Effect of at-home and in-office bleaching on microleakage of class V composite resin restorations using different types of universal adhesives: An in vitro study.

Background: When bleaching agents contact dental structures, they act on restorative materials and adhesive interfaces. This study investigated the effect of "at-home" and "in-office" bleaching on the microleakage of composite resin restorations performed with different universal adhesives in self-etch and etch-and-rinse modes. Methods: Class V cavities were prepared in 132 premolars. The samples were divided into four groups (n=33). All Bond Universal adhesive was used in the first and second groups, and G-Premio Bond adhesive was used in the third and fourth groups. The total-etch mode was used in the first and third groups, and the self-etch mode was used in the second and fourth groups. The samples were divided into three subgroups (n=11). In the first subgroup, home bleaching was used, and in the second subgroup, office bleaching was used. In the third subgroup, bleaching was not performed. The specimens were examined under a stereomicroscope for microleakage. Ordinal regression analysis was applied (P<0.05). Results: The adhesive type, application method, and margin type significantly affected microleakage (P<0.05). The amount of microleakage in All Bond Universal adhesive was significantly higher than in G-Premio Bond adhesive. The chance of microleakage in the self-etch mode was almost twice as high as in the etch-and-rinse mode. The bleaching method did not significantly affect microleakage (P>0.05). Conclusion: Based on the results of the microleakage test, bleaching after composite resin restorations did not significantly affect the microleakage of Class V restorations.

Comparison of the effect of bleaching with 15% carbamide peroxide and 35% hydrogen peroxide on flexural strength of Cention N in selfcured and dual-cured polymerization modes.

Background. The use of bleaching agents might result in microstructural changes in tooth structure and in restorative materials. This study compared the effects of bleaching with %15 carbamide peroxide and %35 hydrogen peroxide on the flexural strength of Cention N restorative material using the self-cured and dual-cured polymerization modes. Methods. Sixty bar-shaped samples of Cention N restorative material were included in this in vitro study and assigned to three groups (n=20) randomly: control, bleaching with %15 carbamide peroxide and bleaching with %35 hydrogen peroxide. Each group was divided into two subgroups: samples polymerized in the self-cured mode and samples polymerized in the dual-cured mode. Then the flexurals trengths of the samples were determined. Two-way ANOVA was used to compare flexural strengths between the three groups in two polymerization modes, followed by post hoc Tukey test. Statisticals ignificance was defined at P<0.05. Results. The difference in the mean flexural strength was significant in terms of the bleaching regimen (P<0.001), with significantly lower flexural strength in the two bleaching groups compared to the control group. However, the mean flexural strengths were not significantly different in terms of the polymerization mode applied (P=0.14). Conclusion. The application of %15 carbamide peroxide and %35 hydrogen peroxide bleaching agents decreased the flexural strength of Cention N restorative material. Irrespective of the bleaching regimen, there was no significant difference in the flexural strength of Cention N between the self-curing and dual-curing polymerization modes.

Chemical modification of MTA and CEM cement to decrease setting time and improve bioactivity properties by adding alkaline salts.

Background. Mineral trioxide aggregate (MTA) and Calcium-enriched Mixture (CEM) cement are used for pulp capping since they induce the formation of a dentinal bridge. Long setting time is a shortcoming of these types of cement. This study aimed to assess the effect of the incorporation of some alkaline salts to MTA and CEM cement on their setting time, ion release profile, pH, and surface morphology. Methods. In this in vitro experimental study, 5% calcium chloride (CaCl2), calcium oxide (CaO), sodium fluoride (NaF), and calcium nitrate [Ca(NO3)2] were separately added to MTA and CEM cement. The primary and final setting times of the cements were measured using a Gillmore needle apparatus. The samples were immersed in simulated body fluid (SBF) for one, seven, and 14 days and subjected to x-ray diffraction (XRD) and scanning electron microscopy (SEM) for phase identification and surface morphology assessment. The change in the pH of solutions was studied, and the calcium ion release profile was determined using inductively coupled plasma atomic emission spectroscopy (ICP-AES). The data were analyzed with ANOVA, followed by post hoc tests. Results. CaCl2 and CaO decreased the setting time of MTA, and Ca(NO3)2 decreased the setting time of CEM cement. The incorporation of the salts increased the pH and calcium ion release from both cements, and hydroxyapatite deposits were noted to cover the surface of the samples (observed by SEM and confirmed by EDXA). Conclusion. The incorporation of CaCl2 and CaO into MTA and Ca(NO3)2 into CEM cement decreased their setting time and increased their pH and calcium ion release.

