Three-year clinical evaluation of a two-step self-etch adhesive with or without selective enamel etching in non-carious cervical sclerotic lesions.

OBJECTIVE: The purpose of this prospective, controlled, randomized study was to evaluate the 3-year clinical performance of a two-step self-etch adhesive (AdheSE, Ivoclar Vivadent; Schaan, Liechtenstein) in non-carious cervical sclerotic lesions with or without selective acid-etching of the enamel margins. MATERIAL AND METHODS: Twenty-two patients (mean age 51.5) having at least two pairs of non-carious cervical sclerotic erosion/attrition/abfraction lesions with incisal or occlusal margins in the enamel and gingival margins in the dentin were included in the study. The two-step self-etch adhesive was applied following either the self-etch approach (AdheSE non-etch, n = 52) or a similar application approach, including prior selective acid-etching of the enamel margins (AdheSE etch, n = 52). Composite resin Point 4 (Kerr Corp; Orange, CA, USA) was used as the restorative material for all 104 restorations. The restorations were evaluated at baseline and after 1, 2, and 3 years, according to the modified USPHS criteria. Data were analyzed using McNemar's test (p < 0.05). RESULTS: The retention rates for AdheSE non-etch were 100 %, 98 %, and 91.5 %; whereas, 100 %, 100 %, and 97.9 % retention rates were recorded for AdheSE etch after 1, 2, and 3 years, respectively. No significant differences were detected between the retention rates, marginal adaptation at the dentin side, secondary caries, and postoperative sensitivity (p > 0.05). A significantly higher number of restorations in AdheSE non-etch group showed clinically acceptable slight marginal discoloration (p = 0.0001) and clinically acceptable small marginal defects at the enamel side (p = 0.008) than in the AdheSE etch group. CONCLUSIONS: After 3 years, the two-step self-etch adhesive exhibited acceptable clinical performance with or without selective enamel etching in non-carious cervical sclerotic lesions. CLINICAL RELEVANCE: Selective acid-etching of the enamel margins enhanced the performance of the two-step self-etch adhesive in terms of marginal discoloration and marginal adaptation at the enamel side.

Influence of different conditioning methods on the shear bond strength of novel light-curing nano-ionomer restorative to enamel and dentin.

The purpose of this study was to investigate shear bond strength (SBS) between a light-curing nano-ionomer restorative and enamel or dentin after acid etching, after erbium:yttrium-aluminum-garnet (Er:YAG) laser etching, or after combined treatment. Forty third molars were selected, the crowns were sectioned, and 80 tooth slabs were obtained. The specimens were assigned to two groups, which were divided into four subgroups(n = 10). Group 1 [enamel (e)], treated with 37% phosphoric acid (A) + Ketac nano-primer (K); group 2 [dentin (d)], (A) + (K); group 3(e), Er:YAG laser etching (L) + (A) + (K); group 4(d), (L) + (A) + (K); group 5(e), (L) + (K); group 6(d), (L) + (K); group 7(e), (K); group 8(d), (K). The SBS of the specimens was measured with a universal test machine (1 mm/min). Data were analyzed by independent samples t-test, one-way analysis of variance (ANOVA) and a post-hoc Duncan test (p < 0.05). No difference was determined between groups 3 and 5 (p > 0.05). Group 7 exhibited higher SBS values than those of groups 3 and 5 (p < 0.05). Group 1 showed higher SBSs than those of groups 3, 5 and 7 (p < 0.05). There was no significant difference between groups 4 and 6 (p > 0.05). No difference was observed between groups 2 and 4 (p > 0.05). However, group 2 presented higher SBSs than did group 6 (p < 0.05). Group 8 exhibited the highest SBS values when compared with groups 2, 4 and 6 (p < 0.05). Er:YAG laser adversely affected the adhesion of the light-curing nano-ionomer restorative to both enamel and dentin.

Microleakage and scanning electron microscopy evaluation of all-in-one self-etch adhesives and their respective nanocomposites prepared by erbium:yttrium-aluminum-garnet laser and bur.

