Flavonoids effects against bacteria associated to periodontal disease and dental caries: a scoping review.

This scoping review focused on exploring the efficacy of flavonoids against bacteria associated with dental caries and periodontal diseases. Inclusion criteria comprise studies investigating the antibacterial effects of flavonoids against bacteria linked to caries or periodontal diseases, both pure or diluted in vehicle forms. The search, conducted in August 2023, in databases including PubMed/MEDLINE, Scopus, Web of Science, Embase, LILACS, and Gray Literature. Out of the initial 1125 studies, 79 met the inclusion criteria, majority in vitro studies. Prominent flavonoids tested included epigallocatechin-gallate, apigenin, quercetin, and myricetin. Predominant findings consistently pointed to bacteriostatic, bactericidal, and antibiofilm activities. The study primarily investigated bacteria associated with dental caries, followed by periodontopathogens. A higher number of publications presented positive antibacterial results against Streptococcus mutans in comparison to Porphyromonas gingivalis. These encouraging findings underline the potential applicability of commercially available flavonoids in materials or therapies, underscoring the need for further exploration in this field.

Effect of experimental dentin etchants on dentin bond strength, metalloproteinase inhibition, and antibiofilm activity.

OBJECTIVE: this study evaluated dentin microtensile bond strength (µTBS) and failure modes (at 24 h and one year), bonding interface regarding hybridization, surface morphology regarding demineralization, in situ metalloproteinase (MMP) activity, and antibacterial effect of three dentin etchants compared to 35% phosphoric acid (PA). MATERIALS AND METHODS: The Adper Single Bond 2 adhesive (3 M Oral Care) was applied on moist dentin etched with PA (control) or on air-dried dentin etched with 3% aluminum nitrate + 2% oxalic acid (AN), 6.8% ferric oxalate + 10% citric acid (FO), or 10% citric acid (CA). The µTBS test used 40 human teeth (n = 10). Failure modes and surface morphology were analyzed by scanning electron microscopy (n = 3), while bonding interface morphology and MMP activity were evaluated by laser scanning confocal microscopy (n = 3). Antibacterial activity was evaluated against S. Mutans biofilm by means of viable cells count (CFU/mL). RESULTS: PA presented the highest bond strengths regardless of aging time. PA, AN, and CA showed stable bond strengths after one year of storage. Adhesive and mixed failures were predominant in all groups. Thin hybrid layers with short resin tags were observed for the experimental etchants. The AN-based etchant was able to inhibit MMP activity. All tested etchants presented antibacterial activity against S. Mutans biofilm. SIGNIFICANCE: This study suggests different dentin etchants capable of inhibiting MMP activity while also acting as cavity disinfectants.

Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research.

Objectives: This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells. Materials and Methods: Electronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed. Results: Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies. Conclusions: Few in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings. Trial Registration: PROSPERO Identifier: CRD42022337192.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness.

This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Microtensile bond strength of resin cements to 3-D printed and milled temporary restorative resins / Resistencia de unión en microtracción de cementos resinosos a resinas para provisionales impresas y fresadas

Abstract To evaluate the microtensile bond strength (µTBS) of two resin cements to 3D printed and milled CAD/CAM resins used for provisional fixed partial dentures. Blocks (5 x 5 x 5 mm) of three 3D-printed resins (Cosmos3DTemp / Yller; Resilab3D Temp / Wilcos and SmartPrint BioTemp, / MMTech) were printed (Photon, Anycubic Technology Co.). A milled material (VitaCAD-Temp, VITA) was used as control. Half the specimens were sandblasted and the rest were untreated. Two blocks were bonded with the corresponding resin cement: PanaviaV5 (Kuraray Noritake) and RelyX Ultimate (3M Oral Care). After 24 hours, the bonded blocks were sectioned into 1 x 1 mm side sticks. Half the beams were tested for µTBS and the other half was thermocycled (5000 cycles, 30s dwell-time, 5s transfer time) before µTBS testing. A four way Generalized Linear Model (material*sandblasting*cement*aging) analysis was applied. VITA exhibited the lowest µTBS, regardless of the cement, sandblasting and thermocycling. Sandblasting significantly improved the µTBS of VIT, especially after aging, but did not improve the µTBS of 3D printed resins. Sandblasting was not beneficial for 3D printed resins, although is crucial for adhesive cementation of milled temporary resins. Airborne particle abrasion affects the integrity of 3D-printed resins, without producing a benefit on the microtensile bond strength of these materials. However, sandblasting is crucial to achieve a high bond strength on milled temporary resins.

