Effects of Polymerization Mode and Interaction with Hydroxyapatite on the Rate of pH Neutralization, Mechanical Properties, and Depth of Cure in Self-Adhesive Cements.

OBJECTIVE: The aim of the study was to evaluate the physicochemical properties of self-adhesive resin cements associated with hydroxyapatite (HAp) according to the polymerization activation. MATERIALS AND METHODS: Specimens of cements (PermaCem 2.0 [DMG]; MaxCem Elite [Kerr], and RelyX U200 [3M ESPE]) were distributed into three groups: activation mode; self-cured and dual-cured modes; and association or not with HAp powder mode. The pH neutralization was evaluated as a function of time. Flexural strength and elastic modulus were also tested (0.5 mm/min.). The depth of cure was also analyzed using the scraping test (ISO 4049). Infrared spectroscopy was also used to collect the spectra of specimens to evaluate the chemical bonds. Statistical comparisons were conducted at 5% of significance. RESULTS: The aggressiveness of the self-adhesive resin cements evaluated varied among the materials with a tendency for neutralization. Self-cure groups exhibited lower pH throughout the entire evaluation when compared with that of the dual-cure ones, irrespective of the addition of HAp. MaxCem Elite when photoactivated was the only cement influenced by the addition of the HAp in terms of mechanical properties. The self-adhesive cements tested presented equivalent depth of cure based on the ISO 4049 requirements, regardless of the evaluated factors. CONCLUSIONS: Based on the parameters evaluated, the results demonstrated that most of the self-adhesive cements remained unaltered or improved when mixed with HAp, regardless of the activation mode.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial.

OBJECTIVES: To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. MATERIAL AND METHODS: This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. RESULTS: Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. CONCLUSIONS: The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Caries progression in non-cavitated fissures after infiltrant application: a 3-year follow-up of a randomized controlled clinical trial

Abstract Objectives To evaluate the efficacy of a conservative treatment to prevent the progression of caries using an infiltrant on non-cavitated pit and fissures. Material and Methods This controlled clinical trial selected 23 volunteers with clinically and radiographically non-cavitated occlusal caries among patients presenting a "rather low" to "very high" caries risk. Eighty-six teeth were randomly divided into two experimental groups: teeth receiving a commercial pit-and-fissure sealant (Alpha Seal-DFL) and contralateral teeth receiving Icon infiltrant (DMG). Caries progression was monitored by clinical (laser fluorescence caries detection) and radiographic examination at 12-month intervals over a period of 3 years of monitored caries progression. Probing the sealing materials to detect areas of retention was also used to evaluate marginal integrity. Results Statistical analysis showed no difference in caries progression using laser fluorescence caries detection when both materials were compared, regardless of the evaluation times (p>0.05). No significance was observed when the marginal sealant integrity of both materials was compared, regardless of the evaluation time (p<0.05). Marginal integrity significantly reduced after 1 year for both materials (p<0.05), but remained stable after 2 and 3 years of evaluation, compared with 1-year results (p>0.05). SEM analysis exhibited a more homogeneous sealing for the infiltrant than obtained by the sealant. Conclusions The infiltrant was effective to prevent the caries progression in non-cavitated pit-and-fissures after 3 years of clinical evaluation, comparable with the conventional sealant. The infiltrant also presented better results in terms of caries progression at the 3-year evaluation time using the radiographic analysis.

Comparative bonding ability to dentin of a universal adhesive system and monomer conversion as functions of extended light curing times and storage.

