Bond strength to different CAD/CAM lithium disilicate reinforced ceramics.

OBJECTIVE: To evaluate the microstructure and the influence of applying universal adhesive only versus universal adhesive with additional silane application on shear bond strength (SBS) to four different lithium disilicate ceramic (LDC) materials. MATERIAL AND METHODS: Specimens (n = 240, 1.5 mm thick) cut from four different CAD/CAM materials were polished and etched with 4.5% hydrofluoric (HF) acid according to manufacturers' instructions (20 s: IPS e.max CAD, n!ce; 30 s: Amber Mill, CEREC Tessera). For cementation, either universal adhesive only or silane + universal adhesive were applied before prefabricated composite cylinders were cemented using a dual-cure resin cement. SBS testing was performed either after 24 h or after 20,000 cycles thermocycling +2 months water storage. Surfaces were analyzed with stereomicroscope for failure mode and with scanning-electron microscopy for microstructure of the LDC. Statistical analysis of the data was performed with non-parametric tests at α = 0.001. RESULT: SBS values for non-aged specimens ranged from 29.08 to 17.87 MPa and for aged specimens from 22.24 to 3.01 MPa. SBS was significantly reduced when silane was omitted after aging, (p < 0.001). Failure mode was mostly mixed with some cohesive failures in the LDC. CONCLUSION: Bond strengths are highly affected by the CAD/CAM LDC and their microstructures. The application of silane after hydrofluoric etching is still essential to obtain long-term bonding, irrespective of the presence of silane in the universal adhesive. Water degradation can significantly affect long-term bonding to novel LDC. CLINICAL SIGNIFICANCE: When using a universal adhesive for bonding to LDC restorations, the best long-term bond is achieved if an additional application of silane precedes the universal adhesive.

Microstructural considerations for novel lithium disilicate glass ceramics: A review.

OBJECTIVE: To review the ultrastructural characteristics of novel lithium disilicate based glass ceramics (LDC), how their manufacturing process influences their structure and their clinical use. OVERVIEW: Lithium disilicate based glass ceramic has been successfully used for indirect restorations ranging from partial tooth coverage up to tooth replacement for over 20 years. It combines esthetic and mechanical properties, unlike any other indirect material which makes it an indispensable part of esthetic and restorative dentistry. Recently, novel LDCs have been introduced to the market. Parameters for their use and their microstructure are still not been widely known. This article will review these materials and highlight with high-resolution scanning electron microscopic images their structural aspects and their resulting clinical relevance. CONCLUSION: Restorations made from LDCs are reliable and can be predictably used only when proper guidelines and protocols during manufacturing and clinical use are followed. For novel LDCs manufacturing and long-term bonding protocols still must be established. Moreover, novel LDCs machinable blocks should be crystallized or heat-treated after milling for superior performance. CLINICAL SIGNIFICANCE: With more and newer etchable LDC materials entering the market, clinicians and technicians need to be aware of the differences in manufacturing and the resulting microstructure to ensure a successful treatment outcome that will last.

Effect of a single-component ceramic conditioner on shear bond strength of precoated brackets to different CAD/CAM materials.

OBJECTIVES: To compare the shear bond strength (SBS) of the CAD/CAM material-bracket interface using three surface treatments: following manufacturers' instructions (MI), Monobond Etch & Prime (MEP) and 9.6% hydrofluoric acid plus silane (9.6% HF), after 24 h of water storage (24 h) and 10,000 cycles of thermocycling (TC). MATERIALS AND METHODS: A total of 126 crowns with four identical buccal surfaces were fabricated using seven different CAD/CAM materials: CEREC Blocs unglazed (CBU), CEREC Blocs glazed (CBG), IPS Empress CAD (EMP), IPS e.max CAD (EMA), VITA SUPRINITY PC (SUP), inCoris TZI (TZI) and VITA ENAMIC (ENA). A total of 504 APC Flash-Free (APC FF)-precoated brackets were bonded applying three surface treatments: (1) MI; (2) MEP and (3) 9.6% HF. SBS was performed after 24 h and TC. Results were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p < 0.05). RESULTS: MEP conditioning yielded lower SBS results compared with MI and 9.6% HF for CBG (24 h and TC) and EMA (TC) materials. EMP conditioning with MEP after 24 h obtained lower SBS values compared with MI; however, after TC, SBS was similar to MI group and higher than with 9.6% HF. After TC for TZI ceramic, MI protocol (sandblasting) obtained higher SBS scores than MEP, but similar than 9.6% HF. Treatment of ENA with MI and MEP produced higher results than 9.6% HF after TC. SBS results were similar for CBU and SUP, regardless of the treatment. CONCLUSIONS: Although each CAD/CAM material requires specific surface treatment to obtain the highest SBS of APC FF brackets, the treatment with MEP is a valid orthodontic alternative for most of the materials tested. TC significantly decreased SBS for most of the materials. CLINICAL RELEVANCE: MEP can be considered a valid and promising product to condition most of the CAD/CAM ceramics evaluated for APC FF bracket bonding purposes, allowing a faster and safer procedure.

