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

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

Effect of topical fluoride applications on residual monomer release from resin-based restorative materials.

BACKGROUND: The effects of topical fluoride applications on the release of monomer ingredients from resin-based dental materials by immersion in various extraction solutions are unclear. The aim of this study was to determine the effect of topical fluorides (APF and NaF) on the elution of residual monomers (Bis-GMA, TEGDMA, UDMA, and HEMA) from resin-based materials. METHODS: Ninety specimens were prepared, 30 bulk-fill composite resin, 30 nanohybrid universal composite resin, and 30 polyacid-modified composite resin (compomer). These were randomly divided into three groups based on fluoride application procedures. Each specimen was kept in 75% ethanol solution, and residual monomers released from materials were analyzed using high-performance liquid chromatography (HPLC) after 10 min, 1 h, 24 h, and 30 days. The groups were compared using the Mann Whitney U and Kruskal Wallis tests. Measurements were analyzed using the Friedman and Wilcoxon signed-rank tests. RESULTS: Fluoride applications generally had no considerable effect on the amount of residual monomer released from resin-based restorative materials. The amount of monomer release after topical APF application was similar to the release in the control group and was lower than the release in the NaF group. The release of monomers from the resin-based material used in the study did not approach toxic levels at the applied time intervals. The compomer released lower amounts of monomer than other resin-based materials. CONCLUSIONS: Fluoride applications do not increase monomer release from resin-based restorative materials. However, compomers should be employed by clinicians due to their lower monomer release compared to other resin restorative materials. The release of monomers from all the resin-based materials did not approach toxic levels at the applied time intervals.

Comparative evaluation of probiotic solutions on surface roughness and microhardness of different restorative materials and enamel.

This research study aimed to investigate the impact of probiotic mouthwash and kefir on the surface characteristics, specifically surface roughness and microhardness, of different restorative materials, as well as permanent and deciduous tooth enamels. Thirty disc-shaped specimens were prepared from composite resin (G-ænial Posterior (GP)), polyacid-modified composite resin (compomer) (Dyract-XP (DXP)), and resin-modified glass ionomer cement (Ionoseal (IS)). Additionally, thirty specimens of enamel were obtained from permanent teeth (PT) and thirty from deciduous teeth (DT) by embedding buccal and lingual sections, acquired through vertical sectioning of 15 permanent and 15 deciduous human tooth crowns in the mesiodistal orientation within acrylic resin blocks. The specimens were then categorized into three distinct groups and immersed for 14 days in one of the following solutions: distilled water, kefir or probiotic mouthwash. The mean surface roughness values of all specimens were assessed using an atomic force microscope, while the mean surface microhardness was measured using a Vickers hardness measuring instrument. The results revealed a statistically significant difference in mean surface roughness among the various restorative materials (p < 0.001). Among the restorative materials, the IS material exhibited notably higher mean surface roughness values than other restorative materials and tooth enamel, while no significant differences were observed between the PT and DT groups. Importantly, the main effect of the solutions under investigation was not statistically significant (p = 0.208). No significant difference was found between the surface roughness values of specimens subjected to the different solutions. When evaluating the effects of materials and solutions on microhardness, the main effects of material and solution variables and the influence of material-solution interactions were statistically significant (p < 0.001). Taken together, these results indicate that consistent use of kefir or probiotic mouthwashes may impact the surface properties of various restorative materials and tooth enamel.

The Effect Of Er,Cr:YSGG Laser Conditioning on Dentin Bond Strength and Nanoleakage of Universal Adhesive Systems: An In Vitro Study.

PURPOSE: To investigate the effect of erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser conditioning on dentin bond strength and nanoleakage of different universal and self-etch adhesives. MATERIALS AND METHODS: A total of 84 intact human third molar teeth were cut at the dentin level, and half of them were laser conditioned. The specimens were divided into three groups; two different universal resins and one self-etch adhesive resin were applied and composite resin restorations were created. For the microtensile bond strength (µTBS) test, 20 microspecimens were prepared from the laser and control group of each adhesive (n = 20) and tested with a universal device. For nanoleakage observation, 10 specimens were prepared from each group (n = 10) and stored in silver nitrate solution, and then the amount of nanoleakage was analyzed by field emission scanning electron microscopy (FESEM). Data were analyzed with two-way ANOVA, Tukey's honestly significant difference, and chi-square tests. RESULTS: The mean dentin bond strength of all adhesives in the laser groups was found to be statistically significantly lower than those of the control groups (P < .05). No difference was found between the mean bond strength of the adhesives in the laser and control groups (P > .05). Higher nanoleakage was observed in all adhesives in the laser groups compared to the control groups (P < .05). CONCLUSIONS: Irradiation of the dentin surface with Er,Cr:YSGG could adversely affect the µTBS and nanoleakage, likely by affecting the structure of the hybrid layer.

