Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals.

OBJECTIVE: To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS: Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS: After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION: GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE: After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Clinical performance of an alkasite-based bioactive restorative in class II cavities: a randomized clinical trial.

OBJECTIVE: This clinical study aimed to evaluate the clinical performance of an alkasite-based bioactive material by comparing it with a resin composite (RC) in the restoration of Class II cavities over a year. METHODOLOGY: A hundred Class II cavities were restored at 31 participants. Groups were as follows: Cention N (CN) (Ivoclar Vivadent, Schaan, Liechtenstein) and G-ænial Posterior (GP) (GC, Tokyo, Japan) in combination with G-Premio Bond (etch&rinse). Restorative systems were applied following manufacturers' instructions. They were finished and polished immediately after placement and scored based on retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified USPHS criteria after 1 week (baseline), 6 months, and 12 months. Statistical analyses were performed using chi-square, McNemar's, and Kaplan Meier tests. RESULTS: After 12 months, the recall rate was 87%. Survival rates of CN and GP restorations were 92.5% and 97.7%, respectively. Three CN and one GP restorations lost retention. Seven CN (17.9%) and five (11.6%) GP restorations were scored as bravo for marginal adaptation and no significant difference was seen between groups (p=0.363). One (2.7%) CN and two GP (4.7%) restorations were scored as bravo for marginal discoloration, but no significant difference was observed between groups(p=1.00). For surface texture, three (8.1%) CN and three (7%) GP restorations were scored as bravo (p=1.00). None of the restorations demonstrated post-operative sensitivity or secondary caries at any examinations. CONCLUSION: The tested restorative materials performed similar successful clinical performances after 12 months. ClinicalTrials.gov (NTC04825379).

Which whitening toothpaste with different contents is more effective on color and bond strength of enamel?

OBJECTIVE: To evaluate the effects of six whitening toothpastes with different whitening ingredients as follows: abrasives, polyphosphates, activated charcoal and hydrogen peroxide on the color, and shear bond strength (SBS) of enamel. MATERIALS AND METHODS: Thirty-five extracted human molars were sectioned in mesiodistal direction, providing 70 enamel specimens and randomly divided into seven groups having different whitening ingredients (n = 10). After baseline color measurements, the specimens were brushed three times daily for the 30 s. At the end of 2 weeks, spectrophotometric readings were repeated, and color change parameters were calculated. Then, composite cylinders were built on the enamel surfaces and the specimens were subjected to SBS test. Failure modes were determined under a stereomicroscope (×10). One specimen from each group was examined with scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis, Wilcoxon signed, one-way-ANOVA (p = 0.05). RESULTS: Clinically acceptable color change was observed in all whitening toothpastes. There were no significant differences among the groups for Δa, ΔL, ΔE00 , and ΔWID (p > 0.05). The differences among the groups were not significant regarding SBS and failure mode distributions (p > 0.05). SEM findings were in line with the SBS test and failure mode distribution results. CONCLUSIONS: All the tested whitening toothpastes showed similar and clinically acceptable efficacy on the color change of the enamel and led to comparable SBS values. CLINICAL SIGNIFICANCE: The tested whitening toothpastes had an acceptable whitening efficacy and did not have a negative effect on the bond strength to the enamel.

Effects of Different Whitening Agents on the Color and Translucency of Different Resin Composites.

