New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial.

Background: The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim: This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods: A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results: The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008). Conclusion: All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance: Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements.Trial registration number RBR-9nqszr. How to cite this article: da Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.

Universal adhesives and dual-cured core buildup composite material: adhesive properties.

OBJECTIVE: Dual-cured buildup composites and simplified light-cured adhesive systems are mixed with a chemical activator to prevent the incompatibility between them. To evaluate microshear bond strength (µSBS) and nanoleakage (NL) of three universal adhesives used under buildup composites using different curing modes, at baseline and after 6-months (6m). METHODOLOGY: Dentin specimens of 55 molars were assigned to: Clearfil Universal Bond[CFU], Prime&Bond Elect[PBE] and One Coat 7 Universal[OCU]. All-Bond Universal[ABU] and Adper Scotchbond Multi-Purpose[SMP] were used as controls. CFU, PBE, and OCU were: light-cured [LC], dual-cured using a self-curing activator [DC], and self-cured, using a self-curing activator and waiting for 20 min [SC]. Upon the application of the adhesive, transparent matrices were filled with a dual-cured buildup composite and light cured, then tested in mSBS. For NL, the specimens were submersed in ammoniacal silver nitrate and sectioned to observe under the SEM. Three-way ANOVA and Tukey's test were applied (α=0.05). RESULTS: OCU/LC-PBE/LC resulted in higher mean µSBS than ABU/LC. For SMP/DC higher mean µSBS were obtained than for both CFU/DC and OCU/DC (baseline). No universal adhesive was significantly affected by curing mode or storage time. CFU, PBE, and OCU did not undergo significant changes in any curing mode (p>0.05). NL (baseline) PBE/LC resulted in higher %NL compared to ABU/LC. SMP/DC resulted in higher %NL than CFU/DC-OCU/DC. CFU/LC/DC resulted in lower %NL than CFU/SC. PBE/SC resulted in lower %NL than PBE/DC. OCU/LC/SC showed lower %NL than OCU/DC. OCU showed significant lower %NL than CFU and PBE. All CFU groups, as well as OCU/SC, resulted in increased %NL at 6m when compared with baseline. CONCLUSION: For universal adhesives used in etch-and-rinse mode, self-cured activator and different curing modes did not influence µSBS. However, some interactions were observed for NL, but this influence was material-specific.

Universal adhesives and dual-cured core buildup composite material: adhesive properties

Abstract Dual-cured buildup composites and simplified light-cured adhesive systems are mixed with a chemical activator to prevent the incompatibility between them. Objective: To evaluate microshear bond strength (μSBS) and nanoleakage (NL) of three universal adhesives used under buildup composites using different curing modes, at baseline and after 6-months (6m). Methodology: Dentin specimens of 55 molars were assigned to: Clearfil Universal Bond[CFU], Prime&Bond Elect[PBE] and One Coat 7 Universal[OCU]. All-Bond Universal[ABU] and Adper Scotchbond Multi-Purpose[SMP] were used as controls. CFU, PBE, and OCU were: light-cured [LC], dual-cured using a self-curing activator [DC], and self-cured, using a self-curing activator and waiting for 20 min [SC]. Upon the application of the adhesive, transparent matrices were filled with a dual-cured buildup composite and light cured, then tested in mSBS. For NL, the specimens were submersed in ammoniacal silver nitrate and sectioned to observe under the SEM. Three-way ANOVA and Tukey's test were applied (α=0.05). Results: OCU/LC-PBE/LC resulted in higher mean μSBS than ABU/LC. For SMP/DC higher mean μSBS were obtained than for both CFU/DC and OCU/DC (baseline). No universal adhesive was significantly affected by curing mode or storage time. CFU, PBE, and OCU did not undergo significant changes in any curing mode (p>0.05). NL (baseline) PBE/LC resulted in higher %NL compared to ABU/LC. SMP/DC resulted in higher %NL than CFU/DC-OCU/DC. CFU/LC/DC resulted in lower %NL than CFU/SC. PBE/SC resulted in lower %NL than PBE/DC. OCU/LC/SC showed lower %NL than OCU/DC. OCU showed significant lower %NL than CFU and PBE. All CFU groups, as well as OCU/SC, resulted in increased %NL at 6m when compared with baseline. Conclusion: For universal adhesives used in etch-and-rinse mode, self-cured activator and different curing modes did not influence μSBS. However, some interactions were observed for NL, but this influence was material-specific.

