Long-Term Evaluation of Pulp Vitality Preservation in Direct and Indirect Pulp Capping: A Retrospective Clinical Study.

Background: This retrospective clinical study aimed to assess dental pulp tissue reactions to direct and indirect pulp capping after 10 years of follow-up. Methods: A total of 276 permanent teeth with deep carious lesions were evaluated and divided into five groups: Group (1), direct pulp capping with Mineral Trioxide Aggregate cement; Group (2), direct pulp capping with a resin-based glass ionomer; Group (3), direct pulp capping with TheraCal; Group (4), indirect pulp capping with a three-step total-etch adhesive system; and Group (5), indirect pulp capping with a two-step self-etch adhesive system. Results: A 72.5% success rate was achieved overall. A statistically significant difference was found when comparing direct and indirect pulp capping with a success rate of 23.8% and 93.8%, respectively. For direct pulp-capping procedures, the area of pulp exposure was correlated with pulp necrosis (p = 0.035), while bleeding after exposure appeared independent (p = 0.053). Patient age was significantly related to the maintenance of pulp vitality (p = 0.013). A statistically significant correlation between the pulp-capping material and the occurrence of pulp necrosis was discovered (p = 0.017). For the indirect pulp-capping treatments, a significant correlation between patient age (p = 0.021) and the adhesive system (p = 0.019) with pulp necrosis was described. Conclusions: The pulp-capping material, patient age, and the width of the pulp exposure before the procedure should be carefully considered when performing direct pulp-capping treatments. The performance of the etch-and-rinse adhesive systems was superior to the self-etch system during the indirect pulp-capping procedures.

Are periodontitis and psoriasis associated? A pre-clinical murine model.

AIM: To investigate the bidirectional influence between periodontitis and psoriasis, using the respective experimental models of ligature- and imiquimod-induced diseases on murine models. MATERIALS AND METHODS: Thirty-two C57/BL6J mice were randomly allocated to four experimental groups: control (P- Pso-), ligature-induced periodontitis (P+ Pso-), imiquimod-induced psoriasis (P- Pso+) and periodontitis and psoriasis (P+ Pso+). Samples (maxilla, dorsal skin and blood) were harvested immediately after death. Measures of periodontitis (distance between the cemento-enamel junction and alveolar bone crest [CEJ-ABC] and the number of osteoclasts) and psoriasis (epidermal thickness and infiltrate cell [/0.03mm2]) severity as well as systemic inflammation (IL-6, IL-17A, TNF-α) were collected. RESULTS: The P+ Pso+ group exhibited the most severe experimental periodontitis and psoriasis, with the highest values of CEJ-ABC, number of osteoclasts, epidermal thickness and infiltrate cells in the dorsal skin, as well as the highest blood cytokine concentration. The P+ Pso- group presented with higher cell infiltrate (/0.03mm2) compared to the control group (p <.05), while the P- Pso+ group showed substantially higher alveolar bone loss (CEJ-ABC) than the control group (p <.05). CONCLUSIONS: Experimental periodontitis may initiate and maintain psoriasiform skin inflammation and, vice versa, experimental psoriasis may contribute to the onset of periodontitis. In a combined model of the diseases, we propose a bidirectional association between periodontitis and psoriasis via systemic inflammation.

Effects of Etching Time and Ethanol Wet Bonding on Bond Strength and Metalloproteinase Activity in Radicular Dentin.

