The Effect of Whitening Toothpastes on the Color Stability of a Smart Monochromatic Composite Resin.

OBJECTIVE: The aim of this study was to evaluate the color stability of smart monochromatic composite resin after coloring with coffee solution, thermal aging and brushing with four different kinds of toothpaste. MATERIALS AND METHODS: According to the manufacturer's instructions, 40 smart monochromatic composite resin (Omnichroma, Tokuyama Dental, Japan) specimens were prepared with a thickness of 2 mm and a diameter of 10 mm. The samples were divided into four groups. The first group (SFM) was brushed with Sensodyne Fresh Mint (Sensodyne GSK, UK), the second group (CW) with Colgate 2 in 1 Whitening (Colgate Palmolive, USA), the third group (OW) with Opalescence Whitening (Ultradent Products, Inc., USA), the fourth group (COW) with Colgate Optic White With Charcoal (Colgate Palmolive, USA). At time point t0, no brushing and thermal cycles were performed. For time point t1, simulations corresponding to 10 days of staining, thermal aging and brushing were performed. For time point t2, simulations corresponding to one year of staining, thermal aging and brushing were performed. The color of all specimens was measured at t0, t1 and t2 with a spectrophotometer. To examine the color change, ΔE00 values were calculated with the CIEDE 2000 color system. Shapiro Wilk, Kolmogorov Smirnov, Wilcoxon Signed Rank, Kruskal Wallis, and Mann-Whitney U tests were used to analyze the data. RESULTS: According to the results of the intergroup comparison, there is no statistically significant difference between the groups in ΔE00(t0-t1) values in terms of t0-t1 time period measurement (p>0.05). There is a statistically significant difference between the groups in ΔE00(t1-t2)values in terms of t1-t2 time period measurement (p<0.05). The COW group had the lowest ΔE00(t1-t2) value and the OW group had the highest ΔE00(t1-t2) value. There is a statistically significant difference between the groups in ΔE00 (t0-t2) values in terms of t0-t2 time period measurement (p<0.05). The COW group had the lowest ΔE00(t0-t2) value and the OW group had the highest ΔE00(t0-t2) value. CONCLUSION: The whitening efficacy of different kinds of toothpaste whitening mechanisms may differ from each other. Toothpastes also show whitening on composite resins. The lowest discoloration was observed in the group brushed with toothpaste containing activated charcoal and blue covarine. The efficacy of whitening toothpastes should be supported by in vivo studies.

A Comparative Study of the Repair Bond Strength of New Self-Adhesive Restorative Materials With a Resin Composite Material.

AIM: The aim of the present study is to compare the repair bond strengths (RBSs) of Cention-N (light-cure and self-cure modes), Equia Forte HT Fil and a nanohybrid resin composite. MATERIALS AND METHODS: Equia Forte HT Fil (GC, Tokyo, Japan), Cention-N (Ivoclar Vivadent, Schaan, Liechtenstein) and Filtek Z550 (3M ESPE, St Paul, MN, USA) were used in this study. Equia Forte HT Fil (EQF), Cention-N self-cure (CSC), Cention-N light-cure (CLC) and Filtek Z550 (Z550) groups were formed. A total of 40 samples were prepared; 10 samples in each group (n = 10). After the polymerization was completed according to the manufacturer's instructions, the samples were polished with OptiDisc (Kerr Corporation, Orange, USA) for 5 s each, from extra-course to extra-fine. After all samples were stored in 37°C water for 24 h, 10,000 cycles of brushing simulator and thermal cycles were applied to the samples. The samples were prepared in accordance with the selected repair protocol, and microshear bond strength (µSBS) test was performed. Fracture analysis on debonded surfaces was visualized by scanning electron microscopy. The conformity of the data to normal distribution was analyzed by the Shapiro-Wilk test. Multiple comparisons were performed using Dunn's test. RESULTS:  Z550 showed significantly higher µSBS as compared to the other three groups. There is no difference between CSC, CLC and EQF. CONCLUSION: The use of Cention-N's self-cure or light-cure mode did not affect the RBS values. The RBS values of Cention-N and Equia Forte HT Fil materials are lower than those of the composite resin material.

Effect of different polishing systems and speeds on the surface roughness of resin composites.