Effect of Bleaching with 15% Carbamide Peroxide on Flexural Strength of Three Resin-Based Restorative Materials.

Objectives: Considering the increasing use of vital bleaching procedures and the increased application of newly introduced resin-based materials for tooth restoration, this study was designed to evaluate the effect of 15% carbamide peroxide gel on the flexural strength of three resin-based restorative materials. Materials and Methods: Three different types of restorative materials namely Beautifil II giomer, Cention N, and Z250 micro-hybrid composite resin were evaluated in this in vitro, experimental study. Twenty-four bar-shaped specimens were prepared from each restorative material, totaling 72 specimens, and were randomly assigned to two subgroups with and without bleaching procedure (n=12). In the bleaching subgroups, 15% carbamide peroxide gel was applied on the specimen surface 8 h a day for 14 days. The flexural strength of the specimens was then measured. Two-way ANOVA was used to compare the flexural strength of the specimens. Results: There was a significant reduction in the flexural strength of materials following exposure to the bleaching agent (P<0.05). The flexural strength was significantly higher in the groups that did not undergo bleaching. However, the mean flexural strength of the restorative materials was not significantly different (P=0.12). Conclusion: The flexural strength of Beautifil II giomer, Cention N, and Z250 micro-hybrid composite resin could be compromised subsequent to bleaching with 15% carbamide peroxide gel. The three resin-based restorative materials exhibited similar flexural strength values irrespective of the use or no use of 15% carbamide peroxide gel.

Correction to: Comparison of the effect of bleaching with 15% carbamide peroxide and 35% hydrogen peroxide on flexural strength of Cention N in self-cured and dual-cured polymerization modes.

[This corrects the article DOI: 10.34172/joddd.2020.023.].

Effect of bleaching protocols on surface roughness and biofilm formation on silorane-based composite resin.

BACKGROUND: Knowledge about the effect of bleaching on behavior of composite resins is important to find a suitable composite resin for restoration of teeth undergoing bleaching. This study aimed to assess the effect of different bleaching protocols on surface roughness and biofilm formation on a silorane-based composite resin. MATERIALS AND METHODS: In this in vitro experimental study, 60 silorane-based composite resin samples measuring 3 mm in thickness and 6 mm in diameter were fabricated and polished. They were then randomly divided into four groups (n = 15). In Group 1, samples were stored in distilled water as control. Samples in Groups 2, 3, and 4 were subjected to bleaching with 15% carbamide peroxide, 35% hydrogen peroxide, and 35% hydrogen peroxide activated by light, respectively. Surface roughness was measured using a profilometer. Streptococcus mutans cultured in brain-heart infusion broth was used for the assessment of biofilm formation on the samples. The bacterial colonies were counted using the pure-plate technique. Data were analyzed using one-way ANOVA and post hoc Tukey's tests. Regression model was used to assess the association between surface roughness and biofilm formation (P < 0.05). RESULTS: The mean surface roughness of the four groups was not significantly different (P = 0.11); however, a significant difference was noted in the mean biofilm formation among the groups (P = 0.00). CONCLUSION: Bleaching decreased biofilm formation. The lowest biofilm formation was noted in the group subjected to light-activated 35% hydrogen peroxide. Increased surface roughness enhanced biofilm formation to a certain level; excessive roughness did not increase biofilm formation.

Color agreement between try-in paste and resin cement: Effect of thickness and regions of ultra-translucent multilayered zirconia veneers.

