Could poor glycaemic control be a predictor of walking speed decline in older adults? Evidence from the English Longitudinal Study of Ageing.

AIM: Although diabetes is a risk factor for walking speed decline in older adults, it remains unclear how glycaemic control [assessed by glycated haemoglobin (HbA1c)] might affect the long-term trajectories of walking speed. We investigated whether the glycaemic control status accelerates the walking speed decline and whether this decline differs depending on previous mobility conditions. MATERIALS AND METHODS: In total, 3202 individuals aged ≥60 years from the English Longitudinal Study of Ageing (ELSA) were classified at baseline and after 4 and 8 years of follow-up according to glycaemic control status as 'without diabetes' (no self-reported diabetes and HbA1c <6.5%), 'good glycaemic control' (self-reported diabetes and HbA1c ≥6.5% and <7.0%) and 'poor glycaemic control' (PGC) (self-reported diabetes and HbA1c ≥7.0%). The generalized linear mixed models verified the walking speed trajectories in m/s. A second analysis was performed, including only participants without slowness at baseline (>0.8 m/s). RESULTS: Compared with the status 'without diabetes', the annual walking speed decline was -0.015 m/s for PGC and -0.011 m/s for good glycaemic control, totalling -0.160 and -0.130 m/s, respectively, over 8 years. Among those without slowness at baseline, only PGC had a significant walking speed decline, corresponding to -0.014 m/s per year and -0.222 m/s over 8 years. CONCLUSIONS: Poor glycaemic control is a discriminator of walking speed decline in older adults, regardless of previous mobility conditions. It may serve as an early screening tool for those at risk of decreased functional performance later in life.

Compressive modulus, translucency, and irradiance transmittance of clear PVS materials used for resin injection molding technique.

OBJECTIVES: To evaluate the compressive modulus, translucency, and light curing irradiance transmittance of four clear polyvinyl siloxane (PVS) materials used for the injection molding technique at varying thicknesses, and to assess the correlation between color parameters and irradiance transmittance. MATERIALS AND METHODS: Four clear PVS materials (Exaclear, Clear Bite Matrix, Affinity Crystal, and Memosil 2) were used in this study. Compressive modulus was measured by compressing cylindrical PVS specimens (n = 9; d = 10 mm; t = 6 mm) up to 30% strain using a universal testing machine. For the translucency analysis and irradiance transmittance, specimens (n = 5) were fabricated with five different thicknesses (d = 12 mm and t = 2, 4, 6, 8 and 10 mm). The L*, a, *b* values of specimens were obtained using a CIELab spectrophotometer (CMD-700, Konica Minolta) with calibrated white and black tiles; the translucency parameter was calculated. The same specimens were placed onto a spectrophotometer (MARC Light Collector) to measure irradiance transmitted through the specimens from a light curing unit (Valo Corded, Ultradent). Data were analyzed using analysis of variance (ANOVA) with Tukey post hoc test and the correlation between translucency and irradiance transmittance of materials for each thickness was evaluated using Pearson's correlation. RESULTS: Compressive modulus differences in PVS materials were significant (one-way ANOVA: df = 3, F = 76.27, p < 0.001); Affinity and Memosil 2 were highest with no significant difference between them (Tukey: t = -1.62; p = 0.382). Clear Bite was higher than Exaclear (Tukey: t = -3.70; p = 0.004). Exaclear was lowest. Translucency decreased with thickness (Two-way ANOVA: df = 3, F = 586.53, p < 0.001; thickness: df = 4, F = 1389.34, p < 0.001). Exaclear was most translucent at all thicknesses. L*, a*, b* values varied by material and thickness (L*: df = 3, F = 1213.32, p < 0.001; a*: df = 3, F = 10766.8, p < 0.001; b*: df = 3, F = 3260.42, p < 0.001). Memosil 2 had lowest b* values. Irradiance transmittance was affected by material and thickness (Two-way ANOVA: df = 4, F = 2388.86, p < 0.001). Exaclear had highest irradiance transmission, surpassing control at >6 mm. Violet/blue irradiance ratio decreased with thickness; Exaclear maintained a constant ratio, indicating preserved violet irradiance. There was a strong positive correlation between translucency and light irradiance (Pearson's r = 0.97, R2 = 0.86-0.96). Radiant exposure analysis suggests adjusting the curing time based on PVS thickness for optimal exposure (10 J/cm2) is achievable within 13-14 s for <2 mm and 21-30 s for 8-10 mm with Clear Bite, Affinity, and Memosil 2; whereas Exaclear requires less time. CONCLUSIONS: Compressive modulus in clear PVS materials varied by type; Affinity and Memosil 2 demonstrate higher modulus, offering more stability of the clear mold. Translucency and irradiance transmission through clear PVS materials decreased as their thickness increased, yet Exaclear exceled in maintaining high translucency and superior light transmission capabilities. Additionally, there is a strong positive linear correlation between translucency and light irradiance transmittance, offering a method to adjust curing times effectively based on material translucency. CLINICAL SIGNIFICANCE: The light curing time to adequately polymerize composite through clear impression material may need to be increased, particularly with thicker matrices or less translucent materials.

