How the repair bonding strength of hybrid ceramic CAD/CAM blocks is influenced by the use of surface treatments and universal adhesives.

We examined how different methods of surface treatment and different universal adhesives with or without extra silane affected the repair bonding strength of hybrid ceramic CAD/CAM restorations. Cerasmart specimens (n=320) were subjected to thermocycling and assigned to the following surface pretreatment protocols: control, diamond bur (DB), hydrofluoric acid (HF), and tribochemical silica coating (TSC). Half the specimens received a coating of silane, followed by application of the universal adhesives Futurabond M+ (FMU), Tokuyama Universal Bond (TUB), Single Bond Universal (SBU), or Clearfil Universal Bond Quick (CUQ) (n=10). A hybrid composite resin was used to simulate repair; then the specimens underwent further thermocycling. Shear bond strength (SBS) was determined and modes of failure were examined. The TSC-CUQ silane (-) group showed the highest SBS values. The best repairs were obtained when the surface was treated with TSC, with the exception of the DB-TUB silane (-) group. TUB increased SBS more than the other adhesives. Additional silane decreased SBS in the HF-TUB and TSC-CUQ groups, while increasing it in the TSC-TUB and DB-FMU groups (p<0.05).

Oral Health Status of Outpatients with Schizophrenia in Ankara, Türkiye: A Descriptive Study. / Ayakta Tedavi Gören Sizofreni Hastalarinin Agiz Sagligi Durumu: Tanimlayici Bir Çalisma (Ankara-Türkiye).

OBJECTIVES: To evaluate the oral health status and denture treatment needs of a group of outpatients with schizophrenia. METHODS: One hundred and eighty-eight patients diagnosed with schizophrenia were evaluated. Socio-demographic characteristics, eating habits, alcohol consumption, smoking status, oral hygiene attitudes, medical status, medications and the data related to dental visit were obtained via structured questionnaire of 45 questions. Medication information were confirmed from hospital records. The DMFT score (the Total of decayed, missing and filled teeth), denture status, Community Periodontal Index of Treatment (CPITN) and attachment loss were recorded in accordance with the criteria defined by the WHO. RESULTS: The mean DMFT score was 11.1±8.6. Total number of teeth decreased, while the number of decayed teeth and DMFT scores increased with age (p<0.001). There was no relationship between the anticholinergic effects of antipsychotics and the teeth count, number of decayed, filled and missing teeth, and the DMFT scores. The CPITN assessment revealed that 71.6% of the patients had healthy periodontium, 7.4% exhibited gingival bleeding upon probing, and 21% had dental calculus. Psychotropic medication and tooth brushing habits were associated with CPITN scores. Male sex was associated with higher frequency of denture need (p<0.001), while no association was observed with the education level and antipsychotic use (p>0.001). CONCLUSION: Physicians and dentists have to work in coordination to maintain good oral health of patients with schizophrenia. Patients should be encouraged for regular dental check-ups and dentist should take utmost care of the oral hygiene maintenance.

Effect of Additional Light Curing on Colour Stability of Composite Resins.

AIM: The objective of this study was to evaluate the effect of additional light curing on the colour stability of composite resins. MATERIALS AND METHODS: Four different composite resins-a nanofill, a nanohybrid, a microhybrid, and a bulk-fill composite resin-were tested. Eighty disc-shaped specimens were prepared from each material using either a quartz tungsten halogen or a light-emitting diode light source and were randomly divided into 2 groups according to the surface treatment: no polishing (nonpolished) or polishing with aluminum oxide discs (polished). Then additional light curing was applied to half of the specimens in each group. All specimens were immersed in coffee solution for 1 week. Colour was measured with a spectrophotometer at baseline and after 1 week of storage in coffee solution. RESULTS: Statistically significant differences in colour stability were observed in the restorative materials according to the composition of composite resin, the polishing protocol, and additional light curing, whilst there were no significant differences according to the light source. Additional light curing reduced discolouration in all groups tested. CONCLUSIONS: Additional light curing may be beneficial after finishing and polishing in order to maintain aesthetics and increase the resistance of composite resins to discolouration.

Three-year clinical evaluation of class II posterior composite restorations placed with different techniques and flowable composite linings in endodontically treated teeth.

