Effect of thickness of CAD/CAM materials on light transmission and resin cement polymerization using a blue light-emitting diode light-curing unit.

OBJECTIVE: Evaluate the effect of thickness of high-translucency (HT) CAD/CAM materials on irradiance and beam profile from a blue light-emitting diode light-curing unit (LCU) and on the degree of conversion (DC) and maximum polymerization rate (Rpmax ) of a light-cured resin cement (LCC). MATERIAL AND METHODS: The direct output from the LCU, the light transmission and irradiance ratio (IR) through one conventional composite and nine HT CAD/CAM materials (0.5, 1.0, 1.5, or 2.0-mm thick; n = 5) were measured with a integrating sphere coupled to a spectrometer. The light beam was assessed with a beam profiler camera. The DC at 600 s and the Rpmax of one LCC was determined using a Fourier transform infrared spectrometer (n = 5). Data were analyzed by ANOVA followed by Tukey's tests, and Dunnett's test was also used for irradiance data (α = 0.05). RESULTS: A significant decrease in irradiance through all materials occurred as thickness increased. Thin CAD/CAM materials improved light homogeneity, which decreased with the increase in thickness. The DC of the LCC directly exposed to light was the same as when exposed to 45%, 25%, 15%, or 5% IRs. Rpmax decreased with the decrease in IR. CONCLUSIONS: Although the HT CAD/CAM materials reduced the irradiance from the LCU, minor effects were observed in the LCC's DC. CLINICAL SIGNIFICANCE: Despite the light attenuation of blue light through different CAD/CAM materials that were up to 2-mm thick, the degree of conversion of one brand of light-cured resin cement was clinically acceptable when the LCU was used for 30 s.

Effect of zirconia decontamination protocols on bond strength and surface wettability.

OBJECTIVE: To evaluate the effects of human saliva decontamination protocols on bond strength of resin cement to zirconia (Y-PSZ), wettability, and microbial decontamination. MATERIALS AND METHODS: Zirconia plates were sandblasted and divided into (a) not contaminated, (b) contaminated with human saliva and: (c) not cleaned, (d) cleaned with air-water spray, (e) cleaned with 70% ethanol, (f) cleaned with Ivoclean, or (g) cleaned with nonthermal atmospheric plasma (NTAP). The wettability and microbial decontamination of the surfaces were determined after saliva contamination or cleaning. Monobond Plus (Ivoclar Vivadent) was applied after cleaning, followed by Variolink LC (Ivoclar Vivadent). The samples were stored 1 week before shear bond strength (SBS) testing, and data (SBS and wettability) were analyzed by one-way analysis of variance and Tukey test (α = .05). RESULTS: Saliva contamination reduced SBS to zirconia compared to not contaminated. Both Ivoclean and NTAP produced higher SBS compared to not cleaned and were not significantly different from the not contaminated. Ivoclean produced the highest contact angle, and NTAP the lowest. With the exception of using just water-spray, all cleaning protocols decontaminated the specimens. CONCLUSIONS: Both Ivoclean and NTAP overcame the effects of saliva contamination, producing an SBS to zirconia comparable to the positive control. CLINICAL SIGNIFICANCE: Dental ceramics should be cleaned prior to resin cementation to eliminate the effects of human saliva contamination, and Ivoclean and NTAP are considered suitable materials for this purpose.

Effect of Composite Polymerization Stress and Placement Technique on Dentin Micropermeability of Class I Restorations.

