Influence of thickness and restorative system on the mechanical behavior of CAD/CAM minimally invasive occlusal veneers - in vitro study.

AIM: The aim of this study was to evaluate the physical-mechanical behavior of the occlusal veneers when subjected to thermomechanical cycling. MATERIALS AND METHODS: Sixty specimens were divided into 04 groups (n=15 per group), according with the different restorative materials and thicknesses: material - lithium dissilicate LD (IPS e.max CAD, Ivoclar Vivadent) and nano- ceramic-resins NCR (ESPE Lava Ultimate, 3M); thickness - 0.6 and 1.2mm. The occlusal veneers were bonded over human flattened fresh extracted molars with dual-polymerizing luting agent (Variolink N, Ivoclar Vivadent and RelyX Ultimate 3M) using the respective adhesive system following the selective-etch technique (self-etch in dentin and total etch in enamel). The resin cement was light cured for 40 seconds each face, using a LED light cure equipment (BlueStar II, Microdont, 1100 mW/cm2). The response variables consisted of veneer survival rates (crack formation, catastrophic cracks and debonding) when subjected to thermal cycling from 5° to 55° C and simultaneous mechanical cycling performed at load intensities of 100, 200, 300, 400 and 450N for 20,000 cycles each. RESULT: Data were submitted to the Kruskall Wallis test and Pairwise Comparison, adopting a significance level of 5%. NCRs presented a lower incidence of failures (p<0.05) when compared to LD. According to thickness factor, 1.2mm thick occlusal veneers withstand higher cycling loads. CONCLUSION: NCR occlusal veneers with 1.2mm thickness presented superior physical-mechanical behavior than lithium disilicate and 0.6mm restorations.

The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4-year follow-up.

OBJECTIVE: This case report described the use of a stamping technique associated with a bulk fill composite to restore an ICDAS 4 carious lesion on a posterior tooth. The 4-year follow-up is also presented. CLINICAL CONSIDERATIONS: A 32-year-old patient presented a carious lesion on tooth 36 with an underlying dark shadow at the dentin seen from the noncavitated enamel occlusal surface, which was compatible with an ICDAS 4 carious lesion. The lesion was radiographically detected and the caries disease was treated with dietary and hygiene habits orientations. Before accessing the lesion and selectively removing the carious tissue, an occlusal stamp was made by applying a flowable resin composite to copy the anatomy of the noncavitated enamel surface. The cavity was restored using a bulk fill resin composite (Opus Bulk Fill, FGM) with 4-mm-thick increments. Before curing the last increment, a Teflon band was adapted at the uncured bulk fill composite surface and the occlusal stamp made with the flowable composite was pressed against it to reproduce the natural characteristics and initial occlusal anatomy. The top surface was light-activated for 40 s. After 4 years, small wear could be seen in the restoration, but still within clinically acceptable levels. CONCLUSION: The occlusal stamp technique allows reproduction of the natural anatomy of teeth affected by ICDAS 4 carious lesions with good clinical longevity over 4 years. CLINICAL SIGNIFICANCE: This case report presents the use of the stamp technique to restore a tooth affected by an ICDAS 4 lesion, in which a carious process reached the dentin and the enamel anatomy was still preserved. The bulk fill resin composite associated with the occlusal stamp was chosen to quickly restore the cavity with clinical predictability. Bulk fill composites allow the insertion of up to 4-mm-thick increments and offer lower shrinkage stress, good clinical longevity and a less time-consuming procedure in cases of posterior teeth, especially if associated with the stamp technique.

Direct vs indirect restorations for diastema closure: determining the suitable approach.

