Effect of adding ytterbium trifluoride filler particles on the mechanical, physicochemical and biological properties of methacrylate-based experimental resins for 3D printing.

OBJECTIVE: To formulate an experimental methacrylate-based photo-polymerizable resin for 3D printing with ytterbium trifluoride as filler and to evaluate the mechanical, physicochemical, and biological properties. METHODS: Resin matrix was formulated with 60 wt% UDMA, 40 wt% TEGDMA, 1 wt% TPO, and 0.01 wt% BHT. Ytterbium Trifluoride was added in concentrations of 1 (G1 %), 2 (G2 %), 3 (G3 %), 4 (G4 %), and 5 (G5 %) wt%. One group remained without filler addition as control (GC). The samples were designed in 3D builder software and printed using a UV-DLP 3D printer. The samples were ultrasonicated with isopropanol and UV cured for 60 min. The resins were tested for degree of conversion (DC), flexural strength, Knoop microhardness, softening in solvent, radiopacity, colorimetric analysis, and cytotoxicity (MTT and SRB). RESULTS: Post-polymerization increased the degree of conversion of all groups (p < 0.05). G2 % showed the highest DC after post-polymerization. G2 % showed no differences in flexural strength from the G1 % and GC (p > 0.05). All groups showed a hardness reduction after solvent immersion. No statistical difference was found in radiopacity, softening in solvent (ΔKHN%), colorimetric spectrophotometry, and cytotoxicity (MTT) (p > 0.05). G1 % showed reduced cell viability for SRB assay (p < 0.05). SIGNIFICANCE: It was possible to produce an experimental photo-polymerizable 3D printable resin with the addition of 2 % ytterbium trifluoride as filler without compromising the mechanical, physicochemical, and biological properties, comparable to the current provisional materials.

Evaluation of direct restorations for pit-and-fissure caries using stamp combined with single-shade composite resin technique: A 12-month follow-up in vivo study.

OBJECTIVES: To evaluate the clinical performance of direct restorations for pit-and-fissure caries in molars using stamp combined with single-shade composite resin (S/SCR) technique, and assess the effect of the number of stamp pressing on the trueness of S/SCR technique. METHODS: Twenty molars of fifteen patients with pit-and-fissure caries but with an intact or micro-cavitated occlusal morphology were restored using S/SCR technique and were randomly divided into single pressing group (n = 10) and double pressing group (n = 10). Intraoral scans were obtained before treatment (scan 1), after filling (scan 2) and after polishing (scan 3). Deviation distribution maps of pairwise fitting were created including comparison 1 (scan1/scan 2), comparison 2 (scan1/scan 3), and comparison 3 (scan2/scan 3) using Geomagic Control X software. Root mean square (RMS) values were calculated to evaluate the trueness of restorations. Clinical performances including esthetic, functional, and biological properties of all restorations were evaluated according to FDI criteria after a 12-month follow-up. Analysis of variance, independent-samples T test and Wilcoxon rank-sum test were used for statistical analysis (α=0.05). RESULTS: RMS values for comparison 1, comparison 2, and comparison 3 were 0.1243 ± 0.0151, 0.0966 ± 0.0136, and 0.0605 ± 0.0137 mm in single pressing group, while 0.0831 ± 0.0140, 0.0741 ± 0.0107, and 0.0475 ± 0.0099 mm in double pressing group, respectively. RMS value of single pressing group was higher than that of double pressing group in the same comparison (p ≤ 0.001). No statistically significant differences were observed between the two groups regarding esthetic, functional and biological properties (p > 0.05). For all properties, all restorations scored within 3, with over 80% scoring 1. CONCLUSION: S/SCR technique presents satisfying clinical performances for pit-and-fissure caries in molars after a 12-month follow-up. Besides, double pressing can improve the trueness of restorations compared to single pressing. CLINICAL SIGNIFICANCE: S/SCR technique is efficient in direct composite resin restoration for pit-and-fissure caries, with satisfying esthetic, functional and biological properties after a 12-month follow-up. Significantly, double pressing improves the trueness of S/SCR technique, reducing the need for occlusion adjustment.

