Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate, Proanthocyanidin, Carbon Dioxide Laser Remineralization on the Bond Integrity of Composite Restoration Bonded to Caries-Affected Dentin.

Objective: Assessment of different remineralizing pretreatment casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), proanthocyanidin (PA), carbon dioxide laser (CO2), eggshell solution (ES) on the shear bond strength (SBS) of resin composite bonded to remineralized carious-affected dentin (CAD). Materials and methods: Eighty human molars were collected with occlusal caries that extended about halfway into the dentin. Using a water-cooled, low-speed cutting saw, a flat, mid-coronal dentin surface was exposed. CAD was differentiated from healthy dentin. Based on the remineralizing agent used on the CAD surface, the teeth were arbitrarily allocated into five groups (n = 10). Group 1: no remineralizing agent, Group 2: CPP-ACP, Group 3: 6.5% PA solution, Group 4: CO2 laser, and Group 5: ES solution. All samples were bonded to composite and light cured and thermocycled. SBS and failure mode analysis were performed using universal testing and stereomicroscope 40 × . Using SPSS, SBS, and failure mode data were analyzed using analysis of variance and Tukey's honesty significant difference (HSD) test Results: Group 3 (6.5% PA solution; 15.59 ± 1.44 MPa) samples established the maximum bond integrity. Nevertheless, Group 1 (No remineralizing agent; 11.19 ± 1.21 MPa) exhibited the minimum outcome of bond strength. Intergroup comparison analysis showed that Group 1 (No remineralizing agent), Group 2 (CPP-ACP), and Group 4 (CO2 laser) established comparable values of bond strength (p > 0.05). Likewise, Group 3 (6.5% PA solution) and Group 5 (EA solution) also revealed equivalent bond integrity (p > 0.05). Conclusions: PA and ES are considered potential remineralizing agents used for caries-affected dentin surfaces in improving bond integrity to composite resin. However, further studies are advocated to extrapolate the findings of this study.

An in vitro evaluation of microleakage of resin based composites bonded to chlorhexidine-pretreated dentin by different protocols of a universal adhesive system.

PURPOSE: This study compared microleakage of different resin based composite (RBC) materials bonded to dentin, after chlorhexidine (CHX) application, by different adhesion protocols of a universal adhesive system. METHODS: Class V cavities were prepared on the buccal and lingual surfaces of 40 premolar teeth. The "etch-and-rinse" technique of a universal bond adhesive system (Single Bond Universal Adhesive) was used on buccal preparations, while the "self-etch" protocol was used on the lingual surfaces. Two RBCs, one bulk fill (Filtek Bulk Fill [FBF]) and one conventional (Filtek Z350 XT [Z350XT]), were used. Teeth were divided into two groups of 20 teeth each, 10 per each RBC (n = 10): (1) control; and (2) pretreatment with 2% CHX. For FBF groups, teeth were restored with a single increment; however, for Z350XT, a layering technique was used. Teeth were aged by thermo-cycling and prepared for microleakage testing. Dye penetration was evaluated and scored from 0 to 4. Data were analyzed at a significance level of P < 0.05. RESULTS: The highest microleakage mean scores were found in the control group of the etched margins for both RBCs (2.80 ± 1.033 FBF and 2.10 ± 1.370 Z350XT). The CHX-pretreated group showed significantly lower microleakage than the control for FBF only (P = 0.008). No significant difference was found between groups for the "self-etch" protocol (χ2 = 0.884, P = 0.08). No significant differences were found between FBF and Z350XT in all study groups (P > 0.2). CONCLUSIONS: When the "self-etch" protocol of the universal adhesive system was used, dentin microleakage was not affected by CHX-pretreatment when teeth were restored with bulk fill or conventional RBCs. In the "etch-and-rinse" protocol, CHX application improved the marginal seal before restoration with bulk fill material. However, in the absence of CHX, the "etch-and-rinse" protocol negatively affected marginal integrity.

Technical Accuracy of Dental Laboratories in the Quality and Shade Matching of Porcelain Fused to Metal Crowns: An In Vitro Study.