Aims and Objectives: The objective of this study was to compare surface roughness of a nano-spherical resin composite using four different multi-step polishing disc systems at five different speeds. Materials and Methods: In total, 154 discs samples were prepared using a supra-nano spherical resin composite. The samples were divided into negative and positive control groups and the following four finishing and polishing disc systems: Sof-Lex, Bisco Finishing Discs, OptiDisc, and Super-Snap. Each polishing disc system was applied at five different speeds (2000, 5000, 10,000, 15,000, and 20,000 revolutions per minute [RPM]) (n = 7). The surface roughness of samples was measured using a profilometer. One sample from each group was evaluated by scanning electron microscopy and atomic force microscopy. Two-way analysis of variance was used to evaluate the average roughness (Ra) data from the profilometric experiments using statistical software (GraphPad Prism4-GraphPad Software; La Jolla, CA, USA). The mean values were compared using the Bonferroni test (P = 0.05). Results: The mean roughness ranged from 0.07 µm to 0.41 µm. The smoothest surfaces were obtained with OptiDisc at 20,000 RPM and Super-Snap at 20,000 RPM. The Bisco Finishing Discs group at 2,000 RPM showed the highest surface roughness values. For all polishing systems, the roughness at 20,000 RPM was lower than that at other speeds. Conclusion: Within the limitations of the present in vitro study, it can be concluded that the polishing performance was in the following order: Super-Snap > OptiDisc > Sof-Lex > Bisco Finishing Discs. In addition, the surface roughness decreased as the polishing speed increased.

Comparative evaluation of a fissure sealant and a flowable composite: A 36-month split-mouth, randomized clinical study.

OBJECTIVES: The purpose of the present clinical evaluation was to investigate the effect of a fissure sealant and a flowable composite at fissures of permanent molars in terms of retention and caries-incidence rates over a 36-month period. METHODS: Thirty-four patients, ages varied from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were involved in the study. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. Teeth were sealed with either a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F)(n = 110). Each restoration was evaluated in terms of retention and caries incidence at 6, 12, 24 and 36 months according to their location as well. Data were analyzed using Mann-Whitney U, Friedman and 1-way ANOVA tests at p < 0.05. RESULTS: Tetric Evo Flow showed total retention with 95.5%, 93.8%, 88.5% and 80.2% at 6, 12, 24 and 36-month follow-ups respectively, while Helioseal F had retention rates of 95.5%, 94.8%, 85.4% and 80.2% respectively. After 36-months, there were 6 subjects totally lost in Helioseal F group, whereas 7 of the Tetric Evo Flow sunjects were totally lost. Caries development was firstly detected at 12-month evaluation for both of the materials however, no significant differences were observed among materials in retention rates or caries incidence after 36-month follow-ups (p > 0.05). SIGNIFICANCE: Using the flowable composite found as effective as the fissure sealant after 36-months regarding retention and caries incidence rates.

Outcomes of visual tooth shade selection performed by operators with different experience.

OBJECTIVE: To evaluate the effect of professional experience and lighting conditions on visual shade selection on natural teeth and comparing the visual-shade-selection results with those of instrumental methods. MATERIALS AND METHODS: Shade selection was performed on five maxillary central incisors. The 25 observers were divided into five groups according to their professional experience. Observers performed visual-shade-selection using shade guide (Vita 3D Master, Vita Zahnfabrik, Bad Säckingen, Germany) under two lighting conditions (4000 and 6500 K) from the cervical, middle and incisal thirds of the teeth. Same teeth were measured using an intraoral scanner (Trios 3Shape, Copenhagen, Denmark) and spectrophotometer (Vita Easyshade Compact, Vita Zahnfabrik, Bad Säckingen, Germany), under the same two lighting conditions. RESULTS: Visual-shade-selection outcomes were not affected by professional experience under both lighting conditions (P < .05). Outcomes of visual-shade-selection and intraoral scanner were not significantly different than that of spectrophotometer (P > .05). Lighting conditions had no effect on the shade measurement outcomes of visual shade selection, Vita Easyshade Compact, and Trios 3Shape (P > .05). CONCLUSIONS: Shade measurement outcomes were not affected by the lighting conditions (4000 and 6500 K). The shade measurement feature of the T-3S could be an alternative to V-ES and VSS. CLINICAL SIGNIFICANCE: This study suggests professional experience and lighting conditions has no effect on visual shade selection. Trios 3Shape could be used for shade determination as an alternative to a Vita Easyshade Compact spectrophotometer.

