A two-year clinical trial of enamel wear opposing 5Y-TZP and lithium disilicate crowns.

STATEMENT OF PROBLEM: Clinical information on enamel wear opposing 5 mol% yttria-stabilized tetragonal zirconia polycrystal (5Y-TZP) or lithium disilicate crowns is lacking. Moreover, the effect of surface roughness on the wear of enamel antagonists remains unclear. PURPOSE: The purpose of this clinical study was to quantify the vertical wear and total volume of wear while also measuring the surface roughness of antagonists at 6-month intervals over 2 years. MATERIAL AND METHODS: A tooth-supported first molar 5Y-TZP Lava Esthetic Fluorescent Zirconia crown or an IPS e.max CAD lithium disilicate crown was randomly provided for 24 participants (n=12). The contralateral first molar and opposite teeth were the natural enamel controls. The crowns were fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology and then polished. The data were gathered every 6 months at recall appointments with an intraoral scanner and a polyvinyl siloxane impression. A 3-dimensional (3D) comparative software program was used to measure the maximum vertical and volume loss on opposing enamel, as well as on the enamel control on the opposite side of the mouth. The surface of epoxy resin replicas was analyzed using a scanning electron microscope. The surface roughness of the cusp replica was measured with a 3D laser microscope. The crown's antagonist enamel and natural enamel wear were compared using a 2-way repeated measure ANOVA (α=.05). RESULTS: No significant difference was found in the average volume loss between the crown's antagonist enamel (ZTE 0.042 ±0.005 mm3, LTE 0.048 ±0.006 mm3) and the enamel control (ZCE 0.046 ±0.004 mm3, LCE 0.050 ±0.005 mm3) (P>.05). No significant difference was found in surface roughness between the crown's antagonist enamel (antagonist enamel of zirconia group [ZTE] 0.7 ±0.3 µm, antagonist enamel of lithium disilicate group [LTE] 0.6 ±0.3 µm) and the enamel control (enamel control of zirconia group [ZCE] 0.7 ±0.3 µm, enamel control of lithium disilicate group [LCE] 0.5 ±0.2 µm) in both zirconia and lithium disilicate groups (P>.05). Also, no correlation was found between the amount of wear and the roughness of the surface. The wear patterns observed on the opposing enamel surfaces of the monolithic zirconia and lithium disilicate materials were found to be similar to those seen on natural enamel. CONCLUSIONS: A 2-year clinical investigation found that polished lithium disilicate and 5Y-TZP crowns did not affect enamel wear more than enamel against enamel, contrary to laboratory studies. Another finding revealed that surface roughness did not significantly affect wear.

The color stability of artificial white spot lesions treated with resin infiltration after exposure to staining beverages.

BACKGROUND: To evaluate the effect of staining beverages on the color-changing of resin-infiltrated artificial white spot lesions (WSLs). METHODS: Thirty-five artificial WSLs were created by pH cycling on flat bovine teeth specimens. The WSLs were treated with resin infiltration and were divided into five groups based on staining beverages: artificial saliva, coffee, wine, green tea, and Coca-Cola. These specimens were subjected to a 28-day exposure to the respective beverages. Color stability was assessed using a spectrophotometer at different time points: baseline, after 7, 14, 21, and 28 days of exposure, and repolishing. The color difference (∆E) between each time point and the baseline was calculated. Statistical analysis was performed using two-way measures ANOVA with a significance level of p = 0.05. RESULTS: All resin-infiltrated specimens exposed to staining beverages for 7 days exhibited more significant color changes than those exposed to artificial saliva. The color change patterns varied based on the type of beverage. The color alterations intensified with extended immersion in the wine and Coca-Cola groups, while there were no significant differences in the color of specimens after 28 days of immersion in the coffee and green tea groups. However, after cleaning with pumice powder, all specimens showed significantly reduced color changes compared to those observed after 28 days of immersion, except those immersed in coffee. CONCLUSIONS: Exposure of resin-infiltrated bovine tooth specimens to staining beverages resulted in a significant color alteration as the immersion time increased. However, the staining effect could be minimized by cleaning with pumice powder, except for the coffee group. CLINICAL RELEVANCE: After resin infiltration treatment, patients should be advised to minimize the consumption of colored beverages to prevent staining that could impact esthetic appearance.