OBJECTIVES: The purpose of this in vitro study was to evaluate the bonding ability and monomer conversion of a universal adhesive system applied to dentin as functions of different curing times and storage. The results were compared among a variety of commercial adhesives. MATERIALS AND METHODS: Flat superficial dentin surfaces were exposed on human molars and assigned into one of the following adhesives (n = 15): total-etch Adper Single Bond 2 (SB) and Optibond Solo Plus (OS), self-etch Optibond All in One (OA) and Clearfil SE Bond (CSE), and Scotchbond Universal Adhesive in self-etch mode (SU). The adhesives were applied following the manufacturers' instructions and cured for 10, 20, or 40s. Specimens were processed for the microtensile bond strength (µTBS) test in accordance with the non-trimming technique and tested after 24h and 2 years. The fractured specimens were classified under scanning electron microscopy (SEM). Infrared (IR) spectra were obtained and monomer conversion (%) was calculated by comparing the aliphatic-to-aromatic IR absorption peak ratio before and after polymerization (n=5). Data were analyzed by 2-way ANOVA/Tukey's tests (α = 0.05). RESULTS: At 24-h evaluation, OA and CSE presented similar bond strength means irrespective of the curing time, whereas SB and SU exhibited significantly higher means when cured for 40s as did OS when cured for 20 or 40s (p < 0.05). At 2-year evaluation, only OA exhibited significantly higher bond strength when cured for 20 and 40s (p < 0.05). When the evaluation times were compared, OA also exhibited the same bonding ability when cured for longer periods of time (20 and 40s). All of the adhesives tested exhibited significantly lower monomer conversion when photoactivated according to the manufacturers' instructions (10s). CONCLUSIONS: Higher monomer conversions obtained with longer light exposure allow only higher immediate bond strength for most of the adhesives tested. After 2-year storage, only the self-etching adhesive Optibond All-In-One exhibited the same bonding ability when cured for longer periods of time.

Mechanical properties of composites as functions of the syringe storage temperature and energy dose

Objective: To investigate the mechanical properties of different classifications of composites indicated for posterior application as functions of the storage condition and of the energy dose. Material and Methods: Specimens (8x2x2 mm) were obtained according to the factors: I) Composites (3M ESPE): Filtek P60, Filtek Z350XT, and Filtek Silorane; II) Syringe storage conditions: room temperature, aged, oven, refrigerator, and freezer; and III) Energy dose: 24 J/cm2 and 48 J/cm2. After photoactivation, the specimens were stored at 37ºC for 24 h. After storage, a three-point bending test was carried out in a universal testing machine at 0.5 mm/min. Flexural strength (S) and flexural modulus (E) were calculated. Data were analyzed by three-way ANOVA and Tukey's test (α=0.05). Results: Different storage conditions significantly affected the silorane composite for S; conversely, no effects were noted in terms of E. The accelerated aging protocol significantly increased the S of Filtek P60 and Filtek Silorane, whereas storage in the oven significantly decreased the S for all of the composites tested. Filtek P60 was the only composite not affected by the lower storage temperatures tested for S, whereas for the silorane this parameter was impacted at the same conditions. The factor "dose" was not statistically significant. Conclusions: The syringe storage at different temperature conditions proved to influence mostly the flexural strength, a clinically important characteristic considering the posterior indication of the materials tested. The silorane composite should not be stored at lower temperatures. .

The effect of polymerization mode on monomer conversion, free radical entrapment, and interaction with hydroxyapatite of commercial self-adhesive cements.

OBJECTIVES: This study evaluated the degree of conversion, the free radical entrapment, and the chemical interaction of self-adhesive resin cements mixed with pure hydroxyapatite, as a function of the polymerization activation mode among a variety of commercial self-adhesive cements. MATERIALS AND METHODS: Four cements (Embrace WetBond, MaxCem Elite, Bifix SE, and RelyX U200) were mixed, combined with hydroxyapatite, dispensed into molds, and distributed into three groups, according to polymerization protocols: IP (photoactivation for 40s); DP (delayed photoactivation, 10 min self-curing plus 40s light-activated); and CA (chemical activation, no light exposure). Infrared (IR) spectra were obtained and monomer conversion (%) was calculated by comparing the aliphatic-to-aromatic IR absorption peak ratio before and after polymerization (n=10). The free radical entrapment values of the resin cements were characterized using Electron Paramagnetic Resonance (EPR) and the concentration of spins (number of spins/mass) calculated (n=3). Values were compared using two-way ANOVA and Tukey's post-hoc test (α=5%). X-ray diffraction (XRD) characterized the crystallinity of hydroxyapatite as a function of the chemical interactions with the resin cements. RESULTS: The tested parameters varied as a function of resin cement and polymerization protocol. Embrace WetBond and RelyX U200 demonstrated dependence on photoactivation (immediate or delayed), whereas MaxCem Elite exhibited dependence on the chemical activation mode. Bifix SE presented the best balance based on the parameters analyzed, irrespective of the activation protocol. CONCLUSIONS: Choice of polymerization protocol affects the degree of conversion, free radical entrapment, and the chemical interaction between hydroxyapatite and self-adhesive resin cement mixtures.