Determining the appropriate technique for diastema closure is challenging, and the decision must be evidence based. The objective of these case reports is to describe different approaches to diastema closure using direct and indirect techniques, focusing on the characteristics of the patient and clinical requirements to guide treatment. In the first case, a 16-year-old patient had multiple diastemas in the maxillary anterior dentition. The clinical evaluation revealed microdontia of the lateral incisors and malpositioned teeth. The treatment included tooth whitening and placement of composite resin veneers using a direct technique. In the second case, a 54-year-old patient displayed a disharmonious and esthetically compromised smile due to small teeth, color changes, multiple diastemas, incisal wear, and severe dentogingival disproportion. Based on the patient's expectations, the patient's age, and the presence of a "black triangle" interdental space, a multidisciplinary restorative treatment was proposed, including gingivoplasty, tooth whitening, and placement of ceramic laminate veneers using an indirect technique. Both approaches achieved successful esthetic rehabilitation and diastema closure with minimal intervention. The choice of procedure and restorative material, as well as the need for tooth preparation, varied based on the clinical requirements, patient expectations, and financial constraints. Careful treatment planning avoided lengthy and inefficient procedures.

Validation of a method of quantifying 3D leakage in dental restorations.

STATEMENT OF PROBLEM: A reliable and validated protocol for nondestructive analysis of the entire restorative interface that could be applicable in studies assessing the adaptation of direct and indirect restorations is lacking. PURPOSE: The purpose of this in vitro study was to validate a 3D protocol for microleakage assessment in class II mesio-occluso-distal (MOD) cavities restored with composite resin. MATERIAL AND METHODS: Sixteen human third molars received standardized class II MOD preparations with cervical margins located 1 mm apical to the cemento-enamel junction. The specimens were restored with Filtek Bulk Fill Posterior (FBP) or Filtek Bulk Fill Flowable (FBF) and submitted to 10 000 thermocycles (5 °C and 55 °C with a 30-second dwell time at each temperature and 5-second transfer time). The specimens were scanned with microcomputed tomography (µCT) before and after immersion in 50% ammoniacal silver nitrate solution for 12 hours. Scanned data were processed, and the 3D amount of infiltrated silver nitrate was analyzed through the entire adhesive interface. In addition, the linear distance of silver nitrate infiltration was assessed using 3 axial images obtained from each specimen proximal box (2D analysis). Data were tested for homogeneity by using the Shapiro-Wilk test and evaluated by using 1-way ANOVA, followed by the post hoc Tukey HSD test (α=.05). RESULTS: FBP showed significantly lower leakage than FBF for both 2D and 3D analyses. A low correlation was observed between the assessment methods. CONCLUSIONS: Three-dimensional analysis of microleakage using µCT is a predictable and more reliable method for nondestructive and comprehensive analysis of the entire specimen.

Clinical perceptions of zirconia-reinforced lithium silicate ceramic: a case report and 6-month follow-up.

Zirconia-reinforced lithium silicate (ZLS) has recently been introduced in an effort to improve the mechanical properties of glass-ceramic materials. In vitro evaluations suggest that this class of material has high flexural strength and exhibits satisfactory adhesion to resin cement and wear resistance. Since few clinical reports of this novel material are currently available, the aim of this case report is to describe clinical perceptions regarding the handling and performance of ZLS ceramics when used for laminate veneers on the maxillary incisors.

Delayed Light Activation Improves Color Stability of Dual-Cured Resin Cements.

PURPOSE: To evaluate the color change caused by post-irradiation conversion (ΔE24h and ΔE8 days ) and artificial aging (ΔEAGING ) of resin cements light activated through ceramics of different opacities immediately and 6 minutes after manipulating the material. MATERIALS AND METHODS: Resin cement disks (Allcem and LuxaCore) were light activated through ceramics (without ceramic, e.max HT, LT, and MO) immediately and 6 minutes after the manipulation (n = 10). Spectrophotometry was used to evaluate ΔE24h and ΔE8 days after 37˚C-dry-dark-storage for 24 hours and 8 days, and ΔEAGING after 60˚C-water-storage for 24 hours. Data were analyzed with three-way ANOVA and Tukey's HSD (α = 0.05). RESULTS: Regarding the post-irradiation color change, significant differences were found between the cements (p < 0.0001), light activation protocols (p = 0.037), and ceramics (p < 0.001). The immediate activation (16.2 ± 0.1) showed lower ΔE values than the delayed activation (16.5 ± 0.1). Ceramics influenced the ΔE values as follows: MO (14.0 ± 1.2) < LT (14.9 ± 1.2) ≈ HT (15.4 ± 1.2) < control (21.2 ± 1.2). Regarding ΔEAGING , significant differences were found between cements (p < 0.001), light activation (p = 0.006), and ceramics (p < 0.001). The delayed activation (8.4 ± 0.1) showed lower values than the immediate activation (8.9 ± 0.1). Ceramic spacers influenced ΔEAGING as follows: control (5.6 ± 0.2) < MO (6.6 ± 0.2) < HT (11.0 ± 0.2) ≈ LT (11.5 ± 0.2). CONCLUSION: The delayed light activation resulted in increased color stability, while the ceramic interposition resulted in lower color stability.

