Comparing Shear Bond Strength Between Pink Opaquer and Other Tooth-Colored Restorative Materials on Demineralized Dentin Treated with Silver Diammine Fluoride.

Purpose: The purposes of this study were to evaluate the effect of silver diammine fluoride (SDF) on the shear bond strength (SBS) of pink opaquer (PO) compared to resin-modified glass ionomer (RMGI) and conventional composite (COMP) on demineralized dentin, and also to investigate the mode of failure (MOF). Methods: Sixty extracted third molars were prepared, demineralized for 14 days, and divided into four groups: (1) COMP; (2) SDF+PO; (3) SDF+RMGI; and (4) SDF+COMP (restoration size: two by two mm). SBS, MOF, modified adhesive remnant index (MARI), and remnant adhesive volume (RAV) were evaluated using an Instron® machine, light microscopy, 3D digital scanner ( 3Shape©), and GeoMagic Wrap© software. Results: There was no significant difference in SBS (MPa) among the COMP mean??standard deviation (2.5±1.59), SDF+COMP (2.28±1.05), SDF+PO (3.31±2.63), and SDF+RMGI groups (3.74±2.34). There was no significant difference in MOF and MARI among the four groups (P>0.05). There was no significant difference in RAV (mm3) among the COMP (0.5±0.33), SDF+COMP (0.39±0.44), SDF+PO (0.42±0.38), and SDF+RMGI groups (0.42±0.38; P>0.05). A significant correlation existed between MOF and RAV (R equals 0.721; P<0.001). MOF, MARI, and RAV did not show any correlations with SBS (P>0.05). Conclusions: Silver diammine fluoride does not affect shear bond strength between carious dentinal surface and tooth color restorative materials. The amount of material left on the interface is not related to the amount of shear force needed to break the restoration.

Investigation of mechanical properties, remineralization, antibacterial effect, and cellular toxicity of composite orthodontic adhesive combined with silver-containing nanostructured bioactive glass.

BACKGROUND: The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength. METHODS: nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA. RESULTS: The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX). CONCLUSION: Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength.

Salivary levels of eluents during Invisalign™ treatment with attachments: an in vivo investigation.

BACKGROUND: The aim of the present study was to investigate qualitatively and quantitatively the elution of substances from polyester-urethane (Invisalign™) aligners and resin composite attachments (Tetric EvoFlow) in vivo. METHODS: Patients (n = 11) treated with the aligners and attachments (16 per patient, without other composite restorations) for an average of 20 months, who were planned for attachment removed were enrolled in the study. Patients were instructed to rinse with 50 mL of distilled water upon entry and the rinsing solution was collected (before removal). Then, the attachments were removed with low-speed tungsten carbide burs for adhesive residue removal, a thorough water rinsing was performed immediately after the grinding process to discard grinding particle residues, and subsequently, after a second water-rinsing the solution was collected for analysis (after removal). The rinsing solutions were analyzed for targeted (LC-MS/MS: Bis-GMA, DCDMA, UDMA, BPA) and untargeted (LC-HRMS: screening of leached species and their degradation products) compounds. RESULTS: Targeted analysis revealed a significant reduction in BPA after attachment removal (4 times lower). Bis-GMA, DCDMA, UDMA were below the detection limit before removal but were all detectable after removal with Bis-GMA and UDMA at quantifiable levels. Untargeted analysis reviled the presence of mono-methacrylate transformation products of Bis-GMA (Bis-GMA-M1) and UDMA (UDMA-M1), UDMA without methacrylate moieties (UDMA-M2), and 4-(dimethylamino) benzoic acid (DMAB), the degradation product of the photo-initiator ethyl-4-(dimethylamino) benzoate (EDMAB), all after attachment removal. Several amino acids and endogenous metabolites were also found both before and after removal. CONCLUSIONS: Elevated levels of BPA were traced instantaneously in patients treated with Invisalign™ and flowable resin composite attachments for the testing period. BPA was reduced after attachment removal, but residual monomers and resin degradation products were found after removal. Alternative resin formulations and attachment materials may be utilized to reduce eluents.