(1) Background: The objective of this in vitro study was to evaluate the impact of different etching times and ethanol pre-treatments on the immediate bond strength of a hydrophilic multi-mode universal adhesive (Clearfil Universal Bond Quick, Kuraray, UBQ) and on the consequent gelatinolytic activity of metalloproteinases (MMPs) on radicular dentin. (2) Methods: Sixty single-root teeth were selected and divided into four groups according to the adhesive protocol applied for fiber post cementation: (G1) 15 s H3PO4 application + UBQ; (G2) 30 s H3PO4 application + UBQ; (G3) 15 s H3PO4 application + ethanol pre-treatment + UBQ; (G4) 30 s H3PO4 + ethanol pre-treatment + UBQ. After adhesive procedures, fiber posts were luted into the post space with a dual-curing cement (DC Core, Kuraray) and light-cured for 40 s. To perform the push-out test and nanoleakage analyses for both coronal end apical areas, 1 mm slices were prepared, following a 24 h storage period in artificial saliva. Additionally, an in situ zymographic assay was conducted to explore endogenous MMP activity within the radicular layer. Results were statistically analyzed with ANOVA and Tukey post hoc tests. Statistical significance was set at p < 0.05. (3) Result: ANOVA revealed a statistically significant difference in push-out bond strength related to the pre-treatment variable but did not highlight any significance of etching time. Specimens pre-treated with ethanol wet bond application showed higher bond strength (p < 0.01). In situ zymography quantification analyses revealed that all tested groups, independently of etching time end ethanol pre-treatment, activated MMP gelatinolytic activity. A significant increase in MMP activity was detected for the 30 s etching time. However, ETOH pre-treatment significantly reduced MMP activity within the adhesive interface (p < 0.01). (4) Conclusions: The tested adhesive showed similar results regardless of the etching time protocol. The gelatinolytic activity of MMPs was observed in all the groups. Further investigations and extended follow-ups are required to validate the results of the present study in vivo.

Scallop shells as biosorbents for water remediation from heavy metals: Contributions and mechanism of shell components in the adsorption of cadmium from aqueous matrix.

To ascertain their potential for heavy metal pollution remedy, we studied the adsorption mechanism of cadmium onto scallop shells and the interactions between the heavy metal and the shell matrix. Intact shells were used to investigate the uptake and diffusion of the metal contaminant onto the shell carbonatic layers, as well as to evaluate the distribution of major and trace elements in the matrix. LA-ICPMS measurements demonstrate that Cd is adsorbed on a very thin layer on the inner and outer surfaces of the shell. Structural and thermal analyses showed the presence of 9 wt.-% of a CdCO3 phase indicating that the adsorption is mainly a superficial process which involves different processes, including ion exchange of Ca by Cd. In addition, organic components of the shell could contribute to adsorption as highlighted by different metal uptake observed for shells with different colours. In particular, darker shells appeared to adsorb more contaminant than the white ones. The contribution of the organic shell components on the adsorption of heavy metals was also highlighted by the element bulk content which showed higher concentrations of different metals in the darker specimen. Raman spectroscopy allowed to identify the pigments as carotenoids, confirmed by XRD measurements which highlighted the presence of astaxanthin phases. The results presented here provide new insights into the Cd adsorption mechanism highlighting the important contribution given by the organic components present in the biogenic carbonate matrix. Furthermore, the high efficiency of Cd removal from water by scallop shells, supported by adsorption kinetic and isotherm studies, has been demonstrated.

How do different intraoral scanners and milling machines affect the fit and fatigue behavior of lithium disilicate and resin composite endocrowns?

The aim of this in vitro study was to evaluate the effect of the combinations of two different intraoral scanners (IOS), two milling machines, and two restorative materials on the marginal/internal fit and fatigue behavior of endocrowns produced by CAD-CAM. Eight groups (n= 10) were considered through the combination of TRIOS 3 (TR) or Primescan (PS) IOS; 4-axes (CR; CEREC MC XL) or 5-axes (PM; PrograMill PM7) milling machines; and lithium disilicate (LD; IPS e.max CAD) or resin composite (RC; Tetric CAD) restorative materials. Specific surface treatments were applied to each material, and the bonding to its corresponding Endocrown-shaped fiberglass-reinforced epoxy resin preparations was performed (Variolink Esthetic DC). Computed microtomography (µCT) was performed to assess the marginal/internal fit, as well as a mechanical fatigue test (20 Hz, initial load = 100 N/5000 cycles; step-size = 50 N/10,000 cycles until a threshold of 1500 N, then, the step-size was increased if needed to 100 N/10,000 cycles until failure or a threshold of 2800 N) to evaluate the restorations long-term behavior. Complementary analysis of the fracture features and surface topography in scanning electron microscopy was performed. Three-way ANOVA and Kaplan-Meier test (α = 0.05) were performed for marginal/internal fit, and fatigue behavior data, respectively. PS scanner, CR milling machine, and RC endocrowns resulted in a better marginal fit compared to their counterparts. Still, the PM machine resulted in a better pulpal space fit compared to the CR milling machine. Regardless of the scanner and milling machine, RC endocrowns exhibited superior fatigue behavior than LD ones. LD endocrowns presented margin chipping regardless of the milling machine used. Despite minor differences in terms of fit, the 'IOS' and 'milling machine' factors did not impair the fatigue behavior of endocrowns. Resin-composite restorations resulted in a higher survival rate compared to glass-ceramic ones, independently of the digital devices used in the workflow.