Interdental papilla formation after diastema closure.

Due to improvements in esthetic dentistry, the number of patients seeking to obtain a more harmonious smile has increased. A 40-year-old woman was referred for treatment because she was dissatisfied with the effect that diastemas and a conoid tooth had on her smile. Her maxillary anterior teeth were relatively short, resulting in a compromised esthetic relationship between height and width. Orthodontic treatment for better distribution of her teeth was recommended to the patient, but she refused, wanting faster and less expensive treatment. After diagnostic and waxed-up study casts were obtained, composite resin esthetic mock-ups were made to confirm that sufficient space was left for formation of the interdental papilla. After the patient approved the mock-ups, her anterior teeth were submitted to bleaching, definitive restoration, and additional occlusal adjustments. At the 1-year follow-up, the patient exhibited a harmonious, esthetic smile without black spaces or periodontal inflammation.

Fracture strength of the remaining dental structure after different cavity preparation designs.

The aim of this in vitro study was to evaluate the loss of tooth structure after cavity preparation for direct (retentive) and indirect (nonretentive) restorations and its relationship to the fracture strength of the prepared tooth. Sound human third molars (60 maxillary and 60 mandibular) were randomly assigned into 12 groups (n = 10) according to the type of cavity preparation and the respective buccolingual width. Class II mesio-occlusodistal cavity preparations, for both indirect inlay and direct resin restorations, were prepared with standardized dimensions of one-half, one-third, or one-quarter of the occlusal intercuspal distance. Fracture resistance was lower and weight loss was greater for all nonretentive preparations. Greater losses in weight and fracture resistance occurred when the buccolingual width for both types of cavities increased, except for the weight loss of the one-quarter and one-third indirect cavity preparations in the mandibular molars, and the fracture resistance of the one-half and one-third direct cavity preparations in maxillary molars. Higher tooth structure loss and lower fracture strength were recorded after preparation of the inlay cavities.

Bleaching technique effect on dentin permeability.

PURPOSE: To evaluate the effect of bleaching techniques on dentin permeability. The hypothesis was that the bleaching agent associated or not to etching and/or energy source would be able to increase dentin permeability (conductance). METHODS: Fifty 1 mm-thick disks of mid-coronal dentin were obtained from human third molars, which were mounted in a filtration chamber, allowing exposure of a standardized area of 0.282 mm2. All specimens were treated with 35% liquid phosphoric acid for 15 seconds to maximize dentin permeability. Then they were randomly allocated to five different conditions: C: placebo gel (negative control); HP: Whiteness HP Maxx (WM)-35% hydrogen peroxide; PA-HP: WM preceded by phosphoric acid etching for 15 seconds. HP-E: WM associated to a light source and PA-HP-E: WM preceded by phosphoric acid etching for 15 seconds and associated to a light source. The bleaching agent was applied for 10 minutes with intermediate agitation at 5 minutes. In the groups associated with a light source, it was activated for 30 seconds every 5 minutes. Afterwards, the permeability (Lp) was measured using the Flodec device. The data were collected and analyzed with one-way ANOVA and Tukey's test (P< 0.05). RESULTS: Mean and standard deviation of Lp were: C = 1.92 (1.04); HP = 1.14 (0.29); PA-HP = 14.40 (8.62); HP-E = 4.18 (5.14); PA-HP-E = 27.32 (13.24). Data revealed that phosphoric acid etching could increase the dentin permeability, while the bleaching agent or light curing alone did not.

Wear and surface roughness of silorane composites after pH cycling and toothbrushing abrasion.