PURPOSE: To investigate the effect of polymerization stress and insertion technique on dentin micropermeability of composites placed under pulpal pressure. MATERIALS AND METHODS: One high-viscosity conventional (HC; Filtek Supreme Ultra; 3M Oral), one low-viscosity conventional (LC; Filtek Supreme Ultra Flowable; 3M Oral), one high-viscosity bulk fill (HBF; Filtek Bulk Fill Restorative; 3M Oral), and one low-viscosity bulk fill (LBF; Filtek Bulk Fill Flowable; 3M Oral) composite were evaluated. Polymerization stress was measured with materials bonded to acrylic rods in a universal testing machine (n = 5). Class I preparations were made in extracted molars, in which tooth roots were removed and the pulpal chambers cleaned. Preparations were coupled to a hydraulic device to simulate pulpal pressure during composite placement (n = 5). Conventional composites were placed in two horizontal increments, while bulk fill materials were placed in one, single increment. Fluid flow rate (µl/min) and dentin micropermeability (%) were monitored. The restoration interface was observed under confocal laser scanning microscopy. RESULTS: LC and LBF presented statistically significant higher polymerization stress than HC and HBF. Fluid flow rate and dentin micropermeability did not differ among the groups. However, different patterns of fluid infiltration and interface integrity were observed. HC and HBF presented well-sealed surrounding margins with small gaps along the pulpal wall, while HBF demonstrated more cracks in the adhesive layer. LC and LBF restorations had larger gaps along all bonded interfaces. CONCLUSION: No difference in polymerization stress was found when conventional and bulk fill composites with similar viscosities were compared. Neither polymerization stress or placement technique demonstrated a significant effect on dentin micropermeability. The incremental placement technique using a conventional, high-viscosity composite exhibited qualitatively better marginal integrity.

Influence of the calcium orthophosphate:glass ratio and calcium orthophosphate functionalization on the degree of conversion and mechanical properties of resin-based composites.

The study verified the influence of calcium orthophosphate (CaP):glass ratio on the degree of conversion and mechanical properties of resin-based composites containing either TEGDMA-functionalized dicalcium phosphate anhydrous (DCPA) or non-functionalized DCPA particles. The null hypotheses were that the evaluated variables are not affected by (1) CaP:glass ratio or (2) DCPA functionalization. DCPA particles were synthesized and half of them were functionalized with TEGDMA. Particle characterization included x-ray diffraction, elemental analysis, laser scattering, helium picnometry and scanning electron microscopy. Two series of composites were prepared containing either DCPA-NF (non-functionalized) or DCPA-F (functionalized), with total inorganic content of 50 vol % and DCPA:silanized barium glass (BG) ratios from 10:40 to 50:0. A composite containing 50 vol % BG was tested as control. DC was determined using FTIR spectroscopy. Biaxial flexural strength and modulus were tested after 24 h in water. Data were analyzed using Kruskal-Wallis/Dunn (flexural properties) or analysis of variance/Tukey tests (DC). Materials with similar actual DCPA contents were compared using Student's t test (alpha: 0.05). DC was higher for materials with DCPA-F, except for the 10:40 ratio. DCPA-F resulted in higher strength than DCPA-NF only at 40:10 ratio. Modulus was not affected by functionalization. Materials with similar actual DCPA contents showed differences in DC (F > NF), while no difference in flexural properties was observed between materials with 28%-30% DCPA. Both null hypotheses were rejected.

Dental Adhesives-Surface Modifications of Dentin Structure for Stable Bonding.

The latest advancements in dentin bonding have focused on strategies to impair degradation mechanisms in order to extend the longevity of bonded interfaces. Protease inhibitors can reduce collagen degradation within the hybrid layer (HL). Collagen cross-linkers allow better adhesive infiltration and also inhibit proteases activity. Particles added to adhesive can promote mineral precipitation within the HL, reducing nanoleakage and micropermeability, besides possible antimicrobial and enzymatic inhibition effects. Most of these approaches are still experimental, and aspects of the adhesive under the clinician's control are still determinant for the long-term stability of adhesive restorations.

Influence of Adhesion Promoter Primers on Polymerization Kinetics and Long-term Bond Strength of Composite Cements to Zirconia.

