The prevalence of non-carious cervical lesions (NCCLs) with or without erosive etiological factors among adults of different ages in Tokyo.

OBJECTIVES: To evaluate the prevalence of non-carious cervical lesions (NCCLs) on teeth with or without erosive etiological factors across a broad range of ages of Japanese adults. MATERIALS AND METHODS: The study sample consisted of a total of 1108 subjects aged 15 to 89 years in Tokyo, Japan. Two examiners evaluated NCCLs and dental erosion (DE) during a full-mouth examination. Subjects were asked to complete a self-administered daily diet, habits, and health condition questionnaire. Subjects who had frequent acid consumption or gastric reflux and at least one tooth with initial enamel wear were placed in the erosion present (EP) group, and the remainder of subjects were placed in the erosion not present (EN) group. Logistic regression analyses were carried out to identify etiological factors of NCCLs associated with DE. RESULTS: Overall prevalence of NCCLs was 60.2%; the prevalence increased with age. There were no statistical differences in the prevalence of NCCLs between the EP and EN groups, except for the 60-69 years group. Multiple logistic regression analysis showed the frequency of consumption of carbonated soft drinks, citrus juice, and acidic fruits such as oranges; tooth brushing pressure; and bruxism were associated with the presence of NCCLs. CONCLUSION: There were no statistical differences in the prevalence of NCCLs with or without erosive etiological factors except for the 60-69 years group. CLINICAL RELEVANCE: NCCL distribution increased with age, and erosive risk factors caused by change in dietary habits might affect the incidence of NCCLs for elders. TRIAL REGISTRATION: UMIN000041982.

Multifactorial logistic regression analysis of factors associated with the incidence of erosive tooth wear among adults at different ages in Tokyo.

OBJECTIVES: The aim of this study was to evaluate factors associated with the incidence of erosive tooth wear (ETW) among adults at different ages in Tokyo using multifactorial logistic regression analysis. MATERIALS AND METHODS: The study sample consisted of a total of 1108 subjects aged 15 to 89 years in Tokyo, Japan. Two examiners evaluated ETW in a full-mouth recording. The subjects were asked to complete a self-administered daily diet, habit, and health condition questionnaire. Subjects who had frequent acid consumption or gastric reflux and at least one tooth with initial enamel wear were placed in the ETW-positive group, and the remainder of the subjects was placed in the ETW-negative group. Logistic regression analyses were carried out to identify factors collectively associated with ETW. RESULTS: Logistic regression analysis showed that greater frequencies of carbonated or sports drink consumption were associated with higher incidence of ETW for all age groups except for 70-89 years. Adults in the 30-39-year group who reported suffering from heartburn were about 22.3 times more likely to develop ETW, while 40-49-year adults who had repeated vomiting were about 33.5 times more likely to exhibit ETW compared with those who did not experience vomiting. CONCLUSION: Age-specific dietary habits were clearly observed among adults at different ages in Tokyo, and there were significant differences in intrinsic and extrinsic factors between ETW-positive and ETW-negative groups for each age group. CLINICAL RELEVANCE: Both greater frequency of carbonated and sports drink consumption were associated with higher incidence of ETW among adults at different ages in Tokyo.

Stress distribution in root filled teeth restored with various post and core techniques: effect of post length and crown height.

AIM: To investigate interfacial stress distribution in restored root filled teeth with various post lengths and crown heights. METHODOLOGY: Three-dimensional mathematical models of a root filled mandibular premolar tooth were constructed. Parts of the tooth structures were replaced with ceramic crowns having three crown heights incorporating, either a cast post and core or a resin post and cores with fibre post or metallic post with four post lengths. Finite element linear analysis was performed to calculate equivalent and shear stress distribution at the interfaces between the teeth and post and cores under mesiodistal symmetrical boundary conditions and an oblique static load of 400 N. RESULTS: For the resin post and core with fibre and metallic posts, shear stress at the interface was greater in the cervical area than the post area, depending on the crown height. The resin post and core with metallic post had lower shear stress at the interface of cervical area than that of the fibre post model; however, the metallic post models produced a high concentration of shear stress at the interface between the post and resin composite. On the other hand, for the cast post and core, the shear stress at the interface was mainly produced in the post end area, which increased with decrease of post length. CONCLUSIONS: For the resin post and core, bonding integrity to the cervical area would play a critical role in the survival of the restored tooth, whereas for the cast post and core, the bond of the post would be essential.