OBJECTIVE: The objective of this study is to evaluate the clinical performance of direct resin composite restorations placed with different techniques (incremental or bulk) and different flowable linings (conventional or bulk-fill) in endodontically treated teeth. MATERIALS AND METHODS: Forty-seven pair class II (mesio-occlusal or disto-occlusal) composite restorations were placed in 37 patients. In all cavities, Adper Single Bond 2 was used. In one of the cavities of each pair, a conventional flowable composite, Aelite Flo, was applied in approximately 2 mm thick, and the remaining cavity was restored incrementally with GrandioSO. In the second cavity, a bulk-fill flowable composite, x-tra base, was applied in approximately 4 mm thick in bulk increments and the remaining 2-mm occlusal part of the cavity was restored with GrandioSO. All cavities were restored with open-sandwich technique by the same operator. At baseline and after 6-month, 1-, 2-, and 3-year follow-up visits, restorations were evaluated by modified USPHS criteria. RESULTS: At 3-year recall, 33 restorations with Aelite Flo lining and 33 with x-tra base lining were available. Two restorations from each group (6.0 %) were scored as Bravo in terms of surface texture. One restoration's color match from x-tra base group scored as Bravo (3.0 %). All other evaluated criteria were scored as Alfa (100 %) for all restorations. No statistically significant difference between the two groups was found in all evaluated criteria during 3-year period (p > 0.05). CONCLUSION: Bulk-filling technique showed clinically acceptable performance comparable to the incremental technique. CLINICAL RELEVANCE: Restorations placed with bulk-filling technique with x-tra base lining and incremental technique with a conventional flowable lining showed highly clinical performance over 3-year period.

Marginal Adaptation of Class V Restorations with a New Universal Adhesive.

This study aimed to evaluate the microleakage of a new universal adhesive used in self-etch (Se) and etch-and-rinse (Er) mode compared with conventional adhesive systems. Fifty standard Class V caries lesions were prepared on the buccal and lingual surfaces of premolar teeth and randomly divided into five groups (n = 10): Group 1 (control), Adper Single Bond 2 (SB); Group 2, Single Bond Universal applied as Er (SBUEr); Group 3, Single Bond Universal applied as Se (SBUSe); Group 4 (control), Clearfil SE (CSE); and Group 5, Xeno V (XE). On both enamel and dentin, XE showed the highest microleakage scores, and SBU showed similar leakage with the control group.

Influence of different staining beverages on color stability, surface roughness and microhardness of silorane and methacrylate-based composite resins.

AIM: To investigate the influence of different staining beverages on color stability, surface roughness and microhardness of silorane and methacrylate-based composite resins. MATERIALS AND METHODS: Three different composite resins (Filtek Silorane, Filtek P60, Filtek Supreme XT) were tested. Thirty cylindrical specimens (10 × 2 mm) per material were prepared and polished with a series of aluminum-oxide polishing disks. Each group was then randomly subdivided into three groups according to the test beverages: distilled water (control), cola and coffee. The samples were immersed into different beverages for 15 days. Color, surface roughness and microhardness values were measured by a spectrophotometer, prophylometer and Vickers hardness device respectively, at baseline and after 15 days. The data were subjected to statistical analysis. RESULTS: Immersion in coffee resulted in a significant discoloration for all the composites tested, although the color change was lower in Filtek Silorane than that of MBCs (p < 0.05). All the composites tested showed similar surface roughness changes after immersion in different beverages (p > 0.05). Besides coffee caused more roughness change than others. Immersion in coffee caused highest microhardness change in Filtek Supreme XT (p < 0.05). CONCLUSION: Cola and coffee altered, to some degree, the color, surface roughness and/or microhardness of the tested resin composites, depending on the characteristics of the materials.

Does the light source affect the repairability of composite resins?

The aim of this study was to examine the effect of the light source on the microshear bond strength of different composite resins repaired with the same substrate. Thirty cylindrical specimens of each composite resin--Filtek Silorane, Filtek Z550 (3M ESPE), Gradia Direct Anterior (GC), and Aelite Posterior (BISCO)--were prepared and light-cured with a QTH light curing unit (LCU). The specimens were aged by thermal cycling and divided into three subgroups according to the light source used--QTH, LED, or PAC (n = 10). They were repaired with the same substrate and a Clearfil Repair Kit (Kuraray). The specimens were light-cured and aged for 1 week in distilled water at 37 °C. The microshear bond strength and failure modes were assessed. There was no significant difference in the microshear bond strength values among the composite resins, except for the Filtek Silorane group that showed significantly lower bond strength values when polymerized with the PAC unit compared to the QTH or LED unit. In conclusion, previously placed dimethacrylate-based composites can be repaired with different light sources; however, if the composite to be repaired is silorane-based, then using a QTH or LED device may be the best option.