Flexural properties and fatigue limit of 3D-printed and milled resin-based materials.

PURPOSE: The purpose of this study was to evaluate the flexural strength (FS), flexural modulus (FM), and fatigue limit (FL) of 3D-printed resin-based polymers and composites and compare them to 3D-printed composites. MATERIALS AND METHODS: A bar-shaped specimen (25 × 2 × 2 mm) was CAD designed according to ISO 4049:2019, and 60 duplicates of the 3D model were nested at a 45-degree angle with the printing platform and 3D-printed with three materials: denture teeth resin (Denture Teeth, Formlabs), temporary crown and bridge resin (Temporary CB, Formlabs), and composite (Flexcera Smile Ultra+, Desktop Health). The 3D model was also imported into a dental CAM software, duplicated 60 times, nested, and milled from a 3D-milled composite puck (Ivotion Denture Teeth, Ivoclar). All specimens were post-processed following the manufacturer's recommendation. The specimens were then subjected to a three-point bending test until failure using a Universal Testing Machine at a crosshead speed of 0.75 mm/min, and FS and FM were calculated. The remaining thirty specimens were tested for Fatigue Limit using the staircase approach starting at 50% FS maximum up to 1.2 M cycles at 10 Hz. The data were analyzed using one-way ANOVA and the Weibull distribution (α = 0.05). RESULTS: The results showed that Ivotion and Flexcera had higher FS (110.3 ± 7.1 MPa and 107.6 ± 6.4 MPa, respectively) and FM (3.3 ± 0.1 GPa and 3.0 ± 0.2 GPa, respectively) compared to the 3D-printed Denture Teeth (FS = 66.4 ± 18.5 MPa and FM = 1.8 ± 0.1 GPa) and Temporary CB (FS = 79.6 ± 12.1 MPa and FM = 2.7 ± 0.4 GPa). Weibull analysis showed that the Ivotion and Flexcera had a more uniform and narrower spatial distribution of defects (m: 27.98 and 29.19) than the printed materials, which had m values of 8.17 and 4.11 for Temporary CB and Denture Teeth, respectively. Although no differences were found in the static properties (FS and FM) between Ivotion and Flexcera, Ivotion presented a higher endurance limit than Flexcera (51.43 vs. 40.95 MPa). The Temporary CB presented 21.08 MPa and Denture Teeth presented 17.80 MPa of endurance limit. CONCLUSIONS: 3D-milled (Ivotion Denture Teeth) and 3D-printed (Flexcera Smile Ultra+) composites outperformed 3D-printed resins (Formlabs Denture Teeth and Temporary Crown & Bridge) in terms of flexural properties and fatigue resistance. 3D-milled (Ivotion) and 3D-printed (Flexcera) composites exhibited similar flexural properties, but 3D-milled composites showed a 25% higher fatigue endurance limit, suggesting improved clinical longevity.

Is dynapenic abdominal obesity a risk factor for cardiovascular mortality? A competing risk analysis.

