Expectancy from, and acceptance of augmented reality in dental education programs: A structural equation model.

OBJECTIVE: Dental schools need hands-on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior-knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use. METHODS: A correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience-sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's ɑ, and composite reliability. Ten primary research hypotheses are tested with path analysis. RESULTS: A total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, ß = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior-knowledge readiness (B = -0.056, ß = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior-knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, ß = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = -0.056, ß = -0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior-knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior-knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, ß = 0.046, L = 0.026, U = 0.086, p = 0.054). CONCLUSION: Infrastructure and prior-knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior-knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands-on experience and program performance by providing training options anywhere and anytime.

The Effect of Aging on Artificial Saliva at Different pH Values on the Color Stability of New Generation Denture Base Materials.

STATEMENT OF PROBLEM: New-generation denture base materials are used successfully in denture fabrication; however, the effect of saliva pH change on the color stability of materials is unknown. PURPOSE: The purpose of this in vitro study is to evaluate the color stability of new-generation denture base materials after immersion in artificial saliva with different pH values (3,7,14). MATERIAL AND METHODS: Disc-shaped samples (Ø 10 mm x 2 mm) were prepared from three different denture base materials (1 pre-polymerized polymethylmethacrylate [PMMA], 1 graphene-reinforced PMMA, and heat-cure polymethyl methacrylate resin) (n=10). After polishing, color coordinates were measured using a PCE-CSM 5 colorimeter programmed in the CIE system (L* a* b*). The samples were kept in artificial saliva at different pH values and 37°C for 21 days. At the end of 21 days, color coordinates were measured again. The suitability of the measurements for a normal distribution was examined with the Kolmogro-Smirnov test. Whether color measurements obtained at different pH levels differed according to groups was examined with the Kruskal-Wallis test. The correlation between the CIEDE2000 and CIELab color difference formulas was examined by correlation analysis. RESULTS: The highest color difference occurred in heat-cure samples at pH 3 (p<0.001). The color difference at different pH values was least observed in pre-polymerized PMMA samples. Significant color differences occurred in the graphene-reinforced pre-polymerized PMMA group at pH 7 (p<0.001). CONCLUSIONS: It was observed that color differences occurred in all groups. Dentures made of new-generation CAD/CAM PMMA, which are less exposed to color differences, can be recommended for elderly patients with systemic diseases who are frequently exposed to pH changes in the oral cavity. CLINICAL IMPLICATIONS: Color differences on denture surfaces over time negatively affect aesthetics. Since pH changes cause changes on the prosthesis surface, it may be recommended for these patients to fabricate dentures from new-generation CAD/CAM PMMA resins, which are less deformable.

Surface roughness, optical properties, and microhardness of additively and subtractively manufactured CAD-CAM materials after brushing and coffee thermal cycling.

PURPOSE: To evaluate the surface roughness, optical properties, and microhardness of additively or subtractively manufactured CAD-CAM materials after simulated brushing and coffee thermal cycling. MATERIAL AND METHODS: Two additively manufactured resins (Crowntec, CT and VarseoSmile Crown Plus, VS) and 3 subtractively manufactured materials (a reinforced composite (Brilliant Crios, BC), a polymer-infiltrated ceramic network (Enamic, VE), and a feldspathic ceramic (Mark II, VM)) were used to fabricate disk-shaped specimens (Ø10×1-mm) (n = 10). Surface roughness, Vickers microhardness, and color coordinates were measured after polishing, while surface roughness was also measured before polishing. Specimens were then subjected to 25000 cycles of brushing and 10000 cycles of coffee thermal cycling, and measurements were repeated after each time interval. Color difference (ΔE00 ) and relative translucency parameter (RTP) were calculated. Robust analysis of variance test was used to evaluate surface roughness, ΔE00 , and RTP data, while generalized linear model analysis was used for microhardness data (α = 0.05). RESULTS: Material type and time interval interaction affected tested parameters (p ≤ 0.002). In addition, material type affected all parameters (p < 0.001) other than surface roughness (p = 0.051), and time interval affected surface roughness and microhardness values (p < 0.001). Tested materials mostly had their highest surface roughness before polishing (p ≤ 0.026); however, there was no clear trend regarding the roughness of materials within different time intervals along with ΔE00 and RTP values within materials or time intervals. VS and CT had the lowest microhardness regardless of the time interval, while the remaining materials were listed as VM, VE, and BC in decreasing order (p < 0.001). Coffee thermal cycling only reduced the microhardness of VM (p < 0.001). CONCLUSIONS: Tested additively manufactured resins can be considered more susceptible to simulated brushing and coffee thermal cycling than the other materials, given the fact that their surface roughness and ΔE00 values were higher than previously reported acceptability thresholds and because they had the lowest microhardness after all procedures were complete.