PURPOSE: To evaluate the effects of toothbrushing abrasion associated with pH cycling on the surface roughness and wear of methacrylate- and silorane-based resin composites. METHODS: Microhybrid methacrylate-based (Filtek Z250), nanofilled methacrylate-based (Filtek Supreme Ultra) and microhybrid silorane-based (Filtek LS) composites were selected for this investigation. For each composite, two groups (n = 10) of rectangular specimens were made. The initial roughness (Ra) of all of the groups was evaluated based on the average of three random tracings with a profilometer, and each specimen had half of its surface protected with two layers of nail varnish to serve as controls. Half of the specimens of each resin were submitted to pH cycling, while the other half were stored in deionized water for 14 days. Subsequently, 100,000 strokes of simulated toothbrushing were performed. Final roughness and wear were measured with the same profilometer, and the values were submitted to ANOVA, Student's t-test and Tukey's test (P < 0.05). RESULTS: The data revealed an increase in surface roughness for Filtek Z250 and Filtek Supreme Ultra after toothbrushing, while Filtek LS showed the opposite behavior. Methacrylate-based composites presented lower wear values [Z250 (4.19 ± 1.73 µm); Supreme Ultra (4.16 ± 0.95 µm)], while the silorane-based composite presented increased surface roughness (11.51 ± 5.69 µm), particularly when submitted to pH cycling (15.31 ± 5.41 µm). Despite the good properties of silorane-based composites, particularly its smooth surface roughness even after pH cycling and toothbrushing abrasion, this composite still presented increased wear, which is an important issue for the development of new resin compositions.

MIH-Affected Teeth: Clinical Challenges from Diagnosis to Restorative Management.

Teeth affected by molar incisor hypomineralization (MIH) present micromorphologic changes and hypersensitivity, which increase the risk of developing caries lesions and affect bonding procedures. Considering that practitioners still misdiagnose teeth affected by MIH, there is an urge for more knowledge about this topic in order to propose a more adequate and conservative treatment. The purpose of this study was to report the clinical challenges regarding the restorative management of a patient with MIH. A 13-year-old girl sought dental treatment, complaining about hypersensitivity in posterior teeth. Under clinical exams, notable enamel alterations mainly affecting posterior teeth (including molars) presented particular characteristics frequently attributed to MIH, and visible stains on maxillary central incisors were present. Because the mineral and organic content of MIH-affected enamel differ from sound enamel, it may imply special care for bonding of a restorative material. Thus, in order to promote a minimally invasive approach, selective removal of carious tissue and restoration with microhybrid composite resin was conducted after application of a universal bonding system used as self-etching strategy. After a 2-year follow-up, the restorations presented good clinical performance and the patient had limited hypersensitivity discomfort, suggesting a promising performance.

MDP-based universal adhesive system irradiated with Er,CR:YSGG: Analysis of its performance up to 6 months.

This study aimed to analyze the interaction of a MDP-based universal dentin bonding system (DBS) with Er, Cr: YSGG laser irradiation, measuring the microtensile bond strength to dentin over a six-month period. The experimental design involved three factors: DBS (Adper Scotchbond Universal; Clearfil SE Bond, Adper Scotchbond Multipurpose and Adper Single Bond 2), laser (Control and Er, Cr: YSGG), and time (initial- 7 days and 6 months). Eighty dentin samples from molars were prepared (n=10) with laser irradiation after primer and DBS application. After 7 days, were subjected to micro tensile bond strength test. The data were analyzed by three-way ANOVA and Tukey tests (p<0.05). Both DBS and laser significantly affected the bonding performance and their interaction was statistically significant (p=0.0194). The self-etching mode of the MDP-based universal DBS maintained the bond strength on dentin irradiated with ER, Cr: YSGG after 6 months, while bonding with all other DBS deteriorated.

In Vitro Evaluation of Desensitizing Agents Containing Bioactive Scaffolds of Nanofibers on Dentin Remineralization.

