LIGHT-CURED CALCIUM SILICATE BASED-CEMENTS AS PULP THERAPEUTIC AGENTS: A META-ANALYSIS OF CLINICAL STUDIES.

OBJECTIVES: To determine the clinical performance of light-cured calcium silicate-based cement for direct or indirect pulp capping. The research question was as follows: in teeth with deep caries lesions, does the use of resin-modified calcium silicate-containing composites improve the radiological success and prevent irreversible pulpitis and pulpal necrosis compared with other pulp-capping agents? MATERIALS AND METHODS: The following databases were screened until September 2021: PubMed, Web of Science, Scielo, Scopus, Embase, and The Cochrane Library. Randomized clinical trials reporting the clinical evaluation of a resin-modified calcium silicate material as an agent for pulp therapy were included. Meta-analysis was performed using the Rev Manager v5.4.1 software. The risk difference and 95% confidence interval of the dichotomous outcome (restoration failure or success) were calculated for comparison. RESULTS: Ten studies were considered for qualitative analysis and meta-analysis. Studies evaluating the performance of light-cured calcium silicate-based cement from 1 month to a maximum follow-up period of 36 months and comparing it with the performance of CaOH, mineral trioxide aggregate, or Biodentine were included. In the global analysis for direct pulp capping at 6-month follow-up, no statistical differences were observed between the experimental group using the light-cured calcium silicate-based cement and control group (P = .28). However, at 12-month follow-up, global analysis favored the control group (P < .001). For indirect pulp capping, at 6- and 24-month follow-ups, no statistically significant differences were observed between the experimental and control groups (P = .88; P = .21). CONCLUSIONS: Light-cured calcium silicate-based cement showed a limited clinical performance as a direct pulp capping agent, especially when evaluated in the long term. However, using it as an indirect pulp capping agent may be a reliable and easy-to-use option for restoring teeth with deep caries. CLINICAL SIGNIFICANCE: This systematic review provides evidence that supports the use of light-cured calcium silicate-based cement as an indirect pulp capping agent.

Response of dental pulp capped with calcium-silicate based material, calcium hydroxide and adhesive resin in rabbit teeth

Direct pulp capping induces a local inflammatory process. Several biomaterials have been used for this procedure. The aim of this study was to compare the dentinal bridge thickness using three different pulp capping biomaterials with the conventional technique (high speed diamond bur) or Er-Yag laser, 1 month after pulp effraction. Materials and Methods: Forty two Class V cavities were prepared on the buccal surface of 4 maxillary incisors and 2 mandibular incisors of New Zealand rabbits. Specimens were divided into 6 treatment groups. Teeth were treated with: In Group 1: Er-Yag laser and Biodentine® (Septodont), in Group 2: Er: Yag laser and calcium hydroxide (Dycal® Dentsply), in Group 3: Er: Yag laser and adhesive system (Prime& Bond® NT Dentsply), in Group 4: high speed diamond bur and Biodentine® (Septodont), in Group 5: high speed diamond bur and calcium hydroxide (Dycal® Dentsply), and in Group 6: high speed diamond bur and adhesive system (Prime& Bond® NT Dentsply). The preparation was done with copious irrigation. The animals were sacrificed at 30 days and the teeth were extracted and prepared for histological analysis. Results: In the group of « laser Er-Yag ¼, iatrogenic pulpal wounds treated with Biodentine® were covered with a thick hard tissue barrier after 1 month. The difference was not significant with the groups of Dycal® used with Er: Yag laser and high speed diamond bur. Prime& Bond® NT Dentsply specimens showed a thin dentinal bridge layer. Conclusion: At 1 month, Er-Yag laser proved to be useful with Biodentine® for direct pulp capping procedures

Effect of Different Desensitizers on Shear Bond Strength of Self-Adhesive Resin Cements to Dentin.

The sealing and bonding characteristics of luting cements may be affected by the application of desensitizers containing ingredients that induce chemical interaction with dentin organic matrix. This study evaluated the effect of different desensitizers on the immediate and long-term shear bond strength (SBS) of a self-adhesive resin cement (SARC) to dentin. Healthy bovine dentin specimens were used for the study. Gluma® Desensitizer, Desensibilize Nano P®, and Soothe® desensitizer were used in study groups, while the control group did not receive any treatment. Next, SARC (RelyXTM U200) in cylindrical mold was applied to the sample surface. All specimens were stored at 37 °C for 24 h or six months and tested for SBS. Additionally, water contact angle was measured using an optical tensiometer. Results were analyzed by analysis of variance and Student-t tests (p ˂ 0.05). Application of the different types of desensitizers had no significant influence on immediate or long-term SBS of SARC to dentin (p > 0.05). Differences for water contact angle were not statistically significant among the tested groups (p = 0.450). Within the limitations of the present study, it can be concluded that the application of the different types of desensitizers had no significant influence on the SBS of a SARC to dentin.

Residual Adhesive Removal Methods for Rebonding of Debonded Orthodontic Metal Brackets: Systematic Review and Meta-Analysis.

Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated. This study aimed to evaluate the bond strength of rebonded brackets after different residual adhesive removal methods. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, The Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Bond strength comparisons were made considering the method used for removing the residual adhesive on the bracket base. A total of 12 studies were included for the meta-analysis. Four different adhesive removal methods were identified: sandblasting, laser, mechanical grinding, and direct flame. When compared with new orthodontic metallic brackets, bond strength of debonded brackets after air abrasion (p = 0.006), mechanical grinding (p = 0.007), and direct flame (p < 0.001) was significantly lower. The use of an erbium-doped yttrium aluminum garnet (Er:YAG) laser showed similar shear bond strength (SBS) values when compared with those of new orthodontic brackets (p = 0.71). The Er:YAG laser could be considered an optimal method for promoting the bond of debonded orthodontic brackets. Direct flame, mechanical grinding, or sandblasting are also suitable, obtaining clinically acceptable bond strength values.