Reproducing Optical Properties of Anterior Teeth after Ultra-Conservative Preparation.

OBJECTIVE: Selecting the appropriate material is essential when restoring color and appearance of esthetically compromised anterior teeth. CLINICAL CONSIDERATIONS: Most of the conventional restorative techniques require tooth reduction in order to mimic optical properties of a natural tooth. Fortunately, bonding techniques associated with improvements on dental ceramics esthetics allow for highly conservative treatment options in which maximum preservation of dental tissues can be attained. An analysis of different ceramic materials available and different types of tooth preparation is presented in a format of a decision tree for treatment planning. CONCLUSIONS: The suggested decision-making aims to facilitate clinicians' selection of the most appropriate restorative technique for reproducing color and appearance of anterior teeth after ultra-conservative preparation and according to different clinical scenarios CLINICAL SIGNIFICANCE: The selection of the appropriate ceramic material for each case is of major importance, since the entire treatment plan will be determined based on the type of ceramic material that will be used for the final restoration. Each restorative material has a specific tooth preparation requirement, indications, and limitations that shall be respected for maximum esthetical outcomes. (J Esthet Restor Dent 28:267-276, 2016).

How Reliable a Bonding Strategy Is the Use of Universal Adhesives?

Universal adhesives (UAs) were introduced about 10 years ago as alternative bonding systems to clinicians' demand for versatility and user-friendly clinical techniques. Clinical studies have shown that the performance of UAs is dependent on the bonding strategy used.

PROA concept: prosthetic restoration with orthodontic appliance.

This paper describes an alternative computer-aided design/computer-aided manufacturing (CAD/CAM) technique for the creation of a combined prosthetic restoration with orthodontic appliance (PROA). This concept allows the use of orthodontic appliances such as brackets, attachments, or any other type of appliance over different types of prosthetic restorations. The PROA concept aims to mitigate problems associated with performing restorative treatment when orthodontic treatment is necessary. This proposed concept provides the clinicians with proper control and planning of the interdisciplinary treatment that will lead to the final tooth shape, form, and proportions while performing orthodontic tooth movements.

Bioactive Dental Adhesive System With tt-Farnesol: Effects on Dental Biofilm and Bonding Properties.

BACKGROUND: Composite dental restorations are commonly used to restore cavitated carious lesions. Unfortunately, the main reason for failure is the development of secondary caries adjacent to the restoration. To improve the long-term survival of restorations, antibacterial agents have been added into dental materials. In this study, we assessed the antibacterial and bonding capacity of a commercial universal dental adhesive incorporated with the antibacterial agent tt-farnesol creating 3 experimental adhesives: 0.38% (v/v), 1.90% (v/v), and 3.80% (v/v), plus a control (no incorporation of tt-farnesol). METHODS: The antibacterial activity was evaluated by assessing colony-forming units (CFU), biofilm dry weight (DW) and production of extracellular insoluble polysaccharides (EIP) at day 2, 3, and 5 of biofilm growth post surface treatment on the surface of composite disks. The effect of tt-farnesol on the chemical and bonding capacity of the adhesive system was assessed via pH analysis, degree of conversion (DC), and microtensile bond strengths to human dentin in both self-etch and etch-and-rinse application modes. A qualitative analysis of the effects of tt-farnesol on biofilm formation was evaluated using scanning electron microscopy (SEM). The sealing capacity of all adhesive systems tested was evaluated using confocal laser scanning microscopy (CLSM). RESULTS: The 3.80% (v/v) experimental adhesive exhibited the lowest CFU count and lowest production of EIP at day 5. DW and pH values did no exhibit statistical differences among all tested groups. Bond strengths and DC decreased with the incorporation of the antibacterial agent into the adhesive system regardless of the concentration of tt-farnesol. CONCLUSION: The incorporation of tt-farnesol into the adhesive system significantly reduced bacterial viability and production of EIP; however, the bonding properties of the experimental dental adhesives were altered.