Mechanical properties of composites as functions of the syringe storage temperature and energy dose.

OBJECTIVE: To investigate the mechanical properties of different classifications of composites indicated for posterior application as functions of the storage condition and of the energy dose. MATERIAL AND METHODS: Specimens (8 x 2 x 2 mm) were obtained according to the factors: I) Composites (3M ESPE): Filtek P60, Filtek Z350XT, and Filtek Silorane; II) Syringe storage conditions: room temperature, aged, oven, refrigerator, and freezer; and III) Energy dose: 24 J/cm(2) and 48 J/cm(2). After photoactivation, the specimens were stored at 37 ºC for 24 h. After storage, a three-point bending test was carried out in a universal testing machine at 0.5 mm/min. Flexural strength (S) and flexural modulus (E) were calculated. Data were analyzed by three-way ANOVA and Tukey's test (α = 0.05). RESULTS: Different storage conditions significantly affected the silorane composite for S; conversely, no effects were noted in terms of E. The accelerated aging protocol significantly increased the S of Filtek P60 and Filtek Silorane, whereas storage in the oven significantly decreased the S for all of the composites tested. Filtek P60 was the only composite not affected by the lower storage temperatures tested for S, whereas for the silorane this parameter was impacted at the same conditions. The factor "dose" was not statistically significant. CONCLUSIONS: The syringe storage at different temperature conditions proved to influence mostly the flexural strength, a clinically important characteristic considering the posterior indication of the materials tested. The silorane composite should not be stored at lower temperatures.

Micro-sized erosions in a nanofilled composite after repeated acidic beverage exposures: consequences of clusters dislodgments

Objective: To evaluate the hardness (KHN), color stability (DE), and superficial micromorphology of two categories of composites after immersion in either distilled water or grape juice for up to 45 days. MATERIAL AND METHODS: Cylindrical specimens (6 mm diameter x 2 mm thick) were obtained according to the factors: composite [Opallis (FGM) and Filtek Z350XT (3M ESPE)]; immersion solution (distilled water and grape juice); and evaluation time: 24 h and 7, 14, 21, 28, and 45 days. After photoactivation, the specimens were stored at 37ºC for 24 h. KHN (50 g/15 s) and ΔE were then repeatedly assessed according to the immersion solutions. Data were analyzed (three-way ANOVA/Tukey's test). Scanning electron microscopy (SEM) topographic analysis was also performed. RESULTS: In general, KHN of both composites reduced after 24 h, irrespective of the immersion solution and time. A significantly lower KHN was noted for Opallis compared with Filtek Z350XT in all parameters. An increase in ΔE over time was noted for both composites, irrespective of the immersion solution. Significantly higher ΔE was noted for Filtek Z350XT immersed in grape juice compared with Opallis, regardless of the evaluation time. The grape juice caused significantly higher DE compared with water in all periods. SEM analysis showed eroded areas for Filtek Z350XT but not for Opallis. CONCLUSIONS: The compositions and immersion solutions influence the composite hardness and the color stability. In spite of the higher hardness, the nanofilled composite is more susceptible to color change than the microhybrid when immersed in an acidic dyed solution. .

Effects of solvent evaporation on water sorption/solubility and nanoleakage of adhesive systems.