Smile Renewal: Incisor Restoration Using the Strip Crown Technique.

Aesthetics has been an important aspect of dentistry along with functionality for decades but its significance is at an all-time high. Hence among techniques that contribute toward this goal, strip crown has shown convincing results. However, its acceptance did not reach its potential, especially among general dentists which could be attributed to its technique-sensitive nature. This case report sheds light on the practicality and reliability of this technique along with various modifications made by authors while striving to improve the quality of treatment provided by the clinician.

Antibacterial properties of mesoporous silica coated with cerium oxide nanoparticles in dental resin composite.

Cerium oxide nanoparticles are known for their antibacterial effects resulting from Ce3+ to Ce4+ conversion. Application of such cerium oxide nanoparticles in dentistry has been previously considered but limited due to deterioration of mechanical properties. Hence, this study aimed to examine mesoporous silica (MCM-41) coated with cerium oxide nanoparticles and evaluate the antibacterial effects and mechanical properties when applied to dental composite resin. Cerium oxide nanoparticles were coated on the MCM-41 surface using the sol-gel method by adding cerium oxide nanoparticle precursor to the MCM-41 dispersion. The samples were tested for antibacterial activity against Streptococcus mutans via CFU and MTT assays. The mechanical properties were assessed by flexural strength and depth of cure according to ISO 4049. Data were analyzed using a t-test, one-way ANOVA, and Tukey's post-hoc test (p = 0.05). The experimental group showed significantly increased antibacterial properties compared to the control groups (p < 0.005). The flexural strength exhibited a decreasing trend as the amount of cerium oxide nanoparticle-coated MCM-41 increased. However, the flexural strength and depth of cure values of the silane group met the ISO 4049 standard. Antibacterial properties increased with increasing amounts of cerium oxide nanoparticles. Although the mechanical properties decreased, silane treatment overcame this drawback. Hence, the cerium oxide nanoparticles coated on MCM-41 may be used for dental resin composite.

Mechanical properties and formulation of hydrophilic fiber and shrimp shell combination as a novel eco-friendly dental restoration material.

This study evaluates the mechanical properties and formulation of dental restoration material comprised of cellulose acetate (CA) from water hyacinth and chitosan (C) from white shrimp shells. The research phases included extraction, formulation, functional group testing, antibacterial, toxicity, water absorption and solubility, compressive, shear, tensile, hardness, microleakage, thermal expansion, and shrinkage. The experimental data were analyzed using probit regression, one-way ANOVA, and Kruskal-Wallis test. The data showed that CA and C had microxyl and amine groups, could inhibit S. mutans, and were non-toxic. Composite resins were divided into nine formulations with different concentrations: F1 (1 % CA + 3 % C), F2 (1 % CA + 5 % C), F3 (1 % CA + 7 % C), F4 (3 % CA + 3 % C), F5 (3 % CA + 5 % C), F6 (3 % CA + 7 % C), F7 (5 % CA + 3 % C), F8 (5 % CA + 5 % C), and F9 (5 % CA + 7 % C). The F9 has mechanical strength close to the control group, with 113.33 µg/mm3 absorption, 80 µg/mm3 solubility, 32.67 Mpa compressive strength, 17.18 Mpa tensile strength, and no shrinkage. It shows that F9 has potential as an eco-friendly dental filling material. The present study completed the development of a formulation for a restoration material by combining water hyacinth fiber and shrimp skin chitosan. The outcomes of a comparative analysis of the mechanical properties of synthetic composite resins and water hyacinth fiber composites containing shrimp skin chitosan revealed that the F9 formulation (CA 5 % + C 7 %) exhibited the following fiber: absorption, compressive strength, tensile strength, hardness, and thermal expansion.

An In Vitro Analysis of the Effects of Mouthwashes on the Surface Properties of Composite Resin Restorative Material.