Dental laboratories (LABs) are integral to the performance of a dentist in providing successful oral rehabilitation. The aim of this study was to compare the adaptation, contour, contacts, and shade matching of different government and commercial dental LABs in the fabrication of porcelain fused to metal (PFM) crowns. Thirty-two dental LABs were selected to fabricate PFM crowns (one PFM crown each). Marginal adaptation, contour, proximal contacts, and shade matching were evaluated. Evaluation of the crowns' quality was performed following modified USPHS/FDI criteria. Visual and colorimeter assessments were employed to evaluate shade matching. Differences between groups were examined by Pearson's Chi-square and Fisher's exact test. The quality of marginal adaptation of crowns was good in 81.25%, however the quality of contours, contacts, and shade matching was compromised in 43.75%, 59.38%, and 39% of all LABs, respectively. Visual and colorimeter shade matching was acceptable in 62.5% and 80% of LABs in the cervical third and middle third regions of crowns, respectively, however in the incisal third the shade matching was unacceptable in nearly 60% of LABs. Commercial laboratories showed significantly better contours and shade matching, but not marginal adaptation. However, no significant differences were found in comparison of proximal contacts between the groups.

Graphene oxide nano-filler based experimental dentine adhesive. A SEM / EDX, Micro-Raman and microtensile bond strength analysis.

AIM: The study aimed to assess graphene oxide (GO) adhesive and its dentin interaction using scanning electron microscopy (SEM), MicroRaman spectroscopy and Microtensile bond strength (µTBS). MATERIALS AND METHODS: Experimental GOA and control adhesives (CA) were fabricated. Presence of GO within the experimental adhesive resin was assessed using SEM and Micro-Raman spectroscopy. Ninety specimens were prepared, sixty teeth were utilized for µTBS, twenty for SEM analysis of interface for CA and GOA and ten were assessed using microRaman spectroscopy. Each specimen was sectioned and exposed dentine was conditioned (35% phosphoric acid) for 10 s. The surface was coated twice with adhesive (15 s) and photopolymerized (20 s). Composite build-up on specimen was photo-polymerized. Among the bonded specimens, thirty specimen were assessed using Micro-Raman spectrometer, SEM and energy dispersive X-ray spectroscopy (EDX), whereas remaining specimens were divided in to three sub-groups (n = 10) based on the storage of 24 h, 8 weeks and 16 weeks. µTBS testing was performed at a crosshead speed of 0.5 mm/min using a microtensile tester. The means of µ-tbs were analyzed using ANOVA and post hoc Tukey multiple comparisons test. RESULTS: No significant difference in µTBS of CA and GOA was observed. Storage time presented a significant interaction on the µTBS (p < 0.01). The highest and lowest µTBS was evident in CA (30.47 (3.55)) at 24 h and CA (22.88 (3.61)) at 18 weeks. Micro-Raman analysis identified peaks of 1200 cm-1 to 1800 cm1, D and G bands of GO nanoparticles in the resin. Uniform distribution of graphene oxide nanoparticles was present at the adhesive and hybrid layer. CONCLUSION: GO showed interaction within adhesive and tooth dentin similar to CA, along with formation of hybrid layer. In ideal conditions (absence of nanoleakage), graphene oxide modified adhesive shows comparable bond strength and durability of resin dentine bond.

Influence of milling systems and marginal configurations on the fit of yttrium stabilized tetragonal zirconia polycrystals (Y-TZP)' copings.