The effect of glutathione on 2-hydroxyethylmethacrylate cytotoxicity and on resin-dentine bond strength.

AIM: To evaluate the influence of reduced glutathione (GSH) application on 2-hydroxyethylmethacrylate (HEMA) cytotoxicity on rat pulpal cells and evaluate the effect of etched-dentine treatment with GSH on the immediate microtensile bond strength (µTBS) of etch-and-rinse adhesive. METHODOLOGY: The cytotoxicity of 10 mmol L(-1) HEMA, 10 mmol L(-1) HEMA + 1 mmol L(-1) GSH, 10 mmol L(-1) HEMA + 5 mmol L(-1) GSH and 10 mmol L(-1) HEMA + 10 mmol L(-1) GSH was compared (6 h and 24 h). Cells viability was measured by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, followed by morphological observation of cells. Etched-dentine surfaces were rinsed and treated with one of the following solutions: 2% GSH, 5% GSH or 10% GSH, bonded with Adper Single Bond Plus (3M, ESPE, St. Paul, MN, USA) and restored with resin composite. The control group received no GSH treatment. After 1 day of water-storage at 37 °C, the specimens were subjected to µTBS testing. Cytotoxicity and µTBS data were analysed by one-way anova and Tukey post hoc tests (P < 0.05). RESULTS: There were significant differences between the groups. HEMA elicited a remarkable toxic effect. 10 mmol L(-1) GSH prevented HEMA-induced damage at both exposure times. Whilst 5 mmol L(-1) GSH lost its protective effect at 24-h exposure time and 1 mmol L(-1) GSH showed no protective effect at both exposure times, GSH had no significant effect on the immediate µTBS; however, 5% GSH had higher bond strength value when compared to 10% GSH (P = 0.003). CONCLUSION: Controlled concentrations of GSH had a protective effect against HEMA cytotoxicity. GSH had neither positive nor negative influence on µTBS.

The Effect of a Deproteinizing Pretreatment on the Bonding Performance and Acid Resistance of a Two-step Self-etch Adhesive on Eroded Dentin.

OBJECTIVES: This study evaluated how deproteinization using sodium hypochlorite (6% NaOCl) or hypochlorous acid (50 ppm HOCl) with or without the subsequent use of an arylsulfinate salt-containing agent (Clearfil DC Activator; DCA; Kuraray Noritake Dental) affects the micro-tensile bond strength (µTBS) and formation of an acid-base resistant zone (ABRZ) of a two-step self-etch adhesive on eroded dentin. METHODS: Coronal dentin surfaces of sound human molars were exposed to 48 cycles of demineralization (1% citric acid; 5 minutes) and remineralization (buffer solution with pH=6.4; 3.5 hours). They were then assigned to experimental groups according to the pretreatment used: none (negative control), NaOCl, NaOCl+DCA, HOCl, and HOCl+DCA. Sound dentin surfaces with no pretreatment were used as a positive control. The dentin surfaces were bonded with Clearfil SE Bond 2 (Kuraray Noritake Dental), and µTBS was measured either after 24 hours or 20,000 thermal cycles (TC). The µTBS data were statistically analyzed using a mixed-model analysis of variance (ANOVA) and t-tests with Bonferroni correction. Failure mode was determined with scanning electron microscopy (SEM), which was also used for the observation of ABRZ. RESULTS: Among experimental groups, there was no significant difference between the negative control, HOCl, and HOCl+DCA after 24 hours, but the HOCl-pretreated groups exhibited significantly higher µTBS than the negative control after TC (p<0.01). Pretreatment with NaOCl and NaOCl+DCA resulted in significantly higher µTBS (p<0.001), but the highest µTBS was measured on sound dentin (p<0.001). TC decreased µTBS significantly in all groups (p<0.001) except for sound dentin and NaOCl+DCA (p>0.05). Adhesive failures prevailed in eroded groups, whereas cohesive failures were predominant on sound dentin. ABRZ was recognized in all groups but marked morphological differences were observed. CONCLUSIONS: The combined use of 6% NaOCl and the arylsulfinate salt-containing agent partially reversed the compromised bonding performance on eroded dentin, while the effect of 50 ppm HOCl was negligible.