Effect of Bonding Agents on the Shear Bond Strength of Tooth-colored Restorative Materials to Dentin: An In Vitro Study.

AIM: The aim of the study is to determine the difference in the shear bond strengths to dentin among dental composite (Filtek Z350®, 3M), compomer (Dyract Flow®, Dentsply) and Giomer (Beautifil®, Shofu) with 3MTM Single BondTM Universal Adhesive (SBU) (7th generation, self-etch, single solution adhesive) and AdperTM Single Bond 2 Adhesive (ASB) (5th generation, total-etch, two solution adhesive). MATERIALS AND METHODS: Sixty extracted human permanent teeth were collected, cleansed of debris, and placed in distilled water. The samples were segregated into two groups depicting the two bonding agents-AdperTM (ASB) and 3MTM Single Bond Universal (SBU) and sub-grouped into three groups depicting the three restorative materials (Composite, Giomer, and Compomer) used. Groups were respresented as follows: Group I-ASB + Composite; Group II-ASB + Giomer; Group III-ASB + Compomer; Group IV-SBU + Giomer; Group V-SBU + Compomer; Group VI-SBU + Composite. After applying the bonding agent as per the manufacturer's instructions, following which the restorative material was placed. A Universal Testing Machine (Instron 3366, UK) was employed to estimate the shear bond strength of the individual restorative material and shear bond strengths were calculated. RESULTS: Composite bonded with SBU (group VI) displayed the greatest shear strength (11.16 ± 4.22 MPa). Moreover, Giomers and flowable compomers displayed better bond strengths with ASB compared with their SBU-bonded counterparts. CONCLUSION: These results mark the importance of careful material selection in clinical practice and the bonding agent used to achieve optimal bond strength and enhance the clinical longevity and durability of dental restorations. CLINICAL SIGNIFICANCE: From a clinical perspective, to avoid a compressive or a shear failure, it would be preferrable to use a direct composite restorative material with SBU (Single bond universal adhesive, 7th generation) to achieve maximum bond strength. How to cite this article: Kuchibhotla N, Sathyamoorthy H, Balakrishnan S, et al. Effect of Bonding Agents on the Shear Bond Strength of Tooth-colored Restorative Materials to Dentin: An In Vitro Study. J Contemp Dent Pract 2024;25(3):245-249.

Color Stability of Bioactive Restorative Material vs Nanohybrid Resin Composite: An In Vitro Study.

AIM: This study aimed to assess the color stability of bioactive restorative materials vs nanohybrid resin composites after 3 months of immersion in three frequently consumed beverages. MATERIALS AND METHODS: Thirty disk-shaped specimens of Giomer dental restorative material (Shofu, Japan) and nanohybrid resin composite (Tokuyama, Japan) were performed using a Teflon mold. Super-Snap system (Shofu, Japan) was utilized to finish and polish the specimens to be preserved for 24 hours in distilled water at 37°C. The samples had been divided into three subgroups (Coffee, tea, Pepsi) (n = 5). The initially displayed color measurements of the samples were performed using a spectrophotometer (VITA Easyshade® V). After 7 days, 30 days, and 90 days, color measurements were repeated, and the E of each sample was estimated. E of each sample was calculated. RESULTS: The Giomer group showed statistically significant higher E values than the nanohybrid resin composite where the p-value was ≤0.0001. Tea subgroup showed the highest statistically significant E values in both groups where the p-value was ≤ 0.0001. The highest statistically significant color change was recorded at 3 months. CONCLUSION: The color of bioactive restorative material is less stable if compared with nanohybrid resin composite. CLINICAL SIGNIFICANCE: As tea and coffee are popular beverages, particularly in Middle Eastern nations, dentists must advise patients about the color change of resin restorations. Patients are advised to brush their teeth immediately after consuming these beverages. How to cite this article: Saber EH, Abielhassan MH, Abed YA, et al. Color Stability of Bioactive Restorative Material vs Nanohybrid Resin Composite: An In Vitro Study. J Contemp Dent Pract 2024;25(3):221-225.