Influence of CAD-CAM milling strategies on the outcome of indirect restorations: A scoping review.

STATEMENT OF PROBLEM: The influence of computer-aided manufacturing (CAM) parameters and settings on the outcomes of milled indirect restorations is poorly understood. PURPOSE: The purpose of this scoping review was to summarize the current CAM systems, parameters, and setting changes, and their effects on different outcomes of milled indirect restorations and aspects related to their manufacture. MATERIAL AND METHODS: The protocol of this review is available online (https://osf.io/x28ps/). Studies that used at least 2 different parameters (CAM units, number of axes, digital spacers, or protocols with different rotatory instruments, grit-sizes, milling speed, or others) for milling indirect restorations were included. A structured search up to July 2023 was performed by 2 independent reviewers for articles written in English in LILACS, MEDLINE via PubMed, EMBASE, Web of Science, and Scopus. RESULTS: Of 1546 studies identified, 22 were included in the review. Discrepancies were found between the planned and actual measured cement space, with a decreasing linear relationship impacting restoration adaptation at different points. The CEREC MC XL milling machine was the most used system in the included studies, with variations in bur types, milling modes, and number of burs uses affecting internal fit and surface trueness. The results demonstrated the better adaptation of restorations made with 5-axis over 3-axis milling machines. Lithium disilicate and zirconia were the most commonly used materials, and crowns and inlays were popular designs. Marginal and internal adaptation were the primary outcomes assessed using the various techniques. CONCLUSIONS: The study presented a comprehensive exploration of CAM systems and parameters, and their influence on indirect restorations. The planned cement space was not properly reproduced by the milling. Bur characteristics can affect restoration fit and trueness. The 5-axis units seem to result in better-adapted restorations compared with 3- and 4-axis units.

Comparing the accuracy of distinct scanning systems and their impact on marginal/internal adaptation of tooth-supported indirect restorations. A scoping review.

OBJECTIVE: To summarize the existing scientific evidence on the effect of distinct intraoral (IOS) and extraoral (EOS) scanners in terms of their accuracy for image acquisition and the marginal/internal adaptation of indirect restorations. METHODS: The protocol of this scoping review is available online (https://osf.io/cwua7/). A structured search, with no date restriction, was performed in LILACS, MEDLINE via Pubmed, EMBASE, Web of Science, and Scopus, for articles written in English. The inclusion criteria were studies that considered at least two scanners, regardless of method (intra or extraoral), for the production of tooth-supported restorations. Two independent and blinded researchers screened the studies, collected and analyzed the data descriptively. RESULTS: 103 studies were included (55 on marginal/internal adaptation, 33 on accuracy, 5 on both outcomes, and 10 reviews). Most of them, shown clinically acceptable adaptation (<120 µm). Factors commonly related to the performance of scanners are: use of anti-reflection powders, method of image acquisition, and restoration/tooth characteristics. The need of anti-reflection powders was controversial. Different scanning principles seems to result on similar performance; IOS that combine them could be promising. The most explored systems were Omnicam - IOS, and inEos X5 - EOS, which showed similar performance on marginal/internal adaptation. Scarce studies explored the performance of EOS systems, especially in terms of accuracy. Different restoration designs as single-unit seemed not to modify the performance of scanners. Limited information is available regarding the planned cement space, restorative material and design (multi-unit restorations), as also techniques to measure adaptation. CONCLUSIONS: Digital scanners are valid approaches to obtain accurate impressions resulting in clinically acceptable restorations. Systems that uses combined principles of image acquisition seems promising for optimal performance. Based on high discrepancy, the quality of evaluated evidence is low, and well-designed studies are still encouraged, especially considering validated IOS/EOS as a control comparison condition.

Influence of height discrepancy between pulp chamber floor and crestal bone in the mechanical fatigue performance of endodontically-treated teeth restored with resin composite endocrowns.