Influence of cleaning methods on bond strength to saliva contaminated zirconia.

OBJECTIVE: To evaluate the influence of saliva contamination and cleaning procedures on shear bond strength (SBS) of a self-adhesive resin cement (SAC) to zirconia surfaces. MATERIALS AND METHODS: A total of 160 sandblasted zirconia blocks were randomly divided into eight groups as follows: No saliva contamination, no cleansing (NC-NC); contamination with saliva, no cleansing (SC-NC); no saliva contamination, cleansing with a zirconia primer (ZP; Z-Bond, Danville Materials, Inc., S. Ramon, California) (NC-ZP); contamination with saliva, cleansing with ZP (SC-ZP); no saliva contamination, cleansing with hydrofluoric acid (HF; Ultradent Porcelain Etch; Ultradent Products, South Jordan, Utah) followed by cleansing with ZP (NC-HF-ZP); contamination with saliva, cleansing with HF followed by cleansing with ZP (SC-HF-ZP); cleansing with ZP, contamination with saliva, cleansing with ZP (ZP-SC-ZP); application of ZP, contamination with saliva, cleansing with HF followed by cleansing with ZP (ZP-SC-HF-ZP). Cylindrical resin composite blocks were luted to the zirconia surfaces with SAC (Clearfil SA Cement Automix, Kuraray, Inc., Tokyo, Japan). Specimens were subjected to shear forces at a cross-head speed of 0.5 mm/min. Data were analyzed with Analysis of Variance and Tukey tests (α = 0.05). RESULTS: The bond strength values to zirconia were significantly influenced by saliva contamination (P < .05). The SC-NC group showed the lowest bond strength values (5.6 ± 1.4 MPa; P < .05). All cleansing or pretreatment agents improved the bond strengths when compared to noncleansing groups, NC-NC and SC-NC. CONCLUSION: In situations where saliva contamination is deemed unavoidable, application of ZP after try-in of the zirconia restoration could be beneficial for the accurate cementation. CLINICAL SIGNIFICANCE: During try-in sessions of fixed dental prostheses, zirconia ceramic restoration may come into contact with saliva and surfaces should be cleansed to obtain an optimal surface for adhesion. Application of zirconia primer to the sandblasted zirconia surface is recommended whether the surface is contaminated with saliva or not.

Nuclear magnetic resonance spectroscopy and infrared spectroscopy analysis of precipitate formed after mixing sodium hypochlorite and QMix 2in1.

BACKGROUND: Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) forms a brown precipitate. QMix-2in1 (QMix) was introduced as a final irrigant. Manufacturer recommends interim flushing with saline between the application of NaOCl and QMix to prevent formation of precipitation. This study assessed whether para-chloroaniline (PCA) is formed after mixing NaOCl with QMix. METHODS: Commercially available, 5.25% NaOCl solution, 2% CHX, QMix, 15% ethylenediaminetetraacetic acid (EDTA) and 98% PCA in powder form were used. Groups were prepared at room temperature. Group 1, 98% PCA in powder form; Group 2, 2% chlorhexidine (CHX); Group 3, QMix; Group 4, 5.25% sodium hypochlorite (NaOCl) mixed with QMix; Group 5, 5.25% NaOCl mixed with CHX; Group 6, 15% EDTA mixed with CHX. The precipitates were extracted and analysed with Proton Nuclear Magnetic Resonance (1H-NMR) and Infrared (IR) Spectroscopy, using PCA as an internal standard. RESULTS: No PCA was found in any of the irrigant-mixture groups tested. CONCLUSIONS: This study used the interpretation of spectral results for the amino signals of precipitate formed after mixing QMix with 5.25% NaOCl using different nondestructive analysis methods, with PCA as an internal standard (control). We conclude that mixing QMix or 2%CHX with 5.25% NaOCl does not yield free PCA.

Flexural strength of fiber reinforced posts after mechanical aging by simulated chewing forces.