BACKGROUND: Restorative composite resins have clinical prime importance in modern dental practice, but numerous factors influence their prognosis in the oral environment. Their interaction with oral care products, like mouthwashes, is one such factor. This study aimed to evaluate the quantifiable effects of different mouthwashes on the surface properties of the composite resin restorative material. METHODOLOGY: The method involved formulating 90 samples of nanohybrid composite resins (Medicept Dental India Private Limited, Mumbai, India). The samples were treated with 1% alcohol, without alcohol, and with a saline solution (control). Surface roughness (Ra values) and microhardness had been checked before and after an exposure period of 24 hours. Data were thus tabulated, and from that, average values of surface roughness and microhardness were derived. This data was analyzed using the IBM SPSS Statistics for Windows, V. 26.0 (IBM Corp., Armonk, NY). Analysis of variance (ANOVA) and a t-test were used to compare the means of the variables. The level of significance was fixed at p < 0.05. RESULTS: The surface roughness value was significantly highest in the ethanol-containing mouthwash-treated samples after 24 hours of exposure (p < 0.05). The microhardness was statistically lower in these samples (p < 0.05). CONCLUSION: These research data give quantitative information, however, about the mass effect of mouthwashes on the composite resin restorative material. The presented changes, which were illustrated by the values of surface roughness and microhardness, are drawing attention to the fact that a cautious approach must be taken in the recommendations for oral care in the provision of intensive treatments with restorative composite resins.

Clinical Effectiveness of High-viscosity Glass Ionomer Cement and Composite Resin as a Restorative Material in Primary Teeth: A Systematic Review of Clinical Trials.

Aim: This systematic review was designed to compare the clinical effectiveness of high-viscosity glass ionomer cement (HVGIC) restorations to direct composite resin (CR) restorations in single- or multisurface cavities in primary teeth. Background: Restorative procedures are typically used to treat caries in primary teeth. Due to their improved preservation of the natural tooth structure and their adhesion to the remaining tooth structure, CR and GIC have drawn attention as the preferred restorative materials. In the literature, over the past 20 years, the term HVGIC has developed. Compared to C-GICs, HVGICs appear to have a higher survival rate. However, isolated studies provide contradictory findings regarding the durability of restorations in primary teeth. Materials and methods: Major electronic databases were thoroughly searched to find publications from the years 2000 to 2021. Studies included were randomized and nonrandomized clinical trials on children aged 3-13 years, in which restoration of primary teeth using HVGIC and CR was performed. Results: This systematic review includes four studies [three randomized controlled trials (RCTs) and one nonrandomized controlled trial]. No statistically significant difference between these materials was seen in any of the included studies. Conclusion: This systematic review of findings supports the assertion that both HVGIC and CR restorations deliver satisfactory outcomes in terms of clinical efficacy and overall survivability. It was found that, for both materials, class I restorations had statistically higher survival rates than class II restorations. Long-term studies are essential to evaluate the clinical efficacy of both restorations. Clinical significance: This systematic review outlines the application of HVGIC and CR as restorative materials for pediatric dentists to use in their everyday dental practices. How to cite this article: Krishnakumar K, Kalaskar R, Kalaskar A, et al. Clinical Effectiveness of High-viscosity Glass Ionomer Cement and Composite Resin as a Restorative Material in Primary Teeth: A Systematic Review of Clinical Trials. Int J Clin Pediatr Dent 2024;17(2):221-228.

Precision layering techniques: Integrating digital tools for accurate color matching and realistic try-ins in anterior composite restorations.

OBJECTIVE: This article aims to demonstrate the clinical application of a comprehensive workflow that integrates digital tools for accurate color matching, and its immediate implementation in the restoration of anterior teeth. CLINICAL CONSIDERATIONS: Two patients demonstrating dissatisfaction regarding a maxillary central incisor had an old restoration replaced resorting to a digital workflow to enhance the predictability of the new direct restoration. OptiShade allowed the precise assessment of tooth color and the CompoShade application provided precise color and material selection, as well as the determination of a layering strategy. Precision and accuracy of the colorimeter and the composite layering application were demonstrated clinically in vivo. CONCLUSIONS: Implementing a digital workflow with the integration of OptiShade measurements and the CompoShade layering recipe calculation, as well as the respective realistic try-in, enables the achievement of precise color matching for anterior composite restorations. CLINICAL SIGNIFICANCE: The employment of a digital colorimeter and layering recipes simplify shade matching, and optimizes composite resin clinical use and success. The implementation of a realistic try-in, previous to the definitive restoration, allows the clinician to perform any adjustments if needed.