PURPOSE: To investigate the influence of primers on polymerization kinetics of resin-based luting and its effect on the microhardness and bond strength to zirconia. Materials and Methods: Panavia V5 (PV; Kuraray Noritake) with Tooth Primer (TPprimer; Kuraray Noritake) or Clearfil Ceramic Primer (CPprimer; Kuraray Noritake), and RelyX Ultimate (RU; 3M Oral Care) with Scotchbond Universal (SUadhesive; 3M Oral Care) were evaluated. Polymerization kinetics of luting materials with or without primers (TPprimer or SUadhesive) were evaluated using Fourier transform near-infrared (FT-NIR) spectroscopy in self- and dual-curing modes (n = 5). Microhardness of luting materials was evaluated after 1, 12, and 24 h (n = 5). Shear bond strengths to zirconia ceramics (Katana Zirconia, Kuraray Noritake; and Lava Esthetic, 3M Oral Care) after 24 h and 1 year (n = 8) were assessed to determine the effect of the following surface treatments: no treatment, non-thermal atmospheric plasma, primer (CPprimer or SUadhesive), and the combination of plasma + primers. Statistical analyses were performed at a 5% significance level. RESULTS: PV achieved a significantly higher degree of conversion (DC) when TPprimer was used, while there was no increase in conversion for RU combined with SUadhesive. Light activation significantly improved polymerization, which also produced greater microhardness. CPprimer and SUadhesive significantly improved immediate bond strength to zirconia ceramics. However, after 1 year, only SUadhesive with RU was able to maintain the bond strength. Plasma surface treatment did not improve bonding to zirconia. CONCLUSION: The use of primers improved the DC for PV only. Light curing produced higher conversion and microhardness for both resin-based luting materials. Bond strength to zirconia was improved when primers were used. However, only RU demonstrated reliable long-term adhesion to zirconia.

Polymerization Kinetics, Shrinkage Stress, and Bond Strength to Dentin of Conventional and Self-adhesive Resin Cements.

PURPOSE: To evaluate the kinetics of polymerization and shrinkage stress of resin cements, as well as their bond strength to dentin after 24-h or one-year water storage. MATERIALS AND METHODS: Three conventional resin cements were evaluated: RelyX Ultimate (RUL), Panavia V5 (PNV), and Multilink N (MLN); and three self-adhesive resin cements: RelyX Unicem 2 (RUN), Panavia SA Cement Plus (PSA), and G-CEM LinkAce (GCL). Degree of conversion (DC), maximum polymerization rate (RPmax) and gel time values were obtained using Fourier-transform infrared spectroscopy (FTIR/ATR). Shrinkage stress values were determined with a tensiometer, using a universal testing machine (n=5). Indirect resin composite restorations (Solidex) were fabricated and cemented to the dentin surface using self-adhesive resin cements, or conventional resin cements with self-etching adhesive (n=5). Bonding performance was evaluated with the microtensile bond strength (µTBS) test after 24 h or one year of water storage. RESULTS: MLN exhibited a higher DC (76.7%), whereas the percentage of other materials differed slightly (ranging from 54% to 58.5%). The RPmax and shrinkage stress values differed significantly between the cements. PSA showed the longest gel time. Significantly higher µTBS were observed for conventional resin cements after 24-h and one-year storage; a decrease in µTBS was observed for MLN only. CONCLUSION: Self-adhesive resin cements may not perform as well as conventional resin cements. Although both categories of cements presented similar polymerization kinetics and shrinkage values, the self-adhesive resin cements showed lower µTBS compared to those of conventional resin cements. Nevertheless, storage time only affected the bonding performance of MLN.

Physicochemical properties of experimental resin-based composites using tris(trimethylsilyl)silane associated with diphenyl iodonium hexafluorophosphate (DPIHP) salt.