OBJECTIVE: The aim of this study was to evaluate marginal fit of yttrium tetragonal zirconia polycrystals (Y-TZP)' copings with different finish line designs fabricated with various digital scanners and milling systems. METHODS: Three model plastic teeth were prepared with three finish line designs: Design-1, continuous chamfer; Design-2, chamfer with shallow depression; Design-3, chamfer with deep depression. The "master models" were replicated using elastomeric polyvinyl siloxane impression material and poured in type IV stone generating 90 dies, 30 dies for each design. Dies were scanned and copings were milled utilizing three digital scanners and computer-aided design/computer-aided manufacturing (CAD/CAM) systems: System-1, InEos Red Scan (Sirona Dental Systems, Germany), Vitablocks® Mark II (VITA, Germany) copings milled by Cerec® inLab (Sirona Dental Systems, Germany); System-2, Cerec® AC Connect with BlueCam (Sirona Dental Systems, Germany), Vitablocks® Mark II (VITA, Germany) copings milled by Cerec® inLab (Sirona Dental Systems, Germany); and System-3, NobleProcera™ Optical Scanner (NobleBiocare™), procera zirconia coping milled by a Noble Procera™ milling machine (NobleBiocare™). Copings were seated on their respective "master models" and secured with uniform force. Eight measurements per coping were performed at pre-established points, with a metallurgical microscope (Zeiss, Germany) connected to a high precision digital video-micrometer (Javelin JV6000, California, USA) at 200 × magnification. RESULTS: The tested systems demonstrated marginal gaps ranging from 12.4 to 26.6 µm. Results for marginal fit of milled copings fabricated using three systems with different finish line designs differed significantly (p < 0.05). Procera zirconia copings scanned and milled with NobleProcera™ exhibited significantly lower marginal gaps compared to other specimen groups. However, InEos Red Scan/Vitablocks® Mark II/Cerec® inLab showed maximum marginal gaps among the study specimens. CONCLUSIONS: CAD-CAM manufactured Y-TZP' copings exhibited marginal gaps ranging from 12.49 to 26.6 µm. The CAD-CAM fabrication system was a significant factor influencing the marginal misfit of Y-TZP' copings. Margin design exhibited system dependent influence on the marginal misfit. Marginal misfit observed for all systems were within clinically acceptable parameters.

Shear Bond Strength of Bulk-Fill Composites to Resin-Modified Glass Ionomer Evaluated by Different Adhesion Protocols.

OBJECTIVE: The aim of this study was to investigate the shear bond strengths (SBS) of different nano-resin-based composites (RBCs) to resin-modified glass-ionomer cement (RMGIC) after the application of different adhesion protocols. MATERIAL AND METHODS: Three RBCs (Filtek One Bulk Fill [FOBF], Tetric N-Ceram Bulk Fill [TNCBF], and Filtek Z350 XT [Z350XT]) were used as layering materials over GC Fuji II LC RMGIC. Three adhesive systems - Total-etch (OptiBond Solo Plus [OB]), self-etch (CLEAR FIL SE Bond 2 [CFSE]), and a universal bond (Single Bond Universal [SBU]) - were used. In total, 160 RMGIC blocks were prepared. Ten samples (n = 10) were layered with the same material to form a reference-cohesive control group. The remaining samples were distributed among the following groups: No treatment [NT]; Total-etch [OB]; Self-etch [CFSE]; Universal bond in the "total-etch" mode [SBU-TE]; and Universal bond in the "self-etch" mode [SBU-SE]. Samples were stored, and aged by thermocycling (5000 cycles at 5 °C / 55 °C, 30 s) and then prepared for SBS testing. Fracture modes were examined by stereomicroscopy. Data were collected and analyzed statistically at a significance level of P<0.05. RESULTS: The highest mean SBS (14.30±1.08 MPa) was reported in the OB group with the TNCBF material, while the lowest was in the NT group (5.05±0.69 MPa) with FOBF. Samples in the NT group showed SBS statistically significantly lower than those of samples in all other groups (P<0.0001). Bulk-fill materials had significantly higher SBS than Z350XT in OB, CFSE, and SBU-SE (P<0.0001). SBU-TE produced SBS statistically significantly lower than those of other groups for FOBF (P<0.0001), and lower than that of OB for TNCBF (P=0.027). CONCLUSION: OB, CFSE, and SBU-SE are reliable adhesion protocols for bonding bulk-fill RBCs to RMGIC when the "sandwich technique" is used for restorations. However, SBU-TE may not be effective in such procedures.