BACKGROUND: Dynapenic abdominal obesity has been shown as a risk factor for all-cause mortality in older adults. However, there is no evidence on the association between this condition and cardiovascular mortality. OBJECTIVE: We aimed to investigate whether dynapenic abdominal obesity is associated with cardiovascular mortality in individuals aged 50 and older. METHODS: A longitudinal study with an 8-year follow-up was conducted involving 7,030 participants of the English Longitudinal Study of Ageing study. Abdominal obesity and dynapenia were respectively defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). The outcome was cardiovascular mortality. The Fine-Grey regression model was used to estimate the risk of cardiovascular mortality as a function of abdominal obesity and dynapenia status in the presence of competing events controlled by socio-demographic, behavioural and clinical variables. RESULTS: The risk of cardiovascular mortality was significantly higher in individuals with D/AO compared with ND/NAO (SHR 1.85; 95% CI: 1.15-2.97). D/NAO was also associated with cardiovascular mortality (SHR: 1.62; 95% CI: 1.08-2.44). CONCLUSION: Dynapenic abdominal obesity is associated with cardiovascular mortality, with a larger effect size compared to dynapenia alone in individuals older than 50 years. Thus, prevention strategies and clinical interventions that enable mitigating the harmful effects of these conditions should be adopted to diminish such risk.

Curing profile and marginal gap formation using a liner containing long-wavelength-absorbing photoinitiator: an in vitro study.

The aim was to evaluate the marginal-gap formation and curing profile of a new restorative technique using a liner with long-wavelength-absorbing photoinitiator (LWAP). Box-shaped preparations (6 mm × 4 mm × 4 mm) were made in third molars. All samples were treated with Clearfill SE Bond and divided into 4 groups (n = 5), according to restorative technique used: (1) incremental technique (INC-Technique); (2) camphorquinone-based liner (CQ-Liner) + bulk-fill resin composite; (3) LWAP-based liner (LWAP-Liner) + bulk-fill resin composite; and (4) bulk-fill technique without liner (BF-Technique). The marginal gaps (%) for all the samples were measured using micro-computed tomography. The restorations were cross-sectioned, and the degree of conversion (DC) and Knoop microhardness were evaluated at different depths (0.3, 1, 2, 3, and 4 mm). INC-Technique, CQ-Liner, and LWAP-Liner groups showed significantly fewer marginal gaps than those from the BF-Technique group. The BF-Technique specimens had the lowest DC and microhardness in depth. All the other techniques presented similar degree of conversion and microhardness at all the depths. The use of liners, regardless of the photoinitiator system, decreased the marginal-gap formation and improved the curing profile of bulk-filling restoration technique.

Using artificial intelligence to predict the final color of leucite-reinforced ceramic restorations.

OBJECTIVES: The aim of this study was to evaluate the accuracy of machine learning regression models in predicting the final color of leucite-reinforced glass CAD/CAM ceramic veneer restorations based on substrate shade, ceramic shade, thickness and translucency. METHODS: Leucite-reinforced glass ceramics in four different shades were sectioned in thicknesses of 0.3, 0.5, 0.7, and 1.2 mm. The CIELab coordinates of each specimen were obtained over four different backgrounds (black, white, A1, and A3) interposed with an experimental translucent resin cement using a calibrated spectrophotometer. The color change (CIEDE2000) values, as well as all the CIELab values for each one of the experimental groups, were submitted to 28 different regression models. Each regression model was adjusted according to the weights of each dependent variable to achieve the best-fitting model. RESULTS: Different substrates, ceramic shades, and thicknesses influenced the L, a, and b of the final restoration. Of all variables, the substrate influenced the final ceramic shade most, followed by the ceramic thickness and the L, a, and b of the ceramic. The decision tree regression model had the lowest mean absolute error and highest accuracy to predict the shade of the ceramic restoration according to the substrate shade, ceramic shade and thickness. CLINICAL SIGNIFICANCE: The machine learning regression model developed in the study can help clinicians predict the final color of the ceramic veneers made with leucite-reinforced glass CAD/CAM ceramic HT and LT when cemented with translucent cements, based on the color of the substrate and ceramic thicknesses.