Effect of coffee thermal cycling on the surface properties and stainability of additively manufactured denture base resins in different layer thicknesses.

PURPOSE: To compare the effect of coffee thermal cycling on surface roughness (Ra), Vickers microhardness (MH), and stainability of denture base resins additively manufactured in different layer thicknesses with those of subtractively manufactured denture base materials. MATERIALS AND METHODS: Eighty disk-shaped specimens (Ø10×2 mm) were fabricated from two subtractively (Merz M-PM [SM-M] and G-CAM [SM-G]) and three additively (NextDent 3D+ [50 µm, AM-N-50; 100 µm, AM-N-100], FREEPRINT Denture [50 µm, AM-F-50; 100 µm, AM-F-100], and Denturetec [50 µm, AM-S-50; 100 µm, AM-S-100]) manufactured denture base materials (n = 10). Ra measurements were performed before and after polishing by using a non-contact optical profilometer, while MH values and color coordinates were measured after polishing. Specimens were then subjected to 5000 cycles of coffee thermal cycling, all measurements were repeated, and color differences (ΔE00) were calculated. A linear mixed effect model was used to analyze Ra and MH data, while one-way analysis of variance was used to analyze ΔE00 data (α = 0.05). Ra values were further evaluated according to a clinically acceptable threshold of 0.2 µm, while ΔE00 values were evaluated according to perceptibility (1.72 units) and acceptability (4.08 units) thresholds. The interaction between the material type and the time interval affected both Ra and MH (p ≤ 0.001). Tested materials had their highest Ra before polishing (p ≤ 0.029). Before polishing, AM-F-100 had the highest, and SM-M and SM-G had the lowest Ra (p < 0.001). After polishing and after coffee thermal cycling, SM-G mostly had lower Ra than those of other materials (p ≤ 0.036). SM-G mostly had higher MH than that of other materials before and after coffee thermal cycling (p ≤ 0.025). Coffee thermal cycling reduced the MH of SM-M and increased that of AM-S-100 (p ≤ 0.024). AM-N-100 had higher ΔE00 than AM-F, AM-S-100, and SM-G (p ≤ 0.009), while AM-F and SM-G had lower ΔE00 than AM-S-50 and AM-N-50 (p ≤ 0.024). CONCLUSIONS: Polishing reduced the surface roughness of all materials, whereas the effect of coffee thermal cycling was nonsignificant. Most of the tested materials had acceptable surface roughness after polishing and after coffee thermal cycling according to the reported threshold. Layer thickness only affected the microhardness of tested additively manufactured resins, which was material-dependent. Subtractively manufactured specimens mostly had high microhardness and that of nonreinforced subtractively manufactured resin decreased after coffee thermal cycling. When reported color thresholds are considered, all materials had acceptable color stability.

The Antibacterial and Antifungal Activity of Chlorhexidine Diacetate Incorporated into Acrylic Resins Used in Provisional Restorations.

Objective: The surface of provisional restorations applied before conventional or implant- supported fixed restorations may cause bacterial or fungal biofilm formation. The aim of this study was to evaluate the antimicrobial activity of acrylic resins used in provisional restorations modified with chlorhexidine diacetate. Methods: 120 cylindrical, auto-polymerized resin samples modified with chlorhexidine diacetate were prepared at concentrations of 0 (control), 1, 3, 5 wt %. The antimicrobial activity was examined against Streptococcus mutans, Enterococcus faecalis, and Candida albicans using Crystal Violet quantification, MTT assay, and Scanning Electron Microscopy. Data were analyzed by ANOVA and paired sample t-tests (α=0.05). Results: The addition of chlorhexidine diacetate influenced the growth rate and metabolic activity of microorganisms. The antimicrobial effect against C. albicans and S. mutans statistically increased with the percentage of chlorhexidine diacetate. E. faecalis bacteria were less affected by chlorhexidine diacetate compared to other pathogens. Conclusion: It has been shown that the effectiveness of CHDA in inhibiting the proliferation of microorganisms correlated positively with increasing concentration levels. More research is needed to confirm the impact of different chlorhexidine concentrations on the mechanical properties, clinical efficacy, and antimicrobial properties of CDHA.