Release of mercury from amalgam filling and its relationship with metallothionein and superoxide dismutase.

Purpose: This study aims at determining the amount of mercury released over time from amalgam after treatment in healthy subjects and to examine the relation of mercury with serum MT-1 and SOD-1 levels. Materials and methods: Amalgam filling was applied to the 15 subjects aged 19-22 years and blood samples were collected before treatment and 1 day, 7 days, 21 days and 35 days after treatment. Mercury analysis of serum samples was performed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). In addition, MT-1 and SOD-1 levels in serum samples were measured using commercial enzyme-linked immunosorbent assay (ELISA). Friedman test and Spearman's correlation analysis was performed to analyse the data. p value was interpreted in significance level of 0.05. Results: As a result of the analysis for MT-1, it was found that the values decreased over time and this decrease was statistically significant after 21 days (p<0.05). In addition, it was found that SOD-1 decreased over time, but this decrease was not statistically significant . In terms of released mercury, there was no statistically significant difference among the values of mercury released over time . According to the results of correlation analysis, no statistically significant relationship was found among the variables. Conclusion: The results of the present study indicated that the amount of mercury released from the tested amalgam were found to be tolerable and no significant relationship was found between MT-1 and SOD-1.

Effect of staining and bleaching on the microhardness, surface roughness and color of different composite resins.

BACKGROUND: There are studies that examined the effect of staining on the surface properties of composite resins, using different solutions and bleaching applications. However, the effect of both staining and bleaching on the same composite specimens is an issue that needs to be investigated. OBJECTIVES: The aim of this study was to investigate the surface microhardness, roughness and color changes (ΔE) of 2 different composite resins after staining and bleaching. MATERIAL AND METHODS: A microhybrid and a nanohybrid composite were used in the study. One hundred and fifty specimens were prepared from each composite. The specimens were divided into 5 groups and stained for 30 days with tea, coffee, cola, red wine, or distilled water (control). Subsequently, each group was divided into 3 subgroups. Each subgroup received a 14-day application of Opalescence™ Boost, Opalescence PF or VivaStyle® Paint On Plus bleaching materials. The color as well as surface microhardness and roughness of all specimens were determined at baseline, after staining and after bleaching. Data was analyzed using the repeated-measures analysis of variance (ANOVA) and the Bonferroni method. RESULTS: A statistically significant decrease was observed in the surface microhardness of the microhybrid composite specimens after bleaching (p < 0.05).The highest ΔE values were observed in the red wine groups for both composite resins. CONCLUSIONS: Staining and bleaching may affect surface properties and color, depending on the type, filler and matrix content of the composite resin.

A deep learning approach to dental restoration classification from bitewing and periapical radiographs.

OBJECTIVE: The aim of this study was to examine the success of deep learning-based convolutional neural networks (CNN) in the detection and differentiation of amalgam, composite resin, and metal-ceramic restorations from bitewing and periapical radiographs. METHOD AND MATERIALS: Five hundred and fifty bitewing and periapical radiographs were used. Eighty percent of the images were used for training, and 20% were left for testing. Twenty percent of the images allocated for training were then used for validation during learning. The image classification model was based on the application of CNN. The model used Resnet34 architecture, which is pre-trained on the ImageNet dataset. Average sensitivity, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were calculated for performance evaluation of the model. RESULTS: The model training loss was 0.13, and the validation loss was 0.63. The independent test group result was 0.67. Amalgam AUC was 0.95, composite AUC was 0.95, and metal-ceramic AUC was 1.00. The average AUC was 0.97. The false positive rate in the validation set was 18, the false negative rate was 18, the true positive rate was 60, and the true negative rate was 138. The true positive rate was 0.82 for amalgam, 0.75 for composite, and 0.73 for metal-ceramic. CONCLUSION: Deep learning-based CNNs from periapical and bitewing radiographs appear to be a promising technique for the detection and differentiation of restorations.