Are Serum 25-Hydroxyvitamin D Deficiency and Insufficiency Risk Factors for the Incidence of Dynapenia?

Epidemiological evidence showing the association between low 25(OH)D and age-related reduction in neuromuscular strength (dynapenia) is a paucity and controversial and, to date, the effect of osteoporosis and vitamin D supplementation on these associations has not been measured. Thus, we analyze whether serum 25(OH)D deficiency and insufficiency are risk factors for the incidence of dynapenia in individuals aged 50 or older and whether osteoporosis or vitamin D supplementation modify these associations. For that, 3205 participants of the ELSA study who were non-dynapenic at baseline were followed for 4 years. Vitamin D was measured at baseline by the serum concentration of 25(OH)D and classified as sufficient (> 50 nmol/L), insufficient (≥ 30 and ≤ 50 nmol/L) or deficient (< 30 nmol/L). The incidence of dynapenia was determined by a grip strength < 26 kg for men and < 16 kg for women at the end of the 4-year follow-up. Poisson regression models were adjusted by sociodemographic, behavioral, clinical and biochemical characteristics. Serum 25(OH)D deficient was a risk factor for the incidence of dynapenia (IRR = 1.70; 95% CI 1.04-2.79). When only individuals without osteoporosis and those who did not use vitamin D supplementation were analyzed, both serum 25(OH)D deficiency (IRR = 1.78; 95% CI 1.01-3.13) and insufficiency (IRR = 1.77; 95% CI 1.06-2.94) were risk factors for the incidence of dynapenia. In conclusion, a serum level of 25(OH)D < 30 nmol/L is a risk factor for the incidence of dynapenia. Among individuals without osteoporosis and those who do not take vitamin D supplementation, the threshold of risk is higher (≤ 50 nmol/L).

Mechanical properties of bulk-fill composite resin with or without a final layer of conventional composite resin.

The objective of this in vitro study was to evaluate the mechanical properties of different bulk-fill composite resins with or without a final layer of conventional composite resin. The null hypothesis was that the mechanical properties of the material would not change regardless of the addition of a layer of conventional composite. Bar-shaped specimens (25 × 2 × 2 mm) were made from 4 different bulk-fill composites (Filtek One Bulk Fill, Filtek Bulk Fill Flowable, Tetric EvoCeram Bulk Fill, and Tetric EvoCeram Bulk Fill Flow) with or without a final layer of a conventional composite of the same brand (Filtek Supreme for the Filtek materials and Tetric EvoCeram for the Tetric materials). Each specimen was light cured at 2 equidistant points using a multiwave curing light with a power output of 20 J/cm2. All of the specimens were subjected to a 3-point bending test in a universal testing machine at a crosshead speed of 0.75 ± 0.25 mm/min and a load rate of 50 ± 16 N/min, and the flexural strength and elastic modulus were calculated. The mean flexural strength and elastic modulus values were analyzed using 1-way analysis of variance, and then the Tukey test was applied for multiple comparisons between groups (α = 0.05). When a final layer of a conventional composite of the same brand was added, the mean flexural strength of the Tetric groups slightly decreased, while that of the Filtek groups did not change. Application of a final layer of conventional composite resulted in a slight increase in the mean elastic modulus of the Filtek groups and either no change or a slight decrease in the Tetric groups. The addition of a final layer of conventional composite resin did not seem to improve the mechanical properties of any of the tested bulk-fill materials. The addition of a final layer of conventional composite resin can affect the mechanical properties of bulk-fill materials; however, it seems these effects are dependent on the type of conventional composite resin used for the final layer.

Dynapenia, abdominal obesity or both: which accelerates the gait speed decline most?