Impact of photodynamic therapy on the push-out bond strength of fiber posts to root dentin: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: This systematic review documents the up-to-date evidence on the efficacy of photodynamic therapy (PDT) on the push-out bond strength of fiber posts cemented to root dentin. MATERIALS AND METHODS: The focused PICO question was: "What impact does PDT have on the push-out bond strength of fiber posts cemented to root dentin?" This systematic review followed the guidelines and recommendations reported in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines chart. An electronic search was performed in MEDLINE/PubMed, SCOPUS, Web of Science, and Embase from January 1980 up to and including January 2020. Heterogeneity was calculated for push-out bond strength by means of the Chi-square test and I2 statistics. For meta-analyses, if the I2 was higher than 50 %, a random effects model was used, otherwise a fixed effects model for I2 ≤50 % was applied. A p-value <0.05 was set for significant heterogeneity. Forest plots were computed reporting standard mean differences (SMD) of outcomes and 95 % confidence intervals (CI). RESULTS: In total, ten studies were included, all of wich demonstrated medium risk of bias. All studies tested the push-out bond strength by means of a universal testing machine with applying a load ranging between 0.5 and 1 mm/min speed. Of the 10 studies, nine (90 %) indicated that PDT had no effect on push-out bond strength of fiber posts to root dentin. Only one study indicated that PDT significantly improved the bond strength when compared with other control groups. The overall mean difference for push out bond strength showed no statistically significant difference between PDT and the control group (SMD = -1.11 [-3.25, 1.02], Z=-1.02, p = 0.305). CONCLUSION: This systematic review concludes that PDT has no effect on improving the push-out bond strength of fiber posts to root dentin.

Clinical efficacy of photodynamic therapy as an adjunct to mechanical debridement in the treatment of per-implantitis with abscess.

AIM: The aim of the present clinical trial was to evaluate the efficacy of photodynamic therapy (PDT) as an adjunct to mechanical debridement (MD) in the treatment of severe peri-implantitis (PI) with abscess. MATERIALS AND METHODS: Selected individuals with severe PI were divided into two groups: Group A: received methylene blue mediated (PDT) using diode laser as an adjunct to MD, whereas, Group B received thrice daily application of 500 mg amoxicillin and 400 mg metronidazole with adjunctive MD. Peri-implant plaque scores (PS), probing depth (PD), bleeding on probing (BOP) and clinical attachment loss (CAL) were reported. Microbial counts of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia were analyzed using polymerase chain reaction. The assessment of pain was done with the help of numeric pain rating scale (NPRS). All assessments were done at baseline and repeated at 6 and 12 months, respectively. RESULTS: A total of 40 individuals completed the clinical trial. Both Group A and Group B comprised of 20 patients respectively. A significant improvement was observed in BOP in Group A at 12 months compared to Group B. No statistically significant changes were seen for NPRS scores between both groups (p > 0.05). Statistically significant differences were observed in values for P. gingivalis, T. denticola and T. forsythia at 6 months follow-up period in comparison to baseline for both Group A and Group B (p < 0.05). Whereas, the values observed at 6 months follow-up period for Porphyromonas gingivalis also reported a statistically significant difference in between the groups (p < 0.05). CONCLUSION: PDT was equally effective in reducing severe peri-implant symptoms compared to antimicrobial therapy as an adjunct to mechanical debridement.

Efficacy of chlorhexidine, Er Cr YSGG laser and photodynamic therapy on the adhesive bond integrity of caries affected dentin. An in-vitro study.

AIM: To evaluate the adhesive bond integrity (shear bond strength-SBS) of composite resin bonded to carious dentin using chlorhexidine gluconate (CHX), Er,Cr:YSGG laser (ECYL) and photodynamic therapy (PDT). MATERIAL AND METHODS: Thirty carious and ten non-carious mandibular teeth were collected through non-traumatic extraction. All samples were embedded in polyvinyl cross-sections to the cemento-enamel junction. The preparation of caries-affected dentin was performed by grinding the specimens using silicon carbide discs. All specimens were randomly allocated in to four groups (n = 10). Group 1, non-affected dentin with no disinfection; Group 2, caries affected dentin treated with 2% CHX; Group 3, affected dentin disinfected with PDT [100 mg/L methylene blue solution (MBS) and Diode laser]; Group 4, affected dentin treated with ECYL. Self-etch adhesive was smeared on all specimens for 10 s and photopolymerized for 10 s. All specimens were placed in an incubator with humid environment for 24 h at 37 °C followed by positioning in universal testing machine for SBS testing. Failure mode examination of debonded samples was performed by a stereomicroscope. Analysis of variance (ANOVA) was used for inter group comparison through mean and standard deviation of each group. For multiple group comparison Tukey HSD was employed. Level of significance was established at p < 0.05. RESULTS: The highest SBS value was observed in group 1 (24.98 ± 1.59 MPa). Whereas, the lowest bond strength was displayed by group 3 (14.22 ± 1.40 MPa) specimens. Lased dentin in group 4 (15.89 ± 3.22 MPa) exhibited SBS values comparable to group 3 (14.22 ± 1.40 MPa). Group 2 (CHX-18.25 ± 1.29 MPa) exhibited statistically significant difference compared to all experimental groups (p < 0.05). CONCLUSIONS: Adhesive bond strength of disinfected carious dentin was higher with CHX treatment as compared to Photodynamic therapy and Er,Cr: YSGG laser treatment. Carious dentin showed lower bond strength to composite resin as compared to non-carious dentin.