Influence of Application Modes on Increasing Bond Strength Longevity of Self-etching and Universal Adhesive Systems to Enamel.

The present study aimed to evaluate the influence of application mode on the short-term microshear bond strength longevity of self-etching and universal adhesive systems to enamel, the failure mode, and the resulting enamel surface micromorphology. Ninety enamel surfaces were obtained from sound third molars, planed, and randomly assigned to nine groups, according to the application mode and the adhesive system (n=10). There were three primer application modes: according to the manufacturer's recommended application time (control), using double the application time recommended for the primer and selective enamel etching. The adhesive systems used were: Clearfil SE Bond (Kuraray), FL-Bond II (SHOFU), and Futurabond U (Voco). At least two resin-bonded composite cylinders (Grandioso Light Flow, Voco) were placed on each enamel surface, and then evaluated for microshear bond strength at 24 hours and 180 days of storage in solution body fluid (SBF) at pH 7.4. Failure modes were evaluated with a stereoscopic microscope at 20× magnification. A micromorphological analysis of the enamel surface was performed under a scanning electron microscope at 5000× magnification before and after the treatments. Mixed models for repeated measures over time showed significant interaction among application modes, adhesive systems, and time periods (p=0.0331). The bond strength of FL-Bond II adhesive to enamel observed after performing selective enamel etching was significantly higher than that observed after applying the control treatment (p=0.0010) at both 24 hours and 180 days. However, no significant difference was observed between the application of this same adhesive at double the time recommended by the manufacturer and the other two application modes (p>0.05). There was also no significant difference in the microshear bond strength for the enamel treatments applied using Clearfil SE Bond and Futurabond U (p>0.05). A significant reduction in bond strength to enamel was observed at the 180-day storage time for all the adhesive systems when selective enamel etching was performed (p<0.0001). No significant association was observed between the adhesive system failure mode and the enamel treatments (p=0.1402 and p=0.7590 for 24 hours and 180 days, respectively). The most prevalent failure was the adhesive type.

Estimation of the enamel and dentin mineral content from the refractive index.

Recent advances in the field of optics have enabled accurate and localized measurement of optical properties of biological substrates. This work aimed to elucidate the relationship between the local refractive index (n) and mineral content (MC) of enamel and dentin. De- and remineralized lesions in bovine enamel and dentin blocks were sectioned into 300- to 400-µm-thick slices, and placed on a metal plate to capture images of sound, de- and remineralized regions transversely by optical coherence tomography. Mean n at each depth level of the lesion (20- or 40-µm steps for enamel or dentin) was measured by the optical path length-matching method and used to plot n through lesion depth. The specimens were further polished and processed for transverse microradiography for analysis of MC. The n and MC ranged from 1.52 to 1.63 and 50 to 87 (vol.%) in enamel, and from 1.43 to 1.57 and 11 to 48 (vol.%) in dentin, respectively. Strong, positive linear correlations were found between n and MC (Pearson's r = 0.95 and 0.91 for de- and remineralized enamel, and r = 0.94 and 0.91 for dentin, respectively, p < 0.001). Experimental data were validated with a theoretical calculation of n from MC. De- and remineralization of enamel and dentin resulted in measurable changes of n, and, in turn, MC changes of the tissue could be estimated with good accuracy from this long-known optical property by the new analytical approach. Compositional changes of enamel crystallites after remineralization affect n.

Effect of solvent evaporation strategies on regional bond strength of one-step self-etch adhesives to root canal dentine.