Objectives: To examine the effects of different whitening agents on the color and translucency of different resin composites, in vitro. Material and methods: A total of 315 specimens (10.0 ×2.0 mm) were fabricated from two microhybrid (G-aenial anterior [G-Ant]) and (G-aenial posterior [G-Post]) and a nano hybrid (G-aenial A'CHORD [ G-ACH]) resin composites and each group was randomly distributed into seven experimental groups (n=15) as follows; 1- control (C); 2- in-office whitening agent (IOW); 3- at-home whitening agent (AHW); 4- prefilled tray (PT); 5- whitening pen (WP); 6- whitening toothpaste (WT) and 7- whitening mouthwash (WMW). The specimens were subjected to staining except control group before application of the different whitening procedures. The color of specimens was measured after 24 h (T0), after staining (T1) and after whitening (T2). Color change [CIEDE2000 (ΔE00)], translucency parameter (TP) values and changes in whiteness index (WID) were calculated. Data were analyzed statistically (p<0.05). Results: No significant 𝑊ID differences were detected among the tested resin composites at T0 and T1 (p>0.05), whereas a significant difference was observed at T2 (p<0.005). AHW and IOW produced higher color change than PT, WP, WT and WMR. Significant TP changes were found after the application of IOW and AHW in G-Ant. Conclusion: The effect of whitening products on the whitening index, color and translucency of resin composites are material and substrate dependent.

Clinical performance of an alkasite-based bioactive restorative in class II cavities: a randomized clinical trial

Abstract Objective This clinical study aimed to evaluate the clinical performance of an alkasite-based bioactive material by comparing it with a resin composite (RC) in the restoration of Class II cavities over a year. Methodology A hundred Class II cavities were restored at 31 participants. Groups were as follows: Cention N (CN) (Ivoclar Vivadent, Schaan, Liechtenstein) and G-ænial Posterior (GP) (GC, Tokyo, Japan) in combination with G-Premio Bond (etch&rinse). Restorative systems were applied following manufacturers' instructions. They were finished and polished immediately after placement and scored based on retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified USPHS criteria after 1 week (baseline), 6 months, and 12 months. Statistical analyses were performed using chi-square, McNemar's, and Kaplan Meier tests. Results After 12 months, the recall rate was 87%. Survival rates of CN and GP restorations were 92.5% and 97.7%, respectively. Three CN and one GP restorations lost retention. Seven CN (17.9%) and five (11.6%) GP restorations were scored as bravo for marginal adaptation and no significant difference was seen between groups (p=0.363). One (2.7%) CN and two GP (4.7%) restorations were scored as bravo for marginal discoloration, but no significant difference was observed between groups(p=1.00). For surface texture, three (8.1%) CN and three (7%) GP restorations were scored as bravo (p=1.00). None of the restorations demonstrated post-operative sensitivity or secondary caries at any examinations. Conclusion The tested restorative materials performed similar successful clinical performances after 12 months. ClinicalTrials.gov (NTC04825379).

Effects of Different Over - the - Counter Whitening Products on the Microhardness, Surface Roughness, Color and Shear Bond Strength of Enamel.

Objective: The purpose of this in vitro study was to evaluate the effects of four over-the-counter (OTC) whitening products on the microhardness, surface roughness, color, shear bond strength (SBS) and surface charecteristics of human enamel compared with a product used for dentist-supervised home whitening. Materials and methods: Seventy eight enamel specimens allocated into 6 groups (n=13): 1-Opalescence PF 10% (OP) dentist prescribed home whitening product, 2-Opalescence Go prefilled tray (PT), 3-Opalescence Whitening Toothpaste (WT), 4-Listerine Healthy White whitening mouth rinse (WMR), 5-Cavex Bite&White whitening pen (WP) and 6- no treatment (Con). The microhardness (VHN), surface roughness (Ra) and color of the specimens were measured (T0). The specimens were then subjected to whitening protocols for 14 days (T1.) followed by artificial saliva storage for 14 days (T2). The measurements were repeated at T1 and T2. The SBS test was done after the application of 35% phosphoric acid (Scotchbond Universal Etchant), followed by a universal adhesive (G-Premio Bond) and a micro hybrid/universal resin composite (Essentia) into a Teflon tube attached to the enamel surface (p<0.05). Surface morphologies of the enamel surfaces were examined by SEM. p value was set at 0.05. Results: Application of OP, PT and WP decrased the microhardness of enamel specimens (p<0.05) whereas, no significant changes were seen in the microhardness of enamel specimens treated with WT and WMR (p>0.05). Ra values of enamel specimens increased with the application of OP, PT and WT (p<0.05); whereas no changes were observed after the applications of WMR and WP (p>0.05). OP, PT, WMR, and WP changed the color of the enamel(p<0.05). There were not any significant differences among the SBSs groups, apart from OP applied enamel specimens. OP showed the least SBS values (p=0.001). SEM observations revealed smooth enamel surfaces. Conclusions: The whitening products affected the microhardness, surface roughness, color of enamel differently. Only OP decreased the SBS of the enamel.