Influence of different photosensitizers on push-out bond strength of fiber post to radicular dentin.

BACKGROUND: To evaluate the effect of different photosensitizer on extrusion bond strength of glass fiber post to radicular dentin. MATERIAL AND METHODS: Forty maxillary and mandibular central incisors were disinfected and decoronated. Mechanical instrumentation of canal was performed using protaper NiTi. Shaping and cleaning of canal comprised of S1, S2, SX with finishing files F1 and F2, followed by continuous irrigation. Canals were dried and obturated with gutta percha. Peso reamers were used to prepare post space. Based on the photosensitizers (PS) used, the samples were divided into three groups (n = 10). Group 1: treated with methylene blue photosensitizer (MBP) at 50 mg/l, Group 2: Curcumin photosensitizer (CP) at 500 mg/l, Group 3: canal space was filled with Toluidine blue photosensitizer (TB) at 100 mg/l. All photosensitizers were activated using different lasers. The samples in group 4 (control) were irrigated using 5.25% sodium hypochlorite (NaOCl) + 17% ethylenediamine tetra acetic acid (EDTA). Posts were cemented and teeth were sectioned into coronal, middle and apical sections. All sections were placed in universal testing machine to evaluate extrusion bond strength in megapascal (MPa). Fracture pattern analysis of samples were seen under stereomicroscope at 50x magnification and categorized into adhesive, cohesive and admixed. Assessment of extrusion bond strength was performed by one-way analysis of variance (ANOVA) and Tukey multiple comparison test (p = 0.05). RESULTS: The highest bond strength was achieved in group 2, including samples treated with curcumin photosensitizer (CP) at all three root levels; cervical (9.01 ±â€¯1.62 MPa), middle (7.95 ±â€¯0.75 MPa) and apical (5.81 ±â€¯0.15 MPa). Whereas, the lowest extrusion bond strength was observed in group 4 (canal irrigated with conventional 5.25% NaOCl +17% EDTA) at coronal (6.10 ±â€¯1.77 MPa), middle (5.11 ±â€¯0.75 MPa) and apical one-thirds (3.65 ±â€¯0.14 MPa). Intra group comparison revealed decrease in extrusion bond strength from coronal to apical direction. Moreover, both group 2 and group 3 showed statistically significant difference to samples in control group and group 1. (p < 0.05). CONCLUSION: TB and CP at concentration of 100 mg/l and 500 mg/l has the potential to be used as an alternate to conventional cleaning regime. TB and CP at this concentration when activated with PDT is likely to improve extrusion bond values.

Immunohistochemical study of dental pulp cells with 3D collagen type I gel in demineralized dentin tubules in vivo.

Dental pulp cells (DPCs) represent good candidates for the regeneration of dental tissue. This study aimed to evaluate the growth and differentiation potential of DPCs cultured inside demineralized dentin tubules in vivo. Six green fluorescent protein-transgenic rats (body weight 100 g each) and thirty-two Sprague-Dawley (SD) male rats (body weight 250 g each) were used for DPC collection and dentin tubules preparation and transplantation, respectively. Third-passage DPCs with or without collagen gels were loaded into demineralized dentin tubules. Both types of grafts were transplanted into the rectus abdominis muscles of SD rats and were harvested after 21 days. The expression of alkaline phosphatase (ALP), bone sialoprotein (BSP), osteopontin (OPN), nestin, and dentin sialoprotein (DSP) was analyzed by immunohistochemistry. Histological analysis showed that DPCs in the collagen gel formed an osteodentin-like hard tissue matrix after 21 days. Increased positive immunoreactivity for ALP, BSP, OPN, nestin, and DSP was observed in experimental groups compared with control. Our results demonstrate that DPCs in collagen gel inside demineralized dentin tubules show increased growth and differentiation.