Resumen Evaluar la resistencia adhesiva en microtracción (µTBS) de dos cementos resinosos a resinas CAD/CAM impresas y fresadas indicadas para restauraciones provisionales. Bloques (5 x 5 x 5mm) de tres resinas impresas (Cosmos3DTemp / Yller; Resilab3D Temp / Wilcos and SmartPrint BioTemp, / MMTech) y una resina fresada (VitaCAD-Temp, VITA) fueron fabricados. La mitad de los especímenes fueron arenados y el resto no recibió tratamiento mecánico. Dos bloques con condiciones de tratamiento iguales fueron cementados con cemento resinoso (PanaviaV5 / Kuraray Noritake y RelyX Ultimate / 3M Oral Care). Después de 24 horas los bloques fueron seccionados en palitos de 1 mm² de área. En la mitad de los especímenes se midió la TBS inmediatamente y el resto fue termociclado (5000 ciclos, 30s remojo, 5s transferencia) antes de la prueba de TBS. Se aplica un análisis estadístico por Modelo Linear General con 4 factores (material*arenado*cemento*termociclado). La resina VITA presentó la menor µTBS, independientemente del cemento usado, el arenado y el termociclado. Sin embargo, el arenado aumentó la µTBS de VIT, especialmente después del termociclado. Por otro lado, el arenado no resultó en un aumento significativo de la µTBS de las resinas impresas. El arenado no fue beneficiosos para las resinas impresas, aunque es un paso crucial para la cementación adhesive de las resinas fresadas. El arenado afecta la integridad de las capas de las resinas impresas, sin generar un beneficio en la TBS.

Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface.

This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials. MATERIALS AND METHODS: Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05). RESULTS: REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic. CONCLUSION: In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

Resistance of glaze application on indirect restorative CAD/CAM materials against abrasive toothbrushing wear.

PURPOSE: The aim of this study was to evaluate the effect of toothbrushing on the surface roughness (Sa), roughness profile (Rv), gloss units (GU) and surface morphology of three glazed ceramics. MATERIALS AND METHODS: Specimens (n=7) from different CAD/CAM materials 1- Lithium disilicate-based glass ceramic (IPS e.max CAD); 2- Zirconia-reinforced lithium silicate glass ceramic (Celtra Duo) and 3- 6 mol% yttria partially-stabilized zirconia (InCoris) were evaluated. IPS e.max CAD and InCoris specimens were sintered and all the groups were pre-polished and glazed according to the manufacturer's recommendations: IPS Ivocolor Glaze Paste (Ivoclar Vivadent) or Universal Overglaze High Flu (Dentsply/Sirona). Sa, Rv, GU and morphology were analyzed before and after brushing at 30.000, 120.000 and 180.000 cycles. The data of Sa and GU were analyzed by ANOVA two-way and post-hoc Tukey's test (α=0.05). Rv was analyzed by Kruskal-Wallis and Student-Newman-Keuls. The surface morphology was analyzed qualitatively. RESULTS: The Sa decreased significantly after 180.000 toothbrushing cycles for all materials tested. CE showed higher Rv than EM and IN, and IN showed the highest GU after 180.000 toothbrushing cycles, which promoted a polishing effect for all materials. CONCLUSION: Long-term toothbrushing was not able to jeopardize the glazed-surface of all tested materials compared to unbrushed.