This study evaluated the effect of the incorporation of bioactive nanofibers in desensitizing agents on dentin permeability. Sixty disks of dentin were randomly distributed in four groups (n = 15). Distribution was based on the desensitizing agents, fluoride varnish and self-etching adhesive, and the presence of nanofibers: C (self-etching adhesive Clearfil SE Bond), CN (Clearfil SE Bond with 1% nanofiber), D (Duraphat varnish), and DN (Duraphat varnish with 1% nanofiber). Dentin permeability was determined using hydraulic conductivity. For a qualitative analysis, confocal laser microscopy and scanning electron microscopy were performed. The C group showed the lowest hydraulic conductance (Lp%) (89.33), while the DN group showed the highest Lp% (116.06). No statistical significance was observed in the Lp% values in all groups after the treatment and 6% citric acid challenge (p > 0.239). In the images, the CN group presented a higher superficial and intratubular deposition. In addition, this group presented a more homogeneous dentin surface and wide occlusion of dentinal tubules than the other treatments. Despite there being no statistical differences among the treatments employed, the images showed that the CN group presented a higher surface and intratubular deposition compared to the other treatments, even after the acid challenge.

Effect of cavosurface angle beveling on the exposure angle of enamel prisms in different cavity sizes.

The quality of the micromechanical retention between the enamel prisms exposed through acid etching and adhesive system can be influenced by the relationship between the angle of the exposed enamel prisms and the external surface/restorative material. Therefore, the aim of the present study was to determine the influence of the enamel cavosurface beveling in different cavity sizes on the angle relation between enamel prisms and the restorative material. For this research, 30 human permanent molars were used and divided into three groups according the isthmus aperture of class I cavities (1/4, 1/3, and 1/2 of the intercuspal distance). Cavosurface angle beveling was performed in each tooth buccal or palatal/lingual side, and a resin composite restoration was placed. Each restored tooth was sectioned in buccal/palatal direction followed by analysis in scanning electron microscope. Means of the angles observed between enamel prisms and the restorative material were registered and statistically analyzed by Kruskal-Wallis test. Results showed higher mean angle values for beveled groups when comparing with the values observed in the unbeveled margins (p < .05) regardless of the isthmus aperture, being 1/4 (beveled = 48.36°; unbeveled = 20.71°), 1/3 (beveled = 39.75°; unbeveled = 29.15°), and 1/2 (beveled = 37.02°; unbeveled = 26.34°). It was also observed that in some unbeveled cavities, there were the presence of laterally exposed enamel prisms (0°), mainly in more conservative cavities. It was concluded that the presence of higher angles values occurred in the samples with beveled margins, without presence of laterally exposed enamel prisms.

Flexural strength of minimum thickness ceramic veneers manufactured with different techniques.

OBJECTIVE: The objective of the present study was to assess the effect of monolithic and bilayer restorations considering heat-pressed and milled/CAD/CAM reinforced lithium disilicate ceramic veneers, on the flexural strength after cementation. METHOD AND MATERIALS: Thirty-five specimens were divided into five groups (n = 7), according to the restorative solution: 2-mm thickness composite resin (CR2); heat-pressed monolithic ceramic 0.6 mm (HPM), CAD/CAM monolithic ceramics 0.6 mm (CCM); heat-pressed monolithic ceramic 0.4 mm + 0.2 mm glass-ceramic (HPB); CAD/CAM monolithic ceramic 0.4 mm + 0.2 glass-ceramic (CCB). Specimens were cemented on composite resin bars and submitted to a three-point bending test on a Universal Testing Machine, until fracture. Fractured samples were analyzed under stereomicroscope and SEM. Flexural strength data were analyzed by one-way ANOVA and Tukey test. RESULTS: The control group showed the highest flexural strength results (119.57 ± 19.49 MPa), with values similar to groups HPM (98 ± 25.62 MPa) and CCM (96.14 ± 20.60 MPa). Groups HPB and CCB showed lower values when compared with the other groups. Fracture started from the base on monolithic groups and from ceramic on bilayer groups. CONCLUSION: Both ceramic systems (CAD/CAM and heat-pressed) have similar fracture strength, although bilayer restorations present lower strength when compared with monolithic ceramics.

Polymerization shrinkage, microhardness and depth of cure of bulk fill resin composites.