AIM: To evaluate the efficacy of different solvent evaporation strategies on bonding of one-step self-etch adhesives to root canal dentine. METHODOLOGY: Two dual-cure resin core systems (Clearfil DC Bond/Clearfil DC Core Automix and Clearfil Tri-S Bond Plus/Clearfil DC Core Plus; Kuraray Noritake Dental, Tokyo, Japan) were equally applied in 24 post spaces from extracted human mandibular premolars. After the adhesive application, specimens were randomly assigned into four water/solvent evaporation strategies as follows (I) insertion of absorbent paper point for 10 s: P, (II) 10 s air-blowing: A, (III) as (II) followed by insertion of absorbent paper point: AP, (IV) as (III) followed by 10 s additional air-blowing: APA. Then, the adhesives were light cured, and resin core materials were placed into the post space, followed by light curing for 60 s. After water storage for 24 h, 0.6 × 0.6 mm-thick beams were prepared to measure the regional µTBS. The mode of failure was also observed. The µTBS values were statistically analysed using three-way anova and Duncan HSD test (α = 0.05). RESULTS: In the coronal region, there were no significant differences in µTBS between each evaporation strategy (P > 0.05), except P group. However, in the apical region, APA and AP groups significantly increased in µTBS compared with A and P groups (P < 0.05). Only in the APA group of Clearfil Tri-S Bond Plus/Clearfil DC Core Plus, was there no significant difference in µTBS between the coronal and apical regions (P > 0.05). CONCLUSION: The use of paper points with additional air-blowing for removing excessive adhesive and evaporating residual water/solvent would be effective in producing higher bond strength for the tested one-step self-etch adhesives and fewer blister formations in deeper regions of the post space.

Phosphoric acid-etching promotes bond strength and formation of acid-base resistant zone on enamel.

This study examined the effect of phosphoric acid (PA) etching on the bond strength and acid-base resistant zone (ABRZ) formation of a two-step self-etching adhesive (SEA) system to enamel. An etch-and-rinse adhesive (EAR) system Single Bond (SB) and a two-step SEA system Clearfil SE Bond (SE) were used. Human teeth were randomly divided into four groups according to different adhesive treatments: 1) SB; 2) SE; 3) 35% PA etching→SE primer→SE adhesive (PA/SEp+a); (4) 35% PA etching→SE adhesive (PA/SEa). Microshear bond strength to enamel was measured and then statistically analyzed using one-way analysis of variance and the Tukey honestly significant difference test. The failure mode was recorded and analyzed by χ( 2 ) test. The etching pattern of the enamel surface was observed with scanning electron microscope (SEM). The bonded interface was exposed to a demineralizing solution (pH=4.5) for 4.5 hours and then 5% sodium hypochlorite with ultrasonication for 30 minutes. After argon-ion etching, the interfacial ultrastructure was observed using SEM. The microshear bond strength to enamel of the SE group was significantly lower (p<0.05) than that of the three PA-etched groups, although the latter three were not significantly different from one another. The ABRZ was detected in all the groups. In morphological observation, the ABRZ in the three PA-etched groups were obviously thicker compared with the SE group with an irregular wave-shaped edge.

Comparison of natural and artificial root caries lesions using microcomputed tomography and microhardness test.

BACKGROUND: This study compared natural root caries lesions with artificial root caries lesions prepared with one of the two demineralising solutions. METHODS: Twelve natural root caries lesions on upper incisors and 24 artificial root lesions were prepared on sound root surfaces using 50 mM acetic acid, 1.5 mM CaCl2 , 0.9 mM KH2 PO4 at pH 5.0 or 80 mL/L Noverite K-702 polyacrylate solution, 500 mg/L hydroxyapatite, 0.1 mol/L lactic acid at pH 4.8 (n = 12/group) for 96 hours. Lesions were scanned using micro-CT. Inciso-gingival oriented images were analysed and mineral density calculated at 7.5 µm increments from the surface to 225-µm deep. Sectioned lesions were analysed by Knoop microhardness up to 250 µm from the lesion surface. Data were analysed by the Dunn's test with Bonferroni correction. RESULTS: Natural and artificial lesion mean mineral densities were not statistically different (P > 0.05). Mineral density from the surface to 75 µm was greater in natural lesions and from 150 to 225 µm was greater in artificial lesions (P < 0.05). Microhardness values were statistically higher in artificial lesions (P < 0.05); no difference was found among artificial lesions produced by the two solutions (P > 0.05). Mineral density and microhardness of natural and artificial root caries are different from each other. A greater mineralized surface layer existed on natural lesions.

Nano-indentation testing of new and fractured nickel-titanium endodontic instruments.