OBJECTIVE: To evaluate the influence of solvent evaporation in the kinetics of water diffusion (water sorption-WS, solubility-SL, and net water uptake) and nanoleakage of adhesive systems. MATERIAL AND METHODS: Disk-shaped specimens (5.0 mm in diameter x 0.8 mm in thickness) were produced (N=48) using the adhesives: Clearfil S3 Bond (CS3)/Kuraray, Clearfil SE Bond - control group (CSE)/Kuraray, Optibond Solo Plus (OS)/Kerr and Scotchbond Universal Adhesive (SBU)/3M ESPE. The solvents were either evaporated for 30 s or not evaporated (N=24/per group), and then photoactivated for 80 s (550 mW/cm2). After desiccation, the specimens were weighed and stored in distilled water (N=12) or mineral oil (N=12) to evaluate the water diffusion over a 7-day period. Net water uptake (%) was also calculated as the sum of WS and SL. Data were submitted to 3-way ANOVA/Tukey's test (α=5%). The nanoleakage expression in three additional specimens per group was also evaluated after ammoniacal silver impregnation after 7 days of water storage under SEM. RESULTS: Statistical analysis revealed that only the factor "adhesive" was significant (p<0.05). Solvent evaporation had no influence in the WS and SL of the adhesives. CSE (control) presented significantly lower net uptake (5.4%). The nanoleakage was enhanced by the presence of solvent in the adhesives. CONCLUSIONS: Although the evaporation has no effect in the kinetics of water diffusion, the nanoleakage expression of the adhesives tested increases when the solvents are not evaporated.

Micro-sized erosions in a nanofilled composite after repeated acidic beverage exposures: consequences of clusters dislodgments.

OBJECTIVE: To evaluate the hardness (KHN), color stability (DE), and superficial micromorphology of two categories of composites after immersion in either distilled water or grape juice for up to 45 days. MATERIAL AND METHODS: Cylindrical specimens (6 mm diameter x 2 mm thick) were obtained according to the factors: composite [Opallis (FGM) and Filtek Z350XT (3M ESPE)]; immersion solution (distilled water and grape juice); and evaluation time: 24 h and 7, 14, 21, 28, and 45 days. After photoactivation, the specimens were stored at 37 ºC for 24 h. KHN (50 g/15 s) and ΔE were then repeatedly assessed according to the immersion solutions. Data were analyzed (three-way ANOVA/Tukey's test). Scanning electron microscopy (SEM) topographic analysis was also performed. RESULTS: In general, KHN of both composites reduced after 24 h, irrespective of the immersion solution and time. A significantly lower KHN was noted for Opallis compared with Filtek Z350XT in all parameters. An increase in ΔE over time was noted for both composites, irrespective of the immersion solution. Significantly higher ΔE was noted for Filtek Z350XT immersed in grape juice compared with Opallis, regardless of the evaluation time. The grape juice caused significantly higher DE compared with water in all periods. SEM analysis showed eroded areas for Filtek Z350XT but not for Opallis. CONCLUSIONS: The compositions and immersion solutions influence the composite hardness and the color stability. In spite of the higher hardness, the nanofilled composite is more susceptible to color change than the microhybrid when immersed in an acidic dyed solution.

Effects of solvent evaporation on water sorption/solubility and nanoleakage of adhesive systems

Objective: To evaluate the influence of solvent evaporation in the kinetics of water diffusion (water sorption-WS, solubility-SL, and net water uptake) and nanoleakage of adhesive systems. Material and Methods: Disk-shaped specimens (5.0 mm in diameter x 0.8 mm in thickness) were produced (N=48) using the adhesives: Clearfil S3 Bond (CS3)/Kuraray, Clearfil SE Bond - control group (CSE)/Kuraray, Optibond Solo Plus (OS)/Kerr and Scotchbond Universal Adhesive (SBU)/3M ESPE. The solvents were either evaporated for 30 s or not evaporated (N=24/per group), and then photoactivated for 80 s (550 mW/cm2). After desiccation, the specimens were weighed and stored in distilled water (N=12) or mineral oil (N=12) to evaluate the water diffusion over a 7-day period. Net water uptake (%) was also calculated as the sum of WS and SL. Data were submitted to 3-way ANOVA/Tukey's test (α=5%). The nanoleakage expression in three additional specimens per group was also evaluated after ammoniacal silver impregnation after 7 days of water storage under SEM. Results: Statistical analysis revealed that only the factor "adhesive" was significant (p<0.05). Solvent evaporation had no influence in the WS and SL of the adhesives. CSE (control) presented significantly lower net uptake (5.4%). The nanoleakage was enhanced by the presence of solvent in the adhesives. Conclusions: Although the evaporation has no effect in the kinetics of water diffusion, the nanoleakage expression of the adhesives tested increases when the solvents are not evaporated. .

Resin composite characterizations following a simplified protocol of accelerated aging as a function of the expiration date.

This study evaluated the mechanical, thermal, and morphological characteristics of different classifications of dental composites as a function of the material condition (new, aged and expired). Specimens were obtained according to these factors: Composites: Filtek P60, Filtek Z250, Filtek Z350XT, and Filtek Silorane; and Material conditions: new, aged, and expired. The syringe composites underwent an accelerated aging protocol (Arrhenius model). The flexural strength (FS) and flexural modulus (E) were obtained. The thermogravimetric analysis (TGA) and differential thermal analysis (DTA) were also performed and the glass transition temperature (Tg) and the weight loss calculated. Topographic analysis of the composites was performed under SEM. The material conditions influenced the mechanical properties of the composites. The silorane composite exhibited a characteristic thermal behavior different from that of the methacrylates. In general, the Tg increased after the accelerated aging protocol and decreased for expired ones, compared to the new composites. A significant increase in FS of Filtek Z350XT after aging was accompanied by an increase in the Tg. The filler packings were in accordance with the manufacture׳s information. The topographic aspects of the composites were modified as a function of the material condition. The mechanical properties of the composites following a simplified protocol of accelerated aging varied as a function of the expiration date. The silorane composite presented a characteristic thermal behavior. Although the dental manufacturers may not be able to control variables as storage temperature and transportation conditions, these effects on the composite clinical performance can be minimized if properly considered.

Compatibility between silorane adhesive and simplified methacrylate-based adhesive systems.

The purpose of this study was to evaluate the impact of replacing P90 primer with simplified adhesive systems (with a conventional, two-step adhesive or a self-etching, one-step adhesive) on bond strength to dentin in Class I restorations. The interfaces were also analyzed using confocal microscopy by adding a fluorophore to the adhesive components and SEM using silver nitrate for nanoleakage investigation. X-ray diffraction (XRD) characterized the chemical interaction of the adhesives. Failure mode and nanoleakage varied among groups. Characteristic micromorphology and higher nanoleakage were noted for silorane combinations. On the other hand, no signs of phase crystallization in the silorane adhesive combinations were noted. Replacing the silorane primer with simplified adhesives proved successful as the modified systems provided bonding to dentin comparable to that of the unmodified silorane systems. However, the dedicated adhesive exhibited signs of degradation immediately after application, which may impact the longevity of restorations in short periods.

Hybridization quality and bond strength of adhesive systems according to interaction with dentin.

OBJECTIVE: To evaluate the hybridization quality and bond strength of adhesives to dentin. MATERIALS AND METHODS: Ten human molars were ground to expose the dentin and then sectioned in four tooth-quarters. They were randomly divided into 5 groups according to the adhesive used: Two single-step self-etch adhesives - Adper Prompt (ADP) and Xeno III (XE), two two-step self-etching primer systems - Clearfil SE Bond (SE) and Adhe SE (ADSE), and one one-step etch-and-rinse system - Adper Single Bond (SB). Resin composite (Filtek Z250) crown buildups were made on the bonded surfaces and incrementally light-cured for 20 s. The restored tooth-quarters were stored in water at 37°C for 24 h and then sectioned into beams (0.8 mm(2) in cross-section). Maximal microtensile bond strength (µ-TBS) was recorded (0.5 mm/min in crosshead speed). The results were submitted to one-way ANOVA and Tukey's test (α = 0.05). Thirty additional teeth were used to investigate the hybridization quality by SEM using silver methenamine or ammoniacal silver nitrate dyes. RESULTS: SE reached significantly higher µ-TBS (P < 0.05); no significance was found between ADSE and XE (P > 0.05), and between SB and ADP (P > 0.05); ADSE and XE were significantly higher than SB and ADP (P < 0.05). The bonding interface of SB showed the most intense silver uptake. SE and ADSE showed more favorable hybridization quality than that observed for ADP and XE. CONCLUSIONS: The bond strength and hybridization quality were affected by the interaction form of the adhesives with dentin. The hybridization quality was essential to improve the immediate µ-TBS to dentin.