The aim of this study was to evaluate the microleakage of all-in-one self-etch adhesives and their respective nanocomposites in class V cavities prepared by erbium:yttrium-aluminum-garnet (Er:YAG) laser and bur. Class V cavities were prepared on both buccal and lingual surfaces of 72 premolars by Er:YAG laser or bur and divided into six groups (n = 24). The occlusal margins were enamel and the cervical margins were cementum. The groups were as follows: group 1 Er:YAG laser preparation (E) + Xeno V (X) + CeramX (C); group 2 bur preparation (B) + X + C; group 3 E + AdheSE One (A) + Tetric EvoCeram (T); group 4 B + A + T; group 5 E + Clearfil S3 Bond (CSB) + Clearfil Majesty Esthetic (CME); group 6 B + CSB + CME. All teeth were stored in distilled water at 37 degrees C for 24 h, then thermocycled 500 times (5-55 degrees C). Ten teeth from each group were chosen for the microleakage investigation and two teeth for the scanning electron microscopy (SEM) evaluation. The teeth that were prepared for the microleakage test were immersed in 0.5% basic fuchsin dye for 24 h. After immersion, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Bur-prepared cavities presented less microleakage in all groups for enamel (P < 0.05); however, in cervical margins, there were no differences between laser-prepared and bur-prepared cavities in the Xeno V + CeramX and AdheSE One + Tetric EvoCeram groups (P > 0.05). SEM observations of restorative material-dentin interfaces seemed to correspond with those of the microleakage test. Microleakage at the cervical interfaces was greater than that at the occlusal interfaces. Er:YAG laser-prepared class V cavities yielded more microleakage in occlusal margins with all-in-one self-etch adhesives and the respective manufacturer's nanocomposites.

Short-term treatment of periapical lesion of anterior tooth affected by microleakage using Nd:YAG laser. Case report.

Tooth-colored restorations are the first choice for anterior restorations. However, microleakage is a significant problem at the margins of anterior cavities restored with resin composites. Microleakage can cause pulpal irritation and periapical inflammation. Today, laser irradiation is used frequently for dental treatments. Nd:YAG laser has been used successfully in endodontic treatments. A 17-year-old male presented to our clinic with a maxillary right lateral incisor that resulted in microleakage of an old composite resin restoration. Clinical examination revealed swelling and abcess formation on the palatal mucosa. The radiographic examination was performed and an inflammation around the apex was diagnosed. Root canal preparation, canal sterilization by Nd:YAG laser and root canal filling were performed at the same visit. The patient was observed for two months. In the case presented here, short-term treatment of a periapical lesion of an anterior tooth affected by microleakage using the Nd:YAG laser is discussed.

Effect of fiber nets, application techniques and flowable composites on microleakage and the effect of fiber nets on polymerization shrinkage in class II MOD cavities.

This study evaluated the effects of fiber nets and application techniques and flowable composites as a liner on microleakage and the effects of fiber nets on polymerization shrinkage in Class II MOD cavities. Standard MOD cavities were performed in 80 extracted third molars. The teeth were randomly divided into eight groups (n=10). Group 1: Filtek Supreme XT (bulk technique) (FSB); Group 2: Filtek Supreme XT (incremental technique) (FSI); Group 3: Filtek Supreme XT Flow (FS Flow)+FSB; Group 4: FS Flow+FSI; Group 5: FS Flow+Ribbond (R)+FSB; Group 6: FS Flow+R+FSI; Group 7: FS Flow+everStick NET (E)+FSB; Group 8: FS Flow+(E)+FSI. All the teeth were then immersed in 0.5% basic fuchsin solution for 24 hours after thermocycling for 1000 cycles (5 degrees C and 55 degrees C). The teeth were sectioned longitudinally and observed under a stereomicroscope. In order to determine the polymerization shrinkage, another study was designed. In Group A, composite was applied as a bulk. In Group B, the resin composite was divided into two parts and Ribbond fiber was placed in the middle of the mass. In Group C, everStick NET fiber was placed inside the composite, as in Group B. Statistical analysis were performed by using one-way ANOVA and Tukey HSD tests for both microleakage and polymerization shrinkage (p < 0.05). Less microleakage was observed in groups where composites were applied by the incremental technique compared with those where the bulk technique was used (p < 0.05). The groups that used flowable composites showed significantly lower microleakage (p < 0.05). In groups where fiber nets were used, a significant decrease was determined in terms of microleakage (p < 0.05). Groups with fiber nets exhibited lower polymerization shrinkage (p < 0.05). Fiber nets decreased both microleakage and polymerization shrinkage. The incremental technique is an effective method for Class II composite restorations.