AIM: To investigate the effect of cyclic fatigue on nickel-titanium (NiTi) endodontic instruments using a nano-indentation test. METHODOLOGY: Eight ProFile NiTi rotary instruments (size 30, taper 0.06; Dentsply Maillefer, Ballaigues, Switzerland) were tested using a cyclic fatigue set-up until fracture. The fractured instruments and eight new NiTi instruments of the same size and taper were used for a nano-indentation test on the internal surfaces of a NiTi instruments in the region just adjacent to their fractured edge (group I) and in the same region of the new group (group II), and the cutting part beside the shaft for both instruments [group III (fractured) and group IV (new)]. Data were statistically analyzed using one-way analysis of variance and Games-Howell post hoc test. The alpha-type error was set at 0.05. RESULTS: Significant differences in terms of hardness and elastic modulus for each group (P < 0.05) were found, with group I having the lowest mean values followed by group III. Additionally, standard deviations increased remarkably after failure, as represented by groups I and III. CONCLUSION: The nano-indentation technique can be applied to determine the performance and the failure mechanism of NiTi instruments. The fatigue process revealed a significant decrease in the hardness and elastic modulus of the NiTi instrument. As indicated by the low hardness, the fatigue process did not result in work hardening but rather work softening.

Noninvasive cross-sectional imaging of incomplete crown fractures (cracks) using swept-source optical coherence tomography.

AIM: To investigate the ability of swept-source optical coherence tomography (SS-OCT) to detect incomplete crown fractures (cracks) in extracted teeth. METHODOLOGY: Cracks were created by subjecting 30 porcine premolars to impaction by a steel rod plunging from the occlusal tip. SS-OCT images and stereomicroscopic photographs of the surface were acquired for each specimen before and after impaction. For evaluation, the focused light beam of SS-OCT was projected from three directions on the same plane: buccal or lingual, 45° to the mesial, and 45° to the distal. Histological sections were prepared after impaction, and length and width of cracks and lamellae were evaluated using the corresponding SS-OCT image. The values were analysed using Pearson's correlation coefficient. RESULTS: Through SS-OCT, cracks and lamellae were clearly detected as intensified scattering signals at the same position on the corresponding microphotographs and histological sections. Amongst the three scanning angles, the greatest lengths and widths were considered the corresponding values of SS-OCT and were used for analysis. Significant correlations regarding line length and width were observed between SS-OCT and histological sections (length: r = 0.65, P < 0.001; width: r = 0.60, P < 0.001). CONCLUSIONS: SS-OCT can clearly discriminate cracks, which appear as highlighted lines due to the scattering of light. The results obtained from the three scanning directions were correlated well with those of the histological sections.

Effects of Material Thickness and Pretreatment on the Interfacial Gap of Translucent Zirconia Restorations with Self-adhesive Resin Cement.

PURPOSE: The first objective was to determine if the dual-curing of self-adhesive resin cement (SAC) with reduced light penetrating through zirconia had an effect on interfacial gap of zirconia restorations. The second purpose was to examine whether pretreatment methods for universal adhesive affected interfacial gap. The last aim was to compare the microhardness of SAC polymerized under different zirconia thicknesses. METHODS AND MATERIALS: This study evaluated self-adhesive resin cement (RelyX U200, 3M ESPE) after different pretreatment with universal adhesive (Single Bond Universal, 3M ESPE) under different polymerization conditions. CAD/CAM inlay cavities were prepared on extracted third molars. Translucent zirconia restorations were milled using Katana UTML (Kuraray). The teeth were divided into three groups: Groups I, II, and III in which the restoration thicknesses were 1, 2, and 3 mm. Each Group had three subgroups according to different pretreatment methods. For subgroup-1, no pretreatment was done on the prepared cavity. For subgroup-2, universal adhesive was applied and light-cured before cement placement (precure method). For subgroup-3, universal adhesive was applied; however, light-curing was done after cement placement (cocure method). After thermo-cycling, the interfacial gap at the restoration-tooth interface was investigated using swept-source optical coherence tomography imaging. Finally, microhardness was measured for SAC under different zirconia thicknesses. For statistical analysis, the interfacial gap was analyzed using two-way analysis of variance (ANOVA) to test the effect of cavity depth and pretreatment. In terms of each cavity depth and pretreatment, the interfacial gap was compared using one-way ANOVA and Scheffe's test. One-way ANOVA was also performed for comparison of the Vickers hardness results. RESULTS: Different thicknesses of the restoration resulted in differences in interfacial gaps except between the precure method of Groups I and II (p<0.05). The effect of universal adhesive pretreatment was different depending on the restoration thickness with exceptions in Groups I and III (p<0.05). Vickers hardness number decreased as the low radiant exposure of light was applied (p<0.05). CONCLUSION: Interfacial gap of zirconia restorations can differ depending on the material thickness, pretreatment, and activation mode. Reduced light intensity penetrating through zirconia may lead to higher interfacial gap percentage and lower microhardness of the self-adhesive resin cement. Application of a universal adhesive showed similar or reduced interfacial gaps in the cement space.