Background . The current study aimed at identifying the color agreement between try-in pastes and the respective resin cements and investigated the effect of thickness and regions of Ultra-Translucent Multilayered Zirconia Veneers. Methods . A total of 90 cubic zirconia discs were prepared at two different thicknesses (0.5 mm and 0.7 mm) (n=45) in five groups in terms of the shade of the try-in paste and resin cement as follows: Universal, Clear, Brown, White and Opaque. Try-in paste and the respective resin cement were applied between the specimens and composite substrate, respectively, and colorimetric evaluation was carried out using CIE-Lab system. For each specimen, ΔE between the try-in paste and cement was calculated. Data were analyzed with SPSS 17 using Multifactor ANOVA (P<0.05). Results . Multifactor ANOVA results showed that ΔE values were significantly affected by the resin cement shade and the thickness of ceramic veneer (P<0.05). The results showed better shade agreement between the try-in paste and the respective resin cement with thicker ceramic veneers. The results of Tukey HSD revealed that ΔE values for the Clear, Universal and Brown shades were less than those of the White and Opaque shades. Lighter shades exhibited better agreement between the try-in paste and the respective resin cement. Conclusion . Perceptible color difference was found between the try-in pastes and the respective resin cement in most colors investigated. Although, the agreement of the try-in pastes and the respective resin cement was affected by the thickness of zirconia veneers, the different regions of multilayered ultra-translucent zirconia ceramic showed no significant effect.

Effect of Different Intraorifice Barriers and Bleaching Agents on the Fracture Resistance of Endodontically Treated Anterior Teeth.

INTRODUCTION: Intraorifice barriers (IOBs) are usually used before internal bleaching for coronal sealing and the prevention of cervical resorption. The aim of this study was to investigate the effect of different IOBs on the fracture resistance (FR) of endodontically treated anterior teeth bleached with various bleaching agents (BAs). METHODS: After performing root canal treatment for 72 extracted bovine upper incisors, the coronal 3 mm of gutta-percha was removed, and samples were classified into 3 based on the type of IOB: calcium-enriched mixture, mineral trioxide aggregate, and resin-modified glass ionomer. After applying IOBs, samples of each group were subdivided into 4 based on the BA: carbamide peroxide 45% (CP), hydrogen peroxide 35% (HP), sodium perborate (PB), and distilled water as the control. At the end of bleaching, the access cavities were restored with composite resin. The FR was measured with a universal testing machine at a crosshead speed of 5 mm/min. The data were analyzed using 2-way analysis of variance and least significant difference post hoc tests (P < .05). RESULTS: The effect of BAs on the FR was significant (P < .05); however, the effect of the IOB and the interactive effect of these variables were not significant (P > .05). The FR in the HP and PB groups was significantly different from the control (P < .05) but that of CP was not significantly different from the control (P > .05). CONCLUSIONS: Mineral trioxide aggregate and calcium-enriched mixture act similarly to resin-modified glass ionomer as an IOB. CP, unlike HP and PB, did not significantly decrease the FR.

Effect of Home Bleaching on the Color Matching of Composite Resin Restorations

Objective: To investigate the effect of home bleaching on color matching between the dental restoration and the adjacent tooth structure after the staining process. Material and Methods: Ten intact maxillary central incisors were used. After preparation (semimesial restoration of the specimens), the specimens were immersed in a colored solution for 14 days and then were washed and the bleaching process was there after performed. A spectrophotometer apparatus was used to determine the color of the specimens in the part of the tooth filled with restorative material three times, including before the staining process, fourteen days after the staining process and immediately after the bleaching process. Paired t-test was employed to compare the color of the intact tooth and the dental restoration before and after the staining and bleaching processes. The level of significance was set at 5%. Results: Pre-bleaching E color of the teeth was 68.1, which increased to 78.8% after bleaching, and this increase was also statistically significant (p<0.001). Pre and Post-bleaching E color of composite restorations was 65% and 77.6%, respectively. This increase was also statistically significant (p<0.001). Postbleaching E color of the tooth and composite material was 78.8% and 77.6%, respectively. This difference was not statistically significant (p=0.342). Conclusion: The staining and bleaching processes had a significant effect on the discoloration of the dental restoration and the tooth; however, the application of bleaching on the teeth and composite improved the tooth composite color-match.