Five-year clinical evaluation of 300 teeth restored with porcelain laminate veneers using total-etch and a modified self-etch adhesive system.

This study evaluated the long-term clinical performance of porcelain laminate veneers luted with hybrid composite in combination with total-etch and self-etch adhesive systems. The study was performed on 30 patients ranging in age between 28 and 54 years. Ten veneers were performed per patient in the maxillary arch. In Group 1, 150 teeth were treated with porcelain veneers, using a total-etch adhesive system (Scotchbond Multi-Purpose Plus, 3M ESPE). In Group 2, 150 teeth were bonded with a self-etch adhesive system (AdheSE, Ivoclar-Vivadent). All the veneers were luted with a light-cured hybrid composite (Z100, 3M ESPE). The patients were recalled after 1, 2 and 5 years. Modified United States Public Health Service (USPHS) criteria were utilized to evaluate the porcelain laminate veneers in terms of marginal adaptation, cavo-surface marginal discoloration, secondary caries, postoperative sensitivity, satisfaction with restoration shade and gingival tissue response. Data were analyzed using the Chi-Square test (p < 0.05). There was no statistically significant difference between the total-etch and self-etch groups in terms of USPHS criteria (p > 0.05). Porcelain veneers exhibited successful clinical performance with both total-etch and two-step self-etch adhesives at the end of five-years.

Effect of phosphoric acid etching and self-etching primer application methods on dentinal shear bond strength.

PURPOSE: To evaluate acid-etching effects prior to the application of self-etching primer and the effect of different primer application techniques on dentin shear bond strength (SBS). MATERIALS AND METHODS: Forty human third molar cervical regions were used in this study. The teeth were randomly divided into four groups (n=10) of different tooth surface conditions: group A: Clearfil Protect Primer applied gently (inactive) + Clearfil Protect Bond; group B: 38% phosphoric acid for 15 s, rinsed 15 s, and dried 15 s + Clearfil Protect Primer applied gently (inactive) + Clearfil Protect Bond; group C: Clearfil Protect Primer applied with agitation by microapplicator brush (active) + Clearfil Protect Bond; group D: 38% phosphoric acid for 15 s, rinsed 15 s, and dried 15 s + Clearfil Protect Primer applied with agitation by microapplicator brush (active) + Clearfil Protect Bond. The SBS test was performed with a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with one-way ANOVA and Tukey HSD tests. RESULTS: The mean SBS values (MPa) and standard deviations are as follows: group A: 36.0 +/- 8.3; group B: 24.0 +/- 3.9; group C: 35.0 +/- 3.3; group D: 30.6 +/- 6.7. CONCLUSION: Acid etching decreased the SBS of the self-etching bonding system to dentin. Active primer application increased the SBS only in acid-etched groups.

The influence of one-step polishing systems on the surface roughness and microhardness of nanocomposites.

OBJECTIVES: This in vitro study evaluated the surface roughness and microhardness of nanocomposites that contain nanoparticles and a microhybrid composite finished and polished with two different one-step polishing systems and a conventional multi-step polishing system. METHODS AND MATERIALS: The materials evaluated were Filtek Supreme XT, Grandio, Ceram X, Aelite Aesthetic Enamel, Tetric EvoCeram and Filtek Z250. A total of 240 specimens (10-mm in diameter, 2 mm thick) were fabricated for both tests (n=120 each test) in a plexiglass mold covered with a Mylar strip. After polymerization, five specimens per group received no polishing treatment and served as the control for both tests. For each composite group (n=15), the specimens were randomly divided into three polishing systems: PoGo, OptraPol and Sof-Lex. All polishing systems were applied according to the manufacturers' instructions after being ground wet with 1200 grid silicon carbide paper. The surface roughness values were determined using a profilometer. The microhardness measurements were performed using a digital microhardness tester (load 500 g; dwell time 15 seconds). The data were analyzed using the one-way ANOVA test at a significance level of 0.05 for both tests. Multiple comparison was performed with the Duncan Multiple Range test. RESULTS: The smoothest surfaces were achieved under Mylar strips in all composite groups (p<0.05). There were no statistically significant differences between polishing systems in the Filtek Supreme XT, Ceram X, Aelite Aesthetic Enamel and Grandio groups for surface roughness (p>0.05). In the Tetric EvoCeram group, Sof-Lex exhibited the highest roughness values. No statistically significant differences were evaluated between polishing systems (p>0.05); whereas, the surfaces under Mylar Strip showed statistically significant lower values than the polished surfaces in terms of microhardness (p<0.05). CONCLUSION: One-step polishing systems may be successfully used for polishing nanocomposites.