Evaluation of bite force, quality of life, and patients' satisfaction in elderly edentulous patients using implant overdentures.

Purpose: This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. Materials and methods: A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. Results: It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. Conclusion: Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.

Influence of polishing technique and coffee thermal cycling on the surface roughness and color stability of additively and subtractively manufactured resins used for definitive restorations.

PURPOSE: To evaluate how different polishing techniques and coffee thermal cycling affect the surface roughness and stainability of additively and subtractively manufactured resins used for definitive prostheses. MATERIALS AND METHODS: Two additively manufactured composite resins (Crowntec, CT and VarseoSmile Crown Plus, VS) and a subtractively manufactured resin nanoceramic (Cerasmart, CS) were used to fabricate 90 rectangular-shaped specimens (14 × 12 × 1 mm) (n = 30). After baseline surface roughness (Ra ) measurements, specimens were divided into three groups based on the polishing technique; conventional polishing with a 2-stage polishing kit (CP) and surface sealant application (Optiglaze, OG or Vita Akzent LC, VA) (n = 10). After polishing, specimens were subjected to 10,000 cycles of coffee thermal cycling. Ra and color coordinate measurements were performed after polishing and after coffee thermal cycling. Color difference (ΔE00 ) was calculated. Scanning electron microscope images were taken at each time interval. Kruskal-Wallis or 1-way analysis of variance (ANOVA) were used to evaluate Ra of materials within each polishing-time interval pair and different polishing techniques within each material-time interval pair, while Friedman or repeated measures ANOVA were used to evaluate Ra at different time intervals within each material-polishing pair. ΔE00 was assessed with 2-way ANOVA (α = 0.05). RESULTS: Other than VA-after polishing (p = 0.055), tested materials had significantly different Ra within each polishing-time interval pair (p ≤ 0.038). When Ra differences among different polishing techniques within each material-time interval pair were considered, CS had differences after coffee thermal cycling, CT had differences before polishing and after coffee thermal cycling, and VS had differences within each time interval (p ≤ 0.038). When Ra differences among different time intervals within each material-polishing pair were considered, significant differences were observed among all pairs (p ≤ 0.016), except for CS-VA (p = 0.695) and VS-VA (p = 0.300). ΔE00 values were affected by material and polishing technique interaction (p = 0.007). CONCLUSIONS: Ra of CS was similar to or lower than the Ra of other materials, regardless of the time interval or polishing technique. CP mostly led to lower Ra than other polishing techniques, whereas VA resulted in a high Ra regardless of the material-time interval pair. Polishing reduced the Ra , while coffee thermal cycling was found to have a small effect. Among tested material-polishing pairs, only CS-VA had moderately unacceptable color change when previously reported threshold values were considered.

Could Helium Plasma Treatment be a Novel Approach to Prevent the Biofilm Formation of Candida albicans?

There is no definitive method to prevent Candida albicans (C. albicans) biofilm formation on polymethyl methacrylate (PMMA) surfaces. The objective of this study was to evaluate the effect of Helium plasma treatment (before the application of removable dentures to the patient) to prevent or reduce C. albicans ATCC 10,231 the anti-adherent activity, viability, and biofilm formation on PMMA surfaces. One hundred disc-shaped PMMA samples (2 mm × 10 mm) were prepared. The samples were randomly divided into 5 surface groups and treated with different concentrations of Helium plasma: G I: Control group (untreated), G II: 80% Helium plasma-treated group, G III: 85% Helium plasma-treated group, G IV: 90% Helium plasma-treated group, G V: 100% Helium plasma-treated group. C. albicans viability and biofilm formations were evaluated using 2 methods: MTT (3-(4,5-dimethyl thiazolyl-2)-2, 5-diphenyltetrazolium bromide) assays and Crystal Violet (CV) staining. The surface morphology and C. albicans biofilm images were observed with scanning electron microscopy. The Helium plasma-treated PMMA groups (G II, G III, G IV, G V) observed a significant reduction in C. albicans cell viability and biofilm formation compared with the control group. Treating PMMA surfaces with different concentrations of Helium plasma prevents C. albicans viability and biofilm formation. This study suggests that Helium plasma treatment might be an effective strategy in modifying PMMA surfaces to prevent denture stomatitis formation.

Anti-adherent activity of nano-coatings deposited by thermionic vacuum arc plasma on C. albicans biofilm formation.

BACKGROUND: The purpose of this study was to analyze the anti-adherent activity of nano-coatings deposited by Thermionic Vacuum Arc plasma on C. albicans ATCC 10231 biofilm. MATERIALS AND METHODS: A total of 80 disc-shaped (2 × 10 mm) polymethymethacrylate samples were prepared and divided into four groups with 10 samples in each group (Control, ZnO, SnO2, Ag) (n = 10). Using thermionic vacuum arc plasma, they were coated with ZnO, SnO2, and Ag. 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and Crystal Viole (CV) assays were conducted for biofilm quantification. Scanning electron microscopy (SEM) was used to observe biofilm images of C. albicans biofilm. RESULTS: MTT and CV mean values differ statistically significantly between all groups (p ⩽ 0.05). The SnO2 group had the lowest mean value, whereas the control group received the highest value. CONCLUSION: SnO2 coating shown greater anti-adherent activity than either metal oxides. C. albicans biofilm formation on denture base surfaces is reduced following Thermionic Vacuum Arc plasma coating with SnO2.

The effects of metal nanoparticles incorporation on the mechanical properties of denture base acrylic resin.

Purpose: The aim of this study was to examine the flexural strength of acrylic resin base material incorporated with iron, copper, and titanium nanoparticles. Materials and methods: Seventy bars of samples (65x10x2.5 mm3) were divided into seven groups. Acrylic samples were prepared according to the manufacturer's instructions. Fe2O3, CuO and TiO2 nanoparticles were manually added in a proportion of 1wt% and 3wt% to the heat-polymerized acrylic resin. The Universal Testing Machine was used for 3-point flexural test of 5 mm/min force. ANOVA and Weibull analyses were used for the statistical analyses. Results: A statistical difference was found between the nanoparticle-added group and the control group. The highest mean value was observed for the 1wt% TiO2 added group, (84.99 MPa) and the lowest value was for the 3wt% CuO added group (71.32 MPa) (p<0,001). The 3wt% Fe2O3 and CuO added groups showed lower values than the control group. Conclusion: The incorporation of TiO2 nanoparticles into acrylic resin in a proportion of 1wt% increased the flexural strength values of the resins. Within the limitations, the nanoparticle addition to acrylic resins could improve the mechanical properties; however, when the percentage of nanoparticle addition increases, the flexural strength values of the acrylic resins decrease.

Effect of Thermal Cycling on the Flexural Strength and Hardness of New-Generation Denture Base Materials.

PURPOSE: To evaluate the flexural strength and Vickers microhardness of different CAD-CAM denture base materials. MATERIALS AND METHODS: Sixty rectangular specimens (64 × 10 × 3.3 ± 0.2 mm) were fabricated from 3 different denture base materials (G-CAM, Graphene-reinforced polymethylmethacrylate, GC), Ivotion Base (Prepolymerized polymethylmethacrylate, IV), and Denturetec (3D-printed resin, DT) either by using additive (DT) or subtractive manufacturing (IV and GC). Specimens of each group were divided into 2 subgroups (thermal cycled or nonthermal cycled, n = 10/group). Nonthermal cycled specimens were stored in distilled water at 37°C for 24 hours and subjected to 3-point flexural strength test with a universal testing machine. Thermal cycled specimens were initially evaluated for Vickers microhardness and subjected to thermal cycling (10,000 cycles at 5-55°C). Vickers microhardness values were remeasured, and the specimens were subjected to 3-point flexural strength test. Data were analyzed by using 2-way analysis of variance and Bonferroni-corrected Tukey honestly significant difference tests (α = 0.05). RESULTS: Material type and condition significantly affected flexural strength (p ≤ 0.004), whereas their interaction was nonsignificant (p = 0.778). Overall flexural strength of the materials in decreasing order was GC, IV, and DT (p < 0.001), regardless of the condition. Material had a higher effect on flexural strength (ηp2 = 0.731) than thermal cycling (ηp2 = 0.142). The effect of the interaction between the material type and thermal cycling on Vickers microhardness was significant (p < 0.001). GC had the highest microhardness before and after thermal cycling (p < 0.001). IV had higher microhardness than DT before thermal cycling (p < 0.001). However, DT and IV showed similar microhardness after thermal cycling (p = 0.665). Thermal cycling decreased the microhardness of GC and IV (p ≤ 0.022), whereas its effect on DT's microhardness was nonsignificant (p = 0.538). Material type had the highest effect on microhardness (ηp2 = 0.864) followed by the interaction between the main factors (ηp2 = 0.258). CONCLUSIONS: Graphene-reinforced polymethylmethacrylate had the highest flexural strength and Vickers microhardness values, regardless of thermal cycling. Thermal cycling reduced the flexural strength of all resins. Thermal cycling reduced the microhardness of milled polymethylmethacrylate, but not that of 3D-printed resin.

Effect of measurement techniques and operators on measured deviations in digital implant scans.

OBJECTIVES: To evaluate the effect of different measurement techniques and operators on measured deviations in vitro implant scans. METHODS: A 2-piece system that comprises a healing abutment (HA) and a scan body (SB) was mounted onto an implant at right first molar site of a polymethylmethacrylate mandibular dentate model. Model was digitized by using an industrial scanner (reference model scan, n = 1) and an intraoral scanner (test scan, n = 20). All standard tessellation language files were imported into a 3-dimensional analysis software and superimposed. Three operators with similar experience performed circle-based and point-based deviation analyses (n = 20). Deviations measured with different techniques were compared with paired samples t-test within each operator, while the reliability of the operators was assessed by using F-tests for both technqiues (α = 0.05). RESULTS: Point-based technique resulted in lower deviations than circle-based technique for all operators (P = .001) with to higher reliability among operators (ICC = 0.438, P = .001). The correlation among the operators was nonsignificant when circle-based technique was used (ICC = 0.114, P = .189). CONCLUSION: Lower deviations were detected with the point-based technique. In addition, different operators' measurements had higher correlation when point-based technique was used compared with circle-based technique. CLINICAL SIGNIFICANCE: Point-based technique may be preferred over circle-based technique for research studies on scan accuracy of implants, given its higher reliability. The accuracy of measured deviations may increase if the number of planes are increased, which can facilitate point generation at different surfaces of the scan body.

Trueness of crowns fabricated by using additively and subtractively manufactured resin-based CAD-CAM materials.

STATEMENT OF PROBLEM: Advancements in digital dental technologies have enabled the use of different resin-based materials that can be fabricated either additively or subtractively. However, knowledge on the fabrication trueness of these materials is scarce. PURPOSE: The purpose of this in vitro study was to investigate the trueness of crowns fabricated by using different resin-based computer-aided design and computer-aided manufacturing (CAD-CAM) materials. MATERIAL AND METHODS: A complete crown for a mandibular right first molar with a 30-µm cement space was designed in standard tessellation language (STL) format. This master STL (MC-STL) was used to fabricate 40 complete crowns with 4 different resin-based CAD-CAM materials and either additive (Crowntec [MS]) or subtractive techniques (Brilliant Crios [BC], breCAM.monoCOM [PMMA], and G-CAM [GR]; n=10). All crowns were digitized with an intraoral scanner (CEREC Primescan SW 5.2) to generate their STL files (TC-STLs). MC-STL and TC-STLs were transferred into a 3-dimensional analysis software program (Medit Link v2.4.4), and a trueness (overall, external, occlusal, intaglio occlusal, and marginal) analysis was performed by using the root mean square (RMS) method. The Kruskal-Wallis and Dunn tests were performed to analyze data (α=.05). RESULTS: The test groups had significantly different deviations on all surfaces (P≤.001). MS crowns had higher overall (P≤.007) and external surface (P≤.001) deviations than GR and PMMA crowns, while the differences between GR and PMMA crowns were not significant (P≥.441). BC crowns had higher external surface deviations than GR crowns (P=.005), higher occlusal deviations than GR and MS crowns (P≤.007), and higher intaglio occlusal deviations than GR and MS crowns (P≤.009). However, BC crowns had lower marginal deviations than MS and GR crowns (P≤.018). CONCLUSIONS: The brand of resin-based CAD-CAM materials affected the trueness of crowns. Additively manufactured crowns (MS) mostly had lower overall and external surface trueness than the other groups. Nevertheless, the deviation values of occlusal, intaglio occlusal, and marginal trueness were generally small; thus, the effect of the tested materials on clinical crown fit may be negligible.

Surface Roughness and Color Stability of 3D-Printed Denture Base Materials after Simulated Brushing and Thermocycling.

Three-dimensional (3D) printing is increasingly used to fabricate denture base materials. However, information on the effect of simulated brushing and thermocycling on the surface roughness and color stability of 3D-printed denture base materials is lacking. The aim of this study was to evaluate the effect of brushing and thermocycling on the surface roughness and color stability of 3D-printed denture base materials and to compare with those of milled and heat-polymerized denture base resins. Disk-shaped specimens (Ø 10 mm × 2 mm) were prepared from 4 different denture base resins (NextDent Denture 3D+ (ND); Denturetec (SC); Polident d.o.o (PD); Promolux (CNV)) (n = 10). Surface roughness (Ra) values were measured before and after polishing with a profilometer. Initial color coordinates were measured by using a spectrophotometer after polishing. Specimens were then consecutively subjected to simulated brushing (10,000 cycles), thermocycling (10,000 cycles), and brushing (10,000 cycles) again. Ra and color coordinates were measured after each interval. Color differences (ΔE00) between each interval were calculated and these values were further evaluated considering previously reported perceptibility (1.72 units) and acceptability (4.08 units) thresholds. Data were analyzed with Friedman, Kruskal-Wallis, and Mann-Whitney U tests (α = 0.05). Ra (p ≥ 0.051) and ΔE00 (p ≥ 0.061) values among different time intervals within each material were similar. Within each time interval, significant differences in Ra (p ≤ 0.002) and ΔE00 values (p ≤ 0.001) were observed among materials. Polishing, brushing, and thermocycling resulted in acceptable surface roughness for all materials that were either similar to or below 0.2 µm. Color of ND printed resin was affected by brushing and thermocycling. All materials had acceptable color stability when reported thresholds are considered.

Influence of atmospheric pressure changes on dentin bond strength of conventional, bulk-fill and single-shade resin composites.

INTRODUCTION: The purpose of this study was to investigate the dentin bond strength of composite resins in response to environmental pressure changes. METHODS: Ninety extracted human molar teeth were used. A mould (3 mm x 4 mm) was adapted on dentin, resin composites (conventional [n = 30] and single-shade composites [Ohmnicroma] [n = 30]) were filled in two increments of 2 mm. The bulk-fill composites (n = 30) were filled with one 4 mm increment. The specimens were stored for 30 days in artificial saliva. The specimens were exposed to hyperbaric pressure (283.6 kPa; 2.8 atmospheres absolute [atm abs]) or hypobaric pressure (34.4 kPa; 0.34 atm abs) once daily for 30 days and the control group was stored at atmospheric pressure for 30 days. The bond strength was tested with a universal testing machine and the failures were examined with a stereomicroscope and scanning electron microscope. Statistical analyses were performed using analysis of variance with post hoc tests, and the Weibull analysis. RESULTS: Regardless of environmental pressure changes, the bulk-fill composites showed the highest bond strength. There was no significant difference in bond strength between the hypobaric and atmospheric pressure (control) groups after 30 days in all resins. The hyperbaric group showed lower bond strength for bulk-fill composites than the control group. CONCLUSIONS: Dentists experienced in diving and aviation medicine should definitely take part in the initial and periodic medical examinations of divers and aircrew to give appropriate treatment. Bulk-fill composite resins can be preferred in divers and aircrew due to high bond strength values.

Effect of simulated brushing and disinfection on the surface roughness and color stability of CAD-CAM denture base materials.

PURPOSE: To evaluate the effect of simulated brushing and chemical disinfection on the surface roughness and color stability of CAD-CAM denture base materials and to compare with those of a heat-cured denture base material. MATERIAL AND METHODS: Disk-shaped specimens (Ø 10mm × 2 mm) were prepared from 3 CAD-CAM denture base resins (AvaDent, Ava; Merz M-PM, Merz; Polident d.o.o, Poli) and a heat-cured polymethylmethacrylate resin (Promolux, Conv) (n = 30). After polishing, baseline surface roughness (Ra) and color coordinates were measured. The measurements were repeated after 20000 cycles of simulated brushing, and the specimens were divided into 3 groups according to disinfection protocol (distilled water, 1% sodium hypochlorite (NaOCl), and effervescent tablet) (n = 10). After 9 cleaning cycles over a period of 20 days, Ra and color coordinates were remeasured. Color differences (ΔE00) were calculated by using CIEDE2000 formula. One-way analysis of variance (ANOVA) and pairwise t-tests were used to analyze Ra and ΔE00 data, while repeated measures ANOVA test was used to compare baseline, after brush, and after disinfection Ra values (α = 0.05). RESULTS: Brushing did not affect the Ra values of tested materials (P ≥ .08). Both before and after brushing, Merz and Conv had higher Ra values than Poli and Ava (P < .001). Among disinfectants, effervescent tablet led to the lowest Ra for Merz (P = .003) and the highest Ra for Poli (P ≤ .039). Only NaOCl resulted in significant differences among the Ra of materials (P < .001), as Merz and Conv had higher Ra values than Poli (P ≤ .002). Repeated measures ANOVA revealed that effervescent tablet disinfection of Merz led to lower Ra values than those of baseline and after brushing (P ≤ .042). After brushing, Ava and Conv had higher ΔE00 values compared with Merz and Poli (P ≤ .015). When compared with other disinfection protocols, effervescent tablet led to higher ΔE00 values for Merz and Poli (P < .001). Significant differences were observed among materials when NaOCl was used; Conv had higher ΔE00 values than Ava and Merz (P = .004). CONCLUSIONS: Brushing did not increase the surface roughness of materials. Disinfection protocol's effect on the surface roughness varied. The effect of brushing on the color of materials varied; color of Ava and Conv was affected from brushing more than the other materials. Color stability of materials varied depending on the disinfection protocol. Effervescent tablet caused higher color change with Merz and Poli compared with other disinfectants. NaOCl led to small color change for Poli, Ava, and Merz materials.

Effect of Potassium Aluminum Sulfate Application on the Viability of Fibroblasts on a CAD-CAM Feldspathic Ceramic before and after Thermocycling.

Potassium aluminum sulfate (alum) is a known adjuvant, which has been used as a mordant in textile industry for color fixation. This material has potential to be incorporated into dentistry for color stability, yet its toxicity first needs to be evaluated. The present study aimed to evaluate the cytotoxic potential of potassium aluminum sulfate (alum) on fibroblasts when applied onto feldspathic ceramic before and after thermocycling. Forty-eight feldspathic ceramic specimens were divided into four groups (FC: no alum application or thermocycling; FCT: thermocycling without alum application; FA: alum application without thermocycling; FAT: alum application and thermocycling) (n = 12). Cell viability was assessed by using a tetrazolium salt 3-[4,5-dimethylthiazol-2-yl]-2,5-diphnyltetrazolium bromide assay at 24 and 72 h, and cell cultures without any ceramic specimens served as control (C). One sample from each material group was further analyzed with energy dispersive X-ray spectroscopy (EDX). Cell viability at different time intervals within each group was analyzed with Friedman tests, while Kruskal−Wallis tests were used to compare the test groups within each time interval. Pairwise comparisons were further resolved by using Wilcoxon tests (a = 0.05). C had lower (p = 0.01) and FA had higher (p = 0.019) cell viability after 72 h. After 24 h, the highest cell viability was observed in C (p ≤ 0.036). After 72 h, the differences between C and FA, C and FAT, FC and FA, and FCT and FAT were nonsignificant (p > 0.05). Cell viability was not affected by alum application or thermocycling at any time interval (p ≥ 0.631). EDX analysis showed an increase in potassium concentration in FA and FAT when compared with FC and FCT. Regardless of the time interval, alum application onto feldspathic ceramic and thermocycling did not influence the cell viability.