OBJECTIVE: To explore and characterize the effect of the discrepancy between crestal bone height (CB) and pulp chamber floor (PCF) in the fatigue performance of endodontically-treated teeth rehabilitated with an endocrown restoration. MATERIALS AND METHODS: A total of 75 human molars free of defects, caries history or cracks were selected, then endodontically treated and randomly allocated into 5 groups (N = 15) according to the difference between PCF and CB, as follows: PCF 2 mm above, PCF 1 mm above, PCF leveled, PCF 1 mm below and PCF 2 mm below. Endocrown restorations were made with composite resin (Tetric N-Ceram, shade B3, Ivoclar) in 1.5 mm thickness and luted with a resin cement (Multilink N, Ivoclar) onto the dental elements. Monotonic testing was performed to define the fatigue parameters, and a cyclic fatigue test was used until failure of the assembly. The collected data were submitted to statistical survival analysis (Kaplan-Meier followed by Mantel-Cox and Weibull), fractographic analysis and finite element analysis (FEA) were performed as complementary analyzes. RESULTS: The PCF 2 mm below and PCF 1 mm below groups presented the best results regarding fatigue failure load (FFL) and number of cycles for failure (CFF) (p < 0.05), but presented no difference between each other (p > 0.05). The PCF leveled and PCF 1 mm above groups presented no statistical difference between them (p > 0.05), but performed better than the PCF 2 mm above group (p < 0.05). The rate of favorable failures of PCF 2 mm above, PCF 1 mm above, PCF leveled, PCF 1 mm below and PCF 2 mm below groups were 91.7%, 100%, 75%, 66.7% and 41.7%, respectively. FEA showed different stress magnitudes according to the pulp-chamber design. CONCLUSION: The insertion level of the dental element to be rehabilitated with an endocrown interferes in the mechanical fatigue performance of the set. The discrepancy between the CB height and the PCF has a direct effect, where the higher the PCF in relation to the CB, the greater the risk of mechanical failure of the restored dental element.

Nanoscale Thermometry of Plasmonic Structures via Raman Shifts in Copper Phthalocyanine.

Temperature measurements at the nanoscale are vital for the application of plasmonic structures in medical photothermal therapy and materials science but very challenging to realize in practice. In this work, we exploit a combination of surface-enhanced Raman spectroscopy together with the characteristic temperature dependence of the Raman peak maxima observed in ß-phase copper phthalocyanine (ß-CuPc) to measure the surface temperature of plasmonic gold nanoparticles under laser irradiation. We begin by measuring the temperature-dependent Raman shifts of the three most prominent modes of ß-CuPc films coated on an array of Au nanodisks over a temperature range of 100-500 K. We then use these calibration curves to determine the temperature of an array of Au nanodisks irradiated with varying laser powers. The extracted temperatures agree quantitatively with the ones obtained via numerical modeling of electromagnetic and thermodynamic properties of the irradiated array. Thin films of ß-CuPc display low extinction coefficients in the blue-green region of the visible spectrum as well as exceptional thermal stability, allowing a wide temperature range of operation of our Raman thermometer, with minimal optical distortion of the underlying structures. Thanks to the strong thermal response of the Raman shifts in ß-CuPc, our work opens the opportunity to investigate photothermal effects at the nanoscale in real time.

Evaluation of Er,Cr:YSGG laser technique for fiber post removal of endodontically treated teeth using micro-computed tomography.

Various clinical techniques such as removal kits, ultrasonic tips, burs, and drills, have been used for fiber post removal in endodontically treated teeth. In most clinical cases, the dental practitioners prefer to use ultrasonic tips, despite the heat generation and the formation of microcracks induced in the radicular dentin. The purpose of this study was to investigate the effectiveness of using erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser (2780 nm) as an alternative fiber post removal technique and to compare it to an ultrasonic method using micro-computed tomography (micro-CT). The operating parameters of the X-ray tube were set to 50 kVp and 300 mA. This approach allowed the generation of 2D lateral projections that were then used to reconstruct the 3D volume in DICOM format. Fiber posts were removed from 20 endodontically treated single-rooted premolars (n = 10) using an ultrasonic vibrator with diamond-coated ultrasonic tip (control method), or Er,Cr:YSGG laser irradiation protocol; average power 2.5 W, repetition rate 20 Hz, pulse duration 140 µs, 40% air and 20% water, and close-contact mode. The number of sections with newly formed microcracks, the loss of dentinal tissue, the amount of the residual resin cement, and the removal time were evaluated for both methods. The data were analyzed using paired t-test, Wilcoxon signed-rank and Mann-Whitney U tests at level of significance a = .05. In the laser-treated group the parameters regarding microcracks formation (21 ± 16) and removal time (4.7 ± 1.1 min) were advantageous compared to the ultrasonic-treated group (42 ± 27 and 9.2 ± 1.0 min, respectively), indicating that Er,Cr:YSGG laser could be an alternative fiber post removal technique.