Effect of attachment flash on clear aligner force delivery: an in vitro study.

BACKGROUND: The introduction of auxiliaries such as composite attachment has improved the force delivery of clear aligner (CA) therapy. However, the placement of the attachment may give rise to a flash, defined as excess resin around the attachment which may affect CA force delivery. This in vitro study aims to determine the differences in the force generated by the attachment in the presence or absence of flash in CA. MATERIALS AND METHODS: Tristar Trubalance aligner sheets were used to fabricate the CAs. Thirty-four resin models were 3D printed and 17 each, were bonded with ellipsoidal or rectangular attachments on maxillary right central incisors. Fuji Prescale pressure film was used to measure the force generated by the attachment of CA. The images of colour density produced on the films were processed using a calibrated pressure mapping system utilising image processing techniques and topographical force mapping to quantify the force. The force measurement process was repeated after the flash was removed from the attachment using tungsten-carbide bur on a slow-speed handpiece. RESULTS: The intraclass correlation coefficient showed excellent reliability (ICC = 0.96, 95% CI = 0.92-0.98). The average mean force exerted by ellipsoidal attachments with flash was 8.05 ± 0.16 N, while 8.11 ± 0.18 N was without flash. As for rectangular attachments, the average mean force with flash was 8.48 ± 0.27 N, while 8.53 ± 0.13 N was without flash. Paired t-test revealed no statistically significant difference in the mean force exerted by CA in the presence or absence of flash for both ellipsoidal (p = 0.07) and rectangular attachments (p = 0.41). Rectangular attachments generated statistically significantly (p < 0.001) higher mean force than ellipsoidal attachments for flash and without flash. CONCLUSION: Although rectangular attachment generated a significantly higher force than ellipsoidal attachment, the force generated by both attachments in the presence or absence of flash is similar (p > 0.05).

Does surface priming increase the bond strength of orthodontic brackets? An experimental study.

OBJECTIVE: To evaluate the effects of metal primer II (MP II) on the shear bond strength (SBS) of orthodontic brackets bonded to teeth and bis-acryl composite provisional material (Bis-Acryl). MATERIAL AND METHODS: Twenty extracted human premolars specimens and 20 premolar shaped Bis-Acryl specimens were obtained and randomly divided into two surface groups. The first group consisted of human premolars (T) bonded to brackets in the conventional way while in the second (T-MP) MP II was applied on the bracket base before bonding. Similarly, one group of provisional material (PM) was prepared according to conventional treatment and another with the application of MP-II metal bonder (PM-MP). In all cases Ortho-brackets (Victory Series, 3 M) were bonded employing Transbond XT resin cement. Then the brackets were debonded under shear and the results were statistically analyzed by two-way analysis of variance and Holm Sidak at α = .05. The debonded surfaces of all specimens were examined by light microscopy and the Adhesive Remnant Index (ARI) was recorded. RESULTS: The SBS results exhibited significant differences er (p < .001). For both the T and TM the application of MP-II increased the SBS compared to respective control groups (p < .001). The T-C group was found inferior compared to PM-C (p < .001) and the same is true for the comparison between T-MP and PM-MP (p < .001). ARI indexes demonstrated that the tooth groups were characterized by a predominantly adhesive failure at the resin-dentin interface. In contrast, the control group for provisional crowns (PM-C) showed a predominantly cohesive failure mode, which moved to predominantly adhesive after the application of MP II. CONCLUSION: The application of MP II enhances the SBS on both, human enamel and provisional crown materials.

Surface deterioration of resin composites and enamel after toothbrush simulation with new and used toothbrushes.

