Evaluation of Bond Strength, Marginal Integrity, and Fracture Strength of Bulk- vs Incrementally-filled Restorations.

PURPOSE: This study evaluated the effect of application technique and preparation size on the fracture strength (FS), microtensile bond strength (µTBS) and marginal integrity (MI) of direct resin composite restorations. MATERIALS AND METHODS: Conservative (5 × 2 × 2 mm) or extended (5 × 4 × 2 mm) preparations below the cementoenamel junction were performed in 140 human maxillary premolars (n = 70 per group). After adhesive application (XP Bond), half of each group was restored with the bulk technique (one 4-mm increment of Surefill SDR Flow plus one 1-mm horizontal capping layer of TPH3 [Spectrum TPH3 resin composite]) and half incrementally (TPH3 in three horizontal incremental layers, 1.5 to 2 mm each), all using a metal matrix band. After storage (24 h at 37°C), the proximal surfaces of each tooth were polished with Sof-Lex disks. For FS measurement, 60 restorations were mounted in a universal testing machine and subjected to a compressive axial load applied parallel to the long axis of the tooth, running at a crosshead speed of 0.5 mm/min. For µTBS testing, 40 teeth were longitudinally sectioned to obtain resin-dentin bonded sticks from the cavity floor (bonded area: 0.8 mm2). Specimens were tested in tension at 0.5 mm/min. The external marginal integrity of both proximal surfaces was analyzed using SEM of epoxy resin replicas. The µTBS, marginal integrity, and fracture resistance data were subjected to two-way ANOVA, and Tukey's post-hoc test was used for pair-wise comparisons (a = 0.05). RESULTS: Fracture resistance, microtensile bond strength, and marginal integrity values were not statistically significantly affected by application technique or preparation size (p = 0.71, p = 0.82, and p = 0.77, respectively). CONCLUSIONS: The use of a bulk-fill flowable composite associated with a conventional resin composite as a final capping layer did not jeopardize the fracture strength, bond strength to dentin, or marginal integrity of posterior restorations.

Association between Tooth Loss and Degree of Temporomandibular Disorders: A Comparative Study.

OBJECTIVE: The aim of this study was to evaluate the association between tooth loss and the signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS: One hundred fifty patients with an average age of 49.2 (±14.06) years were divided into three groups (n = 50/group) according to the degree of tooth loss: GI (dentate -control), GII (edentulous), GIII (partially dentate). After performing anamnesis and clinical examination, a questionnaire was used, so that the patients could fill in information on signs and symptoms of TMD. After analyzing this information, it was possible to classify the degree of severity of TMD. As age is a confounding variable to the level of TMD, an analysis of covariance (ANCOVA) was used to check for differences in the degree of TMD between groups (covariate = age). A post hoc test (Bonferroni) was performed to compare the groups two by two (5% significance level). RESULTS: The mean level of TMD according to the groups was GI - 1.95; GII - 2.15; GIII - 2.55. There were significant differences between the study groups (p > 0.05). A post hoc test (Bonferroni) confirmed the difference between edentulous patients and the other groups. CONCLUSION: The tooth loss is directly related to the signs and symptoms of TMD. The degree of TMD was significantly higher in edentulous patients.

Shear Bond Strength of Orthodontic Brackets Fixed with Remineralizing Adhesive Systems after Simulating One Year of Orthodontic Treatment.

The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n = 16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment. Shear bond strength tests were carried out using a universal testing machine with a load cell of 50 KgF at 0.5 mm/minute. The samples were examined with a stereomicroscope and a scanning electron microscope (SEM) in order to analyze enamel surface and Adhesive Remnant Index (ARI). Kruskal-Wallis and Mann-Whitney (with Bonferroni correction) tests showed a significant difference between the studied groups (p < 0.05). Groups XT, QC, and SEP presented the highest values of adhesive resistance and no statistical differences were found between them. The highest frequency of failures between enamel and adhesive was observed in groups XT, QC, and OL. Quick Cure (QC) remineralizing adhesive system presented average adhesive resistance values similar to conventional (XT) and self-etching (SEP) adhesives, while remineralizing system (OL) provided the lowest values of adhesive resistance.