Bond Integrity of Resin-modified Glass Ionomer to Dentin Conditioned Using Photodynamic Therapy and Low-level Laser Therapy: An In Vitro Study.

AIM: The aim of the study was to assess the conditioning efficacy of photodynamic therapy (PDT) and Er,Cr:YSGG laser (ECYL) to dentin compared with conventional regime bonded to resin-modified glass ionomer (RMGIC). MATERIALS AND METHODS: Forty mandibular teeth were cleaned, disinfected, and mounted vertically within the segments of polyvinyl pipes up to cementoenamel junction. The occlusal surfaces were flattened, and samples were divided into four groups according to conditioning protocols. Samples in groups I and II underwent PDT, samples in group III were conditioned with low-level laser therapy (LLLT) using Er,Cr:YSGG laser (ECYL), and samples in group IV were conditioned using polyacrylic acid (PAA). Fuji II LC was applied incrementally and light cured for 20 seconds. All samples were placed in universal testing machine for shear bond strength (SBS) testing. The fracture surface was analyzed using stereomicroscope at 50× magnification to determine mode of failure. Among different investigational groups Tukey test was used as post hoc along with analysis of variance (ANOVA). Significance level was established at p <0.05. RESULTS: Maximum SBS values were observed in group IV dentin conditioned with PAA (19.55 ± 1.84 MPa), whereas minimum SBS values were shown by group I (methylene blue photosensitizer, MBP) activated by PDT (13.52 ± 1.22 MPa). In group III, dentin conditioned with ECYL (18.22 ± 2.07 MPa) and group IV (19.55 ± 1.84 MPa) surface treated with PAA exhibited comparable SBS values (p > 0.05). Fracture analysis revealed that in PDT group adhesive failure type was in majority. However, admixed failure type was commonly presented in groups III and IV. CONCLUSION: PDT of dentin using photosensitizers MBP and CP deteriorates bond values when bonded to RMGIC. The use of LLLT to condition dentin has the potential to improve SBS. CLINICAL SIGNIFICANCE: Dentin conditioning with LLLT using ECYL may improve, is of utmost importance for better treatment outcome, predictable prognosis, and improved bond integrity to RMGIC.

The effects of different irrigation solutions on the bond strength of cemented fiber posts.

OBJECTIVE: To study effect of root canal irrigant solutions on the bond strength of cemented fiber posts, and resin cement-tags in root canal dentin. MATERIALS AND METHODS: Fifty-two human single-rooted anterior teeth were selected and stored in 1% sodium azide. Crowns were sectioned 2 mm incisal to the cemento enamel junction with diamond bur at high speed under water-cooling. After standard root canal treatment to tested teeth, they were randomly assigned into four groups (n=13) corresponding to the endodontic irrigant solution that was used during post space preparation. The treatment groups were: Group 1: 6.15% sodium hypochlorite; Group 2: 17% EDTA; Group 3: 6.15% NaOCl +17% EDTA; Group 4: 6.15% NaOCl +0.12% chlorhexidine solution. Parallel-sided fiber posts were used for all specimens. Samples were embedded in a cylindrical PVC mounting jig to facilitate perpendicular sectioning. With low speed diamond saw, cervical and apical specimens from each tooth were obtained and subjected to push-out test using universal testing machine. SEM was used to examine the root-canal dentin surface. RESULTS: Statistical analysis revealed significant difference among the groups at P<0.05. Group 2 treated with EDTA, had the highest bond strength; 18.63±2.85 MPa in cervical specimens and 13.49±3.67 MPa in apical specimens. The cervical specimens of Groups 2 and 3 were significantly different than the apical specimens in the same group. Adhesive failure between cement and dentin was the main failure mode observed in all groups. Groups irrigated with EDTA showed cleaner dentin surface and better resin tag formation, while groups treated with NaOCl showed less resin tag formation and insufficient smear layer removal. CONCLUSION: NaOCl had adverse effect on bond strength of self-adhesive resin cement to radicular dentin. EDTA irrigant solution produced higher bond strength and was more effective in removing smear layer than NaOCl.

Effects and Effectiveness of Cavity Disinfectants in Operative Dentistry: A Literature Review.