Sixty-month follow up of three different universal adhesives used with a highly-filled flowable resin composite in the restoration of non-carious cervical lesion.

OBJECTIVE: The purpose of this clinical trial was to evaluate and compare the performances of three different universal adhesives used with a highly filled flowable universal resin composite in the restoration of non-carious cervical lesions (NCCLs) over a 60-month period. MATERIAL AND METHODS: Ninety-nine NCCLs were restored at 18 participants. NCCLs were divided into three different universal adhesive groups: Clearfil Universal Bond (CU) (n = 31), iBOND Universal (IU) (n = 33), and G-Premio Bond (GP) (n = 35). Prior to the adhesive procedures, selective enamel etching was performed with 37% phosphoric acid in all experimental groups. Adhesive systems were applied following the manufacturers' instructions, and the lesions were restored with a highly filled flowable resin composite (G-ænial Universal Flo). Restorations were finished and polished immediately after placement. All restorations were scored with regard to retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified United States Public Health Service (USPHS) criteria after 1 week (baseline) and 6, 12, 18, 24, 36, and 60 months. Statistical analyses were performed using chi-square and McNemar's and Kaplan Meier tests. The level of significance was set at p < 0.05. RESULTS: After 60 months, the recall rate was 72.2%. Survival rates of CU, IU, and GP restorations were 87%, 85.2%, and 96.5%, respectively. Five CU (25%), 8 IU (34.8%), and 12 GP (42.9%) restorations exhibit bravo scores for marginal adaptation. However, no differences were seen among them. CU showed lower bravo score than IU and GP for marginal discoloration (CU, 0%; IU, 26.1%; GP, 32.1%). Two CU, 7 IU, and 6 GP restorations showed bravo scores for surface texture, and 2 (9.1%) CU and 1 (3.3%) GP restorations were scored as bravo score for color match (p > 0.05). CONCLUSION: The tested universal adhesives showed similar success rates during the 60-month follow-up. However, CU showed better clinical performance than IU and GP in terms of marginal adaptation and discoloration. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03415412 CLINICAL RELEVANCE: The long-term clinical performances of the three universal adhesives in the restoration of NCCLs using selective enamel etching mode were successful after 60 months.

The effects of resin infiltration on demineralized root surface: an experimental study.

Purpose: The objective of this experimental invitro study was to investigate the effects of resin infiltration (RI) on surface roughness, microhardness, color and surface characteristics of artificially demineralized root surfaces. Materials and methods: Forty-two root specimens prepared from freshly extracted intact human upper incisors were subjected to surface roughness, microhardness, and color tests. Profilometer was used to measure surface roughness and Vicker's Hardness tester was used to measure the changes in microhardness. The color measurements were performed by a spectrophotometer using the CIELAB parameters. Following measurements, specimens were divided into 3 groups (n=14): G1: intact root surfaces, G2: demineralized root surfaces and G3: Resin infiltrated root surfaces (Icon, DMG) following demineralization. Surface roughness, microhardness and color measurements were repeated in G2 and G3 after demineralization and RI. One specimen from each group was examined by SEM. Data were analyzed statistically (p<0.05). Results: Application of RI to artificially demineralized root surfaces significantly decreased the surface roughness (p<0.001) and increased the microhardness (p=0.023). RI also affected the color of demineralized root surfaces. SEM examinations revealed that the porosities on demineralized root surfaces seemed to be sealed after RI. Conclusion: RI affected the surface roughness, microhardness, color and surface appearance of artificially demineralized root surfaces.