Toothbrushing effects on the surface roughness and cement volume loss of bonded enamel-ceramic interface

Abstract This study evaluated the effect of toothbrushing on enamel-cementing material-ceramic bonded interfaces, using different cementing materials. Materials and Methods: Thirty enamel and thirty ceramic blocks were bonded with cementing materials to produce the samples that were bonded with three types of cementing materials: 1- RelyX Ultimate resin cement (REXU), 2- RelyX Unicem 2 self-adhesive resin cement (REU2) and 3- heated Z100 restorative composite (60°C). Bonded interfaces of the samples were toothbrushed and the surfaces of the 3 cementing materials were evaluated for roughness (RG, in µm), roughness profile (RP, in µm), and volume loss (VL, in µm3) (baseline and after 20,000 and 60,000 toothbrushing cycles). Data were evaluated by Generalized Linear Analysis (two factors: "material" and "toothbrushing cycle") and Bonferroni test (α=0.05). Results: REXU and Z100 exhibited lower RG than that presented by REU2, except after 60,000 toothbrushing cycles when only Z100 differed from REU2. The increase in toothbrushing cycles increased the RG and RP for all materials. REU2 also showed higher RP than those showed by REXU and Z100 when it was analyzed regarding the enamel. The VL of Z100 was the lowest with 20,000 toothbrushing cycles, regarding the enamel and ceramic. For 60,000 cycles, REXU showed the lowest VL regarding the ceramic, and REU2 had the highest VL regarding the enamel and ceramic. Conclusion: In general, REXU and Z100 showed the best results regarding the evaluations performed and the REU2 exhibited the highest RG, RP, and VL.

Resumo Este estudo avaliou o efeito da escovação nas interfaces de união esmalte-material cimentante-cerâmica, utilizando diferentes materiais cimentantes. Materiais e Métodos: Trinta esmaltes e trinta blocos cerâmicos foram unidos com materiais de cimentação para produzir as amostras que foram unidas com três tipos de materiais de cimentação: 1- cimento resinoso RelyX Ultimate (REXU), 2- cimento resinoso autoadesivo RelyX Unicem 2 (REU2) e 3-compósito restaurador aquecido Z100 (60°C). As interfaces coladas das amostras foram escovadas e as superfícies dos 3 materiais cimentantes foram avaliadas quanto à rugosidade (RG, em µm), perfil de rugosidade (RP, em µm) e perda de volume (VL, em µm3) (baseline e após 20.000 e 60.000 ciclos de escovação). Os dados foram avaliados por Análise Linear Generalizada (dois fatores: "material" e "ciclo de escovação") e teste de Bonferroni (α=0,05). Resultados: REXU e Z100 apresentaram menor RG do que REU2, exceto após 60.000 ciclos de escovação, quando Z100 diferiu apenas de REU2. O aumento dos ciclos de escovação aumentou o RG e RP para todos os materiais. O REU2 também apresentou PR maior que o REXU e Z100, quando analisado em relação ao esmalte. O VL de Z100 foi o menor com 20.000 ciclos de escovação em relação ao esmalte e cerâmica. Para 60.000 ciclos, o REXU apresentou o menor VL em relação à cerâmica e o REU2 o maior VL em relação ao esmalte e à cerâmica. Conclusão: De maneira geral, REXU e Z100 apresentaram os melhores resultados nas avaliações realizadas e o REU2 apresentou os maiores RG, RP e VL..

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness

Abstract This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Development and Physicochemical Characterization of Eugenia brejoensis Essential Oil-Doped Dental Adhesives with Antimicrobial Action towards Streptococcus mutans.

Dental caries is a multifactorial, biofilm-dependent infectious disease that develops when detrimental changes occur in the oral cavity microenvironment. The antimicrobial and antivirulence properties of the essential oil obtained from the leaves of Eugenia brejoensis Mazine (EBEO) have been reported against Gram-positive and Gram-negative bacteria. Herein, the antimicrobial action of EBEO towards Streptococcus mutans is reported, along with the development and characterization of dental adhesives doped with. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of EBEO were determined against S. mutans, while its toxicity was analyze using Tenebrio molitor larvae. EBEO (MIC and 10×MIC) was incorporated into the Ambar Advanced Polymerization System® (Ambar APS), a two-step total-etch adhesive system (FGM Dental Group), and the antibiofilm action was evaluated. The reflective strength, modulus of elasticity, degree of conversion, and maximum rate of polymerization of each adhesive were also determined. The MIC and MBC values of EBEO against S. mutans were 62.5 µg/mL. The tested concentrations of EBEO were non-toxic to T. molitor larvae. The formation of S. mutans biofilms was significantly inhibited by EBEO and EBEO-coated resin discs (p < 0.05). Importantly, EBEO incorporation did not affect the mechanical and physicochemical properties in relation to oil-free adhesive version. EBEO showed strong antibacterial and antibiofilm activity against S. mutans, no toxicity effect against T. molitor larvae, and did not jeopardize the physical-chemical properties tested.