A Three-step Etch-and-Rinse vs a Universal Adhesive in Nanohybrid Composite Anterior Restorations: A Retrospective Clinical Evaluation.

PURPOSE: To retrospectively evaluate the clinical behavior of direct anterior composite restorations performed with a universal adhesive or with a three-step etch-and-rinse (E&R) adhesive. MATERIAL AND METHODS: Patients were randomly treated with a three-step E&R adhesive (Optibond FL, Kerr) or a universal adhesive (Clearfil Universal Bond Quick, Kuraray Noritake) applied in E&R mode. All restorations were performed with a nanohybrid composite (ClearFil Majesty ES-2, Kuraray Noritake) by the same experienced operator. Two calibrated examiners evaluated the restorations using a dental mirror and explorer, in accordance with modified United States Public Health Service (USPHS) procedures. Clinical events were registered and classified as either failure (F), survival (SR), or success (S). RESULTS: 168 restorations were evaluated in 90 patients with an average follow-up period of 37.9 (± 22.9) months. A total of 132 restorations were performed on vital teeth, and 36 were performed on endodontically treated teeth (ETT). A total of 128 Class-IV and 40 Class-III restorations were performed. In 89 restorations, a three-step E&R adhesive was applied (14 Class-III and 75 Class-IV), while in 79, a universal adhesive was used (26 Class-III and 53 Class-IV, p = 0.0091). A Cox regression analysis was performed (p < 0.05) to analyze which factors were involved in the failure of the restorations, considering failure (F) as restorations that needed re-intervention at the follow-up period of 37.9 (± 22.9) months. No statistically significant differences were observed when considering parameters directly involved with the adhesives tested. Endodontically treated teeth were more prone to fractures (p = 0.0006) compared to vital teeth. Restorations made with universal adhesives failed by fracturing significantly more frequently (p = 0.0234), while restorations made on endodontically treated teeth had a significantly worse outcome (p = 0.0001). Restorations made on canines also failed significantly more frequently (HR = 3.8, 95% CI = 1.4-10.1, p = 0.0062). CONCLUSIONS: Based on the obtained results, both the universal adhesive and the three-step E&R adhesive proved to be good treatment choices for direct anterior restorations after 37.9 (± 22.9) months of follow-up. Tooth vitality seems fundamental for the prognosis of a direct anterior composite restoration over time.

Pulsed Photothermal Heterogeneous Catalysis.

Anthropogenic climate change urgently calls for the greening and intensification of the chemical industry. Most chemical reactors make use of catalysts to increase their conversion yields, but their operation at steady-state temperatures limits their rate, selectivity, and energy efficiency. Here, we show how to break such a steady-state paradigm using ultrashort light pulses and photothermal nanoparticle arrays to modulate the temperature of catalytic sites at timescales typical of chemical processes. Using heat dissipation and time-dependent microkinetic modeling for a number of catalytic landscapes, we numerically demonstrate that pulsed photothermal catalysis can result in a favorable, dynamic mode of operation with higher energy efficiency, higher catalyst activity than for any steady-state temperature, reactor operation at room temperature, resilience against catalyst poisons, and access to adsorbed reagent distributions that are normally out of reach. Our work identifies the key experimental parameters controlling reaction rates in pulsed heterogeneous catalysis and provides specific recommendations to explore its potential in real experiments, paving the way to a more energy-efficient and process-intensive operation of catalytic reactors.

Does partial adhesive preparation design and finish line depth influence trueness and precision of intraoral scanners?