Surface roughness of enamel and four resin composites.

PURPOSE: To assess surface roughness of resin composites submitted to different polishing techniques compared to intact human enamel. METHODS: Nanofilled (Filtek Supreme XT), microhybrid (Point 4), hybrid (Tetric Ceram), and microfilled (Durafill VS) resin composites were selected. Four polishing techniques were tested (TO: Mylar matrix - control; TI: aluminum oxide discs; T2: felt + diamond paste; T3: aluminum oxide discs + felt + diamond paste) with each resin composite. The specimens were assigned to 16 experimental groups and one control group (n = 4). Flat buccal surfaces of four human maxillary central incisors were used for the analysis of enamel roughness and served as control. The mean roughness was evaluated under atomic force microscopy in the contact mode. The obtained data were submitted to Student's t-test, ANOVA, and Tukey's Test, at 0.05 level of significance. RESULTS: The roughness of enamel was 46.6 +/- 10.7 nm. The smoothest surface was obtained for the Mylar matrix with nanofiller (23.6 +/- 3.0 nm), microhybrid (12.8 +/- 1.4 nm), or hybrid resin (15.2 +/- 1.9 nm). Microfilled resin showed the lowest roughness with aluminum oxide discs (43.0 +/- 5.2 nm). Diamond paste increased the roughness of composites, whereas aluminum oxide discs yielded the smoothest surfaces.

In vitro shear bond strength of dual-curing resin cements to two different high-strength ceramic materials with different surface texture.

OBJECTIVE: The purpose of this study was to evaluate the shear bond strength (SBS) of two dual-curing resin cements to two high-strength ceramics with different surface texture. MATERIAL AND METHODS: Composite cylinders were bonded to aluminum oxide (A) and zirconium oxide (Z) ceramic disks with six different surfaces. Investigated surfaces were for both ceramics: dry-pressed Procera Crown (A1, Z1), machined Procera Bridge (A2, Z2), airborne particle abraded Procera bridge (A3, Z3). Additional surfaces were, for alumina, dry-pressed Procera Laminate (A4) and, for zirconia, two modified surfaces (Z4, Z5). Two adhesive resin cements were used (Clearfil Esthetic and RelyX ARC). SBS was tested in a universal testing machine before and after artificial aging by thermal cycling. RESULTS: Mean SBS ranged from 6.1 to 38.4 MPa before and from 0.0 to 41.4 MPa after aging. Clearfil Esthetic in A3, A4, and Z3 performed better than RelyX ARC. Aging decreased SBS, except for Z1, Z4, and Z5. For alumina, A4 was higher in SBS than A2, but similar to A1 and A3. For zirconia, Z5 showed the highest SBS. Z4 was higher than Z2 and Z3, but similar to Z1. CONCLUSIONS: Shear bond strength to alumina and zirconia increases with surface roughness. The modified zirconia surface Z5 provides stable long-term shear bond strength and can be bonded to either of the two used cements.

Resin-bonded fixed partial dentures with a new modified zirconia surface: a clinical report.

This report describes the clinical application of a new modified zirconia surface. Resin-bonded fixed partial dentures were fabricated for nonprepared abutments, cemented, and evaluated for retention and esthetics. Initial evaluation of this new modified zirconia surface reveals acceptable mechanical and esthetic properties.

An in vitro evaluation of the long-term resin bond to a new densely sintered high-purity zirconium-oxide ceramic surface.