The present in vitro study assessed the polymerization shrinkage/PS, Knoop microhardness/KHN and depth of cure/DC of 9 different resin composites : Filtek Bulk Fill Flowable (FBF), Surefill SDR flow (SDR), Xtra Base (XB), Filtek Z350XT Flowable (Z3F), Filtek Bulk Fill Posterior (FBP), Xtra Fill (SF), Tetric Evo Ceram Bulk Fill (TBF), Admira Fusion Xtra (ADM), and Filtek Z350XT (Z3XT). PS was assessed with a µ-CT machine, scanning 64 mm3 samples (n=8) before and after 20 s curing. KHN and DC were performed with a microhardness tester (n=8 for each group) right after 20 s light curing, with 3 readings per depth at every 0.5 mm. Low viscosity resin composites showed lower KHN values when compared with high viscosity resins. Z3XT showed the highest microhardness among the tested resin composites. Z3XT and Z3F showed lower DC when compared with bulk fill resin composites. All bulk fill resin composites presented depth of cure higher than 4.5 mm and similar or lower PS than conventional resin composites.

Shrinkage stress and elastic modulus assessment of bulk-fill composites.

Bulk-fill composites were introduced in dentistry to accelerate clinical procedures while providing adequate outcomes. Concerns regarding the use of bigger composite increments rely on the polymerization shrinkage and shrinkage stress, which may generate gaps on the adhesive interface and result in a reduced success rate. OBJECTIVE: To evaluate the polymerization shrinkage stress of different bulk-fill resin composites and their elastic modulus. MATERIALS AND METHODS: Fourteen specimens were made for each of the nine different resin composites (seven with 12 mm3 and seven with 24 mm3): Surefill SDR flow (SDR), X-tra Base (XB), Filtek Bulk Fill Flowable (FBF), Filtek Z350XT Flow (Z3F); Tetric Evo Ceram Bulk Fill (TBF), X-tra Fil (XF), Filtek Bulk Fill (FBP), Admira Xtra Fusion (ADM) and Filtek Z350 XT (Z3XT). Linear shrinkage stress was evaluated for 300 s with the aid of a linear shrinkage device adapted to a Universal Testing Machine. For each composite group, seven additional specimens (2x2x25 mm) were made and Young's modulus was evaluated with a 3-point bending device adapted in a Universal Testing Machine with 0.5 mm/min crosshead speed and 50 KgF loading cell. RESULTS: For 12 mm3 specimens, three-way ANOVA showed that only SDR and TBF generated lower stress after 20 s. Considering 300 s, TBF, SDR, and XF generated the lowest stress, followed by ADM, FBP, XB, and FBF, which were similar to Z3XT. Z3F generated the highest stress values for all time points. Considering 24 mm3 specimens after 20 s, all bulk fill composites generated lower stress than Z3XT, except XB. After 300 s, SDR, FBP, and ADM generated the lowest stress, followed by TBF and XF. For elastic modulus, one-way ANOVA showed that FBF, SDR, Z3F, and ADM presented the lowest values, followed by XB and TBF. FBP, Z3XT, and XF presented the highest elastic modulus among the evaluated composites. CONCLUSIONS: Bulk-fill resin composites presented equal to lower shrinkage stress generation when compared to conventional composites, especially when bigger increments were evaluated. Bulk-fill composites showed a wide range of elastic modulus values, but usually similar to "regular" composites.

The effects of hybrid light activation and enamel acid etching on the effectiveness, stability and sensitivity after a single session in-office bleaching: A 12-month clinical trial.

BACKGROUND: The use of hybrid-light (HL) during in-office teeth bleaching can provide faster and reliable results after a single bleaching session, especially if associated with previous acid etching. The present in vivo, interventional, split-mouth, triple-blinded and randomized study evaluated the efficiency of a HL, with and without prior enamel acid etching, assessing the gel application time, degree of color change, sensitivity and treatment stability up to 12 months. METHODS: Thirty-four patients were selected and randomly divided into four groups. The color was evaluated using a spectrophotometer with the CIELab color system, and a VAS questionnaire was used to evaluate the sensitivity. Both upper and lower hemiarches (GI and III) received enamel acid etching with 37% phosphoric acid for 15 s prior to the application of 35% hydrogen peroxide gel (HP). For GI and II, HP was applied on both dental arches for 3-4 consecutive applications and activated by HL (2 × 3' activations with 1' interval); and 3 × 15' (HP) for GIII and IV without HL. Patients returned in 24 h, 1 week, 1-, 6- and 12-months intervals. The clinical operator was different from the clinical measurements operator. RESULTS: After 3-way ANOVA, Tukey's, Wilcoxon and Mann-Whitney tests, all with p < 0.05, no statistical differences were observed between the groups regarding color change (ΔE) and sensitivity in all evaluations. The lowest gel application time was observed for GII (acid etch + HL), followed by GI (HL). CONCLUSIONS: The present study's results reveal the advantages of HL associated with acid etching prior to in office bleaching.