STATEMENT OF PROBLEM: Intraoral scanners (IOSs) are widely used for partial-coverage adhesive restorations, but data on their performance in such preparations with complex geometries are sparse. PURPOSE: The purpose of this in vitro study was to investigate whether the partial-coverage adhesive preparation design and finish line depth affect the trueness and precision of different IOSs. MATERIAL AND METHODS: Seven partial-coverage adhesive preparation designs (4 different onlays, 2 endocrowns, and 1 occlusal veneer) were tested on copies of the same tooth placed in a typodont mounted on a mannequin. Each preparation was scanned 10 times with 6 different IOSs (total 420 scans) under the same light conditions. Trueness and precision, defined according to the International Organization for Standardization (ISO) 5725-1 standard, were analyzed with a best-fit algorithm by superimposition. The obtained data were analyzed by a 2-way analysis of variance to examine the effects of partial-coverage adhesive preparation design, IOS, and their interactions (α=.05). RESULTS: Significant differences were found among different preparation designs and IOSs (P<.05) in terms of both trueness and precision. Significant differences were also found among mean positive and negative values (P<.05). Moreover, crosslinks observed between the preparation area and the adjacent teeth correlated with the finish line depth. CONCLUSIONS: Complex partial adhesive preparation designs affect the trueness and precision of IOSs, resulting in significant differences among them. Interproximal preparations should take into account the IOS's resolution and placing the finish line close to adjacent structures should be avoided.

Does Curing Delay Affect the Bond Strength of Fiber Post with Self-Adhesive Cements?

PURPOSE: To evaluate the effect of three different curing protocols based on different ratios of self-curing and light-curing periods on the bond strength and nanoleakage of fiber posts luted with dual-curing self-adhesive cements. MATERIALS AND METHODS: A total of 48 single-root teeth were endodontically treated and obturated, and an 8-mm post space was prepared with dedicated drills. Specimens were randomly divided into two groups according to the self-adhesive cement employed: group 1 (G1) = PANAVIA SA Plus (Kuraray Noritake), and group 2 (G2) = Bifix SE (VOCO). The specimens were further divided into three subgroups (n = 8 each) according to the light-curing protocol applied: no light-curing (SG1), 20 seconds of light-curing 20 seconds after cement injection (SG2), and 20 seconds of light-curing 120 seconds after cement injection (SG3). Slices of 1-mm thickness were prepared for the pushout test and nanoleakage analyses of the coronal and apical regions after 24 hours of storage in artificial saliva. Results were statistically analyzed with three-way ANOVA and Tukey post hoc tests. Statistical significance was set for P < .05. RESULTS: Three-way ANOVA analysis showed that the factors of cement (P = .02) and curing protocol (P < .001) had a significant influence on bond strength. Tukey post hoc test reported that light-curing 120 seconds after injection showed higher bond strength compared to both no light-curing and photoactivation after 20 seconds. CONCLUSION: To achieve the highest bond strength with self-adhesive cements, photoactivation with a 120-second delay after mixing is required. There is no difference between light-curing immediately and light-curing 20 seconds after mixing.

Effects of Different Fiber-Reinforced Solutions on Fracture Strength and Pattern in Endodontically Treated Molars.

PURPOSE: To evaluate the fracture strength of endodontically treated molars filled with different composite resins with vs without fiber reinforcement. MATERIALS AND METHODS: A total of 60 intact mandibular molars were selected and endodontically treated. A standardized mesio-occlusal-distal cavity was prepared with cervical margins 1 mm above the cementoenamel junction and oral and buccal walls with 1.5-mm thickness. Universal adhesive was used in all specimens in etch-and-rinse mode. Specimens were divided into four groups (n = 15 each) according to restoration technique: group CSM = adhesive overlay with hybrid ceramic; group EXP = direct restoration with short fiber-reinforced composite; group ESU = direct restoration with nanohybrid composite; and group EST = direct restoration with nanohybrid composite reinforced with horizontal bidirectional glass fibers placed over the pulpal chamber floor. After 7 days of storage in water, samples were loaded until fracture using a universal testing machine. The maximum breaking loads were recorded in Newtons, and statistical analysis was then conducted with two-way ANOVA and post hoc Tukey test. Fragments were analyzed using scanning electron microscopy. RESULTS: Mean fracture resistance values were: CSM = 1,428.91 ± 316.90 N; EXP = 1,874.57 ± 299.47 N; ESU = 1,557.44 ± 355.65 N; and EST = 1,870.27 ± 145.11 N. The CSM and EXP groups showed the highest strength values when compared to the other groups. The variable fiber insertion did not significantly alter the fracture resistance. The origin of the fracture was always located on the occlusal surface, mainly in the major contact loading area. CONCLUSION: The use of fiber-reinforced composite showed great improvement in fracture resistance, similar to a cuspal coverage restoration. However, only short fiber-reinforced composites showed a favorable fracture pattern. Int J Prosthodont 2023;36:603-611.