STATEMENT OF PROBLEM: Successful long-term bonding to zirconia ceramic remains a challenge, requiring special cements and surface roughening by airborne-particle abrasion, which might negatively affect the ceramic. PURPOSE: The purpose of this study was to evaluate the shear bond strength (SBS) of composite resin cylinders to a modified zirconia surface using different luting techniques after thermal cycling. MATERIAL AND METHODS: Composite resin (TPH3) cylinders with a diameter of 3 mm were bonded to zirconia ceramics (Procera Zirconia) with a modified surface (RZ) and a machined surface (MZ). Three different adhesive luting cements (Panavia F2.0, RelyX ARC, RelyX Unicem) in combination with and without airborne-particle abrasion (50-microm and 110-microm Al(2)O(3)) were used. RZ was bonded using all 3 cements with (50 mum) and without airborne-particle abrasion; with 110 microm, only Panavia F2.0 was used. MZ was bonded using only Panavia F2.0 with (50 microm, 110 microm) and without airborne-particle abrasion. SBS was tested in a universal testing machine (Instron) before and after 90 days of water storage and 20,000 thermal cycles (dwell time, 15 seconds). Statistical analysis was performed using a multifactorial ANOVA model with alpha=.05. RESULTS: Mean SBS ranged from 10.1 to 20.0 MPa after 3 days and from 0.16 to 14.8 MPa after thermal cycling. Thermal cycling decreased SBS significantly. Airborne-particle abrasion significantly decreased SBS to the modified surface, regardless of cements used. SBS to the modified zirconia surface was significantly higher than to the machined surface. CONCLUSIONS: SBS to the modified zirconia surface is higher than to airborne-particle-abraded, machined zirconia. Airborne-particle abrasion of the modified zirconia surface is not recommended.

The effect of immediate dentin sealing on the marginal adaptation and bond strengths of total-etch and self-etch adhesives.

STATEMENT OF PROBLEM: Sealing ability and bond strengths of total-etch and self-etch dentin adhesives used for immediate dentin sealing have not been assessed and established. PURPOSE: The purpose of this study was to determine the effectiveness of immediate dentin sealing (IDS) using total-etch or self-etch dentin adhesives on microleakage and microtensile bond strength. MATERIAL AND METHODS: Twenty recently extracted molars were selected, and standard MOD inlay preparations were made with the gingival margins located below the cemento-enamel junction. The teeth were assigned to 4 experimental groups (n=5) according to the indirect composite restoration cementation technique used: (1) immediate dentin sealing with Adper Single Bond (TEBI); (2) conventional adhesive cementation technique using Adper Single Bond (TEAI); (3) immediate dentin sealing using Adper Prompt L-Pop (SEBI); or (4) conventional adhesive cementation technique using Adper Prompt L-Pop (SEAI). The restored teeth were thermal cycled 1,000 times between 5 degrees and 55 degrees C and then immersed in 50% ammoniacal silver nitrate. Three specimens per restoration were evaluated for microleakage, according to predefined scores, and submitted to Friedman's test (alpha=.05). The specimens were then sectioned to obtain 0.8 +/-0.2-mm-thick sticks (with n ranging from 32 to 57 specimens) and submitted to microtensile bond strength (muTBS) testing. The obtained data were submitted to 2-way ANOVA test (alpha=.05). RESULTS: None of the experimental groups demonstrated complete elimination of marginal microleakage. There were significant differences in microleakage of the tested adhesives (P>.001). IDS microleakage scores were similar to those obtained using the conventional cementation technique (CCT) for both adhesives. The highest mean bond strengths were obtained with TEBI (51.1 MPa), whereas SEAI showed the lowest mean bond strengths (1.7 MPa). IDS resulted in significantly higher bond strengths than CCT (P<.001). CONCLUSIONS: Total-etch and self-etch adhesives have a significant effect on IDS. IDS resulted in high bond strengths for both adhesives; however, the microleakage was similar to that obtained with CCT. (J Prosthet Dent 2009;102:1-9).

Caries infiltration with resins: a novel treatment option for interproximal caries.

Noninvasive (preventive) measures involving fluoridation, dietary control, and oral hygiene instruction, as well as invasive restorative methods, are the standard treatment options for interproximal caries. Intermediate treatment options, similar to pit-and-fissure sealing on occlusal surfaces that has been shown to be effective in preventing and inhibiting caries, have not yet been established on interproximal surfaces. Recently, the application of resins on interproximal caries lesions has been studied and improved, leading to the development of new materials, which infiltrate and seal the carious lesion, improving the inhibition of caries progression. Clinical data show this new technique complements existing treatment options for interproximal caries by delaying the time point for a restoration and consequently closing the gap between noninvasive and invasive treatment options.

All-on-four rehabilitation using photogrammetric impression technique.