An evaluation of surface roughness after staining of different composite resins using atomic force microscopy and a profilometer.

AIM: The aim of this study was to compare the surface roughness of different composite resins using atomic force microscope (AFM) and a profilometer after storage in different solutions. MATERIALS AND METHODS: Eight different composite resins were used in this study. Twenty specimens of each composite resin material were prepared using a 2-mm thick and 8-mm diameter stainless steel mold. After the composites had been placed in the mold, they were polymerized with a LED curing unit. The surfaces of all specimens were polished using aluminum oxide discs, and the specimens were then divided into four groups. The specimens in the experimental groups were stored in cola, coffee, or red wine, while the control group was stored in distilled water. Specimen surface roughness was examined after 30 days using an AFM and a profilometer, and the data obtained were subjected to analysis. RESULTS: Evaluation of the surface roughness of composite resins using a profilometer revealed no statistically significant difference between the groups, but significant differences were found using the AFM. The mean surface roughness of nanohybrid composites was lower than that of microhybrid composites. CONCLUSIONS: The surface roughness of the composite resins varies with storage in different solutions, depending on the organic matrix structure and inorganic fillers of the resin.

Effect of fiber reinforcement on color stability of composite resins.

AIM: The aim of this in vitro study was to determine the effect of fiber reinforcement on the color changes of two different composite resins. MATERIALS AND METHODS: A silorane-based composite (Filtek Silorane, A2 shade) and a methacrylate-based composite (Valux Plus, A2 shade) were used in this study. Three groups of samples (control group with no reinforcements, polyethylene fiber [Ribbond THM]-reinforced composite, and glass fiber [everStick® Net]-reinforced composite groups) were prepared from each composite (n = 8). The color change was calculated between baseline and 1 day (ΔE1) and between baseline, 7 days (ΔE2), and 21 days (ΔE3) with a spectrophotometer. The data were analyzed by ANOVA, Duncan's multiple-range tests and independent sample t-test. RESULTS: Statistical analysis of variance presented the statistically significance difference between composite, fiber, and time for ΔE (P < 0.05). The Ribbond reinforced composite showed a similar color change to the control group (ΔE = 3.69), while the everStick reinforced composite showed the largest total color change (ΔE = 4.13). It was determined that the time is an effective factor on the color stability of reinforced composites (P < 0.05). CONCLUSION: The addition of fiber may lead to color change in composite resins. The amount of change may differ depending on the structural properties of the composite resin or the fiber and time.

Monomer release from nanohybrid composites after bleaching.

The evaluation of the effect of bleaching on monomer release from two composite resins was performed by bleaching two nanohybrid composite resins Filtek Z550 and Tetric N-Ceram using two bleaching products Whiteness HP Maxx and Vivastyle. In total, 20 samples were made from each composite resin from which four groups were fabricated (two for each bleaching product). The samples were stored in a 75% ethanol solution, and the solutions were renewed after 1, 7, and 28 days. The monomer release was analyzed using high performance liquid chromatography. The data were analyzed using repeated measures analysis of variance and least significant difference multiple comparison test (α = 0.05). Monomers were found to be released from both composite resins. The amounts of monomer released were found to decrease over time (P < 0.05); however, the resins were not affected by bleaching, and the released monomers were well below toxic doses.

A comparison of dentin bond strength and degree of polymerization of bulk-fill and methacrylate-based flowable composites.

OBJECTIVE: This study aimed to evaluate the dentin bond strength and degree of polymerization of bulk-fill and methacrylate-based flowable composites. MATERIALS AND METHODS: Dentin bond strength of composites was evaluated using the microtensile bond strength (µTBS) test. Five different composites were applied on flat dentin surfaces with self-etch and etch-and-rinse adhesives. Twenty microspecimens with a 1 mm2 cross-sectional area were prepared for each group (n = 20). The µTBS test was then applied. To measure the degree of polymerization of composites, eight cylindrical blocks were prepared (n = 8) from each composite. The surface microhardness of each composite was measured on the bottom and top surfaces, and a hardness ratio (HR) was calculated. Data were analyzed using one-way ANOVA and the Tukey's honestly significant difference test (α = 0.05). RESULTS: According to the µTBS test results, the SDR Etch-and-Rinse group exhibited the highest dentin bonding strength and the Aelita self-etch group exhibited the lowest (P < 0.05). HR measurement showed that all composite groups had a sufficient degree of polymerization at a 2-mm thickness, while only the SDR and Xtra-Base groups had sufficient polymerization at a 4-mm thickness. CONCLUSIONS: Bulk-fill composite demonstrates an even higher degree of polymerization of methacrylate-based flowable composite when applied in a 4-mm thickness.

The effects of different antioxidant agents on the microtensile bond strength of composite resin to bleached Enamel / Efecto de diferentes agentes antioxidantes en la resistencia a la microtracción de la resina compuesta al esmalte blanqueado

Abstract The objective of this in vitro study is to examine the effect of antioxidants on the bonding strength of composite resin to bleached enamel. One hundred twenty non decay teeth were used in this study. Specimens were cut from the enamel cement junction. Then the specimens were randomly assigned into two groups-office bleaching and home bleaching. Bleaching antioxidants were applied to the first 12 subgroups. The specimens in the remaining 12 groups were kept in artificial saliva for 14 days and antioxidants were applied. Composite resin restoration was applied to all specimens. A cutting device was employed to obtain six specimens (0.9mm) from each tooth, and the microtensile bond strength (μTBS) test was performed. Data were analyzed using one-way ANOVA, the paired t-test, and Duncan's post hoc test (p=0.05). In office bleaching specimens, immediate antioxidant application increased the μTBS values (p0.05). Mean μTBS values in the groups to which antioxidants were applied two weeks after home bleaching were higher than those in the groups in which antioxidants were applied immediately. The use of antioxidants after bleaching may increase the MTBS value. The clinician should take this into account especially in immediate restoration applications after bleaching.

Resumen El objetivo de este estudio in vitro fue examinar el efecto de los antioxidantes sobre la resistência adhesiva de la resina compuesta al esmalte blanqueado. En este estudio se utilizaron ciento veinte dientes sin caries. Se cortaron especímenes a nivel de la unión esmalte-cemento. A continuación, los especímenes se asignaron aleatoriamente a dos grupos: blanqueamiento en el consultorio y blanqueamiento en casa. Se aplicaron antioxidantes de blanqueamiento a los primeros 12 subgrupos. Los especímenes de los 12 grupos restantes se mantuvieron en saliva artificial durante 14 días y se aplicaron antioxidantes. Se aplicó una resina compuesta a todos los especímenes empleando un dispositivo de corte para obtener seis especímenes (0,9mm) de cada diente, y se realizó la prueba de resistencia a la adhesión por microtensión (μTBS). Los datos se analizaron mediante un ANOVA de una vía, la prueba t pareada y la prueba post hoc de Duncan (p=0,05). En las muestras de blanqueamiento de oficina, la aplicación inmediata de antioxidantes aumentó los valores de μTBS (p0,05). Los valores medios de μTBS en los grupos a los que se aplicaron antioxidantes dos semanas después del blanqueo en casa fueron mayores que los de los grupos en los que se aplicaron antioxidantes inmediatamente. El uso de antioxidantes después del blanqueamiento puede aumentar el valor de μTBS. El clínico debe tenerlo en cuenta, especialmente en las aplicaciones de restauración inmediatas tras el blanqueamiento.

Color changes in resin cement polymerized with different curing lights under indirect restorations.

AIM: The aim of the study was to investigate the effects of different interface materials and curing units on color changes in a resin cement material. MATERIALS AND METHODS: Three interface materials and different curing systems, quartz-tungsten-halogen and polywave and monowave light-emitting diode (LED) light curing units, were studied at two-time intervals. Polystyrene strip was used as a control group. All measurements were made on a white background for standard color measurement. According to the CIE L*a*b* color space, the baseline color values of each specimen were measured. Differences between the measurements were calculated as ΔE, ΔL, Δa, and Δb. Data were analyzed using analysis of variance (ANOVA) and Duncan's tests (α = 0.05) with SPSS 20.0 software (SPSS Inc., Chicago, IL, USA). ANOVA revealed significance for interface materials and curing units and time for ΔE (P < 0.05). RESULTS: Interaction between polymerizing units, material and time was not significant (P > 0.05). Monowave LED exhibited significantly higher color changes than the other units ([P < 0.05] [ΔE 2.94 ± 0.44]). QTH promoted composite specimens significantly less color change ([P < 0.05] [ΔE 0.87 ± 0.41]). CONCLUSION: This study concluded that color of resin cement used in the adhesion of indirect restorations was affected by curing device light and indirect restoration material type.