Bonding interface and dentin enzymatic activity of two universal adhesives applied following different etching approaches.

OBJECTIVES: Etching approaches [37% phosphoric acid, self-etching, 10-3 solution (3% ferric chloride dissolved in 10% citric acid), or 1.4% nitric acid] were evaluated regarding enamel shear bond strength (24 h), dentin microtensile bond strength (24 h and 2 years), failure mode, enzymatic activity of the hybrid layer, and nanoleakage (24 h and 2 years) of Prime&Bond Universal (PBU, Dentsply-Sirona) and Gluma Bond Universal (GBU, Kulzer). METHODS: Adhesives were applied on blot-dried (wet-bonding, positive control) or air-dried (remaining groups) dentin after acid-etching (15 s) or in self-etch mode. Enamel and dentin bond strength tests used 160 human teeth (n = 10). Failure mode of tested samples and nanoleakage within the dentin-adhesive interface (n = 5) were analyzed by scanning electron microscopy. Dentin enzymatic activity was investigated by in situ zymography (n = 3). RESULTS: Enamel bond strengths did not differ statistically among groups. Wet-bonding with 37% phosphoric acid showed similar dentin bond strength compared to 10-3 solution or 1.4% nitric acid at 24 h for both adhesives. None of the etchants inhibited enzymatic activity, and all groups showed dentin bond strength reduction after 2-year storage. GBU showed higher nanoleakage. Experimental etchants did not affect enamel bond strength. Dentin bond strength was not stable after 2 years, despite promising 24-hour results. SIGNIFICANCE: This study suggests multiple etching approaches to optimize and achieve stable dentin bonding, while also offering in-depth information about the performance of recently released universal adhesive systems.

The influence of the renewal or the single application of the peroxide gel on the efficacy and tooth sensitivity outcomes of in-office bleaching-A systematic review and meta-analysis.

OBJECTIVE: To answer the question: "Does the peroxide gel application regimen (single application vs. renewal) influence the efficacy and the tooth sensitivity outcomes of in-office tooth bleaching?" METHODS: The search was done in Pubmed, Cochrane, LILACS, Scopus, Web of Science, and EMBASE in February 2021 (updated in July 2021). Randomized clinical trials (RCT) comparing the single application vs. the renewal protocols of HP were included. The meta-analyses were performed for the objective (ΔEab ), subjective (ΔSGU) color changes, and absolute risk of tooth sensitivity (TS). Heterogeneity was evaluated using Q test (I2 ). Cochrane Collaboration tool assessed the risk of bias (RoB). The GRADE evaluated the certainty of evidence. RESULTS: Five RCT studies remained. Two studies showed high RoB, and three presented some concerns. No significant differences were observed between the protocols in terms of the ΔEab , ΔSGU, and TS. ΔEab exhibited substantial heterogeneity (I2  = 87%), while ΔSGU (I2  = 60%) and the TS (I2  = 62%) presented a moderate one. The certainty of evidence was considered low or very low, depending on the variable response and the evaluation time. CONCLUSION: The application regimen (single vs. renewal of HP) did not impact color change or the absolute risk of TS. CLINICAL SIGNIFICANCE: The renewal of bleaching gel during the in-office appointment may not be necessary. However, there is at least a low certainty of evidence. Because of this, further randomized clinical trials with appropriate methodology on this topic are encouraged.