The purpose was to evaluate the effect of tris(trimethylsilyl)silane (TTMSS) associated with diphenyl iodonium hexafluorophosphate (DPIHP) on the polymerization shrinkage stress (PSS), mechanical properties, color change (CC), and degree of conversion (DC) of resin-based composites (RBCs). Experimental RBCs containing 35 wt% of organic matrix (10.2 wt% BisGMA, 11.1 wt% BisEMA10 and UDMA and 2.1 wt% TEGDMA) and 65 wt% filler (13 wt% fumed silica and 52 wt% BaBSiO2) were assigned to six groups: control (0.2 wt% CQ, 0.5 wt% DMAEMA); TD05 (0.2 wt% CQ, 0.5 wt% TTMSS, 0.5 wt% DPIHP); TD10 (0.2 wt% CQ, 1 wt% TTMSS, 0.5 wt% DPIHP); DTD (0.2 wt% CQ, 0.25 wt% of DMAEMA, 0.25 wt% TTMSS, 0.5 wt% DPIHP); DT (0.2 wt% CQ, 0.25 wt% DMAEMA, 0.25 wt% TTMSS); and T05 (0.2 wt% CQ, 0.25 wt% TTMSS). The experimental formulations were submitted to the following tests: DC; PSS; CC; rate of polymerization (Rp); depth of cure by Knoop hardness; flexural strength; and flexural modulus. TTMSS showed no effect on the DC, Rp, and mechanical properties of the RBCs. DMAEMA reacted with TTMSS and reduced the Rp; the RBCs containing no DMAEMA showed no reduction in CC. DT showed the lowest PSS mean value among the groups. TTMSS differed from DMAEMA only when used in combination with DPIHP, which significantly improved the DC, maximum Rp, and mechanical properties of the RBCs tested. Based on the artificial ageing results, TTMSS was ineffective in reducing CC in the RBCs tested.

Development and Physicochemical Characterization of Eugenia brejoensis Essential Oil-Doped Dental Adhesives with Antimicrobial Action towards Streptococcus mutans.

Dental caries is a multifactorial, biofilm-dependent infectious disease that develops when detrimental changes occur in the oral cavity microenvironment. The antimicrobial and antivirulence properties of the essential oil obtained from the leaves of Eugenia brejoensis Mazine (EBEO) have been reported against Gram-positive and Gram-negative bacteria. Herein, the antimicrobial action of EBEO towards Streptococcus mutans is reported, along with the development and characterization of dental adhesives doped with. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of EBEO were determined against S. mutans, while its toxicity was analyze using Tenebrio molitor larvae. EBEO (MIC and 10×MIC) was incorporated into the Ambar Advanced Polymerization System® (Ambar APS), a two-step total-etch adhesive system (FGM Dental Group), and the antibiofilm action was evaluated. The reflective strength, modulus of elasticity, degree of conversion, and maximum rate of polymerization of each adhesive were also determined. The MIC and MBC values of EBEO against S. mutans were 62.5 µg/mL. The tested concentrations of EBEO were non-toxic to T. molitor larvae. The formation of S. mutans biofilms was significantly inhibited by EBEO and EBEO-coated resin discs (p < 0.05). Importantly, EBEO incorporation did not affect the mechanical and physicochemical properties in relation to oil-free adhesive version. EBEO showed strong antibacterial and antibiofilm activity against S. mutans, no toxicity effect against T. molitor larvae, and did not jeopardize the physical-chemical properties tested.

Electric current effects on bond strength, nanoleakage, degree of conversion and dentinal infiltration of adhesive systems.

To evaluate the effect of three adhesive systems applied under electric current on microtensile bond strength (µTBS) and degree of conversion (DC). Molar teeth were restored with the aid of three adhesive systems (Adper Single Bond 2-SB2; Clearfil SE Bond-CSE; and Single Bond Universal-SBU) under different electric current intensities (0 µA; 25 µA; and 50 µA). Composite resin blocks were built up in increments (2 mm) and sectioned into 1 × 1 mm beams. The µTBS was tested after 24 h and 1 y distilled water storages. Samples (n = 10) from 24 h to 1 y storages were immersed in a 50% ammoniacal silver nitrate solution and submitted to scanning electron microscopy. The silver nitrate in the hybrid layer was quantified (ImageJ software). The adhesive systems' dentinal infiltration was analyzed using confocal laser scanning microscopy. Fourier transform near infrared spectroscopy was used to measure the DC. The µTBS data were submitted to two-way ANOVA (time vs. electric current) and Bonferroni's test (α = 0.05). Quantitative nanoleakage data were submitted to two-way ANOVA (electric current vs. adhesive) and Bonferroni's test (α = 0.05). DC data were submitted to one-way ANOVA and Tukey's test (α = 0.05) for each adhesive system. The electric current statistically increased the µTBS for SB2 and CSE in 24 h storage, as well as for SB2, CSE and SBU in 1 y storage. No significant difference was observed between storage time for CSE and SBU. When compared to the control, electric currents (25 µA and 50 µA) showed significantly higher DC mean values for SB2 and SBU, and had no effect on CSE. The electric currents (25 µA and 50 µA) reduced the adhesive system's nanoleakage after 1-year storage, and improved the infiltration of SB2 and CSE. Both electric current intensities improved dentinal interface stability.