Conventional implant impression techniques may introduce distortions in the framework that can lead to a lack of accuracy of the prostheses. Misfit between the restoration and the implants facilitates the occurrence of biomechanical failures and prostheses complications due to inadequate stress dissipation. Digital impressions present an alternative to eliminate procedural distortions by improving the fit between the restoration and the implants. Among the different types of digital impressions, photogrammetry has emerged as an alternative for multiple implant impressions. This case report describes photogrammetric technique for a full-arch rehabilitation in All-on-four of a 68-year-old patient with a fixed implant-supported restoration on the mandible. Photogrammetric technique has demonstrated to be a successful digital alternative to conventional multiple-implant impression. Esthetics and function remained stable over a follow-up period of 1 year. No biomechanical or biologic complications were observed.

Effects of Light Attenuation through Dental Tissues on Cure Depth of Composite Resins.

OBJECTIVE: Polymerization of light-cured resin-based materials is well documented; however, the intensity of the activating light can be reduced by passage through air, dental structure, or restoration compromising the physical properties of the restoration. The aim of this study was to evaluate the depth of cure of different light cured composite resins polymerized directly or transdental, through enamel and enamel/dentin tissues. MATERIAL AND METHODS: Five composite resins were selected for this experiment: SureFil SDR, Dentsply (SDR), Filtek Supreme Plus, 3M ESPE (FSP), Aelite LS, Bisco (ALS), Filtek LS, 3M ESPE (FLS), and TPH, Dentsply (TPH). Thirty specimens of each material were prepared with 2- or 4-mm thickness. The specimens were light-cured (Elipar 2500, 3M ESPE) for 40 sec using three different protocols: direct or transdental, through a disc of enamel with 1 mm of thickness, and a disc of enamel and dentin with 2 mm of thickness. Eight Vickers microhardness (VH) measurements were taken from each specimen, four on top and four on bottom surface (Micromet, Buehler, 100 g per 15 sec). Data was analyzed with ANOVA three-way, Tukey HSD post-hoc (α = .05). RESULTS: Bottom surfaces of specimens exhibited statistically significant lower Vickers microhardness than the top surfaces for all composite resin evaluated, regardless of the curing conditions, except for the SDR when direct light-cured. Transdental light curing through enamel/dentin layer, significantly decreased VH (P<0.05) on the bottom surface of all composite groups. CONCLUSION: The results of this study showed that light-curing attenuation of dental structures negatively affect the micro-hardness of composite resins.

Microtensile bond strengths and scanning electron microscopic evaluation of self-adhesive and self-etch resin cements to intact and etched enamel.

STATEMENT OF PROBLEM: The longevity of indirect adhesively cemented restorations is directly related to the bond quality of resin cements to dental tissues. Bonding to cervical enamel can generate significantly lower bond strengths than bonding to other enamel areas. The effect of enamel pretreatment on bond strengths of self-etch and self-adhesive resin cements to cervical enamel remains undetermined. PURPOSE: The purpose of this study was to evaluate cervical enamel bond strengths of self-adhesive, self-etch resin cements according to acid pretreatment, using a total-etch resin cement as the control. MATERIAL AND METHODS: The proximal surfaces of 20 extracted molars were sectioned to obtain 40 enamel rectangles with an area of 8.0 x 4.0 mm. The rectangular enamel specimens were assigned to 1 of 5 enamel experimental groups: intact enamel + RelyX Unicem (UN), etched enamel + UN (UNpa), intact enamel + Multilink (ML), etched enamel + ML (MLpa), and the total-etch-based RelyX ARC (RX; control group). Standard 8.0 x 4.0 x 6.0-mm composite resin blocks (Z250) were cemented to all specimens. The bonded enamel surfaces were sectioned into sticks with a cross-section of 0.8 +/-0.2 mm(2) and tested to failure in tension mode at a crosshead speed of 1 mm/min. The data were submitted to 1-way analysis of variance (ANOVA), followed by Tukey's HSD post hoc test (alpha=.05). Additionally, the enamel etching pattern was investigated for all experimental groups using field-emission electron microscopy. RESULTS: Statistical analysis showed significant differences among different resin cements (P<.001) and phosphoric acid etching (P<.002). The highest mean (SD) bond strengths were obtained with UNpa (32.92 (4.23)) > RX (19.40 (9.47)). Acid etching of enamel before application of self-etch resin cement did not improve the mean bond strengths (SD) for self-etch resin cement [ML (5.38 (5.97)); MLpa (5.23 (1.1))]. Self-adhesive and self-etch resin cements yielded the lowest significant mean bond strengths (SD) when applied on intact enamel: UN (13.03 (2.82)) > ML (5.38 (5.97)). Scanning electron microscopy showed a consistent etching pattern for phosphoric acid-etched specimens. Self-etch and self-adhesive resin cements applied directly to intact enamel showed inconsistent areas of etching. CONCLUSIONS: Etching cervical enamel surfaces resulted in significantly higher bond strengths for self-adhesive resin cement. For self-etch resin cement, etching did not improve bond strength.