Effect of operator variability on microleakage with different adhesive systems.

OBJECTIVE: The objective of this study was to evaluate the effect of operator variability on microleakage with different adhesive systems. MATERIALS AND METHODS: A total of 180 standardized Class V cavities were prepared on facial and lingual of 90 extracted human premolar teeth and randomly assigned to five groups according to the adhesive systems used (n = 36): Prime and Bond NT (PB), Single Bond (SB), Futura Bond NR, Xeno III (XE) and Adper Prompt-L-Pop (LP). The adhesive groups were then further subdivided into three operator groups according to level of clinical experience (n = 12): An undergraduate student, a research assistant and a faculty member. All cavities were restored with same composite resin. The restored teeth were thermocycled (500 cycles, 5-55°C) then immersed in 0.5% basic fuchsin and measured for leakage under a stereomicroscope. Statistical analyses were performed with the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: Significant inter-operator variation was found in the enamel margins in the XE group with significantly higher microleakage when used by the undergraduate student (P < 0.05). Although no significant differences in microleakage were found between adhesive systems for the research assistant and faculty member (P > 0.05), significant differences were observed between PB and LP, PB and XE, SB and LP and SB and XE in the enamel margins for the undergraduate student (P < 0.05). CONCLUSION: Microleakage of adhesive systems is more dependent on interactions between the operator and adhesive material than on the choice of adhesive material.

Does the temperature of beverages affect the surface roughness, hardness, and color stability of a composite resin?

OBJECTIVE: To investigate the effect of beverages' temperature on the surface roughness, hardness, and color stability of a composite resin. MATERIALS AND METHODS: Fifty specimens of the Filtek Z250 composite (3M ESPE, Dental Products, St.Paul, MN, USA) were prepared and initial roughness, microhardness, and color were measured. Then the specimens were randomly divided into five groups of 10 specimens each: Coffee at 70°C, coffee at 37°C, cola at 10°C, cola at 37°C, and artificial saliva (control). After the samples were subjected to 15 min × 3 cycles per day of exposure to the solutions for 30 days, the final measurements were recorded. RESULTS: After immersion in beverages, the artificial saliva group showed hardness values higher than those of the other groups (P < 0.001) and the microhardness values were significantly different from the initial values in all groups except for the control group. Both cola groups showed roughness values higher than the baseline values (P < 0.05), while the other groups showed values similar to the baseline measurements. When ΔE measurements were examined, the 70°C coffee group showed the highest color change among all the groups (P < 0.05). CONCLUSION: High-temperature solutions caused alterations in certain properties of composites, such as increased color change, although they did not affect the hardness or roughness of the composite resin material tested.

Clinical evaluation of a nanohybrid and a flowable resin composite in non-carious cervical lesions: 24-month results.

PURPOSE: To evaluate the 24-month clinical performance of cervical restorations using a nanohybrid and a flowable resin composite with a one-step self-etching adhesive. MATERIALS AND METHODS: Twenty-one patients with at least one pair of non-carious cervical lesions participated in this study. A total of 134 non-carious cervical lesions were restored (67 with a nanohybrid resin composite, Grandio; 67 with a flowable resin composite, Grandio Flow) using a one-step self-etching adhesive system, Futura Bond NR, by one dentist. The restorations were evaluated for retention, color match, marginal discoloration, marginal adaptation, surface texture, anatomic form, and secondary caries by two calibrated examiners at baseline and after 6, 12, and 24 months using modified USPHS criteria. The survival rates of the restorations were calculated by the Kaplan-Meier estimator. The comparison of resin composites for each category was performed with the Pearson chi-square test, and the performance of restorations at baseline and after each recall time was evaluated using McNemar's test (p < 0.05). RESULTS: All patients attended the 24-month recall. The retention rates at 6 months were 66% and 58%, and 61% and 57% at 12 months for Grandio and Grandio Flow, respectively. At the 24-month recall, the retention rate was 60% for Grandio and 54% for Grandio Flow. No statistically significant differences were found in retention rates among the restorative materials in any evaluation period (p > 0.05). For marginal discoloration and anatomical form, three Grandio and three Grandio Flow restorations showed Bravo scores at the end of 24 months. The restorations in both groups had Alfa ratings of 100% for the rest of the criteria evaluated. CONCLUSION: The nanohybrid and flowable resin composites showed similar clinical performances in the restoration of non-carious cervical lesions over 24 months.