Shear bond strengths of two newly marketed self-adhesive resin cements to different substrates: A light and scanning electron microscopy evaluation.

The purpose of this in vitro study was to compare the shear bond strengths (SBSs) of two newly marketed self-adhesive resin cements (RCs) to enamel, dentin, and lithium disilicate (LiSi) glass ceramic block. Forty-eight enamel and 48 dentin substrates were obtained from sound human molars. Additionally, 6 × 7 × 5 -mm- sized 24 specimens were produced from LiSi glass ceramic blocks. The tooth specimens were randomly assigned into four groups (n = 12) according to the surface treatments: (1) G-CEM ONE (GCO), (2) G-CEM ONE Adhesive Enhancing Primer (GCO-AEP) + GCO, (3) RelyX Universal (RXU), and (4) Scotchbond Universal Plus (SUP) + RXU. LiSi specimens were randomly divided into two groups (n = 12): (1) G-MultiPrimer (GMP) + GCO and (2) SUP + RXU. Following the RC applications, all specimens were kept in 100% humidity at 37°C for 24 hr and then submitted for SBS testing in a universal testing machine (1 mm/min). Data were analyzed by Welch's, one-way analysis of variance and two independent samples t tests. The nature of failures was examined under a light microscope, and scanning electron microscopy analyses were also performed for interfaces. GCO and RXU showed similar SBS to enamel (p > .05), and the use of adhesives resulted in improved SBS (p < .05). No difference was detected between GCO-AEP + GCO and SUP + RXU. The GCO-AEP + GCO exhibited the highest SBS to dentin (p < .05), followed by GCO ≥ SUP + RXU > RXU (p < .05). There was no significant difference between SBSs of two RCs to LiSi blocks (p > .05). No cohesive failure was determined for the tested groups by light microscope. The use of adhesives prior to the application of self-adhesive RCs improved their bonding to tooth tissues. GCO demonstrated superior SBS to dentin, whereas both self-adhesive RCs generated similar SBS to enamel and LiSi glass ceramic surfaces.

Comparison of mechanical and optical properties of a newly marketed universal composite resin with contemporary universal composite resins: An in vitro study.

The purpose of this study was to evaluate the surface roughness, microhardness, color change, and translucency of a newly marketed universal nanohybrid composite resin (CR) (G-aenial A'CHORD) comparing with four contemporary universal CRs including two nanofilled (Filtek and Estelite Asteria) and two nanohybrid CRs (Charisma Dimond and Neo Spectra ST HV in vitro). Sixty-five specimens (8.0 mm × 2.0 mm) were fabricated (n = 13, per group). After finishing and polishing, specimens were subjected to surface roughness and microhardness tests. Color and translucency of the specimens were evaluated at baseline and after darkening with coffee solution at day 1 and day 7. A representative specimen from each group was investigated under scanning electron microscopy (SEM). Data was analyzed statistically (p < .05). There were significant differences among the groups in terms of surface roughness, microhardness, color, and translucency. The surface roughness was recorded as: Charisma Diamond > Neo Spectra ST HV, Filtek > Estelite Asteria, G-aenial A'CHORD, whereas Vickers Hardness number was as: Filtek, Charisma Diamond > Neo Spectra ST HV > G-aenial A'CHORD, Estelite Asteria. Color change was as: Charisma Diamond > Neo Spectra ST HV, Filtek, G-aenial A'CHORD > Estelite Asteria and the translucency was as: Neo Spectra ST HV > G-aenial A'CHORD, Filtek > Estelite Asteria, Charisma Diamond. SEM examinations revealed smooth surfaces for G-aenial A'CHORD, Neo Spectra ST HV and Estelite Asteria. Mechanical and optical properties of universal composite resins with different compositions show variations.