Evaluation of the Color Matching of Composite Resin Restoration used for Repair with Initial Composite Resin Restoration

Objective: To investigate the color matching of the composite resin used for repaired with initial composite resin restoration after the aging process. Material and Methods: After preparation of 30 composite resin samples, their color were determined using the spectrophotometer four times and the average was recorded. After the initial aging, the color of the samples was measured again. Then, the repair process was performed with an appropriate composite resin color for each sample and the aging process was performed again. After the second aging, the color of the initial and the repaired composite resins were measured. Then, the data were analyzed by paired T-test. The level of significance was set at 5%. Results: The color difference of the initial composite resin between before and after initial aging, as well as the color difference of repaired composite resins between before and after second aging, were significant (p<0.001). Also, after the second aging, the color difference between initial and repaired composite resin restoration were significant (p<0.001). Conclusion: The color matching of the repaired composite resin with the initial one is not acceptable. In this way, replacement of initial composite suggested instead of repaired.

Frequency of Post-Operative Sensitivity in Class II Composite Restorations in Iranian Patients

Objective: To determine the frequency of sensitivity after treatment in composite resin restorations Class II of premolars in Iranian patients. Material and Methods: In this descriptive-cross-sectional study, questionnaires were used which included questions about the extent of post-operative sensitivity in posterior composite resin restorations among 178 patients referred to the restoration section. After restoration of the teeth, the patients were called to record sensitivity after the treatment. Post-operative sensitivity was measured 24 h and 1 month with cold stimulation using Visual Analog Scale (VAS) method. The data were analyzed with the SPSS software, through descriptive statistical methods (frequency and percentage, mean, standard deviation). Group comparisons were evaluated using Mann-Whitney U test and p-value <0.05 was considered to be statistically significant. Results: The mean frequency of sensitivity in terms of gender was 0.75 and 0.76 in males and females, respectively. The mean frequency of sensitivity in terms of type of jaw was 0.59 and 1.1, in the upper and lower jaw, respectively. It was also observed that the frequency of sensitivity is higher in adolescent age group, in comparison with other age groups. No significant association between gender as well as type of jaw and post-operative sensitivity frequency was observed (p>0.05). However, age group has a statistically significant association with the frequency of post-operative sensitivity (p<0.05). Conclusion: There is a significant relationship between extent of sensitivity after treatment in composite resin restorations Class II and the age group of patients.

Reparability of giomer using different mechanical surface treatments.

BACKGROUND: In the repair process achieving high bond strength between the new and old resin based materials is necessary for clinical longevity. This study compared the effect of three different mechanical surface treatments (air abrasion, Nd:YAG laser and diamond bur) on the repair bond strength of giomer. MATERIAL AND METHODS: In this in vitrostudy, 125 cylindrical giomer samples were used. The giomer samples were randomly assigned to 5 groups (n=25). In group 1, the samples did not undergo any surface treatment. In groups 2 to 4, the samples underwent surface treatments with air abrasion, Nd:YAG laser and a diamond bur. The samples in group 5 were prepared to measure giomer cohesive strength. Subsequently, the new giomer was bonded to the existing giomer in groups 1 to 4. Then the repair bond strength of the samples was measured. One-way ANOVA and post hoc Tukey test were used to compare the bond strength. RESULTS: There were significant differences between the different surface treatments (P<0.001); the repair bond strength in the air abrasion group was significantly higher than that in the Nd:YAG laser group, in which it was significantly higher than that in the diamond bur group, which was in turn higher than that in group 1 (no surface treatment) (P<0.001). In addition, the cohesive strength of giomer was significantly higher than the repair bond strength in the 4 other study groups (P<0.001). CONCLUSIONS: Of all the surface treatments, air abrasion and Nd:YAG laser, in descending order, yielded the highest repair bond strength values, with the repair bond strength values of 60‒70% of the giomer cohesive strength. Key words:Air abrasion, bond strength, giomer, Nd:YAG laser, repair, surface treatment.