Two-year follow-up of fractured anterior teeth restored with direct composite resin: report of three cases.

Thirty-five (case 1), 15 (case 2) and 22 (case 3)-year-old female patients presented to Yeditepe University Dental Faculty Clinic because of esthetic reasons. Fractures of maxillar central incisors including enamel and dentin were diagnosed. Beveling with diamond bur was performed in all four cases. Dentin was cleaned with tungsten carbid bur. The teeth were etched with 37% phosphoric acid, restored with an adhesive system and microhybrid composite. Finishing and polishing procedures were performed by discs (Sof-Lex) and burs. Restorations were found successful according to modified United States Public Health Service (USPHS) criteria after 2 years in terms of retention, color match, marginal discoloration, secondary caries, marginal adaptation, and surface texture.

Effect of one-step polishing systems on surface roughness of different flowable restorative materials.

The purpose of this study was to investigate the influence of one-step polishing systems on the surface roughness of different flowable composites and a microhybrid composite. A total of 120 disks were fabricated and divided into six groups according to the different composite restorative materials tested (n = 20). Each group was further divided into four subgroups according to the polishing system (n = 5). For the control group, samples were left undisturbed after removal of Mylar strip. For the other three subgroups, samples were polished with PoGo, OptraPol, or Sof-Lex disks. Surface roughness was determined using a profilometer and observed under scanning electron microscope (SEM). Data were analyzed by one-way ANOVA and Duncan's multiple range test. For Tetric Flow, Grandio Flow, Filtek Supreme XT Flow, and Admira Flow, their lowest surface roughness values were obtained in Mylar Strip and PoGo groups. For Compoglass Flow, there were no significant differences between Mylar Strip, PoGo, and OptraPol. For Filtek Z250, the lowest surface roughness value was obtained with Mylar Strip. In light of the surface roughness results obtained, one-step polishing systems seemed to be a good choice for polishing flowable composites.

Re-attachment of anterior tooth fragment using a self-etching adhesive: a case report.

AIM: The purpose of this case report is to describe the re-attachment of an anterior tooth fragment using a self-etching adhesive. BACKGROUND: Fracture of anterior teeth by trauma is a common problem in children and teenagers due to their active lifestyle. Restoration of these teeth often presents a challenge because of the large pulp in young teeth and open apical foramen depending on the age of the child. New dental adhesive materials offer an alternative solution for the treatment of some anterior tooth fractures. REPORT: A 17-year-old female patient presented for treatment of a fractured maxillary left central incisor. The clinical examination revealed the exposure of dentin, but there was no exposure of the pulp. The patient saved the tooth fragment making it available for re-attachment to the remaining tooth structure. Under local anesthesia and rubber dam isolation the tooth fragment was re-attached using a self-etching adhesive and a microhybrid composite. SUMMARY: The re-attached tooth fragment was assessed clinically, radiographically, and using photographs at one, six, 12, 24, and 36 month intervals. The tooth remained vital, and there was no change in the color of the tooth at the three-year recall.

Influence of location of the gingival margin on the microleakage and internal voids of nanocomposites.