Does a Self-adhesive Flowable Resin Composite Perform Similarly to Highly Filled and Conventional Flowable Resin Composites in Occlusal Cavities? A 2-year Follow-up Study.

PURPOSE: The aim of this clinical trial was to compare a self-adhesive flowable resin composite, a highly filled flowable resin composite used in combination with a universal adhesive applied in self-etch mode, and a conventional flowable resin composite used in combination with a universal adhesive applied using two different application modes in occlusal cavities. MATERIALS AND METHODS: Twenty-eight patients received 114 occlusal restorations. Cavities were divided into four groups: CS: a self-adhering flowable (Constic, DMG); GF: a highly filled flowable (G-ænial Universal Flo, GC) in combination with a universal adhesive applied in self-etch mode (G-Premio Bond, GC); TF-SE: a conventional flowable (Tetric N-Flow, Ivoclar Vivadent) in combination with a universal adhesive (Tetric N-Bond Universal, Ivoclar Vivadent) applied in self-etch mode; TF-ER: a conventional flowable (Tetric N-Flow, Ivoclar Vivadent) in combination with a universal adhesive (Tetric N-Bond Universal, Ivoclar Vivadent) applied in etch&rinse mode. Restorations were scored using modified USPHS criteria. Descriptive statistics were performed using chi-squared tests. RESULTS: At 24-month evaluations, none of the restorations were lost. The CS group showed significantly higher bravo scores for marginal adaptation than did the other experimental groups (p = 0.024). Significant changes were seen for CS and GF regarding marginal adaptation compared to baseline. CONCLUSION: Although the self-adhering flowable resin composite exhibited inferior marginal adaptation compared to the highly filled flowable and conventional flowable resin composites, the restored teeth demonstrated a clinically acceptable performance after 24 months.

Commercially Available Ion-Releasing Dental Materials and Cavitated Carious Lesions: Clinical Treatment Options.

The contemporary approach for operative caries management emphasizes personalized interventions for each patient, dependent upon the individual's caries susceptibility/risk, the stage of the carious lesion and its activity. The clinician's challenge is to optimize the extent of cavity preparation and the choice of dental restorative biomaterials, appreciating the benefits offered by ion-releasing restorative materials. There is a growing application of bioactive/bio-interactive materials in minimally invasive operative dentistry, as they may help with tissue recovery by ion release. In case of moderate or extensive occlusal cavitation, the clinical criteria include the individual caries susceptibility and carious lesion activity. In high caries risk cases, ion-releasing biomaterials (IRB) can be used, as well as for active carious lesions. In proximal lesions, the clinical criteria include the individual caries susceptibility, the lesion activity and presence of cavities with little or no enamel at the gingival margin. This article aims to discuss the restorative ion-releasing options, according to different clinical situations, and the caries susceptibility to manage cavitated carious lesions in permanent adult teeth.

Effects of charcoal-based whitening toothpastes on human enamel in terms of color, surface roughness, and microhardness: an in vitro study.