OBJECTIVE: to investigate whether the combination of dynapenia and abdominal obesity is worse than these two conditions separately regarding gait speed decline over time. METHODS: a longitudinal study was conducted involving 2,294 individuals aged 60 years or older free of mobility limitation at baseline (gait speed >0.8 m/s) who participated in the English Longitudinal Study of Ageing. Dynapenia was determined as a grip strength <26 kg for men and <16 kg for women. Abdominal obesity was determined as a waist circumference >102 cm for men and >88 cm for women. The participants were divided into four groups: non-dynapenic/non-abdominal obese (ND/NAO); only abdominal obese (AO); only dynapenic (D) and dynapenic/abdominal obese (D/AO). Generalised linear mixed models were used to analyse gait speed decline (m/s) as a function of dynapenia and abdominal obesity status over an 8-year follow-up period. RESULTS: over time, only the D/AO individuals had a greater gait speed decline (-0.013 m/s per year, 95% CI: -0.024 to -0.002; P < 0.05) compared to ND/NAO individuals. Neither dynapenia nor abdominal obesity only was associated with gait speed decline. CONCLUSION: dynapenic abdominal obesity is associated with accelerated gait speed decline and is, therefore, an important modifiable condition that should be addressed in clinical practice through aerobic and strength training for the prevention of physical disability in older adults.

Assessing single effects of sugarcane pesticides fipronil and 2,4-D on plants and soil organisms.

The continuous growth in global population since the beginning of the 20th century result in the necessity of food and energy provision favoring the intensive use of agricultural products such as pesticides. Although pesticides are important to prevent losses in the conventional chemically based agriculture, they frequently present side effects, which goes against agricultural production. The use of pesticides cause direct and indirect effects to soil organisms unbalancing essential soil processes (e.g. primary production, organic matter decomposition, nutrient cycling). Under tropical conditions, very little is known regarding the effects of pesticides to terrestrial organisms. Hence, the aim of the present study was to assess the ecotoxicological effects of the herbicide DMA® 806 BR (active ingredient: 2,4-D) and the insecticide Regent® 800 WG (active ingredient: fipronil), on terrestrial plant species (the dicot Raphanus sativus var. acanthioformis and the monocot Allium cepa), and soil invertebrates (the collembolan Folsomia candida and the enchytraeid Enchytraeus crypticus), using natural (NS) and artificial soils (TAS). For both pesticides, negative effects on non-target species were observed at concentrations lower than the doses recommended to prevent pests in sugarcane fields. For both soils, the dicot species was the most affected by the herbicide (R. sativus > A. cepa > F. candida > E. crypticus) and the collembolan species was the most affected by the insecticide (F. candida > E. crypticus = R. sativus = A. cepa). Although the order of the organisms' sensitivity for both pesticides was the same in both soils, results showed that the extent of the effects was soil dependent. Considering the ecologically relevant concentrations tested, and their severe effects to non-target organisms, it may be concluded that the use of fipronil and 2,4-D under recommended conditions may pose a risk to the terrestrial environment.

Whipworm Infection Promotes Bacterial Invasion, Intestinal Microbiota Imbalance, and Cellular Immunomodulation.

Infections with Trichuris trichiura are among the most common causes of intestinal parasitism in children worldwide, and the diagnosis is based on microscopic egg identification in the chronic phase of the infection. During parasitism, the adult worm of the trichurid nematode maintains its anterior region inserted in the intestinal mucosa, which causes serious damage and which may open access for gut microorganisms through the intestinal tissue. The immune-regulatory processes taking place during the evolution of the chronic infection are still not completely understood. By use of the Swiss Webster outbred mouse model, mice were infected with 200 eggs, and tolerance to the establishment of a chronic Trichuris muris infection was induced by the administration of a short pulse of dexamethasone during nematode early larval development. The infected mice presented weight loss, anemia, an imbalance of the microbiota, and intense immunological cell infiltration in the large intestine. It was found that mice have a mixed Th1/Th2/Th17 response, with differences being found among the different anatomical locations. After 45 days of infection, the parasitism induced changes in the microbiota composition and bacterial invasion of the large intestine epithelium. In addition, we describe that the excretory-secretory products from the nematode have anti-inflammatory effects on mouse macrophages cultured in vitro, suggesting that T. muris may modulate the immune response at the site of insertion of the worm inside mouse tissue. The data presented in this study suggest that the host immune state at 45 days postinfection with T. muris during the chronic phase of infection is the result of factors derived from the worm as well as alterations to the microbiota and bacterial invasion. Taken together, these results provide new information about the parasite-host-microbiota relationship and open new treatment possibilities.

