 s). Resin cement cylinders were bonded to the specimens and tested in shear (n = 10) after 24 h and 16-months of water storage. SA and topography were evaluated by atomic force (AFM, n = 10) and scanning electron microscopy. Data were analyzed by ANOVA and Bonferroni test (α = 0.05). RESULTS: Sandblasting promoted the highest SA for ZLS, but 10% HF (40, 60 s) promoted higher SBS at 16 months. 10% HF produced the highest SA for FEL, but sandblasting and 5% HF (20 s) maintained SBS after 16 months, without differences from 10% HF (20 s) (p > 0.05). Overall, MEP produced lower SA and SBS among groups (p < 0.05). HF displayed greater morphological changes on FEL. CONCLUSION: 10% HF (40 s) provided better results for ZLS, while 5% or 10% HF (20 s) was suitable for FEL. CLINICAL SIGNIFICANCE: Surface treatments influenced SA, topography, and SBS of materials. HF etching is the surface treatment of choice for both CAD/CAM glass-ceramics.

Flexural strength and microhardness of bulk-fill restorative materials.

BACKGROUND: Bulk-fill materials can facilitate the restorative procedure mainly for deep and wide posterior cavities. The purpose of this study was to evaluate flexural strength (biaxial flexural strength [BFS]) and microhardness (Knoop microhardness [KHN]) at different depths of bulk-fill materials. METHODS: Five bulk-fill materials were tested: two light-curable composite resins, one dual-cure composite, one bioactive restorative, and a high-viscosity glass ionomer. A conventional composite was used as control. BFS and KHN were tested at different depths. Data was analyzed by two- and one-way ANOVAs, respectively and Tukey's post-hoc (α=0.05). RESULTS: The high-viscosity glass ionomer material presented the lowest BFS at all depths. KHN for the two light-curable and the dual-cure bulk-fill resin composites was reduced following an increase in restoration depth, while the conventional composite, the bioactive material, and the high-viscosity glass ionomer were not affected. CONCLUSION: There are differences in the properties of the tested materials at 4 mm depth, showing that the studied properties of some materials vary according to the cavity depth, although the results are material dependent. CLINICAL SIGNIFICANCE: Mechanical properties of light-cured, bulk-fill materials may be affected by inadequate polymerization. Clinicians should consider complementary strategies to achieve adequate polymerization at high-increment depths.

Effects of extending duration of exposure to curing light and different measurement methods on depth-of-cure analyses of conventional and bulk-fill composites.

This study evaluated the effect of extending the duration of exposure to curing light on the depth of cure of two conventional (RBC1-conventional and RBC2-conventional) and two bulk-fill (RBC1-bulk and RBC2-bulk) resin composites. Polywave and single-peak photocuring units were used. Cylinder-shaped specimens were exposed to curing light either for the time period recommended by the manufacturer or twice the length of that time, and depth of cure was estimated using manual scraping (similar to the ISO-4049 standard) and solvent immersion techniques. Depth of cure was analyzed, using two-way ANOVA, for the factors measurement method and exposure time. For RBC1-conventional and RBC1-bulk, the solvent immersion technique estimated a greater depth of cure than did manual scraping; for RBC1-conventional, both techniques and both light-exposure time periods resulted in a depth of cure of >2 mm; and for RBC1-bulk, only the solvent method after photocuring for twice the manufacturer's recommended time resulted in a depth of cure of 5 mm. For RBC2-conventional and RBC2-bulk, neither technique nor exposure time resulted in estimated depths of cure that matched those indicated by the manufacturer. The results suggest that extending the duration of photopolymerization increases depth of cure. Also, calculation of depth of cure can vary according to the measurement technique used.

Heating and preheating of dental restorative materials-a systematic review.

OBJECTIVES: To perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the benefits and methods of preheating/heating that have been used. MATERIAL AND METHODS: A search was performed in the Pubmed, Scopus, Scielo, and gray literature databases. In vitro studies published from 1980 until now were searched using the descriptors "composite resins OR glass ionomer cements OR resin cements OR adhesives AND heating OR preheating." Data extraction and quality of work evaluation were performed by two independent evaluators. RESULTS: At the end of reading the search titles and abstracts, 74 articles were selected. Preheating of composite resins reduces viscosity, facilitates adaptation to cavity preparation walls, increases the degree of conversion, and decreases the polymerization shrinkage. Preheating of resin cements improves strength, adhesion, and degree of conversion. Dental adhesives showed good results such as higher bond strength to dentin. However, unlike resinous materials, ionomeric materials have an increase in viscosity upon heating. CONCLUSIONS: Preheating improves the mechanical and physical properties. However, there is a lack of clinical studies to confirm the advantages of preheating technique. CLINICAL RELEVANCE: Preheating of dental restorative materials is a simple, safe, and successful technique. In order to achieve good results, agility and training are necessary so the material would not lose heat until the restorative procedure. Also, care is necessary to avoid bubbles and formation of gaps, which compromises the best restoration performance.

Color change, diffusion of hydrogen peroxide, and enamel morphology after in-office bleaching with violet light or nonthermal atmospheric plasma: An in vitro study.

