Comparison of Different Universal Adhesive Systems on Dentin Bond Strength.

Over the past few decades, adhesive dentistry has advanced significantly. In light of minimal-invasive dentistry, this novel technique advocates a more conservative cavity design that relies on the efficiency of present enamel-dentine adhesives. The study aimed to address the scientific deficit in understanding the long-term bonding performance of universal adhesives and to provide a new clinical solution with desirable bond strength to dentin. The dentin bond strength of three bonding agents, G2-Bond Universal (GC), Clearfil SE Bond (Kuraray), and Scotchbond Universal Plus (3M ESPE), was evaluated following various storage and etching modes. The UltraTester (Ultradent) bond strength testing machine was used to assess shear bond strength. The results showed that thermal cycling and the choice of adhesive system significantly affected the shear bond strength (p = 0.018 and p = 0.001, respectively). Among the three adhesives, Scotchbond Universal Plus had the lowest bond strength value (mean value = 24.78 MPa), while G2-Bond Universal was found to have desirable shear bond strength to dentin compared to the other adhesives, even after one year in the oral environment (mean value = 35.15 MPa). These findings imply that the HEMA-free universal adhesive G2-Bond Universal is the most effective universal adhesive for clinical practices, particularly when applied in the self-etch mode.

The Effect of a Green Smoothie on Microhardness, Profile Roughness and Color Change of Dental Restorative Materials.

Acidic drinks are known to exert negative effects on the surface properties of dental restorative materials. However, the effect of increasingly popular green smoothie drinks has not been addressed so far. The present study investigated the effect of cyclic immersions (5 min daily over 30 days) in a green smoothie drink on the surface properties of contemporary dental restorative materials, including resin composites, an alkasite, and a glass hybrid. Vickers microhardness, profile roughness, and perceptible color change in the CIE L* a* b* color space were evaluated as clinically relevant properties of the material surface. After 30-day green smoothie immersion, microhardness values either decreased by 8-28% (for resin composites) or increased by up to 91% (for glass hybrid). The increase in profile roughness (Ra parameter) of smoothie-immersed specimens was 7-26 times higher compared to the control group. The perceptible color change (ΔE*) in the smoothie group was 3-8 times higher compared to the control group. Overall, this study demonstrated that daily exposure of dental restorations made from resin composites, alkasites, and glass hybrid materials to a green smoothie drink can significantly accelerate material degradation, which is reflected as surface softening, as well as higher roughness and higher perceptible color change.

Estimating willingness-to-pay for health care: A discrete choice experiment accounting for non-attendance to the cost attribute.

RATIONALE, AIMS, AND OBJECTIVES: The literature suggests that discrete choice experiments (DCEs) are a preferable method for estimating willingness-to-pay (WTP) values, as they may avoid some biases often observed in contingent valuation surveys, such as protest and strategic behaviour. However, the choice studies have demonstrated that attribute non-attendance may be a serious issue that leads to biased WTP estimates. METHOD: A DCE was used to estimate patients' WTP for dental care at the dental school clinic. The endogenous attribute attendance (EAA) model was used to estimate WTP for dental care attