Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface class II restorations: a 5-year randomised multi-centre study.

OBJECTIVE: To evaluate the 5-year clinical performance of a glass hybrid restorative system and a nano-hybrid resin composite in moderate to large two-surface class II cavities. MATERIALS AND METHODS: This study was carried out by dental schools in Zagreb, Croatia; Izmir, Turkey; Belgrade, Serbia; and Milan, Italy. A total of 180 patients requiring two class-II two-surface restorations in the molars of the same jaw were recruited. The teeth were randomly restored with either a nano-hybrid resin composite (Tetric EvoCeram, Ivoclar Vivadent) or a glass-hybrid material (EQUIA Forte, GC). During the 5-year follow-up, two calibrated evaluators at each centre scored the restorations annually using the FDI-2 scoring system. The survival rates were calculated using the Kaplan-Meier method and compared using non-parametric matched pair tests (p < 0.05). RESULTS: There were no statistically significant differences between the overall survival and success rates of the two types of restorations (p>0.05). The success rates (FDI-2 scores 1-3) for EQUIA Forte were 81.9% (average annual failure rate: 3.9%) and 90.7% for Tetric EvoCeram (average annual failure rate: 1.9%). The survival rates (FDI-2 scores 1-4) for EQUIA Forte and Tetric EvoCeram were 94.5% and 94.4%, respectively, with an average annual failure rate of 1.1%. CONCLUSIONS: In terms of success and survival rates, both the glass-hybrid restorative system and the nano-hybrid resin composite have been shown to perform satisfactorily. CLINICAL RELEVANCE: The results of this study indicate that EQUIA Forte can be one of the therapeutic options for moderate to large two-surface class II restorations of posterior teeth.

The Composite Quality Score (CQS) as a trial appraisal tool: inter-rater reliability and rating time.

OBJECTIVE: To establish the CQS inter-rater reliability and rating time and to compare both against that of the Jadad scale and Cochrane's Risk of Bias Tool (ROBT). MATERIAL AND METHODS: Four independent raters rated 45 trial reports. The inter-rater reliability was established by use of the Brennan-Prediger coefficient (BPC). The coefficients were compared using the two-sample z-test. Secondary analysis included comparison of the inter-rater reliability of the randomization component of all tools, as well as of the allocation concealment component of the CQS to that of the ROBT. The mean rating time with standard deviation (SD) for each tool was determined using one-way repeated measures analysis of variance. Post hoc comparisons were made using the Tukey-Kramer adjustment for three pair-wise multiple comparisons. RESULTS: The inter-rater reliability was significantly higher for the CQS (BPC, 95% CI: 0.95, 0.87-1.00) compared to Jadad (0.70, 0.58-0.82) (adjusted p = 0.0005) and most components of ROBT. The mean (SD) time to complete the CQS (4.0 (1.0) min) did not differ significantly from that of the Jadad scale 4.8 (1.1) min (adjusted p = 0.11), but was significantly shorter compared to that of the ROBT 15.3 (5.9) min (adjusted p < 0.0001). CONCLUSIONS: The results suggest the CQS to be a very reliable and fast trial appraisal tool. Clinical relevance The higher the inter-rater reliability, the higher the probability that trial results reflect therapeutic truth. The CQS will need to take further bias sources into consideration, in order to increase its utility.

Influence of different laser-assisted retrograde cavity preparation techniques on bond strength of bioceramic-based material to root dentine.