OBJECTIVE: Charcoal based oral care products have gained popularity in the last few years. The aim of this in vitro study was to compare the effects of different charcoal based whitening toothpastes on color, surface roughness and microhardness of human enamel. MATERIALS AND METHODS: Forty-eight specimens obtained from human permanent upper incisor teeth were randomly divided into 4 groups(n=12):Group-1:Colgate Total 12(CT); Group-2:Body Kingdom(BK); Group-3:Black is White(BW), Group-4:Colgate optic white(COW). Following 4 days cycle of darkening(2-min chlorhexidine and 60-min black tea per day), a 12- week brushing(twice daily for 1 min)was performed. Color of specimens was measured using a spectrophotometer. A contact type profilometer was used to measure surface roughness (Ra) and Vicker's hardness tester was used for the changes in microhardness(VHN). A representative sample from each group was visualized by SEM. Data were analyzed by One-way ANOVA, Welch, Fisher's, Kruskall-Wallis, Wilcoxon Sign Rank and Paired t-tests(p<0.05). RESULTS: After 12- week brushing, no differences were found among the groups in terms of color change(p=0.989). All toothpastes tested showed no clinically acceptable whitening performances. A substantial increase in surface roughness was found in all groups, except BW(p<0.05). An increase was found in microhardness with CT(p=0.013), while no changes were found with BK, BW and COW(p>0.05).Only few scratches were observed on the enamel surfaces by SEM evaluations. CONCLUSION: Twelve week brushing with charcoal based whitening toothpastes and a regular fluoridated toothpaste presented similar effects in color of enamel. Surface roughness was increased(except BW) while microhardness was not affected(except CT) with charcoal based whitening toothpastes. CLINICAL RELEVANCE: Charcoal based whitening toothpastes do not promise to whiten the human permanent teeth and their effects on enamel abrasion should not be disregarded.

Consensus on glass-ionomer cement thresholds for restorative indications.

OBJECTIVE: The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications. METHODS: Twenty-one experts on GICs evaluated the results of tests on mechanical and optical properties of 18 different brands of restorative GICs: Bioglass R [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z [IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [MA], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. All experiments were carried out by a team of researchers from Brazil and England following strict protocols, under the same laboratory conditions throughout, and maintaining data integrity. RESULTS: There was consensus on: determining as primary properties of the material: compressive strength, microhardness, acid erosion and fluoride release, and as secondary properties: contrast ratio and translucency parameter, in order to rank the materials. Seven brands were below the thresholds for restorative indications: IZ, IM, IG, MA, VF, B and MG. CONCLUSIONS: Based on the primary properties adopted as being essential for restorative indications, the conventional restorative GICs that met the thresholds and could be considered suitable as long-term restorative materials were: EF, GI, GL9, KM, IP, GL2, IS, CR, V, VM and R. A decision-making process to select the best GIC must also include results from clinical trials. CLINICAL SIGNIFICANCE: This study provides a ranking of GICs that could be considered suitable as long-term restorative materials based on their main properties.

Does a new formula have an input in the clinical success of posterior composite restorations? A chat study.

OBJECTIVE: To compare the clinical behavior of a universal light-curing, ultra-fine particle hybrid composite and successor of this material in class I and II cavities after 60 months. MATERIALS AND METHODS: Forty patients (21 females, 19 males) with ages ranging between 18 and 38 years (23.15 ± 5.15) received 80 (13 Cl I and 67 Cl II) resin composite restorations (Charisma/Charisma Classic, Kulzer GmbH) in combination with an etch and rinse adhesive system (Gluma 2Bond) under rubber dam isolation. Two experienced operators performed all the restorations. Restorations were evaluated by the other two examiners according to the FDI criteria at baseline and at 6, 12, 18, 24, 36, 48 and 60 months. Surface characteristics of one restoration selected randomly were examined under a scanning electron microscope (SEM) at each recall. Data were analyzed statistically (p < 0.05). RESULTS: After 60 months, recall rate was 90%. None of the restorations failed. Three restorations from Charisma and 4 from the Charisma Classic group showed minor surface staining. Twelve Charisma and 14 Charisma Classic restorations were scored as 2 for margin staining. Four restorations from both groups showed minor shade deviations but no significant difference was observed between the two restorative materials for any criteria evaluated after 60 months (p > 0.05). SEM evaluations were in accordance with the clinical findings. CONCLUSIONS: Both materials exhibited clinically similar and successful performance over the 60-month observation period. CLINICAL RELEVANCE: A new formulation of resin composite may not always perform better clinical performances. TRIAL REGISTRATION: ClinicalTrials.gov : NCT02888873.

One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial.