This study evaluated the effect of simulated chewing forces on the flexural strength of fiber reinforced posts (FRPs). Four different brands of FRPs were selected as main group for the study: RelyX Fiber Post (RX), IceLight (ICE), Unicore Posts (UC), FlouroPost (FP). Ten posts in each main group didn't receive any aging process and tested as baseline (BL), other ten posts were subjected to simulated chewing forces/mechanical aging (MA) as follows: Post spaces were prepared in acrylic with drill. Depth of preparation was adjusted to leave 4-mm coronal part of posts protruding from canals. Coronal parts were incrementally restored with resin-composite (Clearfil Majesty Posterior A2, Kuraray, Osaka, Japan). Prepared samples were subjected to chewing cycles in a chewing simulator (Chewing Simulator CS-4, Mechatronik, Germany). Flexural strengths of all groups were measured with three-point bending test. Data were analyzed by two-way ANOVA and Tukey's test (α = 0.05). After MA, flexural strengths of all posts were significantly decreased when compared with BL for all FRPs tested (p < 0.05). At BL, highest flexural strength values were obtained for ICE. After MA, similar to BL, highest flexural strength values were obtained for ICE. Only RX showed statistically significant difference when compared with ICE (p < 0.05). UC and FP showed similar flexural strength values with ICE (p > 0.05). It may be concluded that chewing forces on post-core systems may reduce the flexural strengths of FRPs.

Effect of rubbing force magnitude on bond strength of universal adhesives applied in self-etch mode.

This study investigated the effect of rubbing force magnitude on dentin bond strengths of multi-mode adhesives applied in self-etch mode. Seventy-two extracted human molar teeth were used. Two different universal adhesives Single Bond Universal (SB) and Clearfil Universal (CL) were applied onto dentin surfaces in three different modes: without rubbing (NR), rubbing with 40 gf (gram-force) (40) or 80 gf (80) load. Teeth were restored with a resin composite. Half of the specimens were subject to thermal aging (10,000 cycles). Microtensile bond strength was measured and data were statistically analyzed with two-way analysis of variance and Tukey's test (α=0.05). Baseline bond strength values for CL adhesive were improved by rubbing (40 and 80 gf) as compared to no rubbing (p<0.05). Rubbing did not significantly improve bond strength values for SB, regardless of aging (p>0.05). Rubbing improves bonding performance of some universal adhesives to dentin when applied in self-etch mode.

Adhesive system affects repair bond strength of resin composite.

PURPOSE: This study evaluated the effects of different adhesive systems on repair bond strength of aged resin composites. MATERIALS AND METHODS: Ninety composite discs were built and half of them were subjected to thermal aging. Aged and non-aged specimens were repaired with resin composite using three different adhesive systems; a two-step self-etch adhesive, a two-step total-etch adhesive and a one-step self-etch adhesive; then they were subjected to shear forces. Data were analyzed statistically. RESULTS: Adhesive type and aging significantly affected the repair bond strengths (p<0.0001). No statistical difference was found in aged composite groups repaired with two-step self- etch or two-step total-etch adhesive. One-step self-etch adhesive showed lower bond strength values in aged composite repair (p<0.0001). CONCLUSION: In the repair of aged resin composite, two-step self-etch and two-step total-etch adhesives exhibited higher shear bond strength values than that of one-step self-etch adhesive.

Does Para-chloroaniline Really Form after Mixing Sodium Hypochlorite and Chlorhexidine?

INTRODUCTION: Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) forms a brown-colored precipitate. Previous studies are not in agreement whether this precipitate contains para-chloroaniline (PCA). Tests used for analysis may demonstrate different outcomes. Purpose of this study was to determine whether PCA is formed through the reaction of mixing NaOCl and CHX by using high performance liquid chromatography, proton nuclear magnetic resonance spectroscopy, gas chromatography, thin layer chromatography, infrared spectroscopy, and gas chromatography/mass spectrometry. METHODS: To obtain a brown precipitate, 4.99% NaOCl was mixed with 2.0% CHX. This brown precipitate was analyzed and compared with signals obtained from commercially available 4.99% NaOCl, 2% solutions, and 98% PCA in powder form. RESULTS: Chromatographic and spectroscopic analyses showed that brown precipitate does not contain free PCA. CONCLUSIONS: This study will be a cutoff proof for the argument on PCA formation from reaction of CHX and NaOCl.