The purposes of the study were to evaluate the bond strength of bioceramic TotalFill root repair material (RRM) in retrograde cavities prepared using Er:YAG and Er,Cr:YSGG laser and steel bur, and to analyze failure modes. The root canals of 30 single-rooted teeth were endodontically treated, their root-ends were resected using a diamond bur, and the teeth were randomly divided into three groups (N = 10) according to the retrograde cavity preparation technique: (1) Er:YAG laser, (2) Er,Cr:YSGG laser, and (3) steel bur. All retrograde cavities were filled with the TotalFill RRM which was prepared according to the manufacturers' instructions. Push-out test was performed using universal testing machine, and failure mode was analyzed using a scanning electron microscope. The data were analyzed using one-way ANOVA, post hoc analysis with Bonferroni correction, and Fisher-Freeman-Halton exact test (p < 0.05). In the Er:YAG-, Er,Cr:YSGG-, and steel bur-prepared cavities, mean bond strengths (MPa) were 12.76, 8.44, and 6.01, respectively. The bond strength of the TotalFill RRM to dentin was significantly higher in the Er:YAG laser compared with the steel bur-prepared cavities (p = 0.004). The bond strength was not significantly different between the Er:YAG and Er,Cr:YSGG cavities (p = 0.074) and between the Er,Cr:YSGG and bur cavities (p = 0.648). In the cavities prepared by the Er,Cr:YSGG laser and bur, the failure mode of the TotalFill RRM was predominantly mixed, then adhesive and cohesive. In the Er:YAG laser-prepared cavities, the most common failure mode was adhesive, followed by mixed type and no cohesive failure. The bond strength of the TotalFill RRM to dentin was highest in the group of retrograde cavities prepared by the Er:YAG laser.

Push-out bond strength of three different calcium silicate-based root-end filling materials after ultrasonic retrograde cavity preparation.

OBJECTIVE: The aim of this study was to evaluate the bond strength of three calcium silicate-based root-end filling materials. MATERIALS AND METHODS: The root canals of 30 single-rooted teeth were endodontically treated; their root ends were resected and root-end cavities were prepared using ultrasonic tip. The teeth were randomly divided into three groups according to the material: (1) Micro-Mega mineral trioxide aggregate (MM-MTA), (2) Biodentine, and (3) TotalFill root repair material (RRM). Push-out test was performed using universal testing machine, and failure mode was analyzed by stereomicroscope. The data were statistically analyzed using Kruskal-Wallis and Man-Whitney post hoc tests. All p values < 0.05 were considered significant. RESULTS: TotalFill RRM exhibited significantly higher bond strength (12.69 MPa) than Biodentine (9.34 MPa, p = 0.023) and MM-MTA (7.89 MPa, p = 0.002). The difference between Biodentine and MM-MTA was not significant (p = 0.447). Mixed failures were the most noted in all three groups. MM-MTA had more adhesive failures than Biodentine and TotalFill, and no cohesive failures, but without statistical significance (p = 0.591). CONCLUSION: The bond strength was the highest for TotalFill RRM. CLINICAL RELEVANCE: In order to provide a persistent apical seal, root-end filling materials should resist dislodgement under static conditions, during function and operative procedures. TotalFill RRM exhibited higher bond strength to dentin than MM-MTA and Biodentine.

In vitro retention of prefabricated and individually formed posts: A pilot study.

STATEMENT OF PROBLEM: Data on the retention of individually formed fiber-reinforced composite posts (everStick) cemented with self-adhesive cement are lacking. PURPOSE: The purpose of this in vitro study was to investigate the pull-out strength of 2 different fiber-reinforced composite posts (prefabricated and individually formed) cemented into extracted teeth with self-adhesive resin cement. MATERIAL AND METHODS: Thirty extracted single-rooted human teeth were decoronated, endodontically treated, and prepared with post spaces of equal length. Prepared specimens were divided into 2 groups (n=15 each) based on the type of post: commercially prefabricated fiber posts (GC) and individually formed resin posts (using GC reinforcing fibers). Self-adhesive resin cement (G-CEM LinkAce; GC) was used to cement all posts. Each post was held with moderate pressure, and root surfaces were light polymerized for 20 seconds (650 mW/cm2). After cementation, the specimens were stored in saline solution for 30 days. Treated teeth were kept in water for 24 hours before pull-out testing parallel to the longitudinal axis of the posts. Data were analyzed using the Student t test (α=.05) and the coefficient of variance as the ratio of the standard deviation to the mean. RESULTS: The mean pull-out retention strength was 185.7 ±61.2 N for the prefabricated fiber posts and 98.9 ±56.5 N for the individually formed fiber posts (P=.026). CONCLUSIONS: The prefabricated fiber posts exhibited significantly higher retention forces than the individually formed posts.

Effect of photon induced photoacoustic streaming (PIPS) on bond strength to dentine of two root canal filling materials.