Delayed light activation of resin composite affects the bond strength of adhesives under dynamic simulated pulpal pressure.

OBJECTIVE: To evaluate the effect of a time delay before the light activation of resin composite on the microtensile bond strength (µTBS) of self-etch adhesives under dynamic simulated pulpal pressure. MATERIALS AND METHODS: One hundred twenty crown segments were prepared from human third molars. Dentin surfaces were prepared with coarse diamond burs and connected to a dynamic pulpal pressure device. The self-etch adhesives used were Clearfil SE Bond (CSE), G2-Bond Universal (G2B), Clearfil Universal Bond Quick (CBQ), and G-Premio Bond (GPB). Each adhesive was divided into 3 subgroups: immediate light activation of resin composite (T0), delayed light activation for 150 s (T1), and 300 s (T2). The µTBS data were obtained after 24-h water storage. Scanning electron microscopy was used to evaluate the nanoleakage at the resin-dentin surface. The µTBS data were analyzed using two-way ANOVA and Duncan's multiple comparisons. RESULTS: All adhesives demonstrated a significant reduction in µTBS at T2, except for CBQ where the bond strength was not affected by the delayed light activation times. The two-step self-etch adhesives (CSE and G2B) demonstrated higher bond strength than the one-step adhesives at all conditions. Nanoleakage was observed in all adhesives at T2; however, nanoleakage was detected only in CBQ and GPB at T1. CONCLUSIONS: Delayed light activation of resin composite adversely affected the dentin bond strength of self-etch adhesives. Two-step self-etch adhesives had better bonding performance than one-step self-etch adhesives. CLINICAL RELEVANCE: After adhesive application, resin composite should be adapted and cured as soon as possible.

Generation of gaseous sulfur-containing compounds in tumour tissue and suppression of gas diffusion as an antitumour treatment.

BACKGROUND AND AIMS: The mechanisms of cancer cell growth and metastasis are still not entirely understood, especially from the viewpoint of chemical reactions in tumours. Glycolytic metabolism is markedly accelerated in cancer cells, causing the accumulation of glucose (a reducing sugar) and methionine (an amino acid), which can non-enzymatically react and form carcinogenic substances. There is speculation that this reaction produces gaseous sulfur-containing compounds in tumour tissue. The aims of this study were to clarify the products in tumour and to investigate their effect on tumour proliferation. METHODS: Products formed in the reaction between glucose and methionine or its metabolites were analysed in vitro using gas chromatography. Flatus samples from patients with colon cancer and exhaled air samples from patients with lung cancer were analysed using near-edge x-ray fine adsorption structure spectroscopy and compared with those from healthy individuals. The tumour proliferation rates of mice into which HT29 human colon cancer cells had been implanted were compared with those of mice in which the cancer cells were surrounded by sodium hyaluronate gel to prevent diffusion of gaseous material into the healthy cells. RESULTS: Gaseous sulfur-containing compounds such as methanethiol and hydrogen sulfide were produced when glucose was allowed to react with methionine or its metabolites homocysteine or cysteine. Near-edge x-ray fine adsorption structure spectroscopy showed that the concentrations of sulfur-containing compounds in the samples of flatus from patients with colon cancer and in the samples of exhaled air from patients with lung cancer were significantly higher than in those from healthy individuals. Animal experiments showed that preventing the diffusion of sulfur-containing compounds had a pronounced antitumour effect. CONCLUSIONS: Gaseous sulfur-containing compounds are the main products in tumours and preventing the diffusion of these compounds reduces the tumour proliferation rate, which suggests the possibility of a new approach to cancer treatment.

Influence of Lithium- and Zinc-Containing Bioactive Glasses on Pulpal Regeneration.