OBJECTIVE: This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months. METHODOLOGY: 134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer's instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar's tests were used to detect differences over time. RESULTS: After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months. CONCLUSION: Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year. CLINICAL RELEVANCE: Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases.

Mechanical Properties of Glass Ionomer Cements after Incorporation of Marine Derived Porous Cuttlefish Bone Hydroxyapatite.

The purpose of this study was to evaluate the effects of the incorporation of hydroxyapatite (HA) derived from cuttlefish bone on the mechanical properties of glass ionomer cements (GIC). Fuji II LC and Fuji IX GP Extra (GC Corporation, Tokyo, Japan) were used in the study. There were four groups (n = 11-18) for each material: a group without the addition of HA particles and three groups modified by incorporation of 2, 5, and 10 wt% HA. The tests were performed on a universal testing machine (Shimadzu, Duisburg, Germany) and descriptive statistics, two-way analysis of variance (ANOVA) for the comparison of three mechanical properties, and one-way ANOVA for the comparison of different concentrations for each material were performed. Regarding the Fuji IX groups, compressive strength (CS) and flexural strength (FS) were highest in the group without HA particles added. The differences in CS between the Fuji IX group without HA particles and the Fuji IX groups with 2 wt% HA and 10 wt% HA were significant. The Fuji II 5 wt% HA group exhibited higher diametral tensile strength (DTS) and CS than other Fuji II groups, but not significantly. The Fuji II group, modified with 10 wt% HA, exhibited significantly higher FS than the Fuji II group without HA particles (p < 0.05). Porous HA incorporated into the Fuji IX groups had a significant impact on mechanical properties only in the Fuji IX 5 wt% HA group. Fuji II groups modified with 10 wt% HA showed the most favorable results with respect to FS.

Clinical Evaluation of a Self-Adhering Flowable Resin Composite in Minimally Invasive Class I Cavities: 5-year Results of a Double Blind Randomized, Controlled Clinical Trial.

OBJECTIVE: The aim of this study was to evaluate the long-term clinical performance of a self-adhering flowable resin composite compared to a conventional flowable resin composite used with an etch&rinse adhesive system in minimally invasive Class I cavities. MATERIALS AND METHODS: Twenty-five patients received at least one pair of Class I restorations (n=65). After class I cavities had been prepared, they were randomly restored either with a self-adhering flowable resin composite (VertiseFlow/Kerr-VR) [Group-1 (n=33)], or with a flowable resin composite (Luxaflow/DMG-LX) in combination with an etch&rinse adhesive (Teco/DMG) [Group-2 (n=32)] according to the manufacturers' instructions. The restorations were evaluated at baseline and yearly during 5 years according to the FDI criteria by two evaluators. A statistical analysis was carried out using the Pearson Chi-Square test and the Cochran Q-test followed by the Mc Nemar's test (p=0.05). RESULTS: After 5 years a total of 47 restorations were evaluated with a recall rate of 68%. At 4-year, 3 (11.5%) VR and 2 LX (7.6%) restorations exhibited a cumulative retention loss. Seventeen (73.9%) VR and 14 LX (58.3%) restorations exhibited clinically acceptable (2) scores for marginal adaptation. At 5-year evaluations VR and LX showed similar results regarding all evaluated criteria (p > 0.05). The cumulative retention loss rates of VR and LX were 15.3% and 7.6%, respectively. None of the restorations demonstrated a recurrence of caries and post operative sensitivity. Both materials showed significant changes at 4 and 5 years regarding marginal staining when compared to baseline (p<0.001). Furthermore, significant changes were observed for VR and LX at 1, 2, 3, 4 and 5 years for marginal adaptation according to baseline (p<0.001). CONCLUSION: The use of both materials for the restoration of Class-I cavities demonstrated clinically acceptable performance at the end of 5-year. The self-adhering flowable composite exhibited a clinical performance similar to the conventional flowable applied with an etch&rinse adhesive.