OBJECTIVES: The aim of this study was to evaluate the effect of photon induced photoacoustic streaming (PIPS) technique in combination with EDTA on bond strength of gutta-percha/AH Plus and Resilon/RealSeal SE root canal fillings to root dentine. MATERIALS AND METHODS: Forty freshly extracted human maxillary anterior teeth with intact straight roots, were instrumented endodontically with rotating ProTaper instruments and randomly divided into two experimental groups. In group 1 (n = 20), root canals were rinsed for 1 minute with 2 ml of 17% EDTA. In group 2 (n = 20), Er:YAG laser, with a 14 mm long 400 µ diameter tapered PIPS tip, was used for 1 minute with 2 ml of 17% EDTA. The laser parameters used were: 20 mJ per pulse, 15 Hz, 50 microsecond. In each experimental group, half of the root canals (n = 10) were obturated with gutta-percha/AH Plus and other half (n = 10) with Resilon/RealSeal SE. A micropush-out test was performed on sectiond specimens of the filled roots using a universal testing machine and resistance to failure plus failure modes were determined. RESULTS: Both gutta-percha/AH Plus groups had higher bond strength to root dentin than the Resilon/RealSeal SE groups (P < 0.05). The smear layer removal protocol, with EDTA only or combining PIPS technique with EDTA, had no influence on bond strength of either gutta-percha/AH Plus, or Resilon/RealSeal SE (P > 0.05). CONCLUSION: Within the limitations of this study, it was found that the application of the PIPS technique did not have an affect on the push-out bond strength of Resilon/RealSeal SE root canal filling to dentin nor on the gutta-percha/AH Plus. A significant difference in bond strength was noted between the two root canal filling materials. Lasers Surg. Med. 48:951-954, 2016. © 2016 Wiley Periodicals, Inc.

Mechanical Properties and Ion Release from Fibre-Reinforced Glass Ionomer Cement.

The aim of this study was to compare the mechanical properties and ion release from a commercially available resin-modified glass ionomer cement to a formulation reinforced by the addition of short glass fibres at various percentages. Methods: Three experimental groups were prepared by adding a mass ratio of 10%, 15% and 20% of short glass fibres to the powder portion of the cement from a capsule (GC Fuji II LC), while the control group contained no fibres. Microhardness (n = 12), fracture toughness, and flexural, compressive and diametral tensile strength (n = 8) were evaluated. To study ion release, readings were obtained utilising fluoro-selective and calcium-selective electrodes after 24 h, 7 days and 30 days (n = 12). The spatial distribution of fibres within the material was evaluated through scanning electron microscopy. The data were analysed using one-way ANOVA with a Bonferroni adjustment. Results: The findings suggest that elevating fibre weight ratios to 20 wt% results in improved mechanical properties (p < 0.05) in microhardness, flexural strength, diametral tensile strength and fracture toughness. In terms of ion release, a statistically significant difference (p < 0.001) was observed between the groups at the conclusion of 24 h and 7 days, when the fluoride release was much higher in the control group. However, after 30 days, no significant distinction among the groups was identified (p > 0.05). Regarding calcium release, no statistically significant differences were observed among the groups at any of the evaluated time points (p > 0.05). SEM showed the fibres were homogeneously incorporated into the cement in all experimental groups. Conclusions: Resin-modified glass ionomer enhanced with short glass fibres at a weight loading of 20% showcased the most favourable mechanical properties while concurrently maintaining the ability to release fluoride and calcium after a 30-day period.

Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions.

Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.

Comparison of vertical forces during root canal filling with three different obturation techniques.

The aim of this study was to examine and compare vertical forces exerted during root canal obturation with the cold lateral condensation technique, Thermafil technique and ProTaper guttapercha. Fourty-five single-rooted permanent teeth were used in the study. All specimens were instrumented using the ProTaper rotating technique and were randomly divided into three experimental groups (n = 15 per group). In the first group, root canals were obturated using the cold lateral condensation technique. In the second group, the Thermafil technique was used to obturate root canals. In the last group, a ProTaper gutta-percha of the same taper as the instrumented root canals was used for root canal obturation. Vertical forces were measured using the device developed for simulation of endodontic treatment. The results showed a statistically significant difference (p = 0.0001) for vertical forces when cold lateral condensation obturation technique was used in comparison to other techniques. No statistically significant difference was found for vertical forces during obturation with Thermafil and ProTaper gutta-percha (p = 0.16). The cold lateral condensation technique exerted higher vertical forces in comparison to the Thermafil and ProTaper obturation techniques.