Clinical evaluation of a nanofilled fissure sealant placed with different adhesive systems: 24-month results.

OBJECTIVE: This clinical study compared the retention rates of a nanofilled occlusal fissure sealant placed with the use of an etch-and-rinse or a self-etch adhesive over 24 months. METHODS: Two-hundred and forty-four sealants were placed on the permanent premolars and molars of 16 subjects who had no restorations or sealants present on the fissures and no detectable caries. The sealants were placed with either SoloBond M two-step etch-and-rinse adhesive or FuturaBond NR one-step self-etch adhesive by four previously calibrated dentists, using a table of random numbers. After completion of the adhesive application, a nanofilled sealant, Grandio Seal, was applied and light-cured. Clinical evaluations were done at baseline and at 1-, 3-, 6-, 12-, 18- and 24-month recalls. Two other calibrated examiners, who were unaware of which adhesive had been used, independently evaluated the sealants. Evaluation of the sealants on every follow-up visit involved visual examination with the aid of a dental explorer and an intra-oral mirror. Each sealant was evaluated with the following criteria: 1 = completely retained; 2 = partial loss; 3 = total loss. The Pearson Chi-square test was used to evaluate differences in the retention rates among the sealants used with different adhesives for each evaluation period. RESULTS: For the 12-month recalls, complete retention rates of 89.3% for the SoloBond M group and 20.5% for the FuturaBond NR group were observed. Sixteen of the 244 restorations were unavailable after 12 months. At 24 months, a total loss of 9 sealants in the SoloBond M group and 84 in the FuturaBond NR group were observed, resulting in retention rates of 81.6% and 15.8%, respectively. There were statistically significant differences in retention rates between the SoloBond M and FuturaBond NR groups in all periods of evaluation (p < 0.05). No statistically significant difference between the retention rates for premolars and molars was found at each evaluation period (p > 0.05). There was no new caries formation throughout the 24-month recall period. CONCLUSION: Fissure sealants placed with etch-and-rinse adhesive showed better retention rates than those placed with self-etch adhesive.

Effect of different pretreatment methods on dentin bond strength of a one-step self-etch adhesive.

AIM: The aim of this in vitro study was to evaluate the shear bond strength of a one-step self-etch adhesive to dentin pretreated with phosphoric acid, air abrasion, or laser. METHODS AND MATERIALS: Fifty-six extracted non-carious human mandibular molars were mounted and the occlusal surfaces ground with a mechanical grinder to obtain flat occlusal dentin surfaces. The teeth were randomly divided into four groups of 14 teeth according to the different dentin surface pretreatment methods: Group I--acid, Group II--laser, Group III--air abrasion, Group IV (control)--no surface treatment. After applying a one-step self-etch adhesive system, Futura Bond NR, cylinders of Z250 composite resin were bonded to the dentin surfaces by transparent gelatin capsules (2.5 mm diameter; 3 mm high) and then polymerized. All specimens were stored in distilled water at 37 masculineC for 24 hours. Shear bond testing was carried out using an Universal testing machine with a crosshead speed of 0.5 mm/sec. Data were analyzed using the Kruskal Wallis and Mann-Whitney tests at a significance level of 0.05. RESULTS: The bond strength of air abrasion (Group III) and the control group (Group IV) were statistically higher than both the acid (Group I) and laser (Group II) pretreatments (p < 0.05). No statistically significant differences were found in shear bond strength between surfaces treated with air abrasion and the control group (p > 0.05). Surfaces pretreated with laser (Group II) resulted in the lowest bond strength which was not statistically different from those pretreated with acid (Group I) (p > 0.05). CONCLUSION: Surfaces pretreated with acid and laser adversely affected the bond strength of a one-step self-etch adhesive, Futura Bond NR, while pretreatment with air abrasion had no effect on bond strength. CLINICAL SIGNIFICANCE: The pretreatment of dentin surfaces prior to self-etch adhesive seems to be unnecessary and defeats the original purpose of these systems.