AIM: The aim of this in vitro study was to investigate the cervical microleakage and internal voids of nanocomposites comparing them with a hybrid composite in Class II restorations with the margins located coronal and apical to the cementoenamel junction (CEJ). METHODS AND MATERIALS: Standardized MOD cavities (one cervical margin located in dentin, one in enamel) were prepared in 40 extracted human molars and divided into four groups according to the composite used to restore them (n=10/group). Group 1: Adper Single Bond2/Filtek Supreme XT; Group 2: Excite/Tetric EvoCeram; Group 3: Prime & BondNT/Ceram X; and Group 4 (control) Adper Single Bond2/Filtek Z250. Groups were further divided into subgroups A and B. The "A" subgroups represent the level of the location of the cervial margin at 1 mm coronal to the CEJ, and the "B" subgroups represent the level of the cervical margin located 1 mm apical to the CEJ. After restoration of the cavities with nanocomposites, thermocycling, and immersion in 0.5% basic fuchsin, the dye penetration and internal voids were evaluated under a stereomicroscope. Data were analyzed with the Mann-Whitney U and Kruskal-Wallis tests with the Bonferroni correction for microleakage and with the Chi-square test for internal voids (p<0.05). RESULTS: The microleakage in the A subgroups was statistically significantly lower then B subgroups (p<0.05). No statistically significant difference was observed in terms of interface, cervical, and occlusal voids for all groups (p>0.05). No significant difference was observed between each group for three voids in all groups (p>0.05). CONCLUSION: The location of the gingival margin affects the microleakage of nanocomposites but has no significant affect on the internal voids. CLINICAL SIGNIFICANCE: Gingival margin located 1 mm coronal to the CEJ provided a reduction in cervical microleakage in nanocomposite restorations.

Various root abnormalities. Report of three cases.

Disturbances during morphodifferentiation of tooth germs are rare in the permanent dentition. Reasons for abnormalities are: trauma (fighting, falling, any sport activity) occurring during the eruption; mechanical blockage of the path of eruption by neoplasms; cysts; supernumerary teeth; therapeutic irradiation of the area; and orthodontic treatment. Abnormalities are classified as dilaceration, extra root formation, double root formation, concrescence, rizomegali and hypercementozis. In this article, three different root abnormalities are presented.

Effect of flowable composite lining on microleakage and internal voids in Class II composite restorations.

PURPOSE: The aim of this study was to determine the influence of four flowable composite linings on marginal microleakage and internal voids in Class II composite restorations with the margins above the cementoenamel junction (CEJ). MATERIALS AND METHODS: Class II cavities were randomly divided into 8 groups (n = 10). Group 1: One Step Plus/Aelite LS Packable; group 2: One Step Plus/Aelite Flow/Aelite LS Packable; group 3: Comfort Bond/Solitaire 2; group 4: Comfort Bond/Flowline/Solitaire 2; group 5: Solobond M/Grandio; group 6: Solobond M/Grandio Flow/Grandio; group 7: Admira Bond/Admira; Group 8: Admira bond/Admira Flow/Admira. After restoration, all teeth were stored for 24 h, thermocycled (at 5 degrees C to 55 degrees C) 500 times, and soaked in 0.5% basic fuchsin dye for 24 h. After soaking, the teeth were sectioned and observed under a stereomicroscope. Gingival marginal microleakage and internal voids (at the gingival wall interface and in the cervical and the occlusal parts) were recorded. Data were analyzed with the Mann-Whitney U- and Kruskal-Wallis tests (p < 0.05). RESULTS: Statistical analyses indicated that the use of flowable resin composites provided a reduction in microleakage in groups 6 and 8. Groups 2 and 4 showed fewer voids in the cervical area than without flowable composites. CONCLUSION: It was concluded that none of the materials tested was able to eliminate the marginal microleakage on the cervical wall. Flowable resin composites under nanohybrid (group 6) and ormocer (group 8) composites provided a significantly different reduction in microleakage compared to restorations without flowable liners. Fewer cervia voids were observed in packable composites with flowable liner (groups 2 and 4) than without flowable liner (groups 1 and 3s).

The influence of Er:YAG laser conditioning versus self-etching adhesives with acid etching on the shear bond strength of orthodontic brackets.