The Composite Quality Score (CQS) as an Appraisal Tool for Prospective, Controlled Clinical Therapy Trials: Rationale and Current Evidence.

BACKGROUND: Current evidence appraisal concepts, such as the Assessment, Development and Evaluation (GRADE) approach and Cochrane's Risk of Bias (RoB) tool, rely on assumptions related to the classic problem of inductive reasoning and may suffer from insufficient inter-rater reliability. DISCUSSION: The Composite Quality Score (CQS) has emerged as a possible trial appraisal tool that does not rely on inductive assumptions and has been shown to be of potentially very high inter-rater reliability. CONCLUSION: Although the current CQS concept is still under development, its current evidence is encouraging and justifies further study. This article presents the rationale and currently available research concerning the CQS and shows where further research is required.

Effects of Different Whitening Agents on the Color and Translucency of Different Resin Composites.

Objectives: To examine the effects of different whitening agents on the color and translucency of different resin composites, in vitro. Material and methods: A total of 315 specimens (10.0 ×2.0 mm) were fabricated from two microhybrid (G-aenial anterior [G-Ant]) and (G-aenial posterior [G-Post]) and a nano hybrid (G-aenial A'CHORD [ G-ACH]) resin composites and each group was randomly distributed into seven experimental groups (n=15) as follows; 1- control (C); 2- in-office whitening agent (IOW); 3- at-home whitening agent (AHW); 4- prefilled tray (PT); 5- whitening pen (WP); 6- whitening toothpaste (WT) and 7- whitening mouthwash (WMW). The specimens were subjected to staining except control group before application of the different whitening procedures. The color of specimens was measured after 24 h (T0), after staining (T1) and after whitening (T2). Color change [CIEDE2000 (ΔE00)], translucency parameter (TP) values and changes in whiteness index (WID) were calculated. Data were analyzed statistically (p<0.05). Results: No significant 𝑊ID differences were detected among the tested resin composites at T0 and T1 (p>0.05), whereas a significant difference was observed at T2 (p<0.005). AHW and IOW produced higher color change than PT, WP, WT and WMR. Significant TP changes were found after the application of IOW and AHW in G-Ant. Conclusion: The effect of whitening products on the whitening index, color and translucency of resin composites are material and substrate dependent.

Effects of Ion-Releasing Materials on Dentine: Analysis of Microhardness, Appearance, and Chemical Composition.

The aim of this study was to compare the potential of standard ion-releasing materials to repair demineralized lesions with recently introduced alkasite and glass hybrid materials. Glass ionomer (GC Fuji TRIAGE), two glass hybrids (EQUIA Forte HT, Riva SC), calcium silicate cement (Biodentine) and an alkasite (Cention Forte) were tested. A total of 72 human third molars were used for sample preparation; on the dentine surface, a class-I cavity was prepared, and one half was covered with nail varnish. The teeth were subjected to a demineralization protocol, filled with the examined materials, and cut in half. The evaluation included a dentine microhardness assessment (n = 10) and SEM/EDS analysis (n = 2). The results were analyzed using SPSS 22.0 statistical software and compared using an analysis of variance and Scheffe post-hoc test. The statistical significance level was set to 0.05. Mean microhardness values (HV0.1) after 14 and 28 days were, respectively: EQUIA Forte HT (26.7 ± 1.45 and 37.74 ± 1.56), Riva Self Cure (19.66 ± 1.02 and 29.58 ± 1.18), Cention Forte (19.01 ± 1.24 and 27.93 ± 1.33), Biodentine (23.35 ± 1.23 and 29.92 ± 1.02), GC Fuji TRIAGE (25.94 ± 1.35 and 33.87 ± 5.57) and control group (15.57 ± 0.68 and 15.64 ± 0.82). The results were significantly different between most groups (p < 0.001). SEM/EDS revealed varying patterns, material deposits and distinct elemental variations. To conclude, all materials increased microhardness and affected the dentine surface appearance and chemical composition; EQUIA Forte HT demonstrated the most pronounced effects.

Comparison of Different Universal Adhesive Systems on Dentin Bond Strength.