OBJECTIVE: To evaluate the potential of modified bioactive glasses containing lithium and zinc as pulp capping materials by investigating the odontogenic differentiation and mineralization response in the tooth culture model. MATERIALS AND METHODS: Lithium- and zinc-containing bioactive glasses (45S5.1Li, 45S5.5Li, 45S5.1Zn, 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel), fibrinogen-thrombin, and biodentine were prepared to assess Axin2 gene expression at 0, 30 minutes, 1 hour, 12 hours, and 1 day and DSPP gene expression at 0, 3, 7, and 14 days in stem cells from human exfoliated deciduous teeth (SHEDs) using qRT-PCR. The experimental bioactive glasses incorporated with fibrinogen-thrombin and biodentine were placed on the pulpal tissue in the tooth culture model. Histology and immunohistochemistry were analyzed at 2 weeks and 4 weeks. RESULTS: Axin2 gene expression for all experimental groups was significantly higher than the control at 12 hours. The DSPP gene expression for all experimental groups was significantly higher than the control at 14 days. The presence of mineralization foci was significantly higher at 4 weeks for the modified bioactive glasses 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel as well as Biodentine compared with the fibrinogen-thrombin control. CONCLUSION: Lithium- and zinc-containing bioactive glasses increased Axin2 and DSPP gene expression in SHEDs and can potentially enhance pulp mineralization and regeneration. Zinc-containing bioactive glasses are a promising candidate to be used as pulp capping materials.

Effect of brushing on surface roughness, fluoride release, and biofilm formation with different tooth-colored materials.

BACKGROUND/PURPOSE: Tooth brushing, material mechanical ageing procedure, is the most effective way in removing biofilm. The purpose of this study was to investigate the surface roughness, fluoride-release, and S. mutans biofilm formation on various tooth-colored restorative materials before and after brushing. MATERIALS AND METHODS: Discs of materials, a nanocomposite (Filtek Z350XT; CO), a giomer (Beautifil II; GIOMER), a resin-modified glass-ionomer material (Fuji II LC; RMGI), and a conventional glass-ionomer material (Fuji IX GP Extra; GI), were prepared, polished with abrasive discs (SofLex), and divided into brushed and not brushed groups. The surface roughness of specimens was observed using a contact profilometer, fluoride-release was measured using a fluoride-specific ion electrode, and S. mutans biofilm formation, biovolume and live/dead cells, was observed under a confocal laser scanning microscope. RESULTS: Higher roughness was observed on GI and RMGI than on CO and GIOMER. Brushing had no effect on the roughness. The fluoride-release of GI and RMGI was higher than that of GIOMER. The fluoride-release decreased after brushing in all materials. The biovolume of S. mutans was not significantly different between GIOMER, RMGI and GI, while CO showed the highest. Brushing resulted in a higher biovolume for all materials, except CO, which showed no change. After brushing, all the tested materials demonstrated identical biovolumes. There were no significant differences in live/dead cells among all groups. CONCLUSION: Brushing demonstrated a negative effect on the fluoride-release and biovolume of S. mutans biofilms for all tested materials except nanocomposites.

Effect of Stress Generated by Occlusal Cyclic Force on Class I Bulk-Fill Composite Restoration Microleakage.

OBJECTIVE: This study aimed to evaluate the effects of different types and restorative techniques of Class I composite restorations with a single loading force on stress distribution and cyclic loading force on microleakage formation. MATERIALS AND METHODS: Class I cavities were prepared in premolars with 4 mm depth and divided into six groups of different restorations with: (1) Filtek Z250; (2) a 3-mm-thick layer of Filtek Bulk Fill Flowable Restoration and covered with Z250; (3) a 1.5-mm-thick layer of flowable composite and covered with Z250; (4) lining all cavity with flowable composite and restored with Z250; (5) Filtek Bulk Fill Posterior Restoration; and (6) lining all cavity with flowable composite and restored with bulk-fill composite. The specimens with and without cyclic occlusal loading were subjected to microleakage observation. In addition, six different models of Class I restorations corresponding to the microleakage study were generated. Finite element analysis (FEA) was used to identify the stress distribution under a single loading force. STATISTICAL ANALYSIS: Data were statistically analyzed by two-way analysis of variance and multiple comparison. The significance level set at 0.05. RESULTS: Cavity lining or restoration with flowable composite underneath conventional composite reduced stress on composite resin based on FEA (groups 2 and 3). The cyclic stress on composite increased microleakage. Restoration with flowable composite underneath conventional composite reduced the microleakage in Class I restoration (groups 2, 3, and 4). CONCLUSION: The most effective cavity lining with a flowable composite underneath conventional composite restoration was stress reduction under loading force resulting in microleakage reduction.

Effects of dentin surface preparations on bonding of self-etching adhesives under simulated pulpal pressure.