Association of Serum 25-Hydroxyvitamin D Deficiency with Risk of Incidence of Disability in Basic Activities of Daily Living in Adults >50 Years of Age.

BACKGROUND: Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. OBJECTIVES: We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. METHODS: A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. RESULTS: After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. CONCLUSIONS: Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults >50 y old and should be an additional target of clinical strategies to prevent disability in these populations.

Effect of Thickness of Ceramic Veneers on Color Stability and Bond Strength of Resin Luting Cements Containing Alternative Photoinitiators.

PURPOSE: To evaluate the light transmittance of ceramic veneers of different thicknesses and verify their influence on the degree of conversion, color stability, and dentin bond strength of light-curing resin cements containing different photoinitiator systems. MATERIALS AND METHODS: Experimental resin cements were fabricated containing camphorquinone and amine (CQ-amine), TPO, Ivocerin (IVO), or TPO and Ivocerin (TPO-IVO). All photoinitiators were characterized by UV-Vis spectrophotometry. Disk-shaped lithium disilicate ceramic specimens that were 0.4, 0.7, and 1.5 mm in thickness were prepared using IPS e.max Press (Ivoclar Vivadent, shade LT/A2). Light transmittance through each specimen was measured using spectrophotometry. Specimens of each cement (n = 10) were made in a custom-designed mold and were light cured through each glass-ceramic disk using a multiwave LED (Bluephase G2, Ivoclar Vivadent). CS was evaluated using spectrophotometry before and after artificial aging with UV light. DC was evaluated using FTIR-spectroscopy. Dentin µSBS was evaluated using 0.75-mm-thick specimens that were light cured under the same protocol (n = 10). All data were submitted to two-way ANOVA and Tukey's test (α = 0.05; ß = 0.2). RESULTS: CQ-amine cements showed the highest color changes (p < 0.05) due to increased yellowing when compared to the amine-free cements (p < 0.05). However, all cements showed a significant color change after aging when cured through ceramics up to 1.5 mm thick (p < 0.05). The TPO-IVO cement showed the highest DC and the IVO cement showed a similar DC when compared to the CQ-amine cement. The TPO cement presented the lowest DC (p = 0.0377). No differences in mean dentin µSBS were found among the cements, except for the TPO cement, which presented a lower mean dentin µSBS (p = 0.0277). CONCLUSION: Amine-free cements containing Ivocerin and TPO seem to be a better alternative to CQ-amine cements, while not reducing either DC or dentin µSBS of amine-free cements. However, CQ-amine and amine-free cements still seem to change color over time.

Simplified ethanol wet-bonding technique: an alternative strategy for resin-dentin bonding in root canals.

The objective of this study was to evaluate the effect of the simplified ethanol wet-bonding technique on luting of posts to intraradicular dentin. The effect was assessed by push-out bond strength testing and confocal laser scanning microscopic analysis. Thirty endodontically treated roots were distributed into 3 groups (n = 10): water wet-bonding; stepwise ethanol wet-bonding; and simplified ethanol wet-bonding. After cementation of the posts, the roots were sectioned. Specimens were stored for 24 hours or 1 year before they were stressed to failure. Specimens from each group were processed for microscopic analysis. Data were analyzed using a 2-way analysis of variance and the Tukey test (α = 0.05). Statistically significant differences in push-out bond strength values were observed between the technique groups (P < 0.001) and between the storage periods (P = 0.009). The bond strength results in the group bonded using the simplified ethanol wet-dehydration approach did not differ from those in the group bonded using the stepwise ethanol technique at either storage time interval (P > 0.05). From 24 hours to 1 year, there was a similar decrease in bond strength for specimens prepared with the simplified and stepwise techniques. The microscopic results confirmed that ethanol wet-bonding technique improved the quality of the interface. The simplified ethanol wet-dehydration protocol achieved bond strengths and stability over time that were similar to those obtained with the stepwise ethanol technique and may be considered an alternative strategy to accomplish resin cement-root dentin bonding.