Esthetic and functional rehabilitation of crowded mandibular anterior teeth using ceramic veneers: a case report.

The use of ceramic veneers to restore crowded teeth in the maxilla has been widely discussed in the literature. However, the use of this technique in the mandible has received little attention. Therefore, this case report describes the treatment of crowded mandibular anterior teeth using ceramic veneers. The primary treatment challenge in this region is the reduced tooth structure available for rehabilitation. Proper communication between the clinician and dental technician is required to achieve clinical success. This article presents a straightforward treatment plan and restorative technique that includes both the clinical and laboratory sequences necessary for predictable and stable postoperative outcomes.

Interaction morphology and bond strength of nanofilled simplified-step adhesives to acid etched dentin.

OBJECTIVE: To evaluate the effect of nanofillers incorporated into adhesives on the microtensile bond strength (µ-TBS) and interfacial micromorphology to dentin. METHODS: The occlusal enamel of 5 human molars was removed and each tooth sectioned into four quarters. The exposed dentin was treated with one of the following adhesives: Adper Single Bond (SB-unfilled), OptiBond Solo Plus (OS-barium aluminoborosilicate, 400nm Ø), Prime & Bond NT (NT-colloidal silica, 7-40 nm Ø) and Adper Single Bond 2 (SB2-colloidal silica, 5nm Ø). Cylinders of resin-based composite were constructed on the adhesive layers. After 24-hour storage, the restored tooth-quadrants were sectioned to obtain stick-shaped specimens (0.8 mm2, cross-sectional area) and submitted to µ-TBS at a cross-speed of 0.5 mm/min. Data were analyzed using one-way ANOVA and Tukey's test (alpha = .05). Twenty-eight additional teeth were used for interfacial micro-morphologic analysis by SEM (16-teeth) and TEM (12-teeth). The dentin surfaces of 32 discs were treated with the adhesives (8 discs for adhesive) and laminated to form disc-pairs using a flowable resin composite for SEM/EDS analysis. For TEM, 90nm-thick nondemineralized unstained sections were processed. RESULTS: SB2 showed significant higher bond strength than SB, OS and NT. The SEM/EDS and TEM analysis revealed nanofillers infiltrated within the interfibrillar spaces of the SB2-hybrid layer. Fillers were concentrated around patent tubular orifices and in the adhesive layer for OS and NT. CONCLUSION: The presence of nanofillers within the interfibrillar spaces of the SB2-hybrid layer suggests its importance in the improvement of the µ-TBS.

Fracture resistance of teeth restored with different resin-based restorative systems

The aim of the present study was to evaluate the fracture resistance of teeth restored with resin composite. Forty-eight maxillary premolar teeth were chosen and randomly divided to six groups: G1 (control): sound teeth; G2: MOD preparation, unrestored; G3: MOD + Adper Single Bond 2/P60; G4: MOD + Adper Easy One/P60; G5: MOD + P90 restorative system; G6: MOD + Adper Easy One/P90 Bond/P90. Specimens were subjected to compressive axial loading (0.5 mm/min). Flexural strength and the modulus of elasticity were also tested (n = 7). The only statistical equivalence with sound teeth was noted for G3 (p < 0.05). Flexural strength and the modulus of elasticity varied among the composites tested (n = 10). The reestablishment of the resistance to fracture in premolars subjected to Class II MOD preparations is restorative-system-dependent. The silorane restorative system is not able to recover the resistance to fracture.

Hardness, polymerization depth, and internal adaptation of Class II silorane composite restorations as a function of polymerization protocol.