Spot-etch technique and other adhesive strategies for provisional veneers.

AIM: The objective of the present study was to evaluate the influence of different adhesive strategies regarding shear bond strength (SBS) of provisional resin--based materials bonded to the enamel surface as well as on the enamel surface roughness. MATERIALS AND METHODS: Bovine incisors were randomly divided into six groups (n = 10) according to the adhesive strategy used: BRControl (bis-acrylic resin); Spot-etch+BR (spot-etch + bis-acrylic resin); Spot--etchSB2+BR (spot-etch + adhesive + bis-acrylic resin); Spot-etchZ350Flow+BR (spot-etch + flowable composite resin + bis-acrylic resin); SBU+BR (universal adhesive + bis-acrylic resin); Spot-etchSBMP+Z350 (spot-etch + adhesive + composite resin). The enamel surface roughness was determined by a surface profil-ometer. An SBS test was performed in a universal testing machine, and failure modes were classified under magnification. The SBS data were analyzed by one-way analysis of variance (ANOVA). A paired t test was used for enamel surface roughness intragroup comparisons, and the Friedman one-way repeated meas-ures analysis of variance by ranks was used for differences in enamel surface roughness between groups, with the Tukey post hoc test (a = 0.05). RESULTS: BRControl had the lowest SBS values (MPa), with a significant difference (P ≤ 0.001) from the other groups. Spot-etch+BR had the highest SBS values but with no significant differences from the other groups in which the spot-etch technique was also used. Adhesive failure mode was predominant for all groups. BRControl had the lowest surface roughness difference, significantly different (P = 0.001) from all the other groups. CONCLUSIONS: Spot-etch and other adhesive strategies could be applied to increase the SBS values of provisional restorations to enamel compared with no surface pretreatment. However, the adhesive strategy may change the enamel surface roughness, revealing the importance of cleaning the tooth surface.

Effects of Er,Cr:YSGG Laser Surface Treatments and Composites with Different Viscosities on the Repair Bond Strength of CAD/CAM Resin Nanoceramic.

This study aims to evaluate the repair micro-shear bond strength of the CAD/CAM resin nanoceramic block treated using four different surface treatments and composite resins of different viscosities. For the current study, 96 samples with dimensions of 14 × 12 × 2 mm were obtained from a CAD/CAM resin nanoceramic block (Cerasmart) with a low-speed precision cutting saw under water cooling. The relevant samples were randomly divided into four groups according to the surface treatment processes: grinding with diamond bur, aluminum oxide airborne-particle abrasion, long-pulse laser, and short-pulse laser. Following silane application, universal adhesive was applied to all surface-treated samples and cured with an LED for 10 s. The samples prepared for the repair procedure were divided into two subgroups (microhybrid composite and injectable composite) according to the viscosity of the repair material to be used (n = 12). After the repair procedure, care was taken to keep the samples in distilled water in an incubator at 37 °C for 24 h. The repair micro-shear bond strength values (µSBSs) of CAD/CAM resin nanoceramic-composite resin complexes were tested. In addition, randomly selected samples from each group were examined with a scanning electron microscope to evaluate the surface topography after both surface treatments and the micro-shear bond strength test. Data were analyzed by two-way ANOVA and Bonferroni test. It was determined that the surface treatment preferred in the repair protocol significantly affected the µSBS value (p < 0.001). While the highest µSBS value was obtained with the short-pulse laser airradiation group, the lowest µSBS values were found in samples with long pulse laser irradiation. However, samples grinded with a bur and airborne-particle abrasion showed similar µSBS values (p > 0.05). The preferred composite viscosity in the repair procedure has a significant effect on the µSBS value (p < 0.001). However, the interaction between the surface treatment and the viscosity of the repair composite does not affect the µSBS values in a statistically significant way (p = 0.193). It may be recommended to clinicians to repair CAD/CAM resin nanoceramic restoration surfaces with injectable composites or after treatment with short-pulse lasers.

Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Restauração indireta em resina composta: um relato de prontuário / Indirect resin composite restoration: a dental record report

Restaurações diretas em resina composta são amplamente utilizadas em odontologia para restaurar dentes posteriores. Todavia, quando há grande destruição coronária, onde a distância do istmo excede dois terços da distância intercuspídea, as restaurações indiretas em resina composta são indicadas. O presente estudo teve como objetivo relatar a análise de um prontuário de um paciente que recebeu uma restauração indireta em resina composta em dente posterior amplamente destruído. Através da análise de prontuários de pacientes atendidos nas disciplinas de Estágios Supervisionados do Curso de Odontologia da FSG Centro Universitário no ano de 2023, foi selecionado um prontuário de um paciente que compareceu a clínica odontológica da FSG com uma restauração em amálgama fraturada com reparo em resina composta que apresentou sintomatologia dolorosa. O procedimento diagnóstico ocorreu através de exame clínico e radiográfico, que constatou a indicação de substituição da restauração insatisfatória e realização de uma restauração indireta em resina composta. Os resultados estéticos e funcionais apresentados demostraram a viabilidade da técnica restauradora indireta em resina composta para reabilitar dentes posteriores com ampla destruição coronária(AU)

Direct composite resin restoration are widely used in dentistry to restore posterior teeth. However, when there is large coronary destruction, that the distance from the isthmus exceeds two- thirds of the intercuspal distance, indirect composite resin restorations are indicated. This study aimed to report the analysis of a dental record of a patient who received an indirect restoration in composite resin in a badly destroyed posterior tooth. Through the analysis of dental records of patients seen in the disciplines of Supervised Internship of the Dentistry Course at FSG Centro Universitário in the year 2023, the dental record of a patient who attended the FSG dental clinic with fractured amalgam restoration with composite resin repair was selected who had painful symptoms. The diagnostic procedure took place through clinical and radiographic examination, which revealed the indication of replacing the unsatisfactory restoration and carrying out an indirect restoration in composite resin.The aesthetic and functional results presented demonstrated the viability of the indirect composite resin restoration technique for rehabilitating posterior teeth with extensive coronal destruction(AU)

Restauração em resina composta semidireta em dente posterior: relato de caso / Semi-direct composite restoration in posterior toth: a case report

A escolha da técnica restauradora desempenha papel fundamental na eficácia e duração de um tratamento reabilitador. O objetivo deste relato de caso foi descrever a utilização da técnica semidireta para a confecção de uma restauração em resina composta em um primeiro molar inferior. A paciente apresentava uma restauração insatisfatória no dente 36, que necessitava ser substituída devido à infiltração por cárie. Optou-se pela técnica semidireta devido à amplitude da cavidade, que envolvia estruturas de suporte, e pela combinação das vantagens das abordagens direta e indireta. O procedimento envolveu a remoção de tecido cariado, a aplicação de hidróxido de cálcio pasta, seguida da aplicação de uma fina camada de ionômero de vidro e, posteriormente, resina fluída para realizar o selamento dentinário. O preparo foi realizado seguindo os princípios necessários. O elemento em questão foi moldado com silicone de adição e o arco antagonista, com alginato. Ambos modelos foram vertidos com silicone para modelos semirrígidos e montados em oclusor de peças de brinquedo. A restauração semidireta foi confeccionada em resina composta Filtek Z350 XT, respeitando a anatomia do dente 36. Pigmentos foram utilizados para aprimorar detalhes estéticos. Após acabamento e polimento, a peça foi condicionada e cimentada com cimento dual Relyx Ultimate. Pode-se concluir que a abordagem restauradora por meio da técnica semidireta construída em modelo semirrígido é uma opção terapêutica conservadora e vantajosa para dentes com extensa destruição coronária. Essa técnica possibilita a restauração de forma eficaz, garantindo tanto a estética quanto a função adequada do dente afetado(AU)