Effect of preheat repetition on color stability of methacrylate- and silorane-based composite resins.

Background. The aim of this study was to investigate the effect of preheating methacrylate- and silorane-based composite resins on their color stability up to 40 times at 55‒60°C. Methods. Seventy-six methacrylate and silorane-based composite resin samples, with a diameter of 10 mm and a height of 2 mm, were divided into 4 groups (n=19). After the samples were prepared, their color parameters were determined using a reflective spectrophotometer. The composite resin samples were separately stored in a solution of tea for 40 consecutive days. Then the samples underwent a color determination procedure again using a spectrophotometer and color changes were recorded. Finally two-way ANOVA was used to study the effect of composite temperature on its staining (P<0.05). Independent-samples t-test was used to evaluate changes in conversion rates of preheated composite resin samples compared to non-heated samples at P=0.005 and P=0.029 for silorane-based and Z250 composite resin samples, respectively. Results. Both composite resin type (P=0.014) and preheating (P<0.001) had significant effects on ΔE. Conclusion. Repeated preheating of methacrylate- and silorane-based composite resin samples, up to 55‒60°C for 40 rounds, resulted in more color changes compared with unheated composite resin samples. After storage in a solution of tea the color change rate in the composite resin samples of silorane-based was higher than the Z250 composite resin samples.

Effect of two prophylaxis methods on marginal gap of Cl Vresin-modified glass-ionomer restorations.

Background. This study evaluated the effect of two prophylaxis techniques on the marginal gap of CI V resin-modified glass-ionomer restorations. Methods. Standard Cl V cavities were prepared on the buccal surfaces of 48 sound bovine mandibular incisors in this in vitro study. After restoration of the cavities with GC Fuji II LC resin-modified glass-ionomer, the samples were randomly assigned to 3 groups of 16. In group 1, the prophylactic procedures were carried out with rubber cup and pumice powder and in group 2 with air-powder polishing device (APD). In group 3 (control), the samples did not undergo any prophylactic procedures. Then the marginal gaps were measured. Two-way ANOVA was used to compare marginal gaps at the occlusal and gingival margins between the groups. Post hoc Tukey test was used for two-by-two comparisons. Statistical significance was set at P < 0.05. Results. There were significant differences in the means of marginal gaps in terms of prophylactic techniques (P < 0.001), with significantly larger marginal gaps in the APD group compared to the pumice and rubber cup group, which in turn exhibited significantly larger marginal gaps compared to the control group (P < 0.0005). In addition, the means of marginal gaps were significant in terms of the margin type (P < 0.001), with significantly larger gaps at gingival margins compared to the occlusal margins (P < 0.0005). Conclusion. The prophylactic techniques used in this study had a negative effect on the marginal gaps of Cl V resin-modified glass-ionomer restorations.

Comparison of shear bond strength of resin-modified glass ionomer and composite resin to three pulp capping agents.

Background and aims. Present study was designed to compare the bonding strength of resin-modified glass ionomer (RMGI) and composite resin to mineral trioxide aggregate (MTA), MTA mixed with Na2HPO4 (NAMTA), and calcium-enriched mixture (CEM). Materials and methods. Thirty specimens of each CEM, NAMTA, and MTA were prepared. Composite and RMGI restorations were then placed on the samples (15 samples in six subgroups). Shear bond strength was assessed using universal testing machine. Data were analyzed with two-way ANOVA and post-hoc Tukey test. To compare the bond strength in subgroups, one-away ANOVA was applied. Significance level was set at P < 0.05. Results. Bond strength was significantly higher to composite samples compared to RMGI samples (p<0.001). The difference in bond strength of composite samples between MTA and CEM subgroups (P=0.026) as well as MTA and NAMTA subgroups (P= 0.019) was significant, but the difference between NAMTA and CEM subgroups (P=0.56) was not significant. The differences in bond strength in subgroups of RMGI group were not significant (P>0.05). Conclusion. Regarding shear bond strength to the tested substrates, composite was shown to be superior to RMGI. The bond of resin composite to MTA was weaker than that to CEM and NAMTA.