OBJECTIVE: The aim is to evaluate the effect of violet light (VL) and nonthermal atmospheric plasma (NTAP) combined with or without 35% hydrogen peroxide (HP) and 37% carbamide peroxide (CP). METHODS: Bovine crowns were divided into (n = 10) VL, VL/HP, VL/CP, NTAP, NTAP/HP, NTAP/CP, HP, CP, and C (control) groups. Color and whiteness change (CIELAB-Δ Eab, CIEDE2000-Δ E00 , whiteness index-ΔWID ), color parameters (ΔL, Δa, and Δb), and intrapulpal concentration (µL/mL) of HP were assessed by spectrophotometry. Scanning electron microscopy evaluated the morphology of enamel surface. Data were analyzed by two-way analysis of variance and Tukey (Δ Eab , ΔE00 , ΔWID , ΔL, and µL/mL) and Kruskal-Wallis and Mann-Whitney tests (Δ a and Δ b, α = 5%). RESULTS: VL increased ΔEab and ΔWID of CP (P < .05). VL and NTAP alone resulted in perceptible color and whiteness change, but lower than those in the gel-treated groups (P < .05). Activation modes increased ΔL compared with that of C, but only VL enhanced Δb when applied alone or combined with CP. VL and NTAP did not increase HP diffusion (P > .05) or cause alterations in enamel morphology. However, HP and CP promoted topographical changes. CONCLUSION: VL and NTAP changed color to a lesser extent than bleaching gels. VL produced supplementary effectiveness only for CP (ΔEab and ΔWID ), without increasing HP diffusion or changing enamel morphology. CLINICAL SIGNIFICANCE: Although violet LED light and nonthermal atmospheric plasma (NTAP) promoted in vitro perceptible bleaching without compromising enamel morphology, bleaching gels (hydrogen peroxide and carbamide peroxide) were more effective than VL or NTAP. VL or NTAP did not increase intrapulpal diffusion of peroxide.

Effect of zirconia decontamination protocols on bond strength and surface wettability.

OBJECTIVE: To evaluate the effects of human saliva decontamination protocols on bond strength of resin cement to zirconia (Y-PSZ), wettability, and microbial decontamination. MATERIALS AND METHODS: Zirconia plates were sandblasted and divided into (a) not contaminated, (b) contaminated with human saliva and: (c) not cleaned, (d) cleaned with air-water spray, (e) cleaned with 70% ethanol, (f) cleaned with Ivoclean, or (g) cleaned with nonthermal atmospheric plasma (NTAP). The wettability and microbial decontamination of the surfaces were determined after saliva contamination or cleaning. Monobond Plus (Ivoclar Vivadent) was applied after cleaning, followed by Variolink LC (Ivoclar Vivadent). The samples were stored 1 week before shear bond strength (SBS) testing, and data (SBS and wettability) were analyzed by one-way analysis of variance and Tukey test (α = .05). RESULTS: Saliva contamination reduced SBS to zirconia compared to not contaminated. Both Ivoclean and NTAP produced higher SBS compared to not cleaned and were not significantly different from the not contaminated. Ivoclean produced the highest contact angle, and NTAP the lowest. With the exception of using just water-spray, all cleaning protocols decontaminated the specimens. CONCLUSIONS: Both Ivoclean and NTAP overcame the effects of saliva contamination, producing an SBS to zirconia comparable to the positive control. CLINICAL SIGNIFICANCE: Dental ceramics should be cleaned prior to resin cementation to eliminate the effects of human saliva contamination, and Ivoclean and NTAP are considered suitable materials for this purpose.

Effect of non-thermal atmospheric plasma on the dentin-surface topography and composition and on the bond strength of a universal adhesive.

This study investigated the effect of application of non-thermal atmospheric plasma (NTAP) on the topography and composition of the dentin surface, as well as the microtensile bond strength (µTBS) of a universal adhesive to NTAP-treated dentin. Exposed flat dentin surfaces from human third molars were either treated with NTAP for 10 and 30 s or untreated (control). The dentin-surface topography and chemical composition were characterized by atomic force microscopy (n = 3) and Raman confocal spectroscopy (n = 5), respectively. The µTBS (n = 8) of Scotchbond Universal to dentin was determined after storage for 24 h and 1 yr, either by direct water exposure or under simulated pulpal pressure. In-situ zymography was used to evaluate the influence of NTAP on the dentin-enzymatic activity. Non-thermal atmospheric plasma produced no remarkable topographical or chemical alterations at the dentin surface; only the amount of phosphate decreased following 10 s of treatment with NTAP. After 1 yr of direct water exposure, the µTBS of NTAP-treated specimens did not differ statistically significantly from that of untreated controls, whereas simulated pulpal pressure-aging resulted in a significantly higher µTBS for NTAP-treated dentin. The dentin-enzymatic activity appeared to be treatment-dependent, but the untreated controls showed more intense fluorescence within the hybrid layer. Scotchbond Universal maintained its µTBS strength after 1 yr of direct water exposure and simulated pulpal pressure, although remarkable statistical differences between treatments were observed depending on the aging condition.