Effect of thermomechanical aging on bond strength and interface morphology of glass fiber and zirconia posts bonded with a self-etch adhesive and a self-adhesive resin cement to natural teeth.

STATEMENT OF PROBLEM: Information regarding the effect of thermomechanical aging (TMA) on the bond strength of luting cements to root canal dentin and endodontic posts is limited. PURPOSE: The purpose of this study was to investigate the effect of TMA on the bond strength of fiber and zirconia posts bonded to root canal dentin with 2 different resin cements with microtensile and scanning electron microscopic evaluation. MATERIAL AND METHODS: Eighty extracted single-rooted human premolars were endodontically treated and restored with either a glass fiber post (FP) or a zirconia post (ZP) with 2 commercially available resin luting cements. The teeth were divided into 2 main groups. In the first group, posts (n=40) were bonded with a self-etch adhesive cement (SEAC). In the second group (n=40), posts were bonded using a self-adhesive cement (SAC). During the first aging phase, all specimens in each group were stored in distilled water for 30 days at 37°C. During the second phase, half of the specimens in each group were subjected to the TMA. The test groups were as follows: FP/SEAC, FP/SEAC+TMA, ZP/SEAC, ZP/SEAC+TMA, FP/SAC, FP/SAC+TMA, ZP/SAC, and ZP/SAC+TMA. The bond strength was measured with a microtensile test. Data were analyzed by 3-way analysis of variance and the Tukey honest significant different test (α=.05). RESULTS: FP/SEAC at 30 days was higher than in the other groups. However, bond strength values were significantly reduced in this group after TMA (P<.001). CONCLUSIONS: Bond strength values and physical properties of SEAC with higher filler content were more affected by the TMA than those of SALC. According to scanning electron microscopic observation, TMA also affected the micromorphologic interface between the posts and the resin cements as well as between the resin cements and the root canal dentin.

Surface roughness and morphology of resin composites polished with two-step polishing systems.

The purpose of this study was to investigate surface roughness (Ra) and morphology of supra-nanofilled [Estelite Omega (EO), Estelite ∑ Quick (EQ)], micro-hybrid [Esthet.X HD (EHD), G-aenial (GAE)] and nano-hybrid [Clearfil Majesty Posterior (CMP), Charisma Diamond (CD), Beautifil II (BII)] composites polished with two-step polishing systems [Enhance/PoGo (EP); Venus Supra (VS)]. Composite discs, 30 of each type, were prepared. Each composite group was divided into three subgroups: Mylar (control), EP and VS. Ra was evaluated with profilometer. In each composite group, the control had the lowest Ra. With both polishing systems, EO and EQ had significantly the lowest Ra, whereas CMP and BII had the highest. Except for GAE, CD and BII, the differences in Ra between EP and VS in each composite group were significant, showing smoother surfaces for EP. Supra-nanofilled composites created smoother surfaces than nano-hybrids, and their performance was similar or slightly better than that of micro-hybrids.

Three-year randomized clinical evaluation of a low-shrinkage silorane-based resin composite in non-carious cervical lesions.

OBJECTIVE: The clinical suitability of low-shrinkage resin composites for class V cavities has not been investigated in vivo. The purpose of this double-blind randomized clinical trial was to compare the clinical performances of low-shrinkage resin composite Filtek silorane and nanoceramic resin composite Ceram X mono in non-carious cervical lesions (NCCLs) over 36 months. MATERIALS AND METHODS: Two calibrated operators restored 144 NCCLs in 24 patients by using Filtek silorane with silorane system adhesive (FS/SSA) and Ceram X mono with Clearfil SE (CXM/CSE) or XP bond (CXM/XPB). Then, two blinded, calibrated evaluators assessed the restorations at the baseline and 6, 12, 24, and 36 months thereafter by using the modified US Public Health Service criteria. Data were analyzed with the Freidman and Wilcoxon signed-rank tests at a significance level of 5 % (P < 0.05). RESULTS: No restoration was associated with postoperative sensitivity or secondary caries. Further, no group showed significant changes until 12 months. The retention rates of the FS/SSA (97.5 %), CXM/CSE (97.5 %), and CXM/XPB (92.31 %) restorations did not differ significantly (P > 0.05). Six (4 CXM/XPB, 1 FS/SSA, and 1 CXM/CSE) of the 121 restorations evaluated at 36 months were completely lost. However, no significant intergroup differences were observed in the other evaluation criteria. CONCLUSION: The 3-year clinical performances of the restorative materials in NCCLs were not significantly different. CLINICAL RELEVANCE: Filtek silorane is suitable for restoring NCCLs.