OBJECTIVES: To evaluate the influence of various photoactivation techniques on the internal gap, Knoop-hardness, and polymerization depth of silorane- and methacrylate-based composites in Class II restorations. METHODS: Preparations were made in third molars (n = 10), according to composites (Filtek P60: methacrylate; Filtek P90: silorane) and photoactivation techniques (OC: occlusal photoactivation (control); OBL: occlusal+buccal+lingual photoactivation; and BLO: buccal+lingual+occlusal photoactivation (transdental)). Composites were inserted in two increments, both individually photoactivated for 20s. After 24h, specimens were sectioned and the ratio of internal gaps to interface length (%) recorded. Hardness was tested across the transversal section of restorations (1-4 mm below the surface). RESULTS: Silorane restorations showed significantly lower gaps compared with methacrylate, regardless of polymerization technique (P<.05). Supplementary energy dose in OBL and BLO protocols caused significant increase in gaps in silorane restorations (P<.05). For methacrylate restorations, OBL activation caused significantly higher gap formation (P<.05). Significantly lower hardness values were seen for silorane than for methacrylate composites (P<.05), regardless of depth and photoactivation. Significantly higher hardness values were seen in BLO activation for methacrylate restorations compared with control (P<.05); for silorane, no differences were observed. Significantly higher hardness values were observed at 1 and 3 mm compared to 2 and 4 mm for both composites. CONCLUSIONS: Internal gaps and hardness are affected by composite type and photoactivation. Despite the reduced values, hardness of silorane is not influenced by photoactivation or by depth. Internal gaps are dependent on the energy dose for both composites, with silorane showing lower internal gaps.

Fracture resistance of teeth restored with different resin-based restorative systems.

The aim of the present study was to evaluate the fracture resistance of teeth restored with resin composite. Forty-eight maxillary premolar teeth were chosen and randomly divided to six groups: G1 (control): sound teeth; G2: MOD preparation, unrestored; G3: MOD + Adper Single Bond 2/P60; G4: MOD + Adper Easy One/P60; G5: MOD + P90 restorative system; G6: MOD + Adper Easy One/P90 Bond/P90. Specimens were subjected to compressive axial loading (0.5 mm/min). Flexural strength and the modulus of elasticity were also tested (n = 7). The only statistical equivalence with sound teeth was noted for G3 (p < 0.05). Flexural strength and the modulus of elasticity varied among the composites tested (n = 10). The reestablishment of the resistance to fracture in premolars subjected to Class II MOD preparations is restorative-system-dependent. The silorane restorative system is not able to recover the resistance to fracture.

Effectiveness of self-adhesive luting cements in bonding to chlorhexidine-treated dentin.

OBJECTIVES: The aim was to investigate the microtensile bond strength (µ-TBS) and failure pattern of self-adhesive luting cements (SLC) to dentin pre-treated with different concentrations of chlorhexidine (CHX) solutions. METHODS: The occlusal enamel was removed from 30 extracted sound human molars in order to expose a flat dentin. Resin-composite (Filtek Z250, 3M ESPE) discs (12 mm in diameter, 6.0mm thickness) were cemented to the smear layer-covered dentin using the SLC [RelyX U100, 3M ESPE (U100); Multilink Sprint, Ivoclar Vivadent (MS)] with 0.2% or 2.0% CHX solutions. Results were compared with the control, untreated dentin. Six groups were then created based on the SLC and dentin pre-treatment (n=5). After 24h of water storage, restored teeth were serially sectioned into beams with a cross-sectional area of 0.8mm(2) at the bonded interface. Subsequently, specimens were tested in tension with a crosshead speed of 0.5mm/min in a universal testing machine, and the failure patterns were classified. Two-way ANOVA and Tukey's tests were performed (α=0.05). Additionally, 18 teeth were subjected to energy-dispersive X-ray spectroscopy (EDS) analysis and micromorphology characterization of the smear layer-covered dentin and 0.2% or 2.0% CHX-treated dentin surfaces. RESULTS: The µ-TBS obtained for both control groups were significantly higher, regardless of the CHX concentration and/or the cement used. Bond strengths were significantly higher for U100 than for MS, except when 2.0% CHX was applied. Fractographic analysis indicated that most failures in the control groups occurred cohesively in the SLC. Pre-treated dentin with 0.2% and 2.0% CHX solutions presented higher incidences of adhesive failures. EDS/SEM analysis exhibited varied concentrations of chlorine ions and crystal-shaped precipitates, depending upon the CHX concentration. SIGNIFICANCE: Pre-treatment of dentin with 0.2% or 2.0% CHX adversely affects the bonding efficacy when associated with the SLCs tested.