Objectives: This study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure. Materials and Methods: Human third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH2O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests. Results: Only the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives. Conclusions: Superfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

The Influence of Blade Type and Feeding Force during Resin Bonded Dentin Specimen Preparation on the Microtensile Bond Strength Test.

This paper presents the effect of blade type and feeding force during resin-bonded dentin specimen preparation on the microtensile bond strength (µTBS) test. Forty resin-bonded flat middle dentin specimens were divided into four groups. The specimens of each group were sectioned according to type of blade and feeding force as follows: fine grit/20 N, fine grit/40 N, medium grit/20 N, and medium grit/40 N to obtain resin-dentin sticks with a cross-sectional area of 1.0 mm2. Four sticks from the center of each tooth were subjected to the µTBS test. Five remaining sticks of each group were selected for surface topography observation under a scanning electron microscope (SEM). As a result, the bond strength of the medium-grit group was higher than that of the fine-grit group (p < 0.001), whereas the feeding force had no influence on bond strength values (p = 0.648). From the SEM, sticks prepared with the fine-grit blade showed a smoother surface integrity and fewer defects on the specimen edges in comparison with the sticks prepared with the medium-grit blade. The grit type of the blade is one of the considerable factors that may affect the bond strength and the surface integrity of resin-dentin specimens for microtensile testing.

The influence of a local anesthetic containing vasoconstrictor on microtensile bond strengths of two adhesive systems to human dentin in situ.

PURPOSE: To evaluate the bond strengths of an etch-and-rinse adhesive and a self-etching adhesive to human dentin in vitro and under two in situ conditions: non-anesthetization and anesthetization of the teeth with a local anesthetic containing vasoconstrictor. MATERIALS AND METHODS: An in situ study was performed on 49 maxillary premolars scheduled for extraction due to orthodontic reasons. For the bond strength test, occlusal cavities were prepared either with or without a local anesthetic containing vasoconstrictor. The cavities were bonded with Adper Single Bond or Clearfil SE Bond and filled with a resin composite, Filtek Z250. The teeth were then extracted, sectioned, trimmed, and tested for microtensile bond strength. For the observation of dentin surfaces, 20 premolars were used. The impressions of the cavity floors in the anesthetized and non-anesthetized groups were taken before and after acid etching. The replicas were observed under a scanning electron microscope. In vitro, the bond strength test and the SEM observation were also carried out on 24 extracted premolars with the same procedures used in the in situ study. RESULTS: The bond strengths of the two adhesives bonded to dentin in situ were significantly lower than those in vitro. When both adhesives were tested under in situ conditions, there were no significant differences between the bond strengths to dentin of anesthetized and non-anesthetized groups (p > 0.05). No fluid droplets were found on dentin on the cavity floor prepared in vitro, either before or after acid-etching. For the unetched dentin prepared in situ, fluid droplets were found and covered on the smear layer in anesthetized and non-anesthetized groups, but the droplets were slightly larger in the non-anesthetized group. In the non-anesthetized, acid-etched group, dentin surfaces were covered with coalescent dentinal fluid in most specimens. However, in the anesthetized, acid-etched group, patent tubules and some dentinal fluid were observed on the surfaces. CONCLUSION: It was concluded that in situ, dentinal fluid had a detrimental effect on the dentin bond strengths of an etch-and-rinse adhesive and a self-etching adhesive. However, reduction in dentinal fluid due to the effect of a local anesthetic containing vasoconstrictor did not improve the bond strengths in either adhesives.

The effect of the elastic modulus of low-viscosity resins on the microleakage of Class V resin composite restorations under occlusal loading.

This study aimed to evaluate the effectiveness of various intermediate layers on the microleakage of Class V restorations under an occlusal load. Wedge-shaped cavities were prepared on the buccal surface of 72 extracted premolars, which were then treated with an adhesive system (One Up Bond F Plus), divided into three groups, and restored with: 1) Estelite Sigma resin composite, 2) a resin composite with Low Flow flowable composite, or 3) a resin composite with High Flow flowable composite. The specimens were subjected to a nano-indentation test to evaluate the elastic modulus of successive layers at the resin-dentine interface and were subjected to a microleakage test under either unloaded or loaded conditions. The elastic moduli were significantly different among substrates (p<0.05), except between the hybrid layer/Low Flow and the hybrid layer/High Flow. The elastic moduli of the Low Flow composite were higher than those of the High Flow composite. Occlusal force increased dentine leakage in the group that was restored without flowable composites.