PURPOSE: To investigate the effect of toothbrushing with new and used toothbrushes on the surface of resin composites and dental enamel. METHODS: The extracted human incisors were selected after vestibular enamel surfaces (ES) were examined. Disc-shaped specimens of direct composite (DC) and indirect composite (IC) were fabricated. Computer-aided design-computer-aided manufacturing (CAD-CAM) composite blocks (CC) were sliced in 2 mm thickness (n= 8). The surface roughness, gloss, and color were measured. The measurements were performed before and after 3 months of toothbrushing simulation (TBS) for 2,500 circular cycles. The wear index was calculated by using the ImageJ program. The specimens were subjected to an additional 2,500 cycles and the same measurements were repeated. RESULTS: No significant increase in surface roughness values was observed in DC, IC, and CC groups after 3 and 6 months of TBS except in the ES group. The highest change in surface gloss was observed in the DC group. Although the wear index of toothbrushes increased over time, only the increase in the IC group was statistically significant (P= 0.033). CLINICAL SIGNIFICANCE: Changes in surface roughness, gloss, and discoloration of the dental enamel and restorations and wear of toothbrush bristles were increased over time.

Salivary, acidic and enzymatic degradation of resin composite subjected to different finishing and polishing systems.

PURPOSE: To evaluate the effect of different finishing and polishing systems on the surface roughness of a resin composite subjected to simulated saliva-, acid-, and enzyme-induced degradation. METHODS: 160 specimens (n= 40) were fabricated with Filtek Z350 XT nanofilled composite and analyzed for average surface roughness (Ra). The specimens were finished and polished using: AD - Al2O3-impreginated rubberized discs (medium, fine, and superfine grit, Sof-Lex); SD - silicon carbide and Al2O3-impregnated rubberized discs (coarse, medium and fine grit, Jiffy,); MB - 12- and 30-multiblade burs. The control group (CT) (n= 40) comprised specimens with a Mylar-strip-created surface. Specimens from each group were immersed in 1 mL of one of the degradation methods (n= 10): artificial saliva (ArS: pH 6.75), cariogenic challenge (CaC: pH 4.3), erosive challenge (ErC: 0.05M citric acid, pH 2.3) or enzymatic challenge (EzC: artificial saliva with 700 µg/mL of albumin, pH 6.75). The immersion period simulated a time frame of 180 days. Ra measurements were also performed at the post-polishing and post-degradation time points. The data were evaluated by three-way ANOVA for repeated measures and the Tukey tests. RESULTS: There was significant interaction between the finishing/polishing system and the degradation method (P= 0.001). AD presented the greatest smoothness, followed by SD. After degradation, CT, AD and SD groups became significantly rougher, but not the MB group, which presented no difference in roughness before or after degradation. CT and AD groups showed greater roughness in CaC, ErC and EzC than in ArS. The SD group showed no difference in roughness when the specimens were polished with CaC, EzC or ArS, but those treated with ErC had greater roughness. In the MB group, the lower roughness values were found after using CaC and EzC, while the higher values were found using ErC or ArS. CLINICAL SIGNIFICANCE: As far as degradation resistance of nanofilled composite to hydrolysis, bacterial and dietary acids and enzymatic reactions is concerned, restorations that had been finished and polished with Al2O3-impregnated discs had the smoothest surfaces.

Effect of low power Er:YAG laser irradiation of CAD-CAM resin-based composites on resin bonding.

PURPOSE: To investigate the effect of painless low-power Er:YAG laser irradiation of conventional and polymer-infiltrated ceramic network (PICN) type CAD-CAM resin-based composites (RBCs) on resin bonding. METHODS: An Er:YAG laser system, phosphoric acid etchant, universal adhesive, RBC, and two types of CAD-CAM RBC block were used. Microtensile bond strength, fracture mode, scanning electron microscopy (SEM) observations of bonding interfaces and CAD-CAM surfaces, and surface roughness of ground and pretreated surfaces were investigated. As pretreatment methods, low-power Er:YAG laser irradiation and air-abrasion with alumina particles were used. RESULTS: The effect of low-power Er:YAG laser irradiation of CAD-CAM RBCs on bonding to repair resin varied depending on the type of CAD-CAM RBCs. CLINICAL SIGNIFICANCE: The low-power Er:YAG laser irradiation of the conventional CAD-CAM RBCs was shown to be effective as a surface pretreatment for resin bonding, while the laser irradiation of PICN-type CAD-CAM RBCs was not effective.