Effect of dentin conditioning time on nanoleakage.

OBJECTIVES: To study the nanoleakage pattern in the dentin hybrid layer by using different dentin adhesives. The null hypotheses tested in this study were: 1) dentin conditioning time does not affect nanoleakage within the hybrid layer; 2) the type of dentin adhesive used does not affect nanoleakage. METHODS: Standardized Class V cavities were prepared in 30 intact human molars on the buccal and lingual surfaces. The specimens were randomly assigned to 2 total-etch dentin adhesives (OptiBond SOLO Plus [OPS, Kerr] and One-Step [ONS, BISCO Inc]) and 2 self-etch dentin adhesives (Clearfil SE Bond [CSE, Kuraray] and Adper Prompt L-Pop [APL, 3M ESPE]). The specimens were etched or conditioned for 15 seconds, 30 seconds or 60 seconds. Upon restoration of the Class V cavities with the proprietary resin composite, the specimens were isolated with nail polish except for a 2.0-mm rim around the restoration, and they were immersed in 50 wt% ammoniacal silver nitrate solution (pH=9.5) for 24 hours followed by 8 hours of immersion in photo-developing solution to reduce the silver ions to metallic silver. The specimens were fixed, dehydrated and processed for FESEM and TEM. Silver penetration was measured along the cervical wall, and data were analyzed with Kruskal-Wallis non-parametric tests at a significance level of 95%. RESULTS: There were no statistically significant differences among the experimental groups for the factor "conditioning time" (p>0.926). There were significant differences for the variable "dentin adhesive" (p<0.0001). The least amount of nanoleakage within the hybrid layer occurred with CSE, while ONS resulted in the greatest penetration of silver ions. The adhesives OPS and APL ranked in the intermediary subset. Under TEM, all adhesives resulted in some degree of nanoleakage within the hybrid layer. Both spotted/reticular and water-tree nanoleakage patterns were observed. SIGNIFICANCE: Longer conditioning times did not increase nanoleakage within the hybrid layer. Nanoleakage varied with the type of adhesive used.

The influence of intrinsic water permeation on different dentin bonded interfaces formation.

OBJECTIVES: To determine the effects of intrinsic wetness on the formation of dentin bonding interfaces of four resin cement systems bonded to dentin under different pulpal pressures. METHODS: Thirty-six freshly extracted third molars were selected and processed for dentin µTBS. The teeth were randomly assigned into 12 experimental groups, according to the adhesive luting system [Adper Single Bond Plus (3M ESPE) combined with two luting agents RelyX ARC (3M ESPE) and heated Filtek Z250 Universal Restorative (3M ESPE), Clearfil CD Bond (Kuraray) combined with Clearfil Esthetic Cement (Kuraray), and RelyX Unicem 2 Automix (3M ESPE)] and pulpal pressure (0, 5, and 20 cm of simulated pulpal pressure). Leucite-reinforced glass-ceramic slabs (IPS Empress CAD, Ivoclar Vivadent) of 3mm thickness were bonded to dentin. The samples were stored in distilled water for 24h and then sectioned in X/Y directions across the adhesive interface to obtain specimens with a cross section of 0.8 ± 0.2mm(2). All sticks were fractured by tension at a crosshead speed of 1.0mm/min and the data were submitted to Kruskal-Wallis and Mann-Whitney Tests (α=0.05). Ultrastructural analysis of the interfaces was performed using Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscopy (SEM). RESULTS: The statistical analyses showed that pulpal pressure decreased µTBS for all groups. Significantly higher µTBS values were obtained in heated Z250 group restored without any pulpal pressure. CLSM showed that the uptake of water through the dentin tubuli and their anastomosis of lateral branches during the adhesive luting procedures prevented adequate formation of the dentin bonding interfaces. SEM showed that the luting film created is material- dependent and all adhesive failure occurred at the resin-dentin interface. CONCLUSION: The constant intrinsic wetness replenishment prevents adequate formation of the hybrid layer. CLINICAL SIGNIFICANCE: Intrinsic moisture during adhesive luting procedures significantly affects the interaction between luting materials and dentin subtract and decreases the quality and bonding strength of the resin-dentin bond.