Physicochemical properties, metalloproteinases inhibition, and antibiofilm activity of doxycycline-doped dental adhesive.

OBJECTIVES: To evaluate the incorporation of doxycycline (DOX) into a commercial dental adhesive regarding physicochemical properties, microtensile bond strength (µTBS), nanoleakage (NL), nanohardness (NH) and Young's modulus (YM), metalloproteinases (MMP) inhibition, and antibiofilm activity. METHODS: DOX was incorporated into the adhesive at 0.05, 0.1, 0.5, and 1 wt%. Restored teeth were evaluated for µTBS, NL, NH, and YM after 24 -hs and 1-year of water storage. Biofilms of Streptococcus mutans were grown on top of these adhesives and determined for bacterial viability and amount of biomass. The inhibitory effect on MMP was analyzed by in situ zymography under confocal microscopy. RESULTS: Adhesives with 0.5 and 1 wt% of DOX presented reduced pH and degree of conversion. The incorporation of DOX did not affect µTBS and hybrid layer YM. The control group (no DOX) had a decrease in µTBS and the densest silver nitrate areas after 1-year storage. Hybrid layer NH values increased with 0.1 wt% DOX compared to control and 1 wt% DOX groups, at 24 -hs. After 1-year storage, NH of 1 wt% DOX adhesive decreased compared to the control group. The 0.5 and 1 wt% concentrations of DOX decreased the bacterial viability and the biofilm biomass. Confocal images suggest an increased MMP inhibition proportional to the percentage of DOX. CONCLUSION: At any concentration, DOX-doped dental adhesives were able to inhibit MMP activity, diminish nanoleakage, and maintain the resin-dentin bond-strength after 1 year of artificial aging. CLINICAL SIGNIFICANCE: Doxycycline-doped dental adhesive inhibited metalloproteinases activity and preserved interface bond strength. This formulation has a potential to improve adhesive restorations clinical longevity.

The use of bioactive particles and biomimetic analogues for increasing the longevity of resin-dentin interfaces: A literature review.

Protecting resin-dentin interfaces from hydrolytic and enzymatic degradation is critical for the longevity of adhesive restorations. In recent years, several strategies have been tested in vitro to induce apatite precipitation within interfibrillar and intrafibrillar collagen spaces, as well as in resin-sparse regions where the adhesive infiltration was incomplete. Also, the presence of calcium ions and other metallic ions has shown an inhibitory effect on enzymatic activity. Ion-releasing particles and biomimetic analogs have been studied for hybrid layer remineralization. Overall, remineralization strategy is dependent on the remaining mineral content. In partially demineralized dentin, residual apatite crystallites serve as nucleation sites for calcium and phosphate ions precipitation and crystal growth ("top-down" remineralization). In completely demineralized dentin where crystallites are absent (e.g., acid etched dentin) the use of mineral nano-precursors assisted by non-collagenous proteins analogs are necessary ("bottom-up" remineralization). This article reviews the approaches for hybrid layer remineralization and resin-dentin interface preservation.

Modification of filler surface treatment of composite resins using alternative silanes and functional nanogels.

