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).

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).

Clinical Performance of a "No Wait" Universal Adhesive in Noncarious Cervical Lesions: A Two-year Randomized Controlled Clinical Trial.

PURPOSE: To evaluate the 24-month clinical performance of a "no wait" universal adhesive with different application modes in comparison with an etch-and-rinsew and two-step self-etch adhesive in non-carious cervical lesions (NCCLs). MATERIALS AND METHODS: A total of 234 non-carious cervical lesions in 34 patients were restored following 5 different adhesive approaches: 1. Clearfil Universal Bond Quick, self-etch mode (CUQ-SE); 2. Clearfil Universal Bond Quick, selective etch mode (CUQ-SLE); 3. Clearfil Universal Bond Quick, etch-and-rinse mode (CUQ-ER); 4. Clearfil SE Bond (self-etch adhesive) (CSEB); 5. Tetric N-Bond Universal, etch-and-rinse mode (TBU-ER). All NCCLs were restored with a nanohybrid composite (Tetric N-Ceram). The restorations were evaluated at baseline, 6, 12, and 24months of clinical service regarding retention, marginal adaptation, marginal discoloration, secondary caries, post-operative sensitivity, color match, surface texture using modified United States Public Health Service (USPHS) criteria. RESULTS: The patient recall rate at 24 months was 73.5%. Eleven restorations, 6 of the CUQ-SE group, 4 of the CSEB group and 1 of the TBU-ER group, were clinically unacceptable due to retention loss. Regarding marginal adaptation and discoloration, CUQ-SE and CSEB groups exhibited higher bravo scores than other groups after 24 months (p < 0.05). At the end of 24-month examinations, no significant differences were detected among the groups regarding secondary caries, post-operative sensitivity, color match and surface texture. CONCLUSION: The clinical survival rates of the "no wait" universal adhesive at self-etch mode after 24 months were not acceptable. The "no wait" universal adhesive showed clinically acceptable performance in selective-etch and etch-and-rinse mode according to the evaluated USPHS criteria.

A randomized, controlled clinical evaluation of two resin cement systems in the adhesion of CAD/CAM-fabricated resin nanoceramic restorations: 18-month preliminary results.

OBJECTIVE: The purpose of this clinical study was to evaluate the performance of two different adhesive resin cement systems in the cementation of inlay/onlay restorations produced from resin nanoceramic blocks using the CAD/CAM system. MATERIALS AND METHODS: A total of 70 inlay/onlay restorations made from Cerasmart (GC, Tokyo, Japan) resin nanoceramic blocks using CEREC Omnicam (Sirona Dental, Bensheim, Germany) were placed in 53 patients. The restorations were cemented with RelyX U200 Automix (3M ESPE, Seefeld, Germany) self-adhesive resin cement (RXU) after selective enamel etching or with G-CEM LinkForce (GC, Tokyo, Japan) adhesive resin cement (GCL) in combination with a universal adhesive (G-Premio Bond) in selective etch mode. At baseline and after 6, 12, and 18 months, restorations were examined by two calibrated clinicians according to modified USPHS criteria. The data were analyzed using Chi-square (χ2 ) test and Friedman test (p < 0.05). RESULTS: After 18 months, two teeth at RXU group were endodontically treated due to hypersensitivities. At GCL group, three restorations were lost due to debondings (2) and ceramic fracture (1). The survival rates of RXU (94.3%) and GCL group (91.4%) exhibited no statistically significant difference (p = 0.661). No significant differences were detected for surface texture, secondary caries, anatomic form, color match, marginal discoloration, marginal integrity, interproximal contacts, and patient satisfaction (p > 0.05). CONCLUSIONS: The two resin cement systems showed acceptable clinical performance for the cementation of resin nanoceramic CEREC Omnicam inlay/onlay restorations. CLINICAL SIGNIFICANCE: Resin nanoceramic restorations fabricated using CEREC Omnicam and cemented with either a self-adhesive or a universal adhesive/resin cement system demonstrated clinically acceptable results for posterior teeth in a single visit.

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.

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.

A clinical evaluation of resin nanoceramic CEREC Omnicam restorations associated with several factors.

PURPOSE: The aim of this study was to assess the clinical performance of computer-aided design and computer-aided manufacturing resin nanoceramic posterior restorations fabricated by CEREC Omnicam system. MATERIALS AND METHODS: Fifty-seven Lava Ultimate posterior restorations were placed in 44 patients by one operator. Restorations were cemented using a resin cement system (Duo-Link). The clinical performance of the restorations was evaluated with USPHS guidelines in a mean time of 45-month. Data were statistically analyzed using Kaplan-Meier and Log Rank (Mantel-Cox) tests (SPSS 22.0, α = 0.05). RESULTS: Thirty-eight restorations in 26 patients were evaluated at recall examinations by two evaluators other than the clinician who had placed the restorations who were blinded to groups. The survival rates of Lava Ultimate were 86.8%. A total of 5 (13.2%) failures were found. After a mean time of 45-month survival rate of vital and non-vital teeth were 90 and 83.3% respectively. The failures were not significantly influenced by gender, tooth arch, restoration size, the treated region and vitality. CONCLUSION: Chair-side posterior resin nanoceramic restorations were clinically successful restorations with a survival rate of 86.8% after a mean time of 45-month. CLINICAL SIGNIFICANCE: Chair-side CAD/CAM resin nanoceramic restorations can be a successful choice for vital and non-vital teeth with acceptable survival rates.

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.

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.

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

Abstract 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.

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial.