Effect of Nanofiller Loading on Cure Efficiency and Potential Color Change of Model Composites.

OBJECTIVES: To evaluate the effect of nanofiller loading on cure efficiency and potential color change of experimental composites. MATERIALS AND METHODS: Four different polymeric materials were produced using the same organic matrix blend. To this matrix, different amounts of 0.05 µm fumed silica filler were added: no filler, 13, 52, and 65wt%. Fourier transform infrared spectroscopy was used to evaluate the degree of conversion (DC) for each composite using near-IR analysis, and spectrophotometry according to CIELab chromatic space was used to evaluate the color change.To induce color change, composites were artificially aged with exposure to cycles of UV-B light for 300 hours. Trasmission electron microscopy was used to illustrate nanoffiler aglomeration in the resin matrix. Data were analyzed using correlation analysis (α = 0.05). RESULTS: There was an excellent inverse linear correlation between filler wt% and either DC or color change. Greater changes to red (+Δa) and yellow (+Δb) were observed as the filler wt% increased. CONCLUSIONS: A higher percentage of nano-sized filler particles in dental resin composites directly affects their cure efficiency and potential for color change. CLINICAL SIGNIFICANCE: The increase in filler particle loading negatively affected monomer conversion and color stability of resin-based composites. As reduced filler loading results in poorer mechanical properties, to enhance color stability, resin-based composites should be formulated by making the refractive index of the polymeric matrix more closely match that of the filler throughout the polymerization process. (J Esthet Restor Dent, 2016).

Effect of Different In Vitro Aging Methods on Color Stability of a Dental Resin-Based Composite Using CIELAB and CIEDE2000 Color-Difference Formulas.

PURPOSE: To evaluate the effect of different in vitro aging methods on color change (CC) of an experimental dental resin-based composite using CIELAB (ΔEab ) and CIEDE2000 (ΔE00 ) color-difference formulas. MATERIALS AND METHODS: The CC was evaluated with a spectrophotometer (CM700d, Konica Minolta, Tokyo, Japan) according to the CIE chromatic space. Disk-shaped specimens (Φ = 5 × 1 mm thick) (N = 10) were submitted to different in vitro aging methods: 30 days of water aging (WA); 120 hours of ultraviolet light aging (UVA); or 300 hours of an accelerated artificial aging (AAA) method with cycles of 4 hours of UV-B light exposure and 4 hours of moisture condensation to induce CC. The temperature was standardized at 37°C for all aging methods. CC was evaluated with ΔEab and ΔE00 formulas. Differences in individual Lab coordinates were also calculated. Data for the individual color parameters were submitted to one-way analysis of variance and Tukey's test for multiple comparisons (α = 0.05). RESULTS: All in vitro aging methods tested induced CC, in the following order: WA: ΔEab = 0.83 (0.1); ΔE00 = 1.15 (0.1) < AAA: ΔEab = 5.64 (0.2); ΔE00 = 5.01 (0.1) < UVA: ΔEab = 6.74 (0.2); ΔE00 = 6.03 (0.4). No changes in L* or a* coordinates were ≥1; the methods with UV aging showed a yellowing effect due a large positive change in b*. CONCLUSIONS: All in vitro aging methods tested induced a CC, but to different extents. Changes in color followed similar trends, but with different absolute values when calculated with the CIELAB and the CIEDE2000 formulas. CLINICAL SIGNIFICANCE: Establishing the efficacy of different artificial aging methods and differences between color change using CIELAB and CIEDE2000 formulas are important to standardize color stability evaluations and facilitate the comparison of outcomes from different studies in the literature.

Nanoleakage of fiber posts luted with different adhesive strategies and the effect of chlorhexidine on the interface of dentin and self-adhesive cements.

The aim of this in vitro study was to evaluate the nanoleakage of fiber posts luted using different adhesive strategies and to investigate the effect of 2% chlorhexidine (CHX) on nanoleakage at the resin-dentin interfaces of self-adhesive cements. The self-adhesive and etch-and-rinse adhesive groups tested demonstrated similar results with regard to nanoleakage. Pretreatment with CHX promoted an adequate seal at the resin-dentin interface for self-adhesive cements.