Toothpaste prevents debonded brackets on erosive enamel.

UNLABELLED: This study evaluated the effect of high fluoride dentifrice on the bond strength of brackets after erosive challenge. Eighty-four enamel specimens were divided into seven groups (n = 12): WN (distilled water/no acid challenge), W3C (distilled water/3 cycles of acid challenge), and W6C (distilled water/6 cycles of acid challenge) were not submitted to dentifrice treatment. Groups RF3C (regular fluoride dentifrice/3 cycles of acid challenge) and RF6C (regular fluoride dentifrice/6 cycles of acid challenge) were treated with dentifrices containing 1450 µg F(-)/g and HF3C (high fluoride dentifrice/3 cycles of acid challenge) and HF6C (high fluoride dentifrice/6 cycles of acid challenge) were with 5000 µg F(-)/g. Acid challenges were performed for seven days. After bond strength test, there was no significant difference among groups submitted to 3 cycles of acid challenge (P > 0.05). Statistically significant difference was found between the regular and high fluoride dentifrices after 6 cycles of acid challenge (<0.05). Similar areas of adhesive remaining were found among control groups and among groups W6C, RF3C, RF6C, HF3C, and HF6C. The high fluoride dentifrice was able to prevent the reduction of bond strength values of brackets submitted to acid challenge. CLINICAL RELEVANCE: the high fluoride toothpaste prevents debonded brackets on erosive enamel.

Semidirect Restorations in Multidisciplinary Treatment: Viable Option for Children and Teenagers.

Due to the esthetic necessity required nowadays, the multidisciplinary treatment became a fundamental step in the restoration success. When the patient exhibits dental agenesis of one or more elements, he can show difficulty in social interactions. The age of the patient is a limiting factor to esthetic procedures, however, it should be evaluated as a real indicative with each case. The utilization of semi-direct restorations is a viable option due the cost, esthetic and improvement of physical and mechanical properties. The purpose of this paper is to present a case detailing the confection and cementation of anterior semi-direct restorations aimed at an anatomic reestablishment associated with integrated treatment with periodontics and orthodontics.

Effect of Carbamide Peroxide on the Push-out Bond Strength of Different Composition Glass-Ionomer Cement to Root Canal Dentin when used as Cervical Barrier.

AIM: To evaluate the effect of 37% carbamide peroxide on the bond strength of conventional or resin-modified glass-ionomer cements when used as a cervical barrier in endodontically-treated teeth. MATERIALS AND METHODS: After root canal instrumentation and obturation, 40 specimens of the cement-enamel junction were obtained after transversal root canal sectioning from human extracted canines. The root canal specimens were standardized and filled with the following materials (n = 10, each group): G1: zinc phosphate (control), G2: Ketac glass-ionomer, G3: vitrebond glass-ionomer or G4: GC GL glass-ionomer. After 24 hours, the specimens were subjected to an application of 37% carbamide peroxide for 21 days, changed each 7 days and stored in an artificial pulp chamber. The specimens were then submitted to push-out bond strength testing with an electromechanical test machine (EMIC) and the failure mode in each specimen was analyzed with confocal microscopy (LEXT). RESULTS: G3 and G4 showed higher bond strengths values than the other groups (p < 0.05), and were similar to each other (p > 0.05). G1 showed the lowest bond strength value (p < 0.05). CONCLUSION: Glass-ionomer cements showed higher bond strength values than the zinc phosphate cement, and resin-modified glass-ionomer cements presented the highest push-out values to root canal dentin (GC, GL and Vitrebond). CLINICAL SIGNIFICANCE: Glass ionomer cements are recommended to use as cervical barrier materials before the internal dental bleaching, but its efficiency is questionable.

Differential Diagnosis and Treatment Proposal for Acute Endodontic Infection.