Análise da aplicação ativa de sistemas adesivos na resistência de união à dentina e ao esmalte: uma revisão sistemática e meta-análise de estudos in vitro / Effect of active application of dental adhesives on dentin and enamel bond strength: a systematic review and meta-analysis of in vitro studies

A forma de aplicação do sistema adesivo pode interferir na resistência de união imediata e a longo prazo dos diferentes sistemas adesivos. Portanto, o objetivo deste estudo foi de revisar sistematicamente a literatura identificando trabalhos in vitro que avaliaram a resistência de união de sistemas adesivos, independente da sua classificação, aplicados de forma ativa comparado a aplicação de forma passiva, tanto para esmalte quanto para dentina. A busca foi realizada nas plataformas Pubmed/Medline, Embase, Scopus, Web of Science, Lilacs e literatura cinzenta, em abril de 2022. Estudos in vitro que avaliaram a resistência de união de sistemas adesivos aplicados de forma ativa comparado com a forma passiva foram incluídos neste estudo. As meta-análises foram separadas por substrato (esmalte e dentina) e por modo de aplicação (modo convencional ou modo autocondicionante), utilizado um intervalo de confiança de 95%, um modelo de efeito randômico, e a heterogeneidade determinada pelo índice I2. O risco de viés foi acessado por uma versão modificada de "Joanna Briggs Institute". Dos 3022 artigos encontrados, foram incluídos 22 artigos após a remoção das duplicatas, seleção por título e leitura completa dos artigos selecionados. A meta-análise da aplicação de adesivos universais em esmalte após condicionamento ácido (aplicado no modo convencional) demonstrou que a aplicação passiva favorece os resultados de resistência de união. Já para os adesivos convencionais ou universais aplicados no modo convencional, quando aplicados de forma ativa na dentina favorecem os resultados de resistência de união. Para os adesivos autocondicionantes ou universais aplicados no modo autocondicionante, a aplicação ativa, tanto em esmalte quanto em dentina, favorece os resultados de resistência de união. Poucos estudos avaliaram a longevidade, mas os que avaliaram também observaram respostas favoráveis à aplicação ativa do adesivo. Apenas um adesivo universal autopolimerizável apresentou resultados expressivamente divergente. Uma substancial (I2 = 65%) e considerável (I2 = 87%) heterigeinidade fora obtidas nas meta-análises dos adesivos aplicados no modo autocondicionante, respectivamente, em esmalte e em dentina. A aplicação ativa dos sistemas adesivos fotopolimerizáveis no modo convencional favorece a resistência de união à dentina, e no modo autocondicionante favorece a resistência de união ao esmalte não condicionado e à dentina.

The way the adhesive system is applied can interfere with the immediate and long- term bond strength of different dental adhesives. Therefore, the aim of this study was to systematically review the literature, identifying in vitro studies that evaluated the bond strength of adhesives, regardless of their classification, applied actively compared to the passive application, in enamel and dentin. The search was done in Pubmed/Medline, Embase, Scopus, Web of Science, Lilacs, and Gray platforms in April 2022. In vitro studies that evaluated the bond strength of adhesive systems applied actively compared to the passive form were included in this study. Meta- analyses were separated by substrate (enamel and dentin) and application mode (conventional or self-etching), using a 95% confidence interval, a random effect model, and heterogeneity determined by the I2 index. The risk of bias was assessed by a modified version of the "Joanna Briggs Institute". From the 3022 articles found, 22 articles were included after removing the duplicates, selecting by title, and fully reading the selected articles. Meta-analysis of the application of universal adhesives to enamel after acid etching (applied in the etch-and-rinse mode) demonstrated that passive application favors bond strength results. For conventional or universal adhesives applied in etch-and-rinse mode, when actively applied to dentin, they favor bond strength results. For self-etching or universal adhesives applied in self-etching mode, active application, both on enamel and dentin, favors bond strength results. Few studies have evaluated longevity, but those that have evaluated have also observed favorable responses to active application of the adhesives. Only one self-curing universal adhesive showed significantly divergent results. Substantial (I2 = 65%) and considerable (I2 = 87%) heterogeneity were obtained for the meta-analyses of adhesives applied in the self-etching mode, respectively, to enamel and dentin. The active application of light-curing adhesive systems in etch-and-rinse mode favors bond strength to dentin, and in self-etching mode it favors bond strength to unconditioned enamel and dentin.