Over the past few decades, adhesive dentistry has advanced significantly. In light of minimal-invasive dentistry, this novel technique advocates a more conservative cavity design that relies on the efficiency of present enamel-dentine adhesives. The study aimed to address the scientific deficit in understanding the long-term bonding performance of universal adhesives and to provide a new clinical solution with desirable bond strength to dentin. The dentin bond strength of three bonding agents, G2-Bond Universal (GC), Clearfil SE Bond (Kuraray), and Scotchbond Universal Plus (3M ESPE), was evaluated following various storage and etching modes. The UltraTester (Ultradent) bond strength testing machine was used to assess shear bond strength. The results showed that thermal cycling and the choice of adhesive system significantly affected the shear bond strength (p = 0.018 and p = 0.001, respectively). Among the three adhesives, Scotchbond Universal Plus had the lowest bond strength value (mean value = 24.78 MPa), while G2-Bond Universal was found to have desirable shear bond strength to dentin compared to the other adhesives, even after one year in the oral environment (mean value = 35.15 MPa). These findings imply that the HEMA-free universal adhesive G2-Bond Universal is the most effective universal adhesive for clinical practices, particularly when applied in the self-etch mode.

Efficacy of Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS) in the Removal of Different Combinations of Sealers Used with Two Obturation Techniques: A Micro-CT Study.

This study sought to evaluate the efficacy of SWEEPS in the removal of epoxy-resin-based and calcium-silicate-containing endodontic sealer combined with single-cone and carrier-based obturation techniques through a micro-CT analysis. Seventy-six single-rooted extracted human teeth with single root canal were instrumented with Reciproc instruments. Specimens were randomly divided into four groups (n = 19) according to the root canal filling material and obturation technique: (1) AH Plus sealer + Reciproc gutta-percha, (2) TotalFill BC sealer + TotalFill BC Points, (3) AH Plus sealer + Guttafusion obturator, and (4) MTA Fillapex + Guttafusion obturator. All specimens were re-treated one week later using Reciproc instruments. Following re-treatment, root canals were additionally irrigated using the Auto SWEEPS modality. The differences in the root canal filling remnants were analyzed by micro-CT scanning of each tooth after root canal obturation, after re-treatment, and after additional SWEEPS treatment. Statistical analysis was performed using an analysis of variance (p < 0.05). The additional treatment with SWEEPS significantly reduced the volume of the root canal filling materials in all experimental groups compared to the removal of root canal filling using only reciprocating instruments (p < 0.05). However, the root canal filling was not removed completely from any of the samples. SWEEPS can be used to enhance the removal of both epoxy-resin-based and calcium-silicate-containing sealers, in combination with single-cone and carrier-based obturation techniques.

Short-Term Fluoride Release from Ion- Releasing Dental Materials.

Objective: To compare short-term release of fluoride ions from ion-releasing dental restorative materials. Material and methods: Seven experimental groups were prepared using the following six different materials: alkasite (Cention Forte), resin-modified glass ionomer cement (Fuji II LC), bioactive composite (ACTIVA BioACTIVE-RESTORATIVE), fluoride-containing nano-hybrid composite (Luminos UN), coat-free glass hybrid (EQUIA Forte HT), coat-applied glass hybrid (EQUIA Forte HT), and glass ionomer cement (Fuji IX). A total of 40 samples for each group (n=40) were prepared in Teflon molds (8 mm x 2 mm) and placed in polyethylene vials with 5 ml of deionized water. Fluoride release was measured after 6, 24, 48 hours, and for 5 weeks using an ion-selective electrode. The results were expressed in mg/l and the data were statistically analyzed using ANOVA. Results: Significant differences in fluoride release were observed within the first 6 hours (ANOVA p<0.001). EQUIA Forte HT had the highest release, while the other materials showed no significant differences. After 24 hours, EQUIA Forte HT (p<0.001) and Luminos UN (p<0.05) exhibited significantly higher releases, compared to other tested materials. EQUIA Forte HT maintained the highest release at 48 hours (p<0.001), followed by Cention Forte (p<0.05) and Luminos UN (p<0.05). All material pairs showed significant differences in fluoride release at 5 weeks (p<0.001). Conclusion: Coat-free EQUIA Forte HT had the overall highest fluoride release, while Cention Forte demonstrated the greatest increase over time. ACTIVA BioACTIVE-RESTORATIVE exhibited the lowest fluoride release in this study.