OBJECTIVES: This study probes how modifiedapproaches for filler surface treatment in dental composites based on alternative silanes and functional nanogel additives affects physicochemical properties of these materials with a focus on polymerization stress development. METHODS: Nanogels were synthesized from isobornyl methacrylate, ethoxylated bisphenol-A dimethacrylate and isocyanatoethyl methacrylate followed by partial further reaction with 2-hydroxyethyl methacrylate to provide both isocyanate and methacrylate functionalization. A barium glass filler (˜1 µm particle size) was treated with either γ-methacryloxypropyltrimethoxysilane (MPS), N-methylaminopropyltrimethoxy (MAP) or N-allylaminopropyltrimethoxy (AAP) silanes. The reactive nanogels were then covalently attached to the aminosilane-treated fillers. Surface treatment was characterized by thermogravimetric analysis (TGA) and diffuse reflectance infrared spectroscopy (DR-IR). Composites were formulated with 60 wt% of the various functionalized fillers and the materials were evaluated for polymerization kinetics, polymerization stress (PS), volumetric shrinkage, mechanical properties and photorheology. Data were evaluated by one-way ANOVA and Tukey's test at 5% significance level. RESULTS: Filler surface treatments were confirmed by TGA and DR-IR analyses. Nanogel-functionalized fillers significantly reduced PS up to 20%, while the degree of conversion and elastic modulus were not compromised. Similar storage modulus development during polymerization was observed among materials by photorheology although the rate of polymerization was significantly increased for nanogel-based treatments. A significant decrease in flexural strength was observed for amino functional silane groups; however, there was no statistical difference in strength for the MPS control group compared with the nanogel-modified composites. SIGNIFICANCE: Filler surface treatment modified with a reactive nanogel enables significant PS reduction, without compromise to degree of conversion or mechanical properties of dental composites.

Evaluation of bulk-fill systems: microtensile bond strength and non-destructive imaging of marginal adaptation.

The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey's post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett's T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.

Modulation of Streptococcus mutans virulence by dental adhesives containing anti-caries agents.

OBJECTIVES: The aim of this in vitro study was to analyze the effect of the incorporation of two anti-caries agents into dental adhesives on the reduction of the virulence of Streptococcus mutans and on the adhesion to dentin. METHODS: Apigenin (1mM) and tt-Farnesol (5mM) were added separately and in combination to a self-etch adhesive (CS3 - Clearfil S3 Bond Plus) and to an each-and-rinse adhesive (OPT - OptiBond S). Biofilm of S. mutans was grown on adhesive-coated hydroxyapatite disks for 115h and bacterial viability, dry-weight, alkali soluble, water soluble, intracellular polysaccharides and protein were quantified. Bond strength and dentin-adhesive interface were performed to analyze the effects of the incorporation on the physical properties and to identify changes in hybrid layer morphology. RESULTS: Addition of Apigenin and Apigenin+tt-Farnesol to CS3, and Apigenin or tt-Farnesol to OPT reduced the dry-weight of S. mutans biofilm. Insoluble polysaccharide decreased with the addition of Apigenin to CS3 and tt-Farnesol to OPT. Intracellular polysaccharide decreased with addition of Apigenin and Apigenin+tt-Farnesol to CS3. No changes in dentin bond strength, resin-dentin interfacial morphology, total amount of protein and soluble polysaccharide were observed with the additions. SIGNIFICANCE: Biofilms that are less cariogenic around dental restorations could decrease secondary caries formation; in addition, the reduction of virulence of S. mutans without necessarily killing the microorganism is more unlikely to induce antimicrobial resistance.

Monomer conversion, microhardness, internal marginal adaptation, and shrinkage stress of bulk-fill resin composites.