Clinical comparison of a flowable composite and fissure sealant: a 24-month split-mouth, randomized, and controlled study.

OBJECTIVES: The aim of this clinical study was to evaluate the retention rate and caries-prevention effect of a flowable composite compared to a conventional resin-based sealant in a young population over a 24-month period. METHODS: Thirty-four patients, ranging in age from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were selected for this randomized split-mouth design trial. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. The teeth were sealed with a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F). Each restoration was independently evaluated in terms of retention and the presence of caries at baseline and at 1, 6, 12, and 24 months. Data were analyzed using non-parametric Mann-Whitney U and Friedman 1-way ANOVA tests at p<0.05. RESULTS: Tetric Evo Flow showed complete retention with 100%, 95.5%, 93.8%, and 88.5% at 1, 6, 12, and 24-month evaluations, respectively, while Helioseal F retention rates were 98.1%, 95.5%, 94.8%, and 85.4%, respectively, for the same evaluation periods. At the 24-month recall, 4 (4.2%) total losses were observed in subjects treated with Tetric Evo Flow and 2 total losses (2.1%) for Helioseal F, respectively. No significant differences were observed between the materials in retention rates or caries incidence for each evaluation period (p>0.05). CONCLUSION: Placement of flowable composite as fissure sealants in the younger population seems to be as effective as conventional fluoride containing fissure sealants for the prevention of fissure caries. CLINICAL RELEVANCE: The use of a flowable composite as a fissure sealant material, in conjunction with a total-etch, single bottle adhesive, yielded better retention than did the conventional fluoride containing resin-based fissure sealant over a 24-month period in young patients.

Microtensile bond strength to enamel affected by hypoplastic amelogenesis imperfecta.

PURPOSE: This study compared the microtensile bond strengths (µTBS) of two different self-etching (SE) and etchand- rinse (ER) adhesive systems to enamel affected by hypoplastic amelogenesis imperfecta (HPAI) and analyzed the enamel etching patterns created by the two adhesive systems using scanning electron microscopy (SEM). MATERIALS AND METHODS: Sixteen extracted HPAI-affected molars were used for the bond strength tests and 2 molars were examined under SEM for etching patterns. The control groups consisted of 12 healthy third molars for µTBS tests and two molars for SEM. Mesial and distal surfaces of the teeth were slightly ground flat. The adhesive systems and composite resin were applied to the flat enamel surfaces according to the manufacturers' instructions. The tooth slabs containing composite resin material on their mesial and distal surfaces were cut in the mesio-distal direction with a slow-speed diamond saw. The slabs were cut again to obtain square, 1-mm-thick sticks. Finally, each stick was divided into halves and placed in the µTBS tester. Bond strength tests were performed at a speed of 0.5 mm/min. Data were analyzed with two-way ANOVA and Tukey's tests. RESULTS: There was no significant difference between the bond strength values of ER and SE adhesives (p > 0.05). However, significant differences were found between HPAI and control groups (p < 0.05). HPAI-affected enamel surfaces exhibited mild intra- and inter-prismatic enamel etching patterns after orthophosphoric acid application, while conditioning of HPAI-affected enamel with SE primer created a slightly rough and grooved surface. CONCLUSION: SE and ER adhesive systems provide similar bond strengths to HPAI-affected enamel surfaces.

The effects of glass ionomer and flowable composite liners on the fracture resistance of open-sandwich class II restorations.

This in vitro study aimed to investigate the effects of glass-ionomer and flowable composite liners on the fracture resistance of Class II amalgam and composite restorations. Group 1 cavities were restored with amalgam and Group 4 cavities with nanofill composite after the application of a dentin-bonding agent. For the remaining groups, light-cured-glass-ionomer liner was used in a gingival floor proximal box (Groups 2, 5) or flowable composite was used as a liner (Groups 3, 6), the remainder of the cavity was restored with amalgam (Groups 2, 3) or composite (Groups 5, 6). The restorations were loaded in compression to failure. The data was analyzed using Tukey's multiple comparison test. The fracture resistance was significantly higher (p<0.05) in Group 3 than in all other groups, except Group 2 (p>0.05). Flowable composite, glass-ionomer liners increased the fracture resistance of open-sandwich Class II amalgam restorations.