Post-Fatigue Fracture Resistance of Lithium Disilicate and Polymer-Infiltrated Ceramic Network Indirect Restorations over Endodontically-Treated Molars with Different Preparation Designs: An In-Vitro Study.

The aim of the present study was to evaluate the fatigue to cyclic and static resistance of indirect restorations with different preparation designs made either of lithium disilicate (LS) or polymer-infiltrated ceramic network (PICN). Eighty-four (n = 84) molars were chosen, endodontically treated, and prepared with standardized MOD cavities. The molars were randomly divided into 6 study groups (n = 14) taking into account the "preparation design'' (occlusal veneer with 1.2 mm occlusal thickness; overlay with 1.6 mm occlusal thickness; adhesive crown with 2 mm occlusal thickness) and the "CAD/CAM material'' (E-max CAD, Ivoclar vivadent; Vita Enamic, Vita). A fatigue test was conducted with a chewing simulator set at 50 N for 1,500,000 cycles. Fracture resistance was assessed using a universal testing machine with a 6 mm diameter steel sphere applied to the specimens at a constant speed of 1 mm/min. A SEM analysis before the fracture test was performed to visually analyze the tooth-restoration margins. A statistical analysis was performed with a two-way ANOVA and a post-hoc pairwise comparison was performed using the Tukey test. The two-way ANOVA test showed that both the preparation design factor (p = 0.0429) and the CAD/CAM material factor (p = 0.0002) had a significant influence on the fracture resistance of the adhesive indirect restorations. The interaction between the two variables did not show any significance (p = 0.8218). The occlusal veneer had a lower fracture resistance than the adhesive crown (p = 0.042) but not lower than the overlay preparation (p = 0.095). LS was more resistant than PICN (p = 0.002). In conclusion, in the case of endodontically treated teeth, overlay preparation seems to be a valid alternative to the traditional full crown preparation, while occlusal veneers should be avoided in restoring non-vital molars with a high loss of residual tooth structure. LS material is more resistant compared to PICN.

Effects of Surface Pretreatments on Bond Strength and Morphology of Aprismatic Enamel.

PURPOSE: To evaluate the effect of different pretreatment protocols and adhesives on the shear bond strength and surface morphology of aprismatic enamel. MATERIALS AND METHODS: Human maxillary incisors (N = 120) were assigned to five different groups according to pretreatment: 1) no treatment; 2) glycine; 3) sodium bicarbonate; 4) Al2O3 and 5) extra-fine bur. Then the teeth were divided into three subgroups, according to the adhesive applied: 3-step etch-and-rinse (ER), universal adhesive in ER mode, and universal adhesive in self-etch (SE) mode. Shear bond strength (SBS) testing was performed with a universal testing machine. For SEM observation, fifteen human molars were collected and analyzed after pretreatment with/without etching with 37% H3PO4 for 30s. RESULTS: Al2O3 showed higher SBS than all other groups considered. Comparable SBS values were obtained for other pretreatments. Universal adhesive in E&R mode performed better than did 3-step E&R and universal adhesive in SE mode. SEM images showed visible differences in enamel surface roughness. CONCLUSIONS: Airborne-particle abrasion with Al2O3 followed by etching with H3PO4 increased SBS on aprismatic enamel. The combination of airborne-particle abrasion with alumina powder followed by 15 s of H3PO4 etching and application of a universal adhesive in E&R mode proved to be the most effective adhesive protocol.

The influence of finishing lines and margin location on enamel and dentin removal for indirect partial restorations: A micro-CT quantitative evaluation.