18-month clinical evaluation of a copper-containing universal adhesive in non-carious cervical lesions: A double-blind, randomized controlled trial.

OBJECTIVE: This study aimed to evaluate the addition of copper nanoparticles (CuNp) on the clinical performance of a universal adhesive system used as etch-and-rinse (ER) and self-etch (SE). METHODS: 216 restorations were randomly placed in 36 subjects according to the following groups: ERcu = etch-and-rinse with 0.1% CuNp; ERct = etch-and-rinse without CuNp; SEcu = self-etch with 0.1% CuNp; SEct = self-etch without CuNp. Resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline and 6, 12 and 18 months using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α = 0.05). RESULTS: The addition of CuNp did not increase the clinical performance (FDI / USPHS) of the universal adhesive tested after 18-month when applied in the ER mode (p > 0.05). The addition of CuNp in SE restorations increased the retention rate significantly and decreased the marginal discrepancies after 18 months (p < 0.05). CONCLUSION: The clinical performance of universal adhesive was significantly increased when applied in the SE mode with the addition of copper nanoparticles. CLINICAL RELEVANCE: This is the first study that demonstrates a slight improvement in the clinical performance of universal adhesive systems in non-carious cervical lesions when added CuNp in lower concentration.

Effect of self-curing activators and curing protocols on adhesive properties of universal adhesives bonded to dual-cured composites.

OBJECTIVES: To measure microshear bond strength (µSBS) and nanoleakage (NL) of self-etch universal adhesives under core buildup restorations using different curing protocols, at 24h and after 6-month water storage. METHODS: Middle dentin of 55 molars was divided into: Clearfil Universal Bond [CFU], Prime&Bond Elect [PBE], and One Coat 7 Universal [OCU]. All-Bond Universal [ABU] and Clearfil SE Bond [CSE] were used as control. CFU, PBE and OCU were: light-cured [LC], dual-cured [DC] and self-cured [SC]. Data were analyzed separately (two-way ANOVA), Tukey's test (α=0.05). RESULTS: µSBS: At 24h OCU/LC resulted in statistically higher µSBS than ABU. CSE/DC showed statistically higher µSBS than all DC adhesives. PBE/LC resulted in significant lower µSBS than the respective DC/SC modes (p<0.001). At 6-month, both CFU and PBE (LC/SC), resulted in a significant decrease in µSBS. µSBS for OCU/DC decreased significantly (p<0.001) compared to the respective LC/SC modes. NL: At 24h, ABU showed %NL similar to CBU/LC and OCU/LC (p>0.05). CSE/DC resulted in significantly higher %NL than OCU/DC but significantly lower than PBE/DC. CFU/LC/SC resulted in significantly lower %NL than CFU/DC. PBE/SC resulted in significant lower %NL than PBE/LC and PBE/DC. OCU/LC and OCU/DC resulted in significant lower %NL than OCU/SC (p<0.001). At 6-month ABU, CSE, CFU/LC and CFU/SC, resulted in a significant increase in %NL. SIGNIFICANCE: Self-cured activator and different curing protocols influenced µSBS and NL of self-etch universal adhesives, but this influence was material-dependent.

The role of copper nanoparticles in an etch-and-rinse adhesive on antimicrobial activity, mechanical properties and the durability of resin-dentine interfaces.

OBJECTIVES: To evaluate the effect of addition of copper nanoparticles at different concentrations into an etch-and-rinse adhesive (ER) on antimicrobial activity, Knoop microhardness (KHN), in vitro and in situ degree of conversion (DC), as well as the immediate (IM) and 2-year (2Y) resin-dentine bond strength (µTBS) and nanoleakage (NL). METHODS: Seven experimental ER adhesives were formulated according to the amount of copper nanoparticles incorporated into the adhesives (0 [control], 0.0075 to 1wt.%). We tested the antimicrobial activity of adhesives against Streptococcus mutans using agar diffusion assay after IM and 2Y. The Knoop microhardness and in vitro DC were tested after IM and 2Y. The adhesives were applied to flat occlusal dentine surfaces after acid etching. After resin build-ups, specimens were longitudinally sectioned to obtain beam-like resin-dentine specimens (0.8mm2), which were used for evaluation of µTBS and nanoleakage at the IM and 2Y periods. In situ DC was evaluated at the IM period in these beam-like specimens. Data were submitted to appropriate statistical analyses (α=0.05). RESULTS: The addition of copper nanoparticles provided antimicrobial activity to the adhesives only in the IM evaluation and slightly reduced the KHN, the in vitro and in situ DC (copper concentrations of 1wt.%). However, KHN increase for all concentrations after 2Y. After 2Y, no significant reductions of µTBS (0.06 to 1% wt.%) and increases of nanoleakage were observed for copper containing adhesives compared to the control group. CONCLUSION: Copper nanoparticles addition up to 0.5wt.% may provide antimicrobial properties to ER adhesives and prevent the degradation of the adhesive interface, without reducing the mechanical properties of the formulations.