Randomized controlled trial of the 2-year clinical performance of a silorane-based resin composite in class 1 posterior restorations.

PURPOSE: To compare the 2-year clinical performance of a silorane-based resin composite with that of an established nanoceramic resin composite for class 1 posterior restorations. METHODS: In this randomized controlled study, 100 class 1 molar cavities were prepared in 50 subjects. Each subject received a restoration with Filtek Silorane and Ceram.X Duo in different quadrants. The restorations were evaluated using the modified USPHS criteria at baseline and 6, 12, and 24 months. Parametric changes over the 2-year period were assessed with the Friedman test. The baseline and recall scores were compared by using the Wilcoxon signed-rank test (P < 0.05). RESULTS: No subject developed secondary caries or postoperative sensitivity. Further, the resin composites showed no significant differences in all the evaluated parameters over 2 years (P > 0.05). At 2 years, four Filtek Silorane and seven Ceram.X Duo restorations had Bravo scores for anatomic form, marginal adaptation, and surface texture (P < 0.05); however, these changes were mainly the effect of scoring shifts from Alfa to Bravo. Overall, both materials showed good clinical results with predominantly Alfa scores.

Effect of the erbium:yttrium-aluminum-garnet laser or diamond bur cavity preparation on the marginal microleakage of class V cavities restored with different adhesives and composite systems.

The aim of this in vitro study was to compare the microleakage of Er:YAG laser and diamond bur on different bonding systems in class V restorations. Class V cavities were prepared with Er:YAG laser or diamond bur on 80 intact human molars. Teeth were randomly distributed into ten groups and cavities were restored with CeramX duo (DENTSPLY) or Filtek Silorane (3M/ESPE) using different bonding materials (One Coat 7.0 (Coltène), XP Bond (DENTSPLY), Clearfil Protect Bond (Kuraray), AdperSE (3M/ESPE), and Silorane System Adhesive (3M/ESPE). All specimens were subjected to thermocycling and load cycling. After being immersed in silver nitrate dye, the specimens were sectioned. Microleakage was evaluated by stereomicroscope and SEM. Data were statistically analyzed by one-way ANOVA, Kruskal-Wallis, and Mann-Whitney tests. Statistically differences were found between groups (p > 0.05) and cavities prepared with the Er:YAG laser showed higher microleakage than diamond bur. The microleakage of different bonding systems was influenced by the choice of diamond bur or Er:YAG laser for class V composite cavity preparation.

The effects of halogen and light-emitting diode light curing on the depth of cure and surface microhardness of composite resins.

AIM: Light-emitting diode light curing units (LED LCUs) have become more popular than halogen LCUs in routine dental restorative treatment. The aim of the study was to compare the effects of two conventional halogen (Hilux Plus and VIP) and two LED (Elipar FreeLight 2 and Smart Lite) light curing units on the depth of cure and the microhardness of various esthetic restorative materials. MATERIALS AND METHODS: The curing depth and microhardness of a compomer (Dyract Extra), a resin-modified glass ionomer (Vitremer), a packable composite (Sculpt It), an ormocer (Admira), a hybrid composite (Tetric Ceram), two microhybrid composites (Miris and Clearfil Photo Posterior) and, a nanofil composite (Filtek Supreme) were determined using a scraping method and a hardness tester. A total of 320 samples were prepared using the eight different materials (n = 10 samples for each subgroup). The scraping test was based on ISO 4049:2000. Vicker's microhardness testing was carried out using hardness tester (Zwick 3212). Data were analyzed using one-way analysis of variance (ANOVA), Bonferroni and the Kolmogorov-Smirnov tests. RESULTS: Best microhardness results were obtained with the LED light curing units and Tetric EvoCeram and Filtek Supreme achieved the highest hardness values. The nanofil composite, Filtek Supreme, showed the best curing depth results in all the tested light curing systems. CONCLUSIONS: The LEDs were found to be more successful than the halogen units with respect to both curing depth and microhardness properties.