OBJECTIVES: This in vitro research aimed to quantitatively evaluate the enamel and dentin tissue removal and the residual adhesion surface area (RAS) after different margin designs and locations for indirect partial restorations (IPR). METHODS: A human molar was scanned using a Micro-CT and the STL file obtained was used to 3D-print 50 resin-tooth replicas. IPR standardized preparations were performed. The specimens were randomly assigned to 5 groups (n = 10), according to preparation and margin location to the dental equator (DE): 1) Rounded shoulder above the DE (SA); 2) Hollow chamfer above the DE (CA); 3) Butt joint above the DE (BJ); 4) Rounded shoulder below the DE (SB); 5) Chamfer below the DE (CB). Then, the tooth replicas were scanned and each STL file was aligned and superimposed to the original STL model file. Data of enamel and dentin volume removal and RAS were assessed and statistically analyzed (one-way ANOVA and Kruskal-Wallis tests for the two dental substrates respectively). Significance was set at p<0.05. RESULTS: Differences in dental tissue reductions were related to the margin location. Above the equator, SA, CA, and BJ performed comparably (p>0.05). Below the equator, CB was significantly more conservative in enamel reduction than SB (p<0.05) and showed the highest enamel adhesive surface exposure among the tested preparations (p<0.05). CONCLUSIONS: When the preparation margin is placed above DE, BJ determines a greater exposure of dentin, reducing the adhesive surface in enamel. Below DE, SB seems to be more aggressive in terms of tissue removal compared to CB. CLINICAL SIGNIFICANCE: The results of this in vitro study suggest that in teeth requiring partial restoration with the margin below the dental equator, a chamfer preparation would be more conservative than a shoulder preparation. When above the equator, preparations with flat designs would expose more dentine providing a worse substrate for adhesion.

Inverse designed plasmonic metasurface with parts per billion optical hydrogen detection.

Plasmonic sensors rely on optical resonances in metal nanoparticles and are typically limited by their broad spectral features. This constraint is particularly taxing for optical hydrogen sensors, in which hydrogen is absorbed inside optically-lossy Pd nanostructures and for which state-of-the-art detection limits are only at the low parts-per-million (ppm) range. Here, we overcome this limitation by inversely designing a plasmonic metasurface based on a periodic array of Pd nanoparticles. Guided by a particle swarm optimization algorithm, we numerically identify and experimentally demonstrate a sensor with an optimal balance between a narrow spectral linewidth and a large field enhancement inside the nanoparticles, enabling a measured hydrogen detection limit of 250 parts-per-billion (ppb). Our work significantly improves current plasmonic hydrogen sensor capabilities and, in a broader context, highlights the power of inverse design of plasmonic metasurfaces for ultrasensitive optical (gas) detection.

Wear Behaviour of Polymer-Infiltrated Network Ceramics, Lithium Disilicate and Cubic Zirconia against Enamel in a Bruxism-Simulated Scenario.

The present study aimed to evaluate the wear rate of polymer-infiltrated network composites and ceramics against enamel in a bruxism-simulated scenario. Ninety-six (n = 96) molars were divided into six groups (n = 16) according to their occlusal material: group 1-a polymer-infiltrated network ceramic (PINC); group 2-a second polymer-infiltrated network ceramic (PINC2); group 3-nanohybrid resin-based composite (CO); group 4-cubic zirconia (ZR); group 5-lithium disilicate (LS); and group 6-sound enamel (EN). A laser scanner was used to digitalize all of the occlusal surfaces before and after a fatigue test, which was conducted with a chewing simulator set at 80 N and semicircular movement in order to simulate bruxist movement and loads. Statistical analysis of volume loss was performed with a one-way ANOVA and post hoc Bonferroni test. ZR had significantly inferior wear to PINC (p ≤ 0.01) and CO (p = 0.04). LS wore the antagonist enamel significantly more than PINC, CO, PINC2 and EN (p ≤ 0.01). On the other hand, ZR wore the antagonist enamel significantly more than CO (p ≤ 0.01) and PINC2 (p = 0.05). In conclusion, PINCs better preserved antagonist enamel at the expense of a higher wear of their own. LS causes significantly higher enamel wear compared with PINCs. ZR caused significantly higher enamel wear compared with CO and PINC2, but it was wear-resistant.