OBJECTIVE: The aim of this study was to compare the shear bond strength (SBS) of orthodontic brackets after acid etching, laser ablation, self-etching primer application, and combined treatments. METHODS: One hundred defect-free premolars were randomly assigned to five groups. The teeth received the following treatments: group 1: phosphoric acid + Transbond XT primer; group 2: Transbond Plus Self-Etching Primer (TPSEP); group 3: Er:YAG laser ablation + Transbond XT primer; group 4: Er:YAG laser ablation + phosphoric acid + Transbond XT primer; and group 5: Er:YAG laser ablation + TPSEP. Transbond XT Adhesive Paste was used in all groups for bracket bonding. Samples were stored in deionized water at 37 degrees C for 24 h. The shear debonding test was performed at a crosshead speed of 5 mm/min. Failed brackets were examined by a stereomicroscope at 16 x magnification to determine the bond failure interface using a modified adhesive remnant index (ARI). SBS values were compared using one-way analysis of variance (ANOVA). The Kruskal-Wallis test was used for ARI scores and pairwise comparisons were done using the Mann-Whitney U test with Bonferroni correction. RESULTS: Mean SBS values (MPa) and standard deviations for the groups were: group 1, 13.18 +/- 3.45; group 2, 13.52 +/- 4.38; group 3, 10.33 +/- 4.74; group 4, 13.00 +/- 3.47; and group 5, 12.46 +/- 6.31. No significant differences were observed in the SBS of all the groups evaluated, but there was a significant difference in ARI scores, with group 3 showing higher ARI scores than groups 1 and 4. CONCLUSIONS: Er:YAG laser ablation and self-etching primer application showed similar SBS values as conventional acidetching for bonding brackets.

Restoring function and esthetics in a patient with amelogenesis imperfecta: a case report.

AIM: The purpose of this case report is to present the esthetic and functional rehabilitation of the teeth in a 22-year-old patient with Amelogenesis imperfecta (AI). BACKGROUND: AI is a group of hereditary defects of enamel, unassociated with any other generalized defects. It is a rare developmental abnormality of the enamel, with a variable occurrence of approximately 1:4000 to 1:14000 in Western populations. Al results in poor development or complete absence of the enamel of the teeth caused by improper differentiation of the ameloblasts. REPORT: This report describes the diagnosis and treatment of a young male patient with AI and missing molar teeth using contemporary restorative strategies. Initially, the tooth surfaces were treated with a professional cleaning along with conservative restorative treatment. Later, metal-ceramic crowns for posterior teeth and full-ceramic crowns for anterior teeth were utilized for final restorations. SUMMARY: The complexity of the management of patients with AI supports the suggestion the dental profession should have appropriate methods for the rehabilitation of rare dental disorders. The treatment of patients with AI should start with early diagnosis and intervention to prevent later restorative problems.

Evaluation of the effect of different ferrule designs on the fracture resistance of endodontically treated maxillary central incisors incorporating fiber posts, composite cores and crown restorations.

AIM: The purpose of this study was to evaluate the fracture resistance of endodontically treated maxillary central incisors restored with quartz fiber posts, composite cores, and crowns when different types of ferrule designs were incorporated. METHODS AND MATERIALS: Sixty maxillary incisors were divided into six groups: Group 1 (control): teeth with root canal treatments having a full crown prosthesis; Group 2: teeth with a 2 mm circumferential ferrule; Group 3: teeth with a 2 mm ferrule only in the vestibular region; Group 4: teeth with a 2 mm ferrule only in the palatal region; Group 5: teeth with a 2 mm ferrule in the vestibular and palatal region, having cavities in both proximal areas; and Group 6: teeth with no ferrule. The teeth in the experimental groups were restored with quartz fiber posts-composite cores and full metallic crowns. All experimental teeth were subjected to an increasing compressive force with a crosshead speed of 1 mm/min, until fracture occurred. RESULTS: The median fracture values of groups were as follows: Group 1: 574.4 N, Group 2: 472.4 N, Group 3: 474.3 N, Group 4: 480.7 N, Group 5: 463.1 N, and Group 6: 297.9 N. A statistically significant difference was found between Group 1 and Group 6 (p< 0.01). CONCLUSION: It was concluded different ferrule designs did not have any influence on the fracture resistance of teeth with fiber posts. The results of this study indicate fiber posts can safely be used for their reinforcing properties. Furthermore, there is no significant change in the resistance of teeth with fiber posts regardless of which ferrule design is incorporated. The property of these types of posts is an additional advantage in clinical practice.