Effect of light-, chemical-, and dual-cured universal adhesives on the internal adaptation of resin composites to pulpal and gingival internal walls.

PURPOSE: To compare the internal adaptation of restorative systems bonded to mid-coronal and gingival dentin using light-cured, chemical-cured, and dual-cured adhesives, both immediately and after aging. METHODS: 60 molars were selected and received occluso-mesial preparations with dentin gingival margins. Restorations were performed using different restorative systems with light-cured, chemical-cured, and dual-cured adhesives. Internal adaptation was assessed by examining the percentage of continuous margin (%CM) at the pulpal and gingival dentin under a scanning electron microscope at x200 magnification. Half of the teeth were stored in sterile water for 24 hours, while the other half underwent 10,000 thermal cycles. Micro-morphological analysis was conducted on representative samples at x1,000 magnification. RESULTS: The restorative system with light-cured adhesive exhibited significantly lower %CM values at the gingival dentin, particularly after aging. Aging had a negative impact on the %CM values of the pulpal and gingival dentin in restorative systems with light-cured and dual-cured adhesives. Regional dentin variations influenced the %CM values, especially after aging, regardless of the restorative system used. The tested restorative system with chemical-cured adhesive is preferable for achieving improved internal adaptation when bonding to both mid-coronal and gingival dentin, compared to the other tested systems. CLINICAL SIGNIFICANCE: The study highlights the variations in adhesive performance between different regional dentin areas using the tested restorative systems.

Reliability of the color measurement of resin composites using images obtained using a stereoscopic loupe.

This study assessed the reliability of a color measurement method using images obtained from a charge-coupled device (CCD) camera and a stereoscopic loupe. Disc-shaped specimens were created using the composite Filtek Z350 XT (shades DA1, DA2, DA3, and DA4) (n = 3). CIELAB color coordinates of the specimens were measured using the spectrophotometer SP60 over white and black backgrounds. Images of the same specimens were taken using a CCD camera attached to a stereoscopic loupe. The color of the image was measured (red-green-blue [RGB]) using an image processing software and converted to CIELAB coordinates. For each color coordinate, data from images were adjusted using linear regressions predicting those values from SP60. The whiteness index for dentistry (WID) and translucency parameter (TP00) of the specimens as well as the color differences (ΔE00) among pairwise shades were calculated. Data were analyzed via repeated-measures analysis of variance and Tukey's post hoc test (α = 0.05). Images obtained using the loupe tended to be darker and redder than the actual color. Data adjustment resulted in similar WID, ΔE00, and TP00 values to those observed for the spectrophotometer. Differences were observed only for the WID of shade DA3 and ΔE00 for comparing DA1 and DA3 over the black background. However, these differences were not clinically relevant. The use of adjusted data from images taken using a stereoscopic loupe is considered a feasible method for color measurement.

The effect of freezing on the fracture pattern of adhesive on debonding: an in-vitro study.