Bond strength of self-etching adhesives to dentin surface after smear layer removal with ultrasonic brushing.

This study determined the micro-shear bond strength (µSBS) of two self-etching adhesives to dentin surface after smear layer removal with a novel ultrasonic brushing method. Ninety-five dentin discs were ground flat with diamond burs and divided into 5 groups; no treatment (control), brushing with a custom-made brush for 10 and 30 s without and with ultrasonic application. The smear layer thickness was evaluated using SEM. The 24 h µSBS of Clearfil SE Bond (CSE) and Clearfil Tri S Bond (CTS) to these dentin surfaces were evaluated. Smear layer thickness decreased significantly from control, brushing without, and brushing with ultrasonic groups, respectively. The µSBS of CSE were higher than CTS in all groups. The µSBS were improved with ultrasonic brushing for 30 s for both adhesives. Ultrasonic brushing is the effective method in mechanical smear layer removal which can improve bond strength of self-etching adhesives to ground dentin.

Morphological characterization and permeability of attrited human dentine.

OBJECTIVE: Dentine is a vital tissue that can be changed by physiological and pathological condition. The purpose of this study was to clarify the morphology and permeability of dentine that changed by wearing process. METHODS: Twenty extracted human molars with enamel attrition and dentine was exposed and 20 intact human extracted third molars that had not reached occlusion were used. Ten teeth per each group were observed under light microscope (LM) and transmission electron microscope (TEM). Remaining 10 teeth per each group were subjected for evaluation of dentine permeability. RESULTS: Under LM, the transparent dentine and reactionary dentine were found in the attrition group but were not found in the group unaffected by attrition. When the transparent dentine were examined under the TEM, it was found that dentinal tubules were partially or completely occluded by growth of peritubular dentine or by precipitation of needle-like or rhombohedral crystals in transparent dentine. In reactionary dentine, tubular dentine structures that were comparable to those in secondary physiologic dentine were observed whereas atubular dentine demonstrated occlusion of tubules by high mineral substances or by peritubular dentine under the TEM. Permeability of dentine from worn teeth was less than those from unoccluded teeth significantly. CONCLUSION: Change in dentine by wear resulted in the formation of reactionary dentine and transparent dentine that illustrated various types and degrees of tubular occlusion. These decrease the dentine permeability.

The elastic moduli across various types of resin/dentin interfaces.

OBJECTIVE: The purpose of this study was to evaluate the elastic moduli of an unfilled adhesive resin (Adper Single Bond) and a filled adhesive resin (Adper Single Bond 2) used with and without a low-viscosity resin (LVR) (Filtek Flow) as an elastic cavity wall in class V composite restorations, restored with a hybrid resin composite (Z250). METHODS: Buccal class V cavities were prepared on extracted premolars and lined with (1) the unfilled adhesive resin, (2) the filled adhesive resin, (3) the unfilled adhesive resin and the flowable composite, and (4) the filled adhesive resin and the flowable composite. All cavities were restored with the hybrid resin composite. The specimens were cut bucco-lingually, embedded in epoxy resin and polished. The polished specimens were evaluated for the elastic modulus with nano-indentation test at the layer of dentin, hybrid layer, adhesive resin, low-viscosity resin and resin composite. RESULTS: The elastic moduli were 25,111 MPa for dentin, 12,243 MPa for hybrid layer of Adper Single Bond, 11,765 MPa for hybrid layer of Adper Single Bond 2, 7595 MPa for Adper Single Bond, 8430 MPa for Adper Single Bond 2, 13,543 MPa for Filtek Flow and 24,494 MPa for Filtek Z250 resin composite. The statistical analysis demonstrated that the elastic moduli were significantly different among layers (p<0.05) except between hybrid layers of unfilled and filled adhesives (p=1.0). CONCLUSION: The application of filled adhesive did not increase the elastic modulus of hybrid layer when compared with the unfilled adhesive resin. The modulus of filled adhesive resin was significantly higher than that of unfilled adhesive resin.

Effect of smear layer and surface roughness on resin-dentin bond strength of self-etching adhesives.