A randomized controlled 10 years follow up of a glass ionomer restorative material in class I and class II cavities.

OBJECTIVE: To evaluate the durability of a glass ionomer restorative material in Class I and Class II cavities during 10 years compared with a micro filled composite resin. METHODS: Fifty-nine participants (mean age 24 years) received 140 (80 Class I and 60 Class II) glass ionomer (GI) or composite resin (CR) restorations. Evaluation was performed with slightly modified USPHS criteria at baseline, and yearly during the 10 years. Data were analyzed with Cohran's Q and McNemar's tests. RESULTS: Fifty-one patients and 124 restorations (61 GI / 38 Class I - 23 Class II, 63 CR / 38 Class I, 25 Class II) were evaluated after 10 years. The recall rate was 86.4%. The overall clinical recall rate of restorations was 88.6%. The success rate of Class I and II restorations were calculated as 100% for both materials. The cumulative failure rate (CRF) of all Cl I and Cl II GI restorations was 3.17% in total, but CFR was 8 % for Cl II GI restorations. A significant difference was observed between the marginal discoloration scores of restorations at 10 years (p = 0.022). No significant difference was seen between two restorative materials in terms of marginal adaptation (p > 0.05). A significant change was seen in color match of GI restorations at 10 years (p < 0.05). No significant change was found for the anatomical form, secondary caries, postoperative sensitivity, surface texture, and retention for either restorative material (p > 0.05). CONCLUSIONS: Both tested restorative materials showed an acceptable success rate in the restoration of Class I and Class II cavities during the 10-year follow up.

Twenty-four-month clinical performance of a glass hybrid restorative in non-carious cervical lesions of patients with bruxism: a split-mouth, randomized clinical trial.

AIM: The aim of the present study was to evaluate the clinical performance of a glass hybrid restorative compared with a nano-ceramic composite resin in non-carious cervical lesions (NCCLs) of patients with bruxism. MATERIALS AND METHODS: Twenty-five patients with NCCLs and bruxism were enrolled in the present study. Before treatment, the dimensions of the NCCLs (depth, cervico-incisal height, and mesio-distal width) and internal angles were measured. Degree of tooth wear (TWI) and gingival conditions were recorded. A total of 148 NCCLs were randomly restored with a glass hybrid restorative system (GH) (Equia Forte Fil, GC, Tokyo, Japan) or a nano-ceramic composite resin (RBC) (Ceram.X One Universal, Dentsply, DeTrey, Konstanz, Germany). The restorations were evaluated at baseline and after 6, 12, and 24 months according to the modified USPHS criteria. Data were analyzed with Pearson's chi-square, Fisher's exact, Mann-Whitney U, and Cochran's Q tests (P < 0.05). RESULTS: At the 24-month recall, 126 restorations in 22 patients were evaluated. The recall rate was 88.0%. No significant difference was found between the materials for retention (P = 0.285), and no relationships were found between internal angle, depth, cervico-incisal height, or mesio-distal width and retention of the restorations (P > 0.05). A significant difference was observed between the materials for marginal adaptation (P = 0.002), but no relationships were found among depth, cervico-incisal height, and mesio-distal width and marginal adaptation (P > 0.05). RBC showed better results for marginal adaptation. Between marginal adaptation, TWI, and the gingival index, correlations were significant (P < 0.001, P = 0.002). A significant change was found in marginal discoloration in GH and RBC over time (P = 0.039 and P = 0.004, respectively). Neither secondary caries nor tooth sensitivity was observed on any of the restorations at any evaluation. CONCLUSION: Although nano-ceramic RBC showed better marginal adaptation than GH, both tested restoratives showed clinically acceptable performance for the restoration of NCCLs of patients with bruxism after 24 months of clinical service. TRIAL REGISTRATION: This study is registered on http://clinicaltrials.gov under protocol record KA-16020, Clinical Performance of a Glass Hybrid Restorative in NCCL's of Patients With Bruxism.