Color stability and polymerization behavior of direct esthetic restorations.

OBJECTIVES: The current study evaluated the effect of accelerated artificial aging (AAA) on the color stability (CS) and degree of conversion (DC) of nanofilled and nanohybrid resin composites associated to different adhesive systems in direct esthetic restorations. MATERIAL AND METHODS: Eighty bovine incisors were used to obtained dentin blocks (4 × 4 × 1 mm). The restorative systems were bonded to the blocks and photoactivated according to the manufacturer's instructions. Three adhesive systems were used: Adper Scotchbond Multi-Purpose (conventional of three steps), Tetric N-Bond (conventional of two steps) and ClearFill SE Bond (self-etching). Also, two composites were used: Filtek Z350 XT (nanofilled) and IPS Empress Direct (nanohybrid). The restorations were made using a silicone mold placed on top of the prepared dentin blocks (N = 10). CS was measured after 300 hours of AAA by means of ultraviolet light using a spectrophotometer and CIE L*a*b* parameters on the top surface of the composite and at the bonded interface. The DC was performed using Fourier transform infrared spectroscopy (N = 10). Data were analyzed using two-way analysis of variance and Tukey's test (α = 0.05). RESULTS: The adhesive systems had no significant influence on the color stability (ΔE) of either the restoration surface (α = 0.90) or the bonded interface (α = 0.78). However, composite influenced the color as measured by ΔE and isolated coordinates (α < 0.001). The nanohybrid composite showed increased DC values (67%) compared with the nanofilled (61%) with statistically significant differences (α < 0.001). CONCLUSIONS: The adhesive system did not affect the final color of direct esthetic restorations. The nanohybrid composite demonstrated a higher DC and increased color stability after AAA compared to the nanofilled composite. CLINICAL SIGNIFICANCE: The long-term color stability of composite restorations is a critical aspect of esthetic restorative procedures. Optimal Polymerization behavior of resin composite as indicated by the degree of conversion also influence on the color stability after artificial aging of composite restorations.

Minimally invasive cosmetic dentistry: smile reconstruction using direct resin bonding.

Discrepancies in tooth size and shape can interfere with smile harmony. Composite resin can be used to improve the esthetics of the smile at a low cost while offering good clinical performance. This article presents an approach for restoring and correcting functional, anatomic, and esthetic discrepancies with minimal intervention, using composites and a direct adhesive technique. This conservative restorative procedure provided the patient with maximum personal esthetic satisfaction.

Effect of butylated hydroxytoluene (BHT) concentrations on polymerization shrinkage stress and other physicochemical properties of experimental resin composites.

The present study examined different concentrations of the butylated hydroxytoluene (BHT) inhibitor on the kinetics of conversion, polymerization shrinkage stress, and other correlated physicochemical properties of experimental resin composites (ERC). A model composite was formulated with 75 wt% filler containing 0.5 wt% camphorquinone and 1 wt% amine with BHT concentrations of 0.01 wt% (BHT-0.01); 0.1 wt% (BHT-0.1); 0.25 wt% (BHT-0.25); 0.5 wt% (BHT-0.5); 1 wt% (BHT-1), and control (no BHT). They were tested on polymerization shrinkage stress (PSS; n = 5), degree of conversion (DC; n = 3), maximum polymerization rate (RpMAX; n = 5), water sorption (Wsp; n = 0), and solubility (Wsl; n = 10), flexural strength (FS; n = 10), flexural modulus (FM; n = 10), Knoop microhardness (KH; n = 10), and microhardness reduction (HR; n = 10). Data concerning these tests were submitted to one-way ANOVA and Tukey's test (α = 0.05; ß = 0.2). BHT-0.25, BHT-0.5, and BHT-1 showed a gradually significant decrease in PSS (p = 0.037); however, BHT-1 demonstrated a decrease in the physicochemical properties tested. Thus, within the limitations of this study, it was possible to conclude that BHT concentrations between 0.25 and 0.5 wt% are optimal for reducing shrinkage stress without affecting other physicochemical properties of ERCs.