Microhardness homogeneity of RBCs light-cured with a multiple-peak LED and surface characterization after wear.

This in vitro study evaluated the effect of the beam homogeneity of a multiple-peak light-curing unit on the surface microhardness and the effect of toothbrushing wear on the microhardness, surface roughness, roughness profile, volume loss, and gloss retention of incremental and bulk-fill resin-based composites (RBCs). A LED light-curing unit (VALO) with four LEDs at the tip end (405, 445, 465A, and 465B nm emission peak) was used according to each manufacturer-recommended time to obtain disks (n=10) of six RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra, and Filtek Bulk Fill. Microhardness values were obtained according to each LED positioning of the light-curing unit on the top surface of the RBCs and were analyzed before and after toothbrushing regarding microhardness, surface roughness, roughness profile, volume loss, and gloss retention. Microhardness was considered homogeneous on the top surface regardless of the type of RBC or wavelength tested (p>0.05). Overall, toothbrushing did not reduce the microhardness of the RBCs but influenced the gloss values for most RBCs (p<0.001). Charisma Classic presented the greatest surface roughness and roughness profile after toothbrushing (p<0.05). Volume loss did not differ among RBCs (p>0.05). In conclusion, different wavelengths of the LED did not affect the top surface microhardness, regardless of the RBCs tested; and bulk-fill composites presented similar surface changes (microhardness, surface roughness, roughness profile, volume loss, and gloss retention) when compared to conventional composites after toothbrushing.

Microhardness homogeneity of RBCs light-cured with a multiple-peak LED and surface characterization after wear

Abstract This in vitro study evaluated the effect of the beam homogeneity of a multiple-peak light-curing unit on the surface microhardness and the effect of toothbrushing wear on the microhardness, surface roughness, roughness profile, volume loss, and gloss retention of incremental and bulk-fill resin-based composites (RBCs). A LED light-curing unit (VALO) with four LEDs at the tip end (405, 445, 465A, and 465B nm emission peak) was used according to each manufacturer-recommended time to obtain disks (n=10) of six RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra, and Filtek Bulk Fill. Microhardness values were obtained according to each LED positioning of the light-curing unit on the top surface of the RBCs and were analyzed before and after toothbrushing regarding microhardness, surface roughness, roughness profile, volume loss, and gloss retention. Microhardness was considered homogeneous on the top surface regardless of the type of RBC or wavelength tested (p>0.05). Overall, toothbrushing did not reduce the microhardness of the RBCs but influenced the gloss values for most RBCs (p<0.001). Charisma Classic presented the greatest surface roughness and roughness profile after toothbrushing (p<0.05). Volume loss did not differ among RBCs (p>0.05). In conclusion, different wavelengths of the LED did not affect the top surface microhardness, regardless of the RBCs tested; and bulk-fill composites presented similar surface changes (microhardness, surface roughness, roughness profile, volume loss, and gloss retention) when compared to conventional composites after toothbrushing.

Resumo Este estudo in vitro avaliou a homogeneidade do feixe de um fotopolimerizador de múltiplos picos na microdureza superficial e o efeito da escovação na microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e retenção do brilho de compósitos a base de resina (RBCs) incrementais ou bulk-fill. Um fotopolimerizador LED (VALO) com quatro LEDs na ponteira (405, 445, 465A e 465B nm de pico de emissão) foi usado de acordo com o tempo recomendado por cada fabricante para obtenção de discos (n=10) de seis RBCs: Estelite Sigma Quick, Charisma Classic, Tetric EvoCeram Bulk Fill, Filtek Z250, Filtek Supreme Ultra e Filtek Bulk Fill. Os valores de microdureza foram obtidos seguindo o posicionamento de cada LED na superfície superior das amostras e foram analisados antes e após a escovação quanto a microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e retenção do brilho. A microdureza foi considerada homogênea no topo da superfície, independentemente do tipo de RBCs ou comprimento de onda testados (p>0.05). No geral, a escovação não reduziu a microdureza das RBCs, mas influenciou o brilho para a maioria das RBCs (p<0.001). Charisma Classic apresentou os maiores valores de rugosidade superficial e perfil de rugosidade após a escovação (p<0.05). A perda de volume não diferiu entre as RBCs (p>0.05). Em conclusão, os diferentes comprimentos de onda do LED não alteraram a microdureza do topo da superfície, independentemente das RBCs testadas; e as resinas bulk-fill apresentaram alterações superficiais similares (microdureza, rugosidade superficial, perfil de rugosidade, perda de volume e manutenção do brilho) quando comparadas às resinas convencionais após a escovação.