OBJECTIVE: To evaluate degree of conversion (DC), Knoop microhardness (KHN), internal marginal adaptation (IA), and polymerization shrinkage stress (PS) of one conventional and four bulk-fill composites. METHODS: Bulk-fill composites tested were Surefil SDR (SDR), Filtek Bulk-Fill (FBF), Tetric EvoCeram Bulk-Fill (TEC), and EverX Posterior (EXP). The conventional composite Herculite Classic (HER) was tested using both incremental and bulk-fill insertion techniques. Standardized Class I preparations (4-mm-depth) were made in extracted molars and restored with each product system (N=5). After 1-week wet storage, restorations were cross-sectioned and DC and KHN were evaluated at four depths (1, 2, 3, and 4mm) using confocal Raman spectroscopy and KHN techniques, respectively. Epoxy resin replicas of restorations were evaluated using scanning electron microscopy for IA. PS was determined using composite bonded to acrylic rods attached to a universal testing machine (N=5). RESULTS: Within bulk-fill products, only SDR and FBF demonstrated similar DC at all depths, and KHN values did not statistically differ among depths, except for TEC. Neither placement method nor depth affected KHN or DC, except the DC of HER bulk-fill at 4mm. Incrementally layered HER, and bulk-fills SDR and TEC demonstrated the lowest proportion of internal gaps. Highest and lowest PS values were measured for EXP and TEC, respectively. SIGNIFICANCE: DC with depth was not uniform among all bulk-fill materials, although no difference in KHN was found. Higher PS correlated positively with higher proportion of interfacial gaps. The incremental technique using conventional composite showed reduced gap formation.

Self-etch adhesive systems: a literature review.

This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

Evaluation of bulk-fill systems: microtensile bond strength and non-destructive imaging of marginal adaptation

Abstract The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey's post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett's T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.

Self-Etch Adhesive Systems: A Literature Review

This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

Este artigo apresenta o estado da arte de sistemas adesivos autocondicionantes. Quatro temas são apresentados nesta revisão: o histórico desta categoria de agentes de união, o mecanismo de adesão, as características/propriedades, e a formação da zona ácido-base resistente nas interfaces esmalte/dentina-adesivo. Além disso, as vantagens relativas aos sistemas de condicionamento total ( etch-and-rinse ) e as classificações dos sistemas adesivos autocondicionantes de acordo com o número de passos e acidez são abordados. Por fim, são discutidas questões como a durabilidade potencial e a importância clínica. Sistemas adesivos autocondicionantes são materiais promissores porque são fáceis de usar, unem-se quimicamente à estrutura do dente e preservam a hidroxiapatita dentinária, o que é importante para a durabilidade da ligação.

Ação antimicrobiana do hipoclorito de sódio a 2,5% e clorexidina gel 2% em raízes contaminadas com Enterococcus faecalisAntimicrobial action of 2.5% sodium hypochlorite and 2% chlorhexidine gel in roots contaminated by Enterococcus faecalis

Objetivo: avaliar, in vitro, a efetividade antimicrobiana da clorexidina (CHX) 2% gel e do hipoclorito de sódio (NaOCl) a 2,5%, associado ao preparo mecânico do canal radicular em canais infectados com Enterococcus faecalis. Métodos: quarenta e cinco pré-molares com um único canal foram inoculados com E. faecalis por 14 dias. As raízes foram divididas em três grupos (n = 15): GP - grupo de controle positivo, sem tratamento, e G1 e G2, preparados mediante técnica híbrida (manual + ProTaper) e irrigados com CHX 2% e NaOCl 2,5%, respectivamente. Cinco pré-molares não receberam o inóculo, sendo o grupo de controle negativo (GN). Testes microbiológicos (contagem de UFC) foram realizados para avaliação dos tratamentos propostos. As médias dos grupos foram comparadas por Anova, complementada pelo teste de Tukey a 5% de significância. Resultados: não houve diferença estatística entre o hipoclorito de sódio 2,5% e a clorexidina gel 2% (p > 0,05), que reduziram significativamente o E. faecalis em 99,57% e 99,30%, respectivamente, em relação ao grupo de controle positivo. Conclusão: as substâncias testadas, CHX 2% gel e NaOCl 2,5%, são substâncias químicas auxiliares do preparo químico-mecânico do canal que promoveram uma redução significativa do E. faecalis.