MDP Salts: A New Bonding Strategy for Zirconia.

Durable resin-ceramic adhesion may influence the clinical success of ceramic restorations, which has been one of the challenging issues in dentistry. The present study assessed the bond strength and chemical interaction of 10-methacryloxydecyl dihydrogen phosphate (MDP), MDP+silane, and MDP-salt primers to alumina-blasted zirconia ceramic by tensile bond strength test, surface elemental composition with x-ray photoelectron spectroscopy analysis, contact angle measurement, surface morphology with scanning electron microscopy, and surface topography with 3-dimensional confocal laser scanning microscope analyses. MDP-salt showed the highest tensile bond strength before and after thermocycling when compared with MDP and MDP+silane (P < 0.05). The measured contact angle values differed significantly (P < 0.001) in the order of MDP-salt > control (no chemical pretreatment) > MDP+silane > MDP. There was no difference in surface roughness (P = 0.317) and surface topography among all tested groups. Zirconia treated with MDP-salt showed phosphorus peaks in addition to zirconia and alumina peaks. MDP-salt has zirconia priming properties, which improves bonding performance to resin cement.

Degree of Conversion Contributes to Dentin Bonding Durability of Contemporary Universal Adhesives.

CLINICAL RELEVANCE: The degree of conversion of contemporary universal adhesives positively correlates with the bond strength to dentin. The correlation is more marked after thermocycling, suggesting that a high degree of conversion is required for long-term dentin bonding durability. SUMMARY: Purpose: The objectives of this study were to evaluate the micro-tensile bond strength (µTBS) of five contemporary universal adhesives to dentin after 24 hours and thermocycling (TC), to measure their degrees of conversion (DC) and to test the correlation between µTBS and DC.Methods and Materials: Four commercially available universal adhesives, Prime&Bond universal (PBU), Ecosite Bond (EB), G-Premio Bond (GPB), and Clearfil Universal Bond Quick (UBQ), and one experimental adhesive, UBQ without an amide monomer (UBQ-A), were used in this study. For the µTBS test, midcoronal dentin of 50 human molars was exposed, ground using 600-grit SiC paper, and the adhesives were applied according to the manufacturers' instructions. After resin-composite buildup and 24-hour water storage, one-half of the specimens were subjected to 15,000 thermal cycles. The specimens were sectioned into beams and stressed in tension at a crosshead speed of 1 mm/min until failure. The DC of adhesives applied to dentin was evaluated using attenuated total reflectance Fourier-transform infrared spectroscopy immediately after light-curing. All data were statistically analyzed at a significance level of 0.05.Results: The highest µTBSs were obtained with UBQ, UBQ-A, and PBU, which were not significantly different from each other both after 24 hours and TC. The µTBS of GPB was lower compared with the aforementioned adhesives, but significantly only after TC, and the lowest µTBSs were obtained with EB. TC did not affect the µTBSs of UBQ, UBQ-A, and PBU significantly, but a significant decrease was observed with GPB and EB. The highest DC was obtained with PBU and UBQ, followed by 2-hydroxyethyl methacrylate-rich adhesives UBQ-A and EB, which exhibited significantly lower DCs. The DC of GPB could not be determined because the reference peak at 1608 cm-1 was not detected in its spectra. A significant positive correlation was shown between µTBS and DC after 24 hours (r=0.716) and TC (r=0.856).Conclusion: µTBS and DC were positively correlated, more markedly after TC, which suggests that DC may be an important factor for bond durability.

Interfacial Evaluation of CAD/CAM Resin Inlays on the Cavity Floor Using Swept-source Optical Coherence Tomography.