The objective of this study was to describe the main lesions that simulate clinically and propose a treatment protocol for acute endodontic infection. Signs and clinical symptoms of periodontal abscess, gingival abscess, odontoma, herpes simplex, pericoronitis, acute pulpitis and necrotizing ulcerative gingivitis/periodontitis (NUG/NUP) were described and compared with acute endodontic infections. A treatment protocol was described by optimizing the procedures in access cavity, microbial decontamination and detoxification of the root canal, apical debridement, intracanal and systemic medication and surgical drainage procedures. The convenience of the use of 5.25% sodium hypochlorite, root canal instrumentation using a crown-down technique, intracanal medication with 2% chlorhexidine or triple antibiotic paste and the convenience of the use of antibiotics, analgesics, and surgical drainage to solve cases of acute dentoalveolar abscess was discussed.

Nd:YAG Laser to obtain Irregularities on the Inner Surface of Porcelain.

AIM: The aim of this study was to evaluate the inner surface of two ceramic systems: IPS Empress II (Ivoclar Vivadent, Germany) and In-Ceram Alumina (Vita Zahnfabrick, Germany) submitted to surface treatments, especially by Nd:YAG laser. MATERIALS AND METHODS: Fifty samples were prepared in pellet form for each ceramic system according to manufacturers' specifications. The samples were stored at room temperature and then be subjected to surface treatment: without treatment (T0) (control), hydrofluoric acid-etched (T1), hydrofluoric acid-etched associated with the airborne particle-abraded (T2); CoJet system (T3), Nd:YAG laser (T4). The data were performed the statistical analysis by ANOVA and Tukey's test (p < 0.001). RESULTS: The group control (T0) of the ceramics, the analysis showed the lowest roughness values; for the System Alumina In-Ceram, treatment with hydrofluoric acid (T1), associated with hydrofluoric acid and airborne particle-abraded (T2) and Nd:YAG laser (T4), had no statistically significant difference, whereas for the IPS Empress System II treatment with hydrofluoric acid (T1) and hydrofluoric acid associated with airborne particle-abraded (T2), had no statistically significant difference between the system and also CoJet (T3) and hydrofluoric acid associated with the airborne particle-abraded (T2). Photomicrographs of scanning electron microscopy showed different characteristics to the treatments for each ceramic system. CONCLUSION: The IPS Empress II had the appearance of favoring the retention when treated with hydrofluoric acid, as well as its association with the airborne particle-abraded. Uncertainty in Alumina, treatment with hydrofluoric acid associated with the airborne particle-abraded and CoJet system and provided a surface with irregularities. With respect to the laser further studies should be performed for parameters that are ideal for your application. CLINICAL RELEVANCE: The ceramic restorations are attractive due of their excellent esthetics and the ability to stay for long periods. However, the retention of ceramic requires further study.

Comparison of Antimicrobial Activity between Chemical Disinfectants on Contaminated Orthodontic Pliers.

AIM: To compare the antimicrobial activity of the chemical substances--70% isopropyl alcohol, 2% glutaraldehyde (GTA) and 0.25% peracetic acid (PAA) in disinfecting orthodontic pliers contaminated in vitro with Streptococcui mutani, Staphylococci aureui and Candida albicani. MATERIALS AND METHODS: Distal end cutter pliers were divided into five groups: group 1 (negative control--sterilized pliers), group 2 (positive control--sterilized plier, subsequently contaminated), group 3 (disinfected with 70% isopropyl alcohol, friction method), group 4 (disinfected with 2% GTA, immersion method for 30 minutes), group 5 (disinfected with 0.25% peracetic acid (PAA), immersion method for 10 minutes). After the pliers were treated with one disinfectant and submitted to microbiological evaluation (by counting colony forming units), they were submitted to the same cleansing, sterilizing and contaminating processes, and were used in the following groups (crossover and washout study). The two-factor analysis of variance (ANOVA) test, followed by the Tukey test, was used to compare the groups. RESULTS: The results showed that there was no statistically significant difference between the three tested disinfectants. CONCLUSION: Although there were no statistically significant differences between the disinfectants, the chemical agents 2% glutaraldehyde and 0.25% PAA were effective in inhibiting the growth of the three microorganisms tested; however, 70% isopropyl alcohol was unable to completely eliminate S. aureui. CLINICAL SIGNIFICANCE: The chemical substances 2% glutaraldehyde and 0.25% PAA completely eliminated the microorganisms tested.