The bond strength of highly filled flowable composites placed in two different configuration factors.

OBJECTIVE: The aim of this study was to evaluate the microtensile bond strength (µTBS) of different flowable composite resins placed in different configuration factors (C-factors) into Class I cavities. MATERIALS AND METHODS: Fifty freshly extracted human molars were divided into 10 groups. Five different composite resins; a universal flowable composite (AeliteFlo, BISCO), two highly filled flowable composites (GrandioSO Flow, VOCO; GrandioSO Heavy Flow, VOCO), a bulk-fill flowable composite (smart dentin replacement [SDR], Dentsply), and a conventional paste-like composite (Filtek Supreme XT, 3M ESPE) were placed into Class I cavities (4 mm deep) with 1 mm or 2 mm layers. Restored teeth were sectioned vertically with a slow-speed diamond saw (Isomet 1000, Buehler) and four micro-specimens (1 mm × 1 mm) were obtained from each tooth (n = 20). Specimens were subjected to µTBS test. Data were recorded and statistically analyzed with two-way analysis of variance and Tukey's post-hoc test. Fractured surfaces were examined using a scanning electron microscope. RESULTS: The µTBS in SDR-1 mm were higher than other groups, where Filtek Supreme XT-2 mm and GrandioSO Flow-2 mm were lower. No significant differences were found between C-factors for any composite resin (P > 0.05). CONCLUSION: Bulk-fill flowable composite provided more satisfactory µTBS than others. Different C-factors did not affect mean µTBS of the materials tested.

Temperature rise during polymerization of different cavity liners and composite resins.

OBJECTIVE: The purpose of this study was to evaluate the thermal insulating properties of different light curing cavity liners and composite resins during light emitting diode (LED) curing. MATERIALS AND METHODS: Sixty-four dentin discs, 1 mm thick and 8 mm in diameter, were prepared. Specimens were divided into four groups. Calcium hydroxide (Ca[OH]2), resin-modified glass ionomer cement, flowable composite and adhesive systems were applied to dentin discs according to the manufacturers' instructions. The rise in temperature during polymerization with a LED curing unit (LCU) was measured using a K-type thermocouple connected to a data logger. Subsequently, all specimens were randomly divided into one of two groups. A silorane-based composite resin and a methacrylate-based composite resin were applied to the specimens. Temperature rise during polymerization of composite resins with LCU were then measured again. Data were analyzed using one-way ANOVA and post hoc Tukey analyses. RESULTS: There were significant differences in temperature rise among the liners, adhesives, and composite resins (P < 0.05). Silorane-based composite resin exhibited significantly greater temperature rises than methacrylate-based resin (P < 0.05). The smallest temperature rises were observed in Ca(OH)2 specimens. CONCLUSION: Thermal insulating properties of different restorative materials are important factors in pulp health. Bonding agents alone are not sufficient to protect pulp from thermal stimuli throughout curing.

Temperature changes caused by light curing of fiber-reinforced composite resins.

OBJECTIVE: The aim of the study is to evaluate temperature change in fiber-reinforced composite (FRC) resin photopolymerized with a light-emitting diode (LED) light-curing unit (LCU). MATERIALS AND METHODS: Forty dentine disks (1 mm thick and 8 mm diameter) were prepared from human molars. The FRC specimens (2 mm thickness and 8 mm diameter) consisted of polyethylene fiber (Construct (CT)) products or glass fiber (ever Stick (ES)) and one hybrid composite bonded to the dentin disks and polymerized with an LED LCU. Control groups were prepared using the hybrid composite. Temperature rise in dentine samples under the FRC bonded disks was measured using a K-type thermocouple, and data were recorded. Temperature change data were subjected to analysis of variance (ANOVA) and Duncan's test. RESULTS: The results show that addition of fiber (one or two layers) did not change temperature rise values at any of the exposure times (P > 0.05). The CT fiber/two layer/40 s group exhibited the greatest temperature rise (5.49 ± 0.62) and the ES/one layer/10 s group the lowest rise (1.75 ± 0.32). A significant difference was observed in temperature rise measured during 10 and 20 s exposures (P < 0.05). CONCLUSION: Maximal temperature rise determined in all groups was not critical for pulpal health, although clinicians need to note temperature rises during polymerization.