The purpose of this study was to evaluate the effect of surface roughness and smear layer on the micro-shear bond strength (µSBS) of two self-etching adhesives, Clearfil SE Bond (SE) and Clearfil Tri-S Bond (S3). Flat dentin surfaces were prepared with SiC papers (600-, 180- and 120-grit) and diamond burs (extra fine, medium and coarse). They were further divided into smear-covered and smear-free surfaces and bonded with respective adhesives. µSBS test was performed after water storage at 37ºC for 24 h. Smear layer thickness measurement was evaluated by scanning electron microscope (SEM). Surface roughness was examined by contact stylus profilometer. Smear layer thickness and surface roughness were significantly different among all groups (p<0.05). No difference in µSBS was observed among surface prepared by SiC whereas bur-cut smear layer had negative effect on µSBS, especially for S3. Surface roughness from different surface preparations had no influence on µSBS (p<0.05).

Effect of elastic cavity wall and occlusal loading on microleakage and dentin bond strength.

OBJECTIVE: This study evaluated the effect of an unfilled-adhesive resin (Adper Single Bond) and a filled-adhesive resin (Adper Single Bond 2) with and without a low viscosity resin (Filtek Flow) as an elastic cavity wall on marginal leakage and dentin microtensile bond strength in Class V composite restorations under unloaded and loaded conditions. METHODS: V-shaped cavities were prepared on the buccal surfaces of 56 premolars lined with unfilled (Groups 1 and 3) or filled (Groups 2 and 4) adhesives with (Groups 3 and 4) and without (Groups 1 and 2) a low viscosity resin and restored with a resin composite. The restored teeth in each group were divided into two sub-groups for unloaded and loaded conditions with 50N loading force for 250,000 cycles parallel to the long-axis of the tooth. Five specimens from each group were cut bucco-lingually 0.7 mm thick and subjected to a dye leakage test for four hours using 2% methylene blue dye. The tested specimens were then trimmed into dumbbell shapes at the gingival margin and subjected to microtensile testing. The remaining two specimens were cut, embedded and observed for resin/dentin interfaces under a scanning electron microscope. RESULTS: For the microleakage test, there were no significant differences in microleakage among the groups on both the enamel and dentin margin. No statistically significant differences were found between microleakage of the loaded and unloaded groups on enamel margins for all materials. There were statistically significant differences between microleakage of the loaded and unloaded groups on the dentin margin for Groups 3 and 4. For the microtensile test, the significant difference was found between Groups 1 and 4 for the unloaded groups. For the loaded groups, there were no significant differences between Groups 1 and 2 and Groups 3 and 4. There were no statistically significant differences in microtensile bond strength between the loaded and unloaded groups except for Group 2. CONCLUSION: The application of filled adhesive or low viscosity resin had no influence on marginal leakage at both the enamel and dentin margin but it had an influence on the microtensile bond strength to dentin of Class V restorations. Occlusal loading significantly increased the degree of marginal leakage at the dentin margin when low viscosity was applied in combination with either unfilled or filled-adhesives, but it decreased dentin bond strength in the group treated with only filled adhesive.

Bond strengths of two adhesive systems to dentin contaminated with a hemostatic agent.

This study evaluated the bond strength of a total-etch and a self-etch adhesive to dentin contaminated with a hemostatic agent containing aluminum chloride (AlCl3). Eighteen occlusal dentin discs were prepared from human molars. Each disc was ground and sectioned into two halves, one for normal dentin and the other for contaminated dentin. The specimens of both normal and contaminated dentin were randomly divided into three groups and treated with the following materials: (1) Excite (EX); (2) Clearfil SE Bond with 20-second primer application time (CB 20) and (3) Clearfil SE Bond with 40-second primer application time (CB 40). The microshear bond strength specimens were prepared using the resin composite Clearfil APX. The bond strengths were evaluated on a universal testing machine. Statistical analysis was performed at alpha = 0.05. The surface micromorphology and aluminum content of the different dentin conditions were also examined. In EX, no significant difference was found between the bond strengths of normal dentin and contaminated dentin. The bond strength of CB20 to contaminated dentin was significantly lower than that to normal dentin. The extension of primer application time from 20 to 40 seconds significantly increased the bond strength of CB to contaminated dentin.