The purpose of this study was to quantitatively evaluate adhesive remnants on the enamel surface following bracket debonding using a freezing element. Thirty-six sound premolars were used in this study. In each case, a bracket was bonded onto each tooth with conventional light-cured composite resin and de-bonded after one week. Freezing of the underlying composite through the bracket was performed immediately before debonding with a portable cryosurgical system (-55 °C). Specimens were divided into three groups according to the duration of freezing: a control group without freezing was used as a reference and two interventional groups with different durations of freezing (15 or 40 s). Brackets were removed by using debonding pliers to squeeze the wings of the bracket in an occluso-gingival manner. Adhesive remnants on the tooth were then quantitatively evaluated by stereo-microscopy. Pearson's Chi-squared test was used to investigate the relationship between the proportion of remaining resin and the group of teeth. In the control group, 100% of the composite remained on the enamel surface of all specimens. Significantly less adhesive remnants were found in the intervention groups (p = 0.001 for the 15 s group and p = 0.043 for the 40 s group). There was no significant difference between the two interventions (p = 0.165) in terms of the proportion of remaining adhesive remnants. Freezing of the bracket and the underlying adhesive resin prior to bracket debonding may favorably alter the behavioral pattern of composite fracture, thus reducing the extent of adhesive remnants on the enamel. Increasing the freezing time from 15 to 40 s did not exert significant effects on adhesive remnants following debonding. Further research now needs to investigate the effect of freezing on the mechanical properties of the adhesive remnants and its in-vivo effect on pulp vitality over both short- and long-terms.

Comparative evaluation of probiotic solutions on surface roughness and microhardness of different restorative materials and enamel.

This research study aimed to investigate the impact of probiotic mouthwash and kefir on the surface characteristics, specifically surface roughness and microhardness, of different restorative materials, as well as permanent and deciduous tooth enamels. Thirty disc-shaped specimens were prepared from composite resin (G-ænial Posterior (GP)), polyacid-modified composite resin (compomer) (Dyract-XP (DXP)), and resin-modified glass ionomer cement (Ionoseal (IS)). Additionally, thirty specimens of enamel were obtained from permanent teeth (PT) and thirty from deciduous teeth (DT) by embedding buccal and lingual sections, acquired through vertical sectioning of 15 permanent and 15 deciduous human tooth crowns in the mesiodistal orientation within acrylic resin blocks. The specimens were then categorized into three distinct groups and immersed for 14 days in one of the following solutions: distilled water, kefir or probiotic mouthwash. The mean surface roughness values of all specimens were assessed using an atomic force microscope, while the mean surface microhardness was measured using a Vickers hardness measuring instrument. The results revealed a statistically significant difference in mean surface roughness among the various restorative materials (p < 0.001). Among the restorative materials, the IS material exhibited notably higher mean surface roughness values than other restorative materials and tooth enamel, while no significant differences were observed between the PT and DT groups. Importantly, the main effect of the solutions under investigation was not statistically significant (p = 0.208). No significant difference was found between the surface roughness values of specimens subjected to the different solutions. When evaluating the effects of materials and solutions on microhardness, the main effects of material and solution variables and the influence of material-solution interactions were statistically significant (p < 0.001). Taken together, these results indicate that consistent use of kefir or probiotic mouthwashes may impact the surface properties of various restorative materials and tooth enamel.

Effect of fiber-reinforced direct restorative materials on the fracture resistance of endodontically treated mandibular molars restored with a conservative endodontic cavity design.

OBJECTIVE: This study aimed to evaluate the fracture strength of teeth restored using fiber-reinforced direct restorative materials after endodontic treatment with a conservative mesio-occlusal access cavity design. MATERIALS AND METHODS: A total of 100 extracted intact mandibular first molars were selected and distributed into a positive control group where teeth left intact and the following four test groups comprised of teeth with conservative mesio-occlusal access cavities that had undergone root canal treatment (n = 20/group): access cavity without restoration (negative control), bulk-fill resin composite with horizontal glass fiber post reinforcement, fiber-reinforced composite with bulk-fill resin and bulk-fill resin composite. Following thermocycling (10,000 cycles), fracture resistance was measured using a universal testing machine. Statistical analyses (one-way analysis of variance and the Tamhane test) were performed, and statistical significance was set at p < 0.05. RESULTS: Groups with minimally invasive access cavities had lower fracture strength than intact teeth, regardless of the restoration material (p < 0.05). Fiber-reinforced composite groups demonstrated higher fracture strength than bulk-fill resin composite alone (p < 0.05). Fracture types varied among groups, with restorable fractures predominant in the fiber-reinforced composite groups. CONCLUSION: This study suggests that using fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, can effectively enhance the fracture strength of endodontically treated teeth with conservative access cavities. However, using only bulk-fill resin composite is not recommended based on the fracture strength results. CLINICAL SIGNIFICANCE: When teeth that undergo endodontic treatment are restored using a conservative access cavity design and fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, the fracture strength of the teeth can be effectively increased.