The choice of restorative technique plays a fundamental role in the effectiveness and duration of rehabilitation treatment. The objective of this case report was to describe the use of the semi-direct technique to create a composite resin restoration in a lower first molar. The patient had an unsatisfactory restoration on tooth 36, which needed to be replaced due to cavity infiltration. The semi-direct technique was chosen due to the amplitude of the cavity, which involved support structures, and the combination of advantages of the direct and indirect approaches. The procedure involved the removal of carious tissue, and the application of calcium hydroxide paste, followed by the application of a thin layer of glass ionomer and, subsequently, fluid resin to seal the dentin. The preparation was carried out following the necessary principles. The element in question was molded with addition silicone and the antagonist arch was molded with alginate. Both models were poured with silicone for semi-rigid models and mounted on toy parts occluders. The semi-direct restoration was made in Filtek Z350 XT composite resin, respecting the anatomy of tooth 36. Pigments were used to improve aesthetic details. After finishing and polishing, the piece was conditioned and cemented with Relyx Ultimate dual cement. It can be concluded that the restorative approach using the semi-direct technique built on a semi-rigid model is a conservative and advantageous therapeutic option for teeth with extensive coronal destruction. This technique allows for effective restoration, ensuring both the aesthetics and adequate function of the affected tooth(AU)

Clinical Difficulties Related to Direct Composite Restorations: A Multinational Survey.

AIMS: Composite materials are widely used in dentistry for direct tooth restorations. However, they are highly sensitive to the working technique employed during the restorative procedure. Even minor procedural errors can have a significant impact on the quality including the longevity of the restoration. Hence the aim of this study was to determine the material preferences and analyse the clinical problems associated with direct composite restorations in a cohort of dentists. METHODS: A 20-item online questionnaire was created in English and administered 1830 general dentists and specialists in 13 countries. The first section of the questionnaire included four questions to elicit demographic data, and the second section comprised 16 questions focused on material preferences for conservative restorations, durability of composite restorations, and the most challenging stages the dentists faced during the composite restorative procedures. RESULTS: Respondents decided most often to use composite materials for the tooth restorations (OR 997.4, 95% CI 233.8-4254.8, P value <.001). Most respondents indicated that the durability of composite restorations was approximately 7 to 10 years (41.5%). Among the factors affecting durability, maintenance of a dry cavity was the most often reported reason (47.1%) and the foremost challenge faced by dentists (61.0%) during the composite restorative procedures. CONCLUSIONS: Our study confirmed that resin-based composites are the most popular material for direct restoration in many countries. Although working with this material is difficult and involves multiple steps, maintaining a dry cavity during bonding, and material application may affect the therapeutic success and durability of these restorations. Clinicians need to be attentive to this issue and be prepared to adapt their decision-making and consider opting for alternative restorative materials, if appropriate.

An in vitro study on the influence of laser-activated irrigation on infiltration and leakage of a dual curing-resin cement as an endodontic sealer.

Objectives: The study aims to investigate the effects of laser-activated irrigation on infiltration and microleakage of a dual-curing resin cement applied as a root canal sealer. Methods: Thirty-eight extracted upper molars were attributed to four experimental groups. Roots were mechanically enlarged and disinfected (NaOCl). Control samples (n = 11) were irrigated with conventional needles and three different lasers were used to activate the irrigant in the other groups (n = 9): 2.94 µm Er:YAG laser, 9,300 µm CO2 laser and 808 nm diode laser with a modified black coated laser tip. Final irrigation was performed in each group with ethylenediaminetetraacetic acid (EDTA), sodium hypochlorite (NaOCl) and sodium chloride (NaCl) activated with lasers and in the control without activation.Dentin tubules were then labeled with a red fluorophore (Rhodamine B) and the root canals were sealed with a dual-curing resin cement (Paracore). The cement fixed the dye on the sealed and infiltrated dentin parts. To remove the Rhodamine not fixed by the cement, roots were then sectioned horizontally and immersed in hydrogen peroxide (H2O2). The empty dentin tubules spaces were then labeled with a green fluorophore (Fluorescein) allowing the visualization of infiltration and microleakage by confocal microscopy. Results: Percentages of infiltration were significantly higher in the middle root third of the control and Er:YAG laser-activated samples compared to CO2 or diode laser groups. Microleakage was present in all experimental groups but significantly less after CO2 laser activation. Conclusion: Laser-activated irrigation impacted resin cement infiltration and microleakage dependent on the applied wavelength. Er:YAG laser activation led to higher values of infiltration and microleakage compared to CO2 and diode lasers.