In vivo Evaluation of Proximal Resin Composite Restorations performed using Three Different Matrix Systems.

OBJECTIVE: The aim of this in vivo study was to radiographically evaluate the proximal contour of composite resin restorations performed using different matrix systems. MATERIALS AND METHODS: Patients with premolars needing class II type resin composite restorations involving the marginal ridge were selected. Thirty premolars were selected and randomly divided into three groups (n = 10 each) to receive restorations using different matrix systems: group 1: metal matrix coupled to a carrier matrix and wood wedge (G1-MMW); group 2: sectioned and precontoured metal matrix and elastic wedge (G2-SME); and group 3: a polyester strip and reflective wedge (G3-PMR). After the restorative procedure, bitewing radiographs were performed and analyzed by three calibrated professionals. The quality of the proximal contact and marginal adaptation of the proximal surfaces was classified as either correct or incorrect (undercontour/overcontour). RESULTS: The Pearson Chi-square statistical test (α = 5%) revealed a statistically difference between frequencies of correct and incorrect restorations (α(2) = 6.787, p < 0.05). The group G2 SME produced a higher frequency of correct proximal contours (90%), while G1-MMW and G3-PMR had a ratio of 40% correct and 60% incorrect contours respectively. CONCLUSION: None of the matrix systems was able to prevent the formation of incorrect proximal contours; however, the sectioned and precontoured metal matrix/elastic wedge configuration provided better results as compared to the other groups.

Effectiveness of Oral Antiseptics on Tooth Biofilm: A Study in vivo.

AIM: To evaluate the effectiveness of five different mouthwashes through measurement of the plaque index. MATERIALS AND METHODS: Fifty subjects took part in this blind study, randomized into blocks of five groups according to the active ingredient of the mouthwash: CHX group (0.12% chlorhexidine gluconate), essential oils (EO) group, cetylpyridinium chloride (CPC) group, Tri group (triclosan) and Hamamelis virginiana (HV) group. All subjects were evaluated for a reduction in the bacterial plaque index at 7, 14 and 21 days. RESULTS: There was a significant reduction in the mean plaque index during the period of evaluation (p < 0.01), and the reduction during the period of evaluation was different between mouthwashes (p < 0.01). The reduction in the plaque index at the end of 21 days was, in decreasing order, CHX > EO > CPC > Tri > HV. CONCLUSION: The reduction in the plaque index during the period of evaluation was different between the types of mouth-wash. The mouthwash containing the active ingredient chlorhexidine was the most effective, followed by the essential oil, cetylpyridinium chloride, triclosan and H. virginiana.

Deflection Evaluation of Thermoactivated Nickel-Titanium Archwires after Heat Treatment on their Distal Ends.

OBJECTIVE: This study evaluated in vitro the mechanical changes of 0.018" (0.45 mm) and 0.016 × 0.022" (0.40 × 0.55 mm) thermoactivated nickel-titanium archwires subjected to heat treatment on their distal ends. MATERIALS AND METHODS: Ten archwires in diameters 0.018" and 0.016 × 0.022" by different manufacturers Ormco, Morelli, Orthometric and Unitek were tested. Each tested archwire had an experimental side, submitted to heat treatment, and an annealing-free control. Tests for load/deflection were performed using a universal testing machine, with temperature control in the austenitic transformation phase through tempe rature-controlled chamber. The variables showed normal distribution (Kolmogorov-Smirnov), the t-student test was applied in order to observe the difference between the experi mental and control groups. Statistical significance was set at p < 0.05. RESULTS: There were no statistically significant differences between the groups. CONCLUSION: Heat treatment carried out in the region corresponding to the first molar distal region on thermoactivated nickel-titanium archwires did not influence the load/deflection values in adjacent portion.

The Effect of Self-adhesive and Self-etching Resin Cements on the Bond Strength of Nonmetallic Posts in Different Root Thirds.