Incorporation of Apigenin and tt-Farnesol into dental composites to modulate the Streptococcus mutans virulence.

OBJECTIVES: The aim of this in vitro study was to incorporate two anti-caries agents, Apigenin and tt-Farnesol, to resin composite and resin cement to reduce the virulence of Streptococcus mutans around dental restorations. METHODS: Apigenin (Api, 5 mM) and tt-Farnesol (Far, 5 mM) were added alone, together, and combined with fluoride (F). Biofilm of S. mutans was grown on composite discs, and the dry-weight, bacterial viability, and the polysaccharides (alkali-soluble, intracellular and water-soluble) were quantified. CLSM images of the S. mutans biofilm were obtained after three years of water-storage. The effect of the additions on the physicochemical properties and the composite colorimetric parameters were also analyzed. RESULTS: The additions did not affect bacterial viability. Api alone and combined with Far or combined with Far and F decreased the bacterial dry-weight, alkali-soluble and intracellular polysaccharides. After three years, the composites containing the additions presented a greater EPS matrix on the top of biofilm. Statistical difference was obtained for the degree of conversion; however, the maximum polymerization rate and curing kinetics were unaffected by the additions. No difference was observed for the water-soluble polysaccharides, flexural strength, and elastic modulus. Api increased the yellowness of the composites. SIGNIFICANCE: Api, alone and combined, reduced the expression of virulence of S. mutans without jeopardizing the physicochemical properties of the composites.

Physicochemical properties, metalloproteinases inhibition, and antibiofilm activity of doxycycline-doped dental adhesive.

OBJECTIVES: To evaluate the incorporation of doxycycline (DOX) into a commercial dental adhesive regarding physicochemical properties, microtensile bond strength (µTBS), nanoleakage (NL), nanohardness (NH) and Young's modulus (YM), metalloproteinases (MMP) inhibition, and antibiofilm activity. METHODS: DOX was incorporated into the adhesive at 0.05, 0.1, 0.5, and 1 wt%. Restored teeth were evaluated for µTBS, NL, NH, and YM after 24 -hs and 1-year of water storage. Biofilms of Streptococcus mutans were grown on top of these adhesives and determined for bacterial viability and amount of biomass. The inhibitory effect on MMP was analyzed by in situ zymography under confocal microscopy. RESULTS: Adhesives with 0.5 and 1 wt% of DOX presented reduced pH and degree of conversion. The incorporation of DOX did not affect µTBS and hybrid layer YM. The control group (no DOX) had a decrease in µTBS and the densest silver nitrate areas after 1-year storage. Hybrid layer NH values increased with 0.1 wt% DOX compared to control and 1 wt% DOX groups, at 24 -hs. After 1-year storage, NH of 1 wt% DOX adhesive decreased compared to the control group. The 0.5 and 1 wt% concentrations of DOX decreased the bacterial viability and the biofilm biomass. Confocal images suggest an increased MMP inhibition proportional to the percentage of DOX. CONCLUSION: At any concentration, DOX-doped dental adhesives were able to inhibit MMP activity, diminish nanoleakage, and maintain the resin-dentin bond-strength after 1 year of artificial aging. CLINICAL SIGNIFICANCE: Doxycycline-doped dental adhesive inhibited metalloproteinases activity and preserved interface bond strength. This formulation has a potential to improve adhesive restorations clinical longevity.