Inter-rater reliability of the extended Composite Quality Score (CQS-2).

Aim: To establish the inter-rater reliability of the Composite Quality Score (CQS-2) and to test the null hypothesis that it did not differ significantly from that of the first CQS version (CQS-1). Materials and methods: Four independent raters were selected to rate 45 clinical trial reports using CQS-1 and CQS-2. The raters remained unaware of each other's participation in this study until all rating had been completed. Each rater received only one rating template at a time in a random sequence for CQS-1 and CQS-2 rating. Raters completed each template and sent these back to the principal investigator. Each rater received their next template 2 weeks after submission of the completed previous template. The inter-rater reliabilities for the overall appraisal score of the CQS-1 and the CQS-2 were established by using the Brennan-Prediger coefficient (BPC). The coefficients of both CQS versions were compared by using the two-sample z-test. During secondary analysis, the BPCs for every criterion and each corroboration level for both CQS versions were established. Results: The BPC for the CQS-1 was 0.85 (95% CI: 0.64-1.00) and for the CQS-2 it was 1.00 (95% CI: 0.94-1.00), suggesting a very high inter-rater reliability for both. The difference between the two CQS versions was statistically not significant (p = 0.17). The null hypothesis was accepted. Conclusion: The CQS-2 is still under development, This study shows that it is associated with a very high inter-rater reliability, which did not statistically significantly differ from that of the CQS-1. The promising results of this study warrant further investigation in the applicability of the CQS-2 as an appraisal tool for prospective controlled clinical therapy trials.

Comparison of Er:YAG laser and surgical drill for osteotomy in oral surgery: an experimental study.

PURPOSE: High-energy lasers have been proposed as an alternative to the conventional surgical drill in oral and maxillofacial surgery. The aims of this study were to compare thermal changes of the bone surface, procedure time, and volume of the removed bone after drilling with an erbium (Er):yttrium-aluminum-garnet (YAG) laser versus a low-speed surgical drill. The bone sections were observed under light microscopy and examined histologically. MATERIAL AND METHODS: Thirty bone blocks were prepared from porcine ribs. On each block 2 holes (tunnel preparations) were performed using a low-speed, 1.0-mm-wide, surgical pilot drill and an Er:YAG laser (pulse energy, 1,000 mJ; pulse duration, 300 µs; frequency, 20 Hz). The temperature induced by the preparation techniques was measured using an infrared camera. The removed bone volume was calculated by a modified mathematical algorithm. The time required for the preparation was measured with a digital stopwatch and a time-measurement instrument integrated within the computer program. The cortical and spongiose surfaces of the specimens were examined microscopically and histologically under a light microscope with a high-resolution camera. RESULTS: The Er:YAG laser removed significantly more bone tissue than the drill (P < .01) in a significantly shorter time (P < .01). The temperature was statistically lower during the laser preparation (P < .01). Cavities prepared with the laser were regular with clear sharp edges and knifelike cuts. In the drill group, the preparations exhibited irregular edges full of bone fragments and fiberlike debris. Histologic examination of the laser sides showed a 30-µm-thick altered sublayer. The tissue in the drill group was covered with a smear layer without any alterations. CONCLUSIONS: The Er:YAG laser produced preparations with regular and sharp edges, without bone fragments and debris, in a shorter time, and with less generated heat. Thermal alterations in the treated surface were minimal.

Comparison of mechanical and optical properties of a newly marketed universal composite resin with contemporary universal composite resins: An in vitro study.