CLINICAL RELEVANCE: When a resin nanoceramic inlay is cemented using self-adhesive cement, a universal dentin adhesive can be applied to the prepared cavity. The application of the adhesive before self-adhesive cement placement provides similar or better interfacial adaptation than without the adhesive. SUMMARY: Purpose: The first objective of this study was to determine whether the luting material used for computer-aided design and computer-aided manufacture resin nanoceramic inlays affected interfacial adaptation. The second objective was to investigate whether application of a universal dentin adhesive before cementation affected interfacial adaptation. The final objective was to compare the inlay-side and dentin-side interfaces in the cement space.Methods and Materials: Seventy-four class I cavities were prepared on extracted human third molars. Cavities were optically scanned, and resin nanoceramic inlays were milled using Lava Ultimate blocks (3M ESPE). For the control groups, the fabricated inlays were cemented using Panavia V5 (Kuraray Noritake) or FujiCem 2 (GC). For the experimental groups, the teeth were randomly divided into groups I and II. Group I contained four subgroups using different luting materials; in all subgroups, the inlays were cemented and dual cured without pretreatment. Group II contained six subgroups in which inlays were cemented and dual cured after application of a universal dentin adhesive. After thermocycling, interfacial adaptation was measured using swept-source optical coherence tomography (SS-OCT) imaging and statistically compared among groups.Results: Interfacial adaptation was different depending on the luting material used (p<0.05). After application of a universal adhesive, some subgroups showed improved interfacial adaptation (p<0.05). In the comparison of inlay-side and dentin-side interfaces, no difference was found in interfacial adaptation (p>0.05).Conclusions: Interfacial adaptation for resin nanoceramic inlays differed with luting material. For some self-adhesive cements, application of a universal adhesive before cementation improved interfacial adaptation.

Role of lysine in interaction between surface protein peptides of Streptococcus gordonii and agglutinin peptide.

INTRODUCTION: Streptococcus gordonii interacts with the salivary pellicle on the tooth surface and plays an important role in dental biofilm formation. Reports show that the analog Ssp peptide (A11K; alanine to lysine at position 11 in the arranged sequence, (1)DYQAKLAAYQAEL(13)) of SspA and SspB of S. gordonii increased binding to the salivary agglutinin (gp-340/DMBT1) peptide (scavenger receptor cysteine-rich domain 2: SRCRP2). To determine the role of lysine in the binding of the Ssp(A11K) peptide to SRCRP2, we investigated whether an additional substitution by lysine influenced the binding of Ssp(A11K) peptide to SRCRP2 using a BIAcore biosensor assay. METHODS: Six analogs of the Ssp peptide with positive charges in surface positions on the structure were synthesized using substitution at various positions. RESULTS: The binding activity of analog Ssp(A4K-A11K) peptide was significantly higher than the other Ssp analogs. The binding activity rose under low ionic strength conditions. The distance between positively charged amino acids in the Ssp(A4K-A11K) peptide between 4K and 11K was 1.24 +/- 0.02 nm and was close to the distance (1.19 +/- 0.00 nm) between Q and E, presenting a negative charged area, on SRCRP2 using chemical computing graphic analysis. The molecular angle connecting 1D-11K-4K in the Ssp(A4K-A11K) peptide secondary structure was smaller than the other peptide angles (1D-11K-XK). The Ssp(A4K-A11K) peptide showed higher inhibiting activity for Streptococcus mutans binding to saliva-coated hydroxyapatite than the (A11K) peptide. CONCLUSION: The positioning of lysine is important for binding between Ssp peptide and SRCRP2, and the inhibiting effect on S. mutans binding to the tooth surface.

Bond strengths of resin cements to astringent-contaminated dentin.