Effect of zirconia decontamination protocols on bond strength and surface wettability.

OBJECTIVE: To evaluate the effects of human saliva decontamination protocols on bond strength of resin cement to zirconia (Y-PSZ), wettability, and microbial decontamination. MATERIALS AND METHODS: Zirconia plates were sandblasted and divided into (a) not contaminated, (b) contaminated with human saliva and: (c) not cleaned, (d) cleaned with air-water spray, (e) cleaned with 70% ethanol, (f) cleaned with Ivoclean, or (g) cleaned with nonthermal atmospheric plasma (NTAP). The wettability and microbial decontamination of the surfaces were determined after saliva contamination or cleaning. Monobond Plus (Ivoclar Vivadent) was applied after cleaning, followed by Variolink LC (Ivoclar Vivadent). The samples were stored 1 week before shear bond strength (SBS) testing, and data (SBS and wettability) were analyzed by one-way analysis of variance and Tukey test (α = .05). RESULTS: Saliva contamination reduced SBS to zirconia compared to not contaminated. Both Ivoclean and NTAP produced higher SBS compared to not cleaned and were not significantly different from the not contaminated. Ivoclean produced the highest contact angle, and NTAP the lowest. With the exception of using just water-spray, all cleaning protocols decontaminated the specimens. CONCLUSIONS: Both Ivoclean and NTAP overcame the effects of saliva contamination, producing an SBS to zirconia comparable to the positive control. CLINICAL SIGNIFICANCE: Dental ceramics should be cleaned prior to resin cementation to eliminate the effects of human saliva contamination, and Ivoclean and NTAP are considered suitable materials for this purpose.

Flowable and Regular Bulk-Fill Composites: A Comprehensive Report on Restorative Treatment.

This article reports a comprehensive restorative treatment using bulk-fill composites and discusses their properties and clinical performance. A 20-year-old man sought dental treatment due to the dark shade of his smile and multiple old amalgam fillings. Based on clinical and radiographic findings, and the patient's demand for tooth-colored fillings, treatment comprised enamel microabrasion and in-office dental bleaching, followed by the replacement of amalgam fillings by bulk-fill composites. Bulk-fill composites exhibit modifications in the filler size and shape or in the chemistry of monomers that allow them to be applied in thicker layers (4 to 5 mm), creating opportunities for simpler, faster, and more-efficient clinical procedures, as seen in the present report.

Accuracy of Irradiance and Power of Light-Curing Units Measured With Handheld or Laboratory Grade Radiometers.

This study measured and compared exitance irradiance and power of 4 commercial dental light-curing units (LCU) (Elipar S10, Elipar DeepCure-S, Corded VALO and Bluephase Style) using different types of radiometers. The devices used to analyze the LCU were classified as either handheld analog (Henry Schein, Spring, Demetron 100A, Demetron 100B and Demetron 200), handheld digital (Bluephase 1, Bluephase II, Coltolux, CureRite and Hilux), or laboratory instruments (Thermopile and Integrating Sphere). The laboratory instruments and the Bluephase II radiometer were also used to measure the LCU's power (mW). The LCU's were activated for 20 s (n=5). Data were analyzed using Kruskal-Wallis and Student-Newman-Keuls multiple comparison test (a=0.05). Among the LCU, the laboratory instruments presented different irradiance values, except for Corded VALO. The Coltolux and Hilux radiometers measured greater irradiance values compared to the laboratory instruments for the four LCUs tested. Within a given LCU, handheld analog units measured lower irradiance values, compared to handheld digital and laboratory instruments, except using the Spring radiometer for the Elipar S10 LCU. None of the handheld radiometers were able to measure similar irradiance values compared to laboratory instruments, except for Elipar S10 when comparing Bluephase 1 and Thermopile. Regarding power measurement, Bluephase II always presented the lowest values compared to the laboratory instruments. These findings suggest that the handheld radiometers utilized by practitioners (analog or digital) exhibit a wide range of irradiance values and may show lower outcomes compared to laboratory based instruments.