The purpose of this study was to evaluate the surface roughness, microhardness, color change, and translucency of a newly marketed universal nanohybrid composite resin (CR) (G-aenial A'CHORD) comparing with four contemporary universal CRs including two nanofilled (Filtek and Estelite Asteria) and two nanohybrid CRs (Charisma Dimond and Neo Spectra ST HV in vitro). Sixty-five specimens (8.0 mm × 2.0 mm) were fabricated (n = 13, per group). After finishing and polishing, specimens were subjected to surface roughness and microhardness tests. Color and translucency of the specimens were evaluated at baseline and after darkening with coffee solution at day 1 and day 7. A representative specimen from each group was investigated under scanning electron microscopy (SEM). Data was analyzed statistically (p < .05). There were significant differences among the groups in terms of surface roughness, microhardness, color, and translucency. The surface roughness was recorded as: Charisma Diamond > Neo Spectra ST HV, Filtek > Estelite Asteria, G-aenial A'CHORD, whereas Vickers Hardness number was as: Filtek, Charisma Diamond > Neo Spectra ST HV > G-aenial A'CHORD, Estelite Asteria. Color change was as: Charisma Diamond > Neo Spectra ST HV, Filtek, G-aenial A'CHORD > Estelite Asteria and the translucency was as: Neo Spectra ST HV > G-aenial A'CHORD, Filtek > Estelite Asteria, Charisma Diamond. SEM examinations revealed smooth surfaces for G-aenial A'CHORD, Neo Spectra ST HV and Estelite Asteria. Mechanical and optical properties of universal composite resins with different compositions show variations.

Shear bond strengths of two newly marketed self-adhesive resin cements to different substrates: A light and scanning electron microscopy evaluation.

The purpose of this in vitro study was to compare the shear bond strengths (SBSs) of two newly marketed self-adhesive resin cements (RCs) to enamel, dentin, and lithium disilicate (LiSi) glass ceramic block. Forty-eight enamel and 48 dentin substrates were obtained from sound human molars. Additionally, 6 × 7 × 5 -mm- sized 24 specimens were produced from LiSi glass ceramic blocks. The tooth specimens were randomly assigned into four groups (n = 12) according to the surface treatments: (1) G-CEM ONE (GCO), (2) G-CEM ONE Adhesive Enhancing Primer (GCO-AEP) + GCO, (3) RelyX Universal (RXU), and (4) Scotchbond Universal Plus (SUP) + RXU. LiSi specimens were randomly divided into two groups (n = 12): (1) G-MultiPrimer (GMP) + GCO and (2) SUP + RXU. Following the RC applications, all specimens were kept in 100% humidity at 37°C for 24 hr and then submitted for SBS testing in a universal testing machine (1 mm/min). Data were analyzed by Welch's, one-way analysis of variance and two independent samples t tests. The nature of failures was examined under a light microscope, and scanning electron microscopy analyses were also performed for interfaces. GCO and RXU showed similar SBS to enamel (p > .05), and the use of adhesives resulted in improved SBS (p < .05). No difference was detected between GCO-AEP + GCO and SUP + RXU. The GCO-AEP + GCO exhibited the highest SBS to dentin (p < .05), followed by GCO ≥ SUP + RXU > RXU (p < .05). There was no significant difference between SBSs of two RCs to LiSi blocks (p > .05). No cohesive failure was determined for the tested groups by light microscope. The use of adhesives prior to the application of self-adhesive RCs improved their bonding to tooth tissues. GCO demonstrated superior SBS to dentin, whereas both self-adhesive RCs generated similar SBS to enamel and LiSi glass ceramic surfaces.

Extension of the Composite Quality Score (CQS) as an appraisal tool for prospective, controlled clinical therapy trials-A systematic review of meta-epidemiological evidence.

AIM: To conduct a survey of current meta-epidemiological studies to identify additional trial design characteristics that may be associated with significant over- or underestimation of the treatment effect and to use such identified characteristics as a basis for the formulation of new CQS appraisal criteria. MATERIALS AND METHODS: We retrieved eligible studies from two systematic reviews on this topic (latest search May 2015) and searched the databases PubMed and Embase for further studies from June 2015 -March 2022. All data were extracted by one author and verified by another. Sufficiently homogeneous estimates from single studies were pooled using random-effects meta-analysis. Trial design characteristics associated with statistically significant estimates from single datasets (which could not be pooled) and meta-analyses were used as a basis to formulate new or amend existing CQS criteria. RESULTS: A total of 38 meta-epidemiological studies were identified. From these, seven trial design characteristics associated with statistically significant over- or underestimation of the true therapeutic effect were found. CONCLUSION: One new criterion concerning double-blinding was added to the CQS, and the original criteria for concealing the random allocation sequence and for minimum sample size were amended.