Special Issue Foreward.

PURPOSE: On behalf of the University of Washington School of Dentistry Department of Restorative Dentistry, we would like to welcome you to the proceedings publication on "Antibacterial and Bioactive Dental Restorative Materials: Do They Really Work? " We believe it was high time that such an event took place to focus on and discuss some of the basic questions related to the topic. We made a special effort to invite presentations from a diversity of research back-grounds. The symposium, supported by the Dental Materials Group under the same title, was held during the 94th General Session & Exhibition of the IADR in Seoul, Korea on June 24, 2016, and provided a valuable opportunity for research scientists, industry specialists, clinicians and academicians to share experiences.

Antibacterial and bioactive dental restorative materials: Do they really work?

PURPOSE: This proceedings reviews current antibacterial and bioactive dental materials and new agents in development. METHODS: Experts from across academia, industry and clinical practice were invited to present, discuss, and work together to develop solutions to the challenge of formulating and applying antibacterial dental materials in a symposium in Seoul, Korea in June, 2016.

Antibacterial-containing dental adhesives' effects on oral pathogens and on Streptococcus mutans biofilm: Current perspectives.

PURPOSE: To describe the literature findings regarding commercially available antibacterial-containing dental adhesives and the futures perspectives of this field. RESULTS: High-risk caries patients could yield benefits from restorative materials containing antibacterial properties in order to reduce the recurrent caries formation. Dental adhesives with antibacterial agents may reduce restoration replacement, as recurrent caries is still one of the major reasons for replacing a resin restoration. Literature results of three commercially available adhesives: Gluma 2Bond, Clearfil SE Protect and Peak Universal Bond, containing glutaraldehyde, MDPB and chlorhexidine, respectively indicates that Clearfil SE Protect seems to have better results against oral pathogens and on Streptococcus mutans biofilm. Besides the promising findings, clinical studies are still necessary in order to validate the clinical efficacy when exposed to a more complex environment and the long-term effect of either commercially available materials, experimental antibacterial monomers or antibacterial incorporations. As a suggestion of this article and according to the current scientific trends in this specific field, future directions should focus on restorative materials with therapeutic components targeting the virulence factors of cariogenic biofilm with minimal toxicity and side effects, and long-term action. CLINICAL SIGNIFICANCE: Antibacterial-containing dental adhesives may have therapeutic effects, working as an additional source to reduce recurrent caries development in patients with high-risk of caries, and consequently the reduction in restoration replacements.

Reactions: Antibacterial and bioactive dental restorative materials: Do they really work?

PURPOSE: The study and development of antibacterial materials for use in dental applications is growing with the development of novel materials and procedures. Examination of the effects of such antibacterial materials on oral pathogens as well as on stability and longevity of dental restorations is of paramount importance to the field. RESULTS: This review addressed the range of topics covered by the manuscripts presented at the Seoul symposium on antibacterial dental materials. CLINICAL SIGNIFICANCE: Based on the presented works, it seems that the emerging antibacterial and bioactive mate-rials can potentially benefit restorative dentistry; however, like many other subjects in clinical dentistry, good quality evidence on their effectiveness under clinical situations is yet to be accumulated.

1-Year clinical study of indirect resin composite restorations luted with a self-adhesive resin cement: effect of enamel etching

In vitro studies have recommended enamel-etching before luting indirect restorations with self-adhesive resin cement. However, there is no scientific proof that this procedure has any clinical relevance. Thus, the aim of this study was to evaluate the effect of enamel-etching on the marginal quality of indirect composite resin restorations (inlay/onlay) using the self-adhesive cement RelyX Unicem clicker. Forty-two posterior teeth were selected from 25 patients that presented one or two teeth with large restorations in need of replacement. All teeth were prepared by the same operator and impressed with polyvinylsiloxane material. The composite resin restorations were built over plaster casts using the incremental technique with a LED device for light-curing the increments. The inlays/onlays were cemented according to one of the following protocols: 1. Etched group (ETR) - selective enamel phosphoric-acid etching + RelyX Unicem clicker; 2. Non-etched group (NER) - RelyX Unicem clicker alone. Each surface was light-cured for 60 s. Recalls occurred after 1 week (baseline), 6 and 12 months when the teeth were evaluated according to previously established scores (modified USPHS criteria). The clinical analysis showed little or no visible changes in the marginal quality after 1 year, even though a probe could detect all the restorations margins. Statistical analysis (Fisher’s exact test, p<0.05) detected no differences between the groups after 12 months. No restorations failed and no secondary caries were found. Enamel acid etching had no clinical relevance on the marginal quality of indirect composite resin restorations luted with RelyX Unicem clicker after 1 year of follow up.

Estudos in vitro têm recomendado condicionamento ácido do esmalte antes da cimentação de restaurações indiretas com cimento resinoso autoadesivo. Entretanto, não há nenhuma prova científica de que este procedimento tenha relevância clínica. Assim, o objetivo deste estudo foi avaliar o efeito do condicionamento ácido do esmalte na qualidade marginal de restaurações indiretas de resina composta (inlay/onlay) usando o cimento autoadesivo RelyX Unicem clicker. Quarenta e dois dentes posteriores foram selecionados de 25 pacientes com 1 ou 2 restaurações amplas com necessidade de substituição. Todos os dentes foram preparados pelo mesmo operador e impressos com material à base de polivilsiloxano. As restaurações de resina composta foram construídas sobre troquel de gesso usando a técnica de colocação em camadas e polimerizadas usando aparelho de luz emitida por diodo (LED). Osinlays/onlays foram cimentados de acordo com um dos protocolos: 1. Grupo condicionado (ETR)- condicionamento seletivo do esmalte com ácido fosfórico + cimentação com RelyX Unicem clicker; 2. Grupo não condicionado (NER)- cimentação com RelyX Unicem clicker somente. Cada superfície foi fotoativada por 60 s. Os retornos para acompanhamento foram feitos após 1 semana (baseline), 6 e 12 meses onde os dentes foram avaliados de acordo com critérios previamente estabelecidos (USPHS Modificado). A análise clínica mostrou pouca ou nenhuma alteração visível na qualidade marginal após 1 ano, porém uma sonda clínica pode detectar todas as margens restauradoras. A análise estatística (Teste exato de Fisher, p<0,05) não detectou diferença entre os grupos após 12 meses. Nenhuma restauração falhou e nenhuma cárie secundária foi encontrada. O condicionamento ácido do esmalte não teve relevância clínica na qualidade marginal de restaurações indiretas de resina composta cimentadas com RelyX Unicem clicker após 1 ano de acompanhamento.