Investigation of the Er: YAG laser and diamond bur cavity preparation on the marginal microleakage of Class V cavities restored with different flowable composites.

The purpose of this study was to evaluate the efficiency of the Er:YAG laser and diamond bur cavity preparation on the marginal microleakage of Class V cavities. Group 1: bur preparation (bp) + Vertise Flow (VF); Group 2: laser preparation (lp) + VF; Group 3: bp + Adper Easy One (AEO) + Filtek Ultimate Flowable Composite (FUFC); Group 4: lp + AEO + FUFC; Group 5: bp + Clearfil S3 Bond (CSB) + Clearfil Majesty Flow (CMF); Group 6: lp + CSB + CMF. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p < .05). More microleakage was observed in cervical regions compared to occlusal regions in all groups (p < .05). No significant difference was observed among all groups in terms of occlusal and cervical surfaces, respectively (p > .05). The use of the Er:YAG laser for cavity preparation with different adhesive systems and flowable composites did not influence microleakage.

Influence of Bleaching Regimen and Time Elapsed on Microtensile Bond Strength of Resin Composite to Enamel.

OBJECTIVES: The aim of this study was to evaluate the effects of time elapsed since bleaching and different bleaching regimens on the microtensile bond strength of resin composite to enamel. METHODOLOGY: Forty flattened buccal enamel surfaces were divided into four groups: An unbleached (control) group and three bleaching groups. Control group specimens were not subjected to a bleaching regimen (Group 1), while those in the bleaching groups were bleached as follows: opalescence 10% (Group 2), whiteness perfect 16% (Group 3), and whiteness hydrogen peroxide 35% (Group 4). Thereafter, the bleached specimens were divided into three subgroups (n = 4 teeth each) for restoration according to predetermined posttreatment time intervals (immediately, 1 week, and 2 weeks). Bonded specimens were then sectioned and subjected to µTBS testing. The data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests at α = 0.05. RESULTS: There was a significant difference in the µTBS of the resin composite to enamel in groups that were bonded immediately after bleaching and in the control group (P < 0.05). Compared to the control group, the µTBS in Groups 2, 3, and 4 decreased significantly 1-week postbleaching (P < 0.05). No significant difference in µTBS was observed between the bleached and unbleached groups 2 weeks after treatment (P > 0.05). CONCLUSIONS: Adhesive restorative procedures could not be performed immediately or after 1 week irrespective of the type or concentration of bleaching system used. Composite restorations on bleached enamel surfaces should be performed after an interval of at least 2 weeks.

Qualitative and quantitative evaluation of enamel after various stripping methods.

INTRODUCTION: In this study, we investigated ultramorphology, surface roughness, and microhardness of permanent and deciduous tooth enamel after various stripping methods. METHODS: One hundred twenty deciduous and permanent teeth (n = 60 each) were used. Qualitative (scanning electron microscopy) and quantitative (surface roughness and microhardness tests) experiments were carried out in the following experimental groups: group 1, stripping disk; group 2, diamond-coated metal strip; group 3, stripping disk and Sof-Lex discs (3M-ESPE, Seefeld, Germany); group 4, diamond-coated metal strip and Sof-Lex discs; group 5 (chemical stripping), 37% orthophosphoric acid in conjunction with diamond-coated metal strip; group 6 (control), no stripping. Surface roughness values (Ra) for permanent and deciduous enamel were evaluated with Welch analysis of variance (ANOVA) and Tamhane tests, and Kruskal-Wallis and Mann-Whitney tests, respectively. Microhardness values were evaluated statistically with Kruskal-Wallis, 1-way ANOVA, and Duncan tests. RESULTS: Deciduous and permanent teeth showed similar results in terms of surface roughness and surface morphology. Groups 3 and 4 had the smoothest deciduous and permanent enamel surfaces, whereas chemical stripping (group 5) produced the roughest surfaces in both enamel types. Stripping did not lead to a significant change in the microhardness of permanent enamel. CONCLUSIONS: All stripping methods significantly roughened the enamel surfaces. Polishing the stripped surface with Sof-Lex discs decreased the roughness.