Enhancement of Adhesive Bonding Properties of Polyetheretherketone-based Materials using Plasma Surface Modifications.

PURPOSE: To investigate the effects of plasma surface treatments and methyl methacrylate-based adhesives on polyetheretherketone. MATERIALS AND METHODS: One hundred ten polyetheretherketone specimens were fabricated and divided into five pretreatment groups: group ArP, 100% argon plasma; group ArOP, 50% argon + 50% oxygen plasma; group ArNP, 50% argon + 50% nitrogen plasma; group ArONP, 75% argon + 12.5% oxygen + 12.5% nitrogen plasma; group C, control. Atomic force microscopy and scanning electron microscopy were performed after surface treatments. After topographical surface examinations, Visio.link primer (Bredent) (n = 10) was applied to the surface of half of the samples in each group (n = 20) and the veneering resin was polymerized onto the polyetheretherketone. The shear bond strengths were measured using a universal test machine. RESULTS: The mean bond strengths of the Visio.link primer applied to group ArP and group ArONP (13.9 and 13.6 MPa, respectively) were statistically significantly higher than that of group C (9.0 MPa). The average shear bond strength of the Visio.link subgroups was higher than that of the Visio.link subgroups (p > 0.05). CONCLUSIONS: The use of a methyl methacrylate-based adhesive (Visiolink) provides bonding between polyetheretherketone-veneering composites. Different plasma treatments without primer application had no significant effect on bonding.

Effect of selective infiltration etching on the bond strength between zirconia and resin luting agents.

OBJECTIVE: To evaluate the shear bond strength of resin cements to zirconia treated with the selective infiltration etching technique (SIE). MATERIALS AND METHODS: Forty-seven zirconia specimens were prepared with a sequence of silicon carbide abrasives, cleaned in an ultrasonic bath. Three samples were separated for atomic force microscope (AFM) analyses (one nontreated for control, one sandblasted, and one selective infiltration etched) and the remaining were randomly distributed in four groups, according to the combination of surface treatment and resin cement: group 1a (sandblasting + Variolink II), group 1b (sandblasting + Panavia SA Plus), group 2a (SIE + Variolink II), group 2b (SIE + Panavia SA Plus). A composite resin cylinder (3 mm × 3 mm) was cemented to the zirconia surface, as per each group's specific protocol. After storing 24 hours in distilled water at 37°C, the specimens were tested for shear bond strength and the results were subjected to statistical analysis. RESULTS: At 24 hours, the highest SBS values were observed in group 2b, where the SIE technique was used in conjunction with Panavia SA Plus. Lowest values were found in group 1a. Increased surface roughness was observed with SIE. CONCLUSIONS: SIE significantly enhanced the resin bond strength to zirconia. However, cement selection was also an important factor, for both surface treatments tested. CLINICAL SIGNIFICANCE: Use of SIE method combined with MDP monomer containing resin cement can provide clinically acceptable bond strength between zirconia and resin cement.

Coloration of provisional restoration materials: a comparison of the effects of mouth rinses and green tea.

PURPOSE: The present study aimed to evaluate the color stability of provisional restorative materials stored in different mouth rinses and green tea extract for 14 days. MATERIALS AND METHODS: Forty cylinders of fixed provisional restoration material of 15-mm diameter and 2-mm thickness were prepared. The samples were separated into four storage solutions (three different mouth rinses and green tea) (n=10). The values of L*, a*, and b* were determined before and after storage in the solutions using a spectrophotometer, and the ΔE* value was calculated. The effect of mouth rinses and green tea extract on the color change of provisional restoration materials was determined with one-way analyses of variance. The Tamhane multiple comparison analysis was used to determine the differences between the groups (p<0.05). RESULTS: The color stability of the provisional restoration materials varies depending on the solution. Listerine mouth rinse showed more color change than Sensodyne or Colgate did. Minimal color change was found in the green tea solution. CONCLUSION: The effect of mouth rinses on the color stability of fixed temporary restorative materials is remarkable. As green tea shows less color change, it can be suggested as an alternative to mouth rinses.