Effect of LED light-curing time for the adhesive resin on the modulus of elasticity.

PURPOSE: To evaluate the elastic modulus of successive layers where an adhesive resin was cured by different light-curing times. METHODS: Eighty dentin discs which were 2 mm thick were prepared from 40 sound third molars. The dentin discs were further divided into four groups and bonded with 3M Single Bond 2 and cured with an LED for 5, 10, 15 and 20s. Bonded specimens were restored with a microhybrid resin composite. Specimens were cut perpendicular to the resin dentin interface, embedded in epoxy resin, and polished. Polished specimens were evaluated for the elastic modulus at the layer of dentin, hybrid layer, adhesive resin, and resin composite at 24 hours after preparation. RESULTS: Light-curing times influenced the elastic modulus of hybrid layer and adhesive resin. The significant differences of elastic modulus among successive layers were found. The results suggested that extension of light-curing times of adhesive resin from 5 to 20 seconds increased the mechanical properties of the resin dentin interface.

Age-related changes in hardness and modulus of elasticity of dentine.

OBJECTIVES: Little knowledge has been clarified about the relationship between the morphological and physical changes of dentine during aging. The purpose of this study was to clarify the modulus of elasticity and hardness related to the morphological changes of dentine by aging using a transmitted light microscope (TLM) and a nano-hardness tester (NHT). METHODS: Aged human molars and young third molars were used. The dentine morphology was observed under a TLM. The hardness and Young's modulus of elasticity related to the morphologic study were evaluated with an NHT. RESULTS: The thickness of mantle dentine and globular dentine of aged teeth were less than that of young teeth. Transparent dentine was observed only underneath the attrition of young teeth. Reactionary tertiary dentine formed and a "dark zone" was found at the junction between physiologic secondary and reactionary dentine only in aged teeth. At the mantle dentine, hardness and modulus of elasticity of aged dentine were higher than those of young dentine. The reactionary dentine in aged teeth and newly developed secondary dentine in young teeth demonstrated lower modulus of elasticity and hardness than those of other circumpulpal dentine. Relatively low modulus of elasticity and hardness were observed at the zone between secondary and reactionary dentine. CONCLUSIONS: Changes in dentine due to aging resulted in transformation of morphological features causing changes to their hardness and modulus of elasticity at the explicit areas such as the increase of hardness and modulus of elasticity at mantle dentin and the reduction of these properties at the "dark zone" that found in aged teeth.

Microtensile bond strength of a filled vs unfilled adhesive to dentin using self-etch and total-etch technique.

OBJECTIVE: The purpose of this study was to evaluate the effect of a filled adhesive (One-Step Plus; Bisco) versus an unfilled adhesive (One-Step; Bisco) on the microtensile bond strength (muTBS) to dentin using total-etch (Uni-etch; Bisco) and self-etch (Tyrian SPE; Bisco) techniques. METHODS: Twenty extracted human third molars were ground flat to expose occlusal dentin. After the dentin surfaces were polished with 600-grit SiC paper, the teeth were randomly assigned to four groups according to the bonding agent and technique being used. Dentin surfaces were bonded with One-Step Plus+total-etch; One-Step Plus+self-etch; One-Step+total-etch and One-Step+self-etch. Composite buildups were performed with Clearfil AP-X (Kuraray Medical). Following storage in distilled water at 37 degrees C for 24 h, the bonded specimens were serially sectioned into 0.7 mm-thick slabs and then trimmed to hour-glass shapes with a 1 mm2 cross-sectional area (n=20). Microtensile bond strengths were determined using the EZ-test (Shimadzu) at a cross-head speed of 1 mm/min. Data were analyzed using two-way ANOVA and Tukey's post hoc test. RESULTS: There were no significant differences in the muTBS between One-Step Plus and One-Step adhesives when they were used with the total-etch and self-etch techniques (p>0.05). However with the total-etch technique both adhesives yielded significantly higher bond strength values than the self-etch technique (p<0.001). CONCLUSION: The filled adhesive One-Step Plus did not show any beneficial effect than the unfilled adhesive One-Step on the muTBS to dentin with total-etch and self-etch techniques. Irrespective from the adhesive type, self-etch technique revealed lower bond strengths than the total-etch technique.