PURPOSE: The purpose of this study was to evaluate the effect of self-adhesive and self-etching resin cements on the bond strength of nonmetallic posts in different root regions. MATERIALS AND METHODS: Sixty single-rooted human teeth were decoronated, endodontically treated, post-space prepared, and divided into six groups. Glass-fiber (GF) posts (Exacto, Angelus) and fiber-reinforced composite (FRC) posts (EverStick, StickTeck) were cemented with self-adhesive resin cement (Breeze) (SA) (Pentral Clinical) and self-etching resin cement (Panavia-F) (SE) (Kuraray). Six 1-mm-thick rods were obtained from the cervical (C), middle (M), and apical (A) regions of the roots. The specimens were then subjected to microtensile testing in a special machine (BISCO; Schaumburg, IL, USA) at a crosshead speed of 0.5 mm/min. Microtensile bond strength data were analyzed with two-way ANOVA and Tukey's tests. RESULTS: Means (and SD) of the MPa were: GF/SA/C: 14.32 (2.84), GF/SA/M: 10.69 (2.72), GF/SA/A: 6.77 (2.17), GF/SE/C: 11.56 (4.13), GF/SE/M: 6.49 (2.54), GF/SE/A: 3.60 (1.29), FRC/SA/C: 16.89 (2.66), FRC/SA/M: 13.18 (2.19), FRC/SA/A: 8.45 (1.77), FRC/SE/C: 13.69 (3.26), FRC/SE/M: 9.58 (2.23), FRC/SE/A: 5.62 (2.12). The difference among the regions was statistically significant for all groups (p < 0.05). The self-adhesive resin cement showed better results than the self-etching resin cement when compared to each post (p < 0.05). No statistically significant differences in bond strengths of the resin cements when comparable to each post (p > 0.05). CONCLUSION: The bond strength values were significantly affected by the resin cement and the highest values were found for self-adhesive resin cement.

Can Whitening Strips interfere with the Bond Strength of Composite Resins?

AIM: The aim of this study was to investigate in vitro the bond strength of composite resins on enamel previously treated with whitening strips. MATERIALS AND METHODS: A total of 48 bovine incisors were allocated to four experimental groups (n = 12 each): G1 (WSC)- treated with 9.5% hydrogen peroxide whitening strips (3D White Whitestrips® Advanced Vivid/CREST); G2 (WSO)-treated with 10% hydrogen peroxide whitening strips (3D WhiteTM/Oral B); G3 (WG)-treated with 7.5% hydrogen peroxide gel with fluorine, calcium and potassium nitrate (White Class®/FGM); and G4 (C)-control not subjected to bleaching treatment. The specimens were subjected to bleaching over 2 weeks following the manufacturers' instructions. Following the elaboration of the composite resin test specimens, the samples were stored in artificial saliva and subsequently subjected to the micro-shear test using the universal testing machine (EMIC®). The bond strength values were analyzed by one-way ANOVA and Tukey's statistical test (5%). RESULTS: Significant differences were observed among the investigated groups (p < 0.05). The G3-WG exhibited greater values compared with the control group and the groups treated with strips, G1-WSC and G2-WSO. Analysis of the bond interface revealed that a large fraction of the failures occurred at the enamel-resin interface. CONCLUSION: The bond strength decreased following 14 days of treatment with bleaching strips, whereas the whitening gel with 7.5% hydrogen peroxide, calcium and fluorine increased the bond strength.

Influence of standard load micro- and nanopatterned in surface roughness of bleached teeth and submitted to different surface treatments.

The aim of this study was evaluate the dental enamel after whitening treatment with Opalescence Boost PF™ 38%, correlating the structural alterations in the surface of the enamel with its respective pH and verify if whitened teeth submitted to different finishing and polishing techniques show similar surface texture to healthy teeth (control group). Sixty premolars were divided in 6 groups (n = 10), which had been immersed in artificial saliva during all the experiment. Protocol whitening was performed according to the manufacturer recommendations, and then the specimens were submitted to different polishing technique with Sof-Lex Pop On™ disks, Flex Diamond™ felt disks using two different micrometric polishing pastes (Enamelize™ and Diamond Polish™) and two nanometric polishing pastes (Lummina-E Diamond and Lummina-E Alumina), according to the groups. Representative specimens were analyzed in scanning electronic microscopy (SEM). Whitening gel used in this experiment had modified the morphologic aspect of the enamel surface. It was found that two nanometric polishing pastes (G5 and G6) promoted a less rough surface compared to control group even after the whitening process.