Paedodontic preformed crowns in primary teeth and relative degree of dental wear.

AIM: Prosthetic rehabilitation of deciduous teeth in paediatric age using pre-formed crowns has been considered one of the best methods of dental restoration since their introduction. Their main advantages are related to durability, longevity and a low rate of recurrent cavities. Since stainless steel crowns do not coincide with aesthetic needs of parents and patients, preformed paedodontic crowns made of zirconia and nano-hybrid composite was introduced. The aim of the study is to evaluate the degree of wear on the enamel and on themselves of the different paedodontic crowns. MATERIALS: Nine bovine teeth and nine paedodontic crowns for deciduous molars were selected for the study, three of which in zirconia, three in nano-hybrid composite and three in stainless steel. Wear test was carried out on the Rtech™ Instruments tribometer applying a force of 50 N. After that, both the bovine teeth and the paedodontic crowns were observed using a stereo microscope (Zeiss Stemi C-500) and a scanning electron microscope (SEM, Cambridge Stereoscan 440). The areas of wear were calculated with a software [ImageJ, version 1x, Wayne Rasband, Maryland, USA]. CONCLUSION: Pre-formed paediatric crowns in zirconia, nano-hybrid composite and stainless steel are a valid aid for the restoration of deciduous teeth and do not compromise the physiological wear characteristic of the phases of the dental exchange. The stainless steel crown is preferable for the restorations in the posterior sectors as its behaviour is the most similar to that of a natural tooth. Zirconia and nano-hybrid composite crowns showed an inversely proportional behaviour between their wear volume and that of the opposing tooth.

Effect of Printing Layer Thickness on Optical Properties and Surface Roughness of 3D-Printed Resins: An In Vitro Study.

PURPOSE: To investigate the impact of printing layer thickness on the optical properties and surface roughness of various 3D-printed resins manufactured by digital light processing (DLP) and indicated for provisional and definitive restorations. MATERIALS AND METHODS: A total of 240 specimens from four different 3D-printing resins-VarseoSmile Crown Plus (Bego; VS), Crowntec (Saremco Dental; CR), GC Temp PRINT (GC Dental; TG), and NextDent C&B MFH (NextDent; ND)-were divided into four groups (n = 60 per group). Each group was further divided into three subgroups (n = 20) according to printing layer thickness (25, 50, and 100 µm). All specimens were subjected to thermocycling with coffee before measurements were taken with a spectroradiometer to calculate color differences. The Kubelka-Munk (K-M) absorption (K) and scattering coefficients (S), translucency parameters (TP), and surface roughness (Ra) values were calculated for each printing layer thickness and compared with those of the 2M2 shade tab (target). The data were analyzed using Mann-Whitney U test, the variance accounted for (VAF) coefficient by Cauchy-Schwarz, and post hoc comparisons using Tukey test (α ≤ .05). RESULTS: S (79% ≤ VAF ≤ 100%) and K (40.45% ≤ VAF ≤ 100%) spectral distribution depended on the wavelength. A 25-µm layer thickness resulted in no significant differences from the 2M2 shade for S (P > .230) and K (P > .200). VS showed significantly different S (P = .004) and K (P = .003) values from those of the shade tab with 50-µm layering thickness, whereas other materials did not show significant differences from the 2M2 shade for S (P > .280) and K (P > .301). The 100-µm layer thickness specimens had significantly different S and K values compared to the 2M2 shade tab (P < .004). TP values of resins with 100-µm layer thickness were significantly lower than resins in 25- and 50-µm layer thicknesses (P < .001). The Ra values of resins increased significantly with 100-µm layer thickness (P ≤ .001). CONCLUSIONS: All tested materials, except for VS, showed color properties similar to the target shade when 25- and 50-µm printing layer thicknesses were used. The translucency of resins tended toward an inverse relationship with printing layer thickness. The surface roughness of resins increased significantly with 100-µm layer thickness. However, all resins with a printing thickness of 25 µm showed better color properties and surface roughness.