Composition control of additively manufactured color-graded temporary veneer.

OBJECTIVE: The aim of this study was to design and assess composite resin composition for patient-specific esthetic color-graded temporary veneer. METHODS: Various compositions of composite structures (assorted by Ba2SiO4 filler, TiO2 pigment, and photoinitiator) were prepared via additive manufacturing with 3 s UV exposure (405 nm, 10 W/cm2) per 50 µm thick layer followed by 20 min post-curing treatment after fabrication. The effect of each component on the generated color shades was observed and compared to the commonly used VITA shade guide. The coloration was explored by staining aging treatment under dry, wet, artificial saliva environments, coffee, and cola. The mechanical properties were also evaluated. Color measurement and comparison were done using a colorimeter (lightness (L*), green-red color (a*), and blue-yellow color (b*)), and the changes were calculated by CIEDE2000 (ΔE00), translucency parameter (TP) and whiteness index (WID). The composition color analysis results were then applied to produce a color-graded temporary veneer for mimicking a natural look. RESULT: Mechanically, all composition result in adequate bending strength with maximum achievable strength of 111.64 MPa. At the same time, the composite color was affected by each constituent differently. The L* value, which indicates the color lightness of the composite, was considerably tuned by the TiO2 pigment, whereas Ba2SiO4 filler only triggered minor changes. Photoinitiator concentration significantly affected the yellowness, indicated by the increased b* value. Similar tendency also observed toward the calculated TP and WID as well. Based on these evaluations, color-graded temporary veneer successfully generated, matching the VITA A3, A2, and B1 shades gradation. However, the stability of the composite color decreased at high amounts of Ba2SiO4 and photoinitiator. SIGNIFICANCE: The study presents a composition guide for fabricating temporary patient-specific color-graded veneer. It provides insights on the effect of the constituent material on dental esthetics.

The effect of detox solution on color stability, roughness, and microhardness of monochromatic universal composite resins.

BACKGROUND: Currently, the advantages of monochromatic universal composite resin restorative materials have increased their use in dentistry. Accordingly, the optical, surface and mechanical properties of these materials have become more important. This study aimed to evaluate the effect of detox solution on discoloration, surface roughness (SR), and microhardness of different monochromatic universal composite resins (Omnichroma [O], Zenchroma [Z], Vittra [V], and Charisma Diamond One [CDO]). Another aim of this study was to evaluate the monomer conversion degree (DC) of the materials. METHODS: A total of 80 specimens were prepared to evaluate the materials (n = 10). After the initial measurements, the specimens were immersed in a red detox solution for 21 days. Statistical data analysis was performed using one-way ANOVA and Tukey's multiple comparisons. RESULTS: The ∆E values of Z were highest on the 21st day. There was an increase in the SR values of the materials immersed in the detox solution. On the 21st day, top surface microhardness of O was lower than the other materials. There was no statistically significant difference at DC values among material groups. CONCLUSIONS: The use of detox solutions for a commercially recommended period of 21 days is suggested. However, this usage period can cause discoloration in restorative materials. Furthermore, especially in the initial one-week period, detox solution may have a negative impact on the microhardness of the materials. In light of all these data, we recommend the cautious use of detox solutions to prevent adverse effects on restorative materials.

Esthetic rehabilitation of labial tooth defects caused by caries of the anterior teeth using a composite resin injection technique with veneer-shaped 3D printing indices.