OBJECTIVE: The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). MATERIAL AND METHODS: Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). RESULTS: The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. CONCLUSION: GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

An 18-month clinical evaluation of three different universal adhesives used with a universal flowable composite resin in the restoration of non-carious cervical lesions.

OBJECTIVE: The aim of this randomized, controlled prospective clinical trial was to evaluate and compare the performances of three different universal adhesives using a flowable universal composite resin in the restoration of non-carious cervical lesions (NCCLs) over an 18-month period. MATERIALS AND METHODS: Eighteen participants recieved 99 restorations from a single operator. NCCLs were divided into three groups according to adhesive systems used: Clearfil Universal Bond (CU), iBOND Universal (IU), and G-Premio Bond (GP). No enamel bevel was placed and no mechanical retention was created for the NCCLs. Prior to adhesive procedures, selective etching was performed with 37% phosphoric acid. Adhesive systems were applied following manufacturers' instructions and the lesions were restored with a flowable composite resin (G-ænial Universal Flo). Restorations were finished and polished immediately after placement and scored with regard to retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified USPHS criteria after a week (baseline) and 6, 12, and 18 months. Descriptive statistics were performed using chi-square tests. RESULTS: The 18-month recall rate was 88.8% and retention rates for CU, IU, and GP were 100%, 96.8%, and 100%, respectively. No restorations exhibited post-operative sensitivity and secondary caries. After 18 months, CU, IU, and GP groups showed similar alpha rates for marginal adaptation (CU 93.1%, IU 90%, GP 81.8%) and marginal discoloration (CU 100%, IU 90%, GP 87.9%). A total of ten (CU 2, IU 3, GP 5) restorations exhibited bravo scores for surface texture and three (CU 2, GP 1) restorations showed bravo score for color match. No statistical differences were found among the tested adhesives for any criteria evaluated (p > 0.05). CONCLUSION: The three adhesive systems demonstrated similar performances during the 18-month follow-up in the restoration of NCCLs. CLINICAL RELEVANCE: Universal adhesives could be used successfully in the restoration of NCCLs.

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial

Abstract Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

Comparison of Er,Cr:YSGG Laser Handpieces for Class II Preparation and Microleakage of Silorane- or Methacrylate-Based Composite Restorations.

OBJECTIVE: The aim of this study was to evaluate the influence of cavity preparation with different Er,Cr:YSGG laser handpieces on microleakage of different posterior composite restorations. METHODS: Fifty-four extracted intact human premolars were randomly assigned to three groups according to cavity preparation method: Bur Group: high-speed diamond bur (Diatech), MD Group: Er,Cr:YSGG laser Waterlase MD handpiece (Biolase Millennium II), and Turbo Group: Er,Cr:YSGG laser Waterlase MD TURBO handpiece (Biolase Millennium II). One hundred eight Class II slot cavities were prepared on the mesial and distal proximal surfaces of each tooth, and the cavity preparation times required were determined. The groups were then subdivided according to the restorative systems used (n = 12): a conventional methacrylate-based microhybrid composite (Filtek P60+Adper Single Bond 2/3M); a silorane-based resin composite (Filtek Silorane+Silorane System Adhesive/3M); and a nanohybrid methacrylate-based composite (Kalore+G-Bond/GC). The restorative systems were applied according to the manufacturers' recommendations. Following thermocycling (X5000; 5°C-55°C), the teeth were coated with nail varnish except the restoration margins, immersed in 0.5% basic fuchsin dye solution, and sectioned in a mesiodistal direction. Dye penetration was evaluated under a light microscope for occlusal and cervical margins. Data were analyzed with one-way ANOVA and chi-square tests (p < 0.05). RESULTS: The cavity preparation time (mean ± SD) required for Bur, MD, and Turbo group was 31.25 ± 3.82, 222.94 ± 15.85, and 92.5 ± 7.42 sec, respectively, and the differences among the groups were statistically significant (p < 0.05). Comparing the occlusal and cervical microleakage scores, no statistically significant differences were found among the groups and subgroups (p > 0.05). CONCLUSIONS: Er;Cr:YSGG laser cavity preparation with the Turbo handpiece needed shorter time than the MD handpiece, although it needed longer time than the conventional diamond bur. The use of different handpieces of Er,Cr:YSGG laser did not differ from conventional preparation with diamond bur in terms of microleakage with the tested methacrylate- and silorane-based posterior composite restorative systems.

Effect of various bleaching treatments on shear bond strength of different universal adhesives and application modes.

OBJECTIVES: The aim of this in vitro study was to evaluate the bond strength of 2 universal adhesives used in different application modes to bleached enamel. MATERIALS AND METHODS: Extracted 160 sound human incisors were used for the study. Teeth were divided into 4 treatment groups: No treatment, 35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide. After bleaching treatments, groups were divided into subgroups according to the adhesive systems used and application modes (n = 10): 1) Single Bond Universal, etch and rinse mode; 2) Single Bond Universal, self-etch mode; 3) Gluma Universal, etch and rinse mode; 4) Gluma Universal, self-etch mode. After adhesive procedures nanohybrid composite resin cylinders were bonded to the enamel surfaces. All specimens were subjected to shear bond strength (SBS) test after thermocycling. Data were analyzed using a 3-way analysis of variance (ANOVA) and Tukey post hoc test. RESULTS: No significant difference were found among bleaching groups (35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide, and no treatment groups) in the mean SBS values. There was also no difference in SBS values between Single Bond Universal and Gluma Universal at same application modes, whereas self-etch mode showed significantly lower SBS values than etch and rinse mode (p < 0.05). CONCLUSIONS: The bonding performance of the universal adhesives was enhanced with the etch and rinse mode application to bleached enamel and non-bleached enamel.