Comparison of the Flexural Strength of Three Different Aged and Nonaged 3D-Printed Permanent Crown Resins.

AIM: The aim of this study was to evaluate the flexural strength properties of three different aged and nonaged 3D-printed resins built by different 3D printing systems used in dental applications. MATERIALS AND METHODS: Bars (2 × 2 × 25 mm) were additively fabricated using a 3D printer and different dental crown resins (Saremco Crowntec, Senertek P-Crown V2, and Senertek P-Crown V3) per the manufacturers' recommendations. Each subgroup was divided into aged and nonaged subgroups (n = 10 bars per group). Thermocycling procedures (5° to 55°C; 5,000 cycles) were performed under favorable conditions for the aged subgroups from each material. Flexural strength (MPa) was measured in all samples using a universal test machine. RESULTS: When both aged and nonaged resins are compared, significant differences were found in flexural strength measurements (P < .001). The highest flexural strength was observed in the Saremco Crowntec group, while the lowest flexural strength was observed in the Senertek P Crown V2 group. The flexural strength measurements of Saremco Crowntec and Senertek P Crown V3 displayed no significant difference between their aged and nonaged groups (P > .05), while Senertek P Crown V2 (P = .039) showed significant differences between its aged and nonaged groups. CONCLUSIONS: Saremco Crowntec showed the highest flexural strength both in aged and nonaged groups, while Senertek P Crown V2 had the lowest strength. The artificial aging process decreased flexural strength values in all 3D-printed resin groups.

Manufacturing Accuracy, Intaglio Surface Adaptation, and Survival of Additively and Subtractively Manufactured Definitive Resin Crowns After Cyclic Loading: An In Vitro Study.

PURPOSE: To assess the manufacturing accuracy, intaglio surface adaptation, and survival of resin-based CAD/CAM definitive crowns created via additive manufacturing (AM) or subtractive manufacturing (SM). MATERIALS AND METHODS: A maxillary right first molar crown was digitally designed and manufactured using AM hybrid resin composite (VarseoSmile Crown Plus, Bego [AM-HRC]), AM glass filler-reinforced resin composite (Crowntec, Saremco Dental [AM-RC]), and SM polymer-infiltrated ceramic (Vita Enamic, VITA Zahnfabrik [SM-PICN]). Manufacturing accuracy (trueness and precision) was assessed by computing the root mean square (RMS) error (in µm; n = 15 per material). Intaglio surface adaptation was assessed by calculating the average gap distance (µm). Ten crowns from each group were cemented on fiberglass-reinforced epoxy resin dies and cyclically loaded to simulate 5 years of functional loading. One-way ANOVA, post hoc Bonferroni comparison tests, and Levene's test were used to analyze the data (α = .05). RESULTS: AM-RC had higher overall trueness than AM-HRC and SM-PICN (P ≤ .05), whereas the trueness of AM-RC on the external surface was similar to that of SM-PICN (P = .99) and higher than AM-HRC (P = .001). SM-PICN had lower precision than AM-RC and AM-HRC overall and at internal occlusal surfaces (P ≤ .05). Overall intaglio surface adaptation was similar between all groups (P = .531). However, for the axial intaglio surface, AM-RC and AM-HRC had higher adaptation than SM-PICN (P ≤ .05). All tested crowns survived the cyclic loading simulation of 5 years clinical use. CONCLUSIONS: AM-RC showed high manufacturing accuracy and adaptation. The tested resin-based CAD/CAM materials demonstrated clinically acceptable manufacturing accuracy and simulated medium-term durability, justifying the initiation of clinical investigations to determine their potential implementation in daily clinical practice.