PATIENTS: An 18-year-old woman sought treatment for caries of the anterior teeth after completing orthodontic treatment. Direct composite resin restoration was chosen because the patient preferred a minimally invasive and cost-effective treatment whenever possible. Based on diagnostic wax-up, veneer-shaped indices for composite resin injection were designed to replicate and restore tooth defects rapidly and accurately. The overall esthetic result was excellent after a 1-year of follow-up. DISCUSSION: Direct freehand composite resin restorations are clinically challenging. The recently proposed 3D printing index for the composite resin injection technique is helpful for direct restoration but is challenging to remove. The veneer-shaped indices avoid the formation of an undercut in the direction of removing the index, making them easy to remove after finishing the restorations. CONCLUSIONS: Using veneer-shaped indices for composite resin injection enables rapid esthetic rehabilitation of labial tooth defects caused by caries. This approach reduces chairside time and operational difficulty while allowing for easy index removal after completing the restorations.

Effect of Different Adhesive Resin and Composite Veneering Materials on Adhesion to Polyetheretherketone.

OBJECTIVE: To evaluate the effect of different adhesives and veneering resins on the shear bond strength (SBS) of polyetheretherketone (PEEK). METHODS: A total of 138 PEEK specimens were randomly divided into 6 groups according to adhesive material application: Control (C, no application), Adhese Universal (A) (Ivoclar Vivadent, Schaan, Liechtenstein), Gluma Bond Universal (G) (Heraeus Kulzer, South Bend, IN, USA), G-PremioBOND (P) (GC Corporation, Tokyo, Japan), Single Bond Universal (S) (3M, Saint Paul, MN, USA) and visio.link (V) (Bredent, Senden, Germany). Each adhesive group was divided into two subgroups according to the type of veneering material: Estenia direct composite (D) and Gradia Plus indirect composite (IN) (both GC Corporation). After the veneering process, the specimens were aged by thermal cycling. Kruskal-Wallis and Mann-Whitney U tests were used for SBS analysis (P < 0.05). RESULTS: The highest SBS results were obtained in the VIN group, followed by the VD, PD, GIN, AIN, AD, SIN, SD, PIN, GD, CIN and CD groups, respectively (P = 0.001). There were no significant differences in terms of the type of veneering composite when the same adhesive was applied (P > 0.05), except for Gluma Bond Universal (P = 0.009). All the adhesives tested showed clinically acceptable SBS results. CONCLUSION: Visio.link offered the highest adhesion to PEEK, whereas the tested universal adhesives may be used as an alternative to visio.link in clinical settings. It was determined that changing the veneer type has no statistical difference when the same adhesive material is used.

Evaluation of Shear Bond Strengths of 3D Printed Materials for Permanent Restorations with Different Surface Treatments.

The development of high-filled 3D printing resin necessitates a bonding protocol for dental indirect restorations to achieve optimal bond strength after cementation. This study evaluates shear bond strengths of high-filler 3D printed materials for permanent restorations with various surface treatments. Rodin Sculpture 1.0 (50% lithium disilicate fillers) and 2.0 Ceramic Nanohybrid (>60% zirconia and lithium disilicate fillers) were tested, with Aelite All-Purpose Body composite resin as control. Samples were prepared, post-cured, and sandblasted with alumina (25 µm). Surface roughness was analyzed using an optical profilometer. Two bonding protocols were compared. First, groups were treated with lithium disilicate silane (Porcelain Primer) or zirconia primer (Z-Prime Plus) or left untreated without a bonding agent. Beam-shaped resin cement (DuoLink Universal) specimens were bonded and stored in a 37 °C water bath. Second, additional sets of materials were coated with a bonding agent (All-Bond Universal), either followed by silane application or left untreated. These sets were then similarly stored alongside resin cement specimens. Shear bond tests were performed after 24 h. SEM images were taken after debonding. One-Way ANOVA and post hoc Duncan were performed for the statistical analysis. Rodin 1.0 exhibited increased adhesive failure with silane or zirconia primer coating, but significantly improved bond strengths with bonding agent application. Rodin 2.0 showed consistent bond strengths regardless of bonding agent application, but cohesive failure rates increased with bonding agent and filler coating. In all groups, except for Rodin 1.0 without bonding agent, silane coating increased cohesive failure rate. In conclusion, optimal shear bond strength for high-filler 3D printing materials can be achieved with silane coating and bonding agent application.