Effects of CO2 laser irradiation on matrix-rich biofilm development formation-an in vitro study.

BACKGROUND: A carbon dioxide (CO2) laser has been used to morphologically and chemically modify the dental enamel surface as well as to make it more resistant to demineralization. Despite a variety of experiments demonstrating the inhibitory effect of a CO2 laser in reduce enamel demineralization, little is known about the effect of surface irradiated on bacterial growth. Thus, this in vitro study was preformed to evaluate the biofilm formation on enamel previously irradiated with a CO2 laser (λ = 10.6 µM). METHODS: For this in vitro study, 96 specimens of bovine enamel were employed, which were divided into two groups (n = 48): 1) Control-non-irradiated surface and 2) Irradiated enamel surface. Biofilms were grown on the enamel specimens by one, three and five days under intermittent cariogenic condition in the irradiated and non-irradiated surface. In each assessment time, the biofilm were evaluated by dry weigh, counting the number of viable colonies and, in fifth day, were evaluated by polysaccharides analysis, quantitative real time Polymerase Chain Reaction (PCR) as well as by contact angle. In addition, the morphology of biofilms was characterized by fluorescence microscopy and field emission scanning electron microscopy (FESEM). Initially, the assumptions of equal variances and normal distribution of errors were conferred and the results are analyzed statistically by t-test and Mann Whitney test. RESULTS: The mean of log CFU/mL obtained for the one-day biofilm evaluation showed that there is statistical difference between the experimental groups. When biofilms were exposed to the CO2 laser, CFU/mL and CFU/dry weight in three day was reduced significantly compared with control group. The difference in the genes expression (Glucosyltransferases (gtfB) and Glucan-binding protein (gbpB)) and polysaccharides was not statically significant. Contact angle was increased relative to control when the surface was irradiated with the CO2 laser. Similar morphology was also visible with both treatments; however, the irradiated group revealed evidence of melting and fusion in the specimens. CONCLUSION: In conclusion, CO2 laser irradiation modifies the energy surface and disrupts the initial biofilm formation.

SEM analysis of internal adaptation of adhesive restorations after contamination with saliva.

PURPOSE: This study tested the null hypothesis that different treatments of saliva-contaminated substrate would not affect microgap formation at the dentin walls of bonded restorations. MATERIALS AND METHODS: Forty freshly extracted human molars received standardized Class V preparations on buccal and lingual surfaces. The specimens were assigned to four experimental groups (n = 20): [G1] no contamination (control group), [G2] saliva contamination (10 s) after etching followed by 5 s air stream; [G3] saliva contamination after etching and rinsed for 10 s; and [G4] re-etching for 10 s after saliva contamination. All specimens were restored with a one-bottle adhesive (Single Bond, 3M ESPE) and microhybrid composite resin (Filtek Z250, 3M ESPE) according to the manufacturer's instructions. The specimens were thermocycled, sectioned through the center of the restoration, and then processed for SEM. Microgaps were measured at the axial wall at 1500X magnification. The data were submitted to Kruskal-Wallis nonparametric statistical analysis at p < 0.05. RESULTS: The data revealed that different groups resulted in a statistically significant difference (p < 0.01) in gap formation. Air drying [G2] and rinsing [G3] the saliva-contaminated dentin resulted in similar microgap values (p > 0.05). However, re-etching the dentin after saliva contamination [G4] increased microgap formation (p < 0.05) when compared with the groups G1 and G2. Although air drying and rinsing produced results comparable to noncontaminated dentin, the presence of microgaps was not completely eliminated. CONCLUSION: Contaminated saliva did not prevent hybrid layer formation; however, it did reduce the adaptation of the restorative material to bonded surfaces.