Physico-mechanical properties of resin cement light cured through different ceramic spacers.

The purpose of this in vitro study was to compare the micro hardness, color stability/ΔE, and degree of conversion/DC of a resin cement light cured through different ceramic spacers. Lithium-disilicate ceramic samples were obtained from IPS E-max CAD blocks (HT A1) and IPS in-Ceram (transparent neutral); and divided in 7 groups (n = 8 for each test): CTR/control group; 06 M/0.6 mm monolithic; 12 M/1.2 mm monolithic; 20 M/2.0 mm monolithic; 06B/0.4 + 0.2 mm bilayered; 12B/1.0 + 0.2 mm bilayered; 20B/1.8 + 0.2 mm bilayered. The resin cement (Variolink veneer) was light cured through the ceramic spacers. The resin cement samples were evaluated for ΔE using a spectrophotometer after 24 h, 7days and after aging (24 h in water at 60 °C). Knoop microhardness and DC tests were conducted immediately after light curing, after 24 h and 7days. All experimental groups showed similar microhardness values, although being lower than CTR group. Similar results were observed after 7days. ΔE was similar between all groups after 24 h (except for 12B and 20B), and increased for all groups after 7days and after artificial aging, especially for thicker and bilayer groups. Only 06 M showed values similar to CTR group. DC values were similar to all groups immediately after light curing, increasing after 24 h and 7days. After 7days, only group 20B showed lower DC than CTR group. A tendency of higher DC could be observed for monolithic and thinner ceramics. All test results showed strong correlation (0.9987). Ceramic interposition can reduce mechanical and physical properties of resin cements, especially with thicker and bilayered ceramics. Group 06 M showed the best ΔE overtime.

Effect of diode laser irradiation on the bond strength of polymerized non-simplified adhesive systems after 12 months of water storage.

OBJECTIVES: The aim of this in vitro study was to evaluate the bonding strength of non-simplified dentin bonding systems (DBS) to dentin irradiated with a diode laser (970 nm) immediately and after 12 months of water storage following either primer or bond application. MATERIAL AND METHODS: The experimental design included three different factors: DBS type [AdperTM Scotchbond Multipurpose (MP) and Clearfil™ SE Bond (CSE)], irradiation [without irradiation - control (C), irradiation after primer application (AP), and irradiation after bond application (AB)], and time [initial (I) and after 12 months of water storage (12 m)]. Sixty sound human third molars (n = 10) were obtained, and their flat occlusal dentin areas were prepared and standardized. Laser irradiation was performed in the contact mode perpendicular to the dental surface over an automatically selected scanning area at a pulse energy of 0.8 W, frequency of 10 Hz, and energy density of 66.67 J/cm2. After 7 days of treatment, the specimens were cut, and half of them were subjected to microtensile testing (500 N/0.05 mm/min), whereas the remaining sticks were examined after 12 months of water storage. The obtained data were analyzed by three-way analysis of variance (ANOVA) followed by a Tukey test (p<0.05). The observed fracture modes were investigated using a portable digital microscope with a magnification of 40x. RESULTS: Among the utilized DBS, MP generally exhibited higher bond strengths, but did not always differ from CSE under similar conditions. The irradiation factor was statistically significant only for the MP/AB groups. After 12 months of storage, all groups demonstrated a significant reduction in the bond strength, whereas the results of fracture analysis showed a predominance of the adhesive type. CONCLUSIONS: The laser treatment of non-simplified DBS was not able to stabilize their bonding characteristics after 12 months.