Analysis of metal contents in Portland Type V and MTA-based cements.

The aim of this study was to determine, by Atomic Absorption Spectrometry (AAS), the concentration levels of 11 metals in Type V gray and structural white PC, ProRoot MTA, and MTA Bio. Samples, containing one gram of each tested cement, were prepared and transferred to a 100 mL Teflon tube with a mixture of 7.0 mL of nitric acid and 21 mL of hydrochloric acid. After the reaction, the mixture was filtered and then volumed to 50 mL of distilled water. For each metal, specific patterns were determined from universal standards. Arsenic quantification was performed by hydride generator. The analysis was performed five times and the data were statistically analyzed at 5% level of significance. Only the cadmium presented concentration levels of values lower than the quantification limit of the device. The AAS analysis showed increased levels of calcium, nickel, and zinc in structural white PC. Type V PC presented the greatest concentration levels of arsenic, chromium, copper, iron, lead, and manganese (P < 0.05). Bismuth was found in all cements, and the lowest concentration levels were observed in Portland cements, while the highest were observed in ProRoot MTA. Both PC and MTA-based cements showed evidence of metals inclusion.

Predictable interproximal tissue removal with a surgical stent.

The correction of diastemas in the anterior region with composite resin is considered to be practical and conservative. Harmony between the restorative material and the periodontium is necessary to achieve satisfactory functional and esthetic results. Whenever excessive gingiva occurs in the interproximal region, removal is necessary to avoid excessively contoured restorations. A predictable technique is described to conservatively remove interproximal tissue in situations in which crown lengthening is required to treat bilateral diastemas. A surgical template based on the diagnostically waxed cast was produced to serve as a reference during periodontal surgery.

Conservative treatment of intraosseous hemangiomas in the mandible: case report with a 17-year follow-up period.

Intraosseous hemangiomas in the jaws are rare lesions and may lead to several complications. The authors present a case of a 12-year-old girl with a radiolucent periapical lesion between tooth 35 and 36 where nocturnal exsanguinating bleeding started to occur from periodontal sulcus during orthodontic treatment. Diagnosis of an intraosseous hemangioma in the mandible was based on positive needle aspiration for blood, computed tomography and arteriography. At first the family chose to only follow-up the lesion but episodes of nocturnal hemorrhage were becoming more frequent and a treatment was requested. Embolization and dental extraction were performed in order to treat the lesion. After a follow-up period of 17 years no more cases of hemorrhage occurred and lesion regressed.

Human dental enamel and dentin structural effects after Er:YAG laser irradiation.

UNLABELLED: Ideally projected to be applied on soft tissues, infrared lasers were improved by restorative dentistry to be used in hard dental tissues cavity preparations--namely enamel and dentin. This paper evidentiates the relevant aspects of infrared Erbium laser's action mechanism and its effects, and characterizes the different effects deriving from the laser's beams emission. The criteria for use and selection of optimal parameters for the correct application of laser systems and influence of supporting factors on the process, such as water amount and its presence in the ablation process, protection exerted by the plasma shielding and structural factors, which are indispensable in dental tissues cavity preparation related to restorative technique, are subordinated to optical modifications caused by the interaction of the energy dissipated by these laser light emission systems in the targeted tissue substrate. CLINICAL RELEVANCE: Differences in the action of infrared Erbium laser system in regard to the nature of the ablation process and variations on the morphological aspects observed in the superficial structure of the target tissue irradiated, may be correlated to the structural optical modifications of the substrate produced by an interaction of the energy propagated by laser systems.

Marginal adaptation of class V restorations with current-generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with Filtek™ Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.