Protocolo das possibilidades técnicas de aplicação dos sistemas adesivos universais: revisão de literatura com relato de caso / Clinical strategies using universal adhesive systems: literature review with case report

Este relato de caso demonstra a utilização clínica de um novo sistema adesivo universal, Xeno Universal (Dentsply DeTrey, Alemanha) descrevendo quatro formas possíveis de aplicação: autocondicionante, com ou sem condicionamento seletivo do esmalte, ou com condicionamento ácido total, seguido da aplicação do adesivo sobre dentina seca ou úmida. Os adesivos universais de uma maneira geral são de fácil aplicação e versáteis, uma vez que o mesmo produto pode ter várias formas de aplicação, reduzindo o tempo clínico e em muitas situações a sensibilidade técnica. No entanto, mais estudos laboratoriais e clínicos que comprovem a eficácia deste novo adesivo universal em particular são necessários, antes que seu uso seja bem indicado aos cirurgiões-dentistas.

This case report describes the clinical application of a new universal adhesive system, Xeno Universal (Dentsply DeTrey, Germany) describing four application modes: self-etching, with or without selective enamel etching, or total etching followed by adhesive application on dry or moist dentin. Universal adhesive systems usually are versatile and easy to use, facilitating the operator, since the same product has several technical possibilities, thus reducing the operating time and the technique sensitivity. However, long-term laboratory studies and more clinical reports and/or clinical trials are needed to prove the quality of this new universal adhesive system, before dentists can start using them in their dental offices.

Mechanical properties and modeling of drug release from chlorhexidine-containing etch-and-rinse adhesives.

OBJECTIVES: To evaluate the effects of chlorhexidine (CHX) addition in different concentrations into simplified etch-and-rinse adhesives on the ultimate tensile strength (UTS), water sorption (WS), solubility (SO) and the rate of CHX release over time. METHODS: We added CHX diacetate to Ambar [AM] (FGM) and XP Bond [XP] (Dentsply) in concentrations of 0, 0.01, 0.05, 0.1 and 0.2 wt%. For UTS (n=10 for each group), adhesive specimens were constructed in an hourglass shape metallic matrix with cross-sectional area of 0.8 mm(2). Half of specimens were tested after 24 h and the other half after 28 days of water storage in tension of 0.5 mm/min. For WS and SO (n=10 for each group), adhesive discs (5.8 mm×1.0 mm) were prepared into a mold. After desiccation, we weighed and stored the cured adhesive specimens in distilled water for evaluation of the WS, SO and the cumulative release of CHX over a 28-day period. For CHX release (n=10 for each group), spectrophotometric measurements of storage solution were performed to examine the release kinetics of CHX. We subjected data from each test to ANOVA and Tukey' test (α=0.05). RESULTS: XP Bond adhesive showed significantly more WS and SO and lower UTS than Ambar. In general, the addition of CHX did not alter WS, SO and UTS of the adhesives. XP showed a higher CHX release than AM (p<0.05) in all concentrations and the final amount of CHX release was directly proportional to the initial CHX concentration added to the adhesives. After 28 days of water storage, approximately 20% of CHX was released from XP and 8.0-12.0% from AM. CONCLUSIONS: Addition of CHX to commercial adhesive is a feasible method to provide a controlled release of CHX over time without jeopardizing WS, SO and UTS of the adhesives. SIGNIFICANCE: Manufacturers should consider adding CHX to commercial adhesives to provide a controlled release of CHX over time.