The degree of success in the elimination of bacteria during cavity preparation and prior to the insertion of a restoration may increase the longevity of the restoration and therefore the success of the restorative procedure. The complete eradication of bacteria in a caries-affected tooth, during cavity preparation, is considered a difficult clinical task. In addition to weakening the tooth structure, attempts to excavate extensive carious tissue completely, by only mechanical procedures, may affect the vitality of the pulp. Therefore, disinfection of the cavity preparation after caries excavation can aid in the elimination of bacterial remnants that can be responsible for recurrent caries, postoperative sensitivity, and failure of the restoration. However, the effects of disinfectants on the restorative treatment have been a major concern for dental clinicians and researchers. This review aims to explore existing literature and provide information about different materials and techniques that have been used for disinfecting cavity preparations and their effects and effectiveness in operative dentistry and, therefore, helps dental practitioners with clinical decision to use cavity disinfectants during restorative procedures. Antimicrobial effectiveness and effects on the pulp and dental restorations, in addition to possible side effects, were all reviewed in this paper.

The effect of sodium hypochlorite and resin cement systems on push-out bond strength of cemented fiber posts.

OBJECTIVE: This study investigated the effect of different endodontic irrigant solutions and resin cement systems on the bond strength of cemented fiber posts. METHODS: Sixty human single-rooted anterior teeth were sectioned transversely at 2 mm incisal to the cemento-enamel junction (CEJ). The roots were treated endodontically, and teeth were distributed into six groups: group A, includes 5.25%NaOCl irrigant with MultiCore Flow Core Build-Up material; group B, includes 5.25%NaOCl irrigant with RelyX-Unicem Self-Adhesive Universal Resin Cement; group C, includes 2.5% NaOCl irrigant with MultiCore Flow; group D, includes 2.5%NaOCl irrigant with RelyX-Unicem; group E, includes NaCl, irrigant with MultiCore Flow; and group F, includes NaCl irrigant with RelyX-Unicem. Universal tapered fiber posts (No. 3 RelyX Fiber Post) were cemented, and roots were sectioned into cervical and apical segments. Samples were then subjected to a push-out bond strength test and failure modes were examined. RESULTS: The mean push-out bond strength for group D showed the highest mean value (20.07 MPa), while the lowest value was found in group A. There was a significant difference between groups with regard to the irrigants used (p<0.001), however, no significant difference was found between groups with regard to resin systems (p>0.05). The total mean push-out bond strength of the cervical segments was found to be significantly higher than the apical segments (p<0.001). CONCLUSION: The irrigant solution have a clear influence on the push-out bond strength of the fiber posts regardless of the cement used. Both adhesive resin systems showed similar bonding strength.

The effect of post type and length on the fracture resistance of endodontically treated teeth.

STATEMENT OF PROBLEM: Few studies have been conducted to determine a correlation between the flexural modulus of metal and fiber-reinforced posts and the fracture resistance and failure mode of teeth restored with posts. Questions remain as to whether a longer post length or a post with a higher flexural modulus will significantly improve the fracture resistance of a tooth restored with a prefabricated post and core. PURPOSE: The purpose of this study was to compare the fracture resistance and mode of failure of endodontically treated teeth restored with 3 different post systems, including 2 fiber-reinforced posts (Light-Post and Snowlight) and a stainless steel post (ParaPost XP). MATERIAL AND METHODS: Seventy single-rooted premolars were sectioned at the cemento-enamel junction and then endodontically treated. Teeth were distributed into 7 groups. Three different prefabricated posts were cemented into a post space either 5 or 10 mm in depth, and composite resin (ParaPost ParaCore automix) cores were fabricated. A composite resin core group without a post served as a negative control. Specimens were loaded at 90 degrees to the longitudinal axis until ultimate failure occurred. An initial failure load and mode of failure were also recorded. Statistical analysis was performed for initial and ultimate failure loads of groups by using 2-way ANOVA (P=.05). RESULTS: The groups with ParaPost XP posts demonstrated significantly higher initial and ultimate mean failure loads when compared with the fiber-reinforced post groups. The highest mean (SD) initial failure load was with the ParaPost XP group with a 10-mm post length (170.05 (60.08) N), and the lowest was with the Snowlight group with the 5-mm post length (62.85 (18.47) N). CONCLUSIONS: The stiffness and the load to initial fracture of the teeth restored with ParaPost XP posts were higher compared with the fiber-reinforced post groups.