The current study evaluated the micro-shear bond strength of two resin cements to astringent-contaminated dentin. Twelve occlusal dentin discs were prepared from extracted caries-free human molars and divided into two groups subjected to two types of resin cements, Panavia F (PF) and Variolink II (VL). Each disc was ground with 600 grit SiC paper and sectioned into two semi-disks, one for the normal dentin surface and the other for the contaminated dentin surface. For contaminated dentin, an astringent containing aluminum chloride was applied for two minutes and rinsed before the bonding procedures. A micro tygon tube was placed on the dentin surface following the bonding application and then filled with a resin cement. After the resin was polymerized, the specimen was kept in water for 24 hours before the micro-shear bond strengths evaluation. The micro morphology of the treated surfaces and resin-dentin interfaces were observed under a scanning electron microscope (SEM). Aluminum content under different dentin conditions was also examined. No significant differences were found between the dentin bond strengths to normal dentin and contaminated dentin surfaces in both the PF and VL groups (p>0.05). PF showed similar bond strengths to VL on normal and contaminated dentin (p>0.05). SEM observations of the VL groups revealed no differences in the treated dentin surfaces and the resin-dentin interfaces between normal and contaminated dentin. However, for the PF group, an inconsistent etching pattern of the self-etching primer and gap formation at the interface of resin cement to contaminated dentin were observed.

Effect of Calcium-phosphate Desensitizers on Staining Susceptibility of Acid-eroded Enamel.

OBJECTIVE: To investigate the effect of calcium-phosphate-based desensitizers, Teethmate AP paste (TMAP) and Teethmate Desensitizer (TMD) (Kuraray Noritake Dental, Tokyo, Japan), on the prevention of staining on acid-eroded enamel. METHODS AND MATERIALS: Forty polished enamel samples (4×4×1 mm) from bovine incisors were randomly divided into five groups (n=8). After immersion in 50 mL of 0.5% citric acid (pH 2.5) for 15 minutes to form acid-eroded surfaces, the surfaces were subjected to different treatments with TMAP, TMD, and NaF (0.21% means 950 ppm) for five minutes. Another eroded group was not treated with desensitizer. For the control group, the samples were not eroded or treated. All the samples were stored in artificial saliva (AS) at pH 7.2 for 24 hours at 37°C. The TMAP, TMD, or NaF was reapplied at eight and 16 hours during the 24 hours of storage time. The surface roughness (Sa) was evaluated following ISO 25178 for surface texture using confocal laser scanning microscopy (VK-X 150 series, Keyence, Osaka, Japan) before acid erosion, after acid erosion, and after 24 hours of incubation in AS. Afterward, the color difference was measured with a dental colorimeter (Shade Eye NCC, Shofu, Kyoto, Japan) before and after staining with tea solution. RESULTS: One-way repeated measures analysis of variance showed that acid erosion significantly increased Sa (p<0.001). TMAP- and TMD-treated groups exhibited lower Sa values than the NaF group and the no-desensitizer treatment group. The greatest staining was observed in the NaF group and the no-desensitizer group, while the TMAP and TMD groups significantly decreased the formation of stains. CONCLUSIONS: Acid-eroded enamel increased surface roughness and tended to absorb more stains. However, the application of TMAP and TMD moderated the roughness and thus prevented the formation of extrinsic stains.

Effects of root dentin surface coating with all-in-one adhesive materials on biofilm adherence.

OBJECTIVES: Sealing of exposed root dentinal surfaces with adhesive materials is expected to be a promising approach for preventing root dentin caries. The aim of this study was to evaluate the effects of surface coating with all-in-one adhesives on inhibiting Streptococcus mutans biofilm attachment. MATERIALS AND METHODS: Bovine root dentin was cut and ground with #600-grit SiC paper. Each of the three all-in-one adhesives, Hybrid Bond (HB), Reactmer Bond (RB) or Shake One (SO) was single-coated on the dentin surfaces according to the manufacturers' instructions. The dentin surface without coating served as the control. The surface roughness of the coated and non-coated dentin surfaces was recorded by means of laser microscope measurements. S. mutans artificial biofilms were then grown on the surface of each specimen in a microcosm for 20h. The amounts of bacteria and water insoluble glucan in the retained biofilm on the surface of the specimens were measured. All numerical data were statistically analyzed using one-way ANOVA & Tukey's HSD (p<0.05). RESULTS: All of the coated groups showed significantly lower susceptibility to biofilm attachment compared with the non-coated root dentin (p<0.05). Among the coated groups, SO showed the lowest susceptibility for biofilm formation. CONCLUSIONS: Three all-in-one adhesive materials could be effective for root surface coating. A fluoride-releasing adhesive, SO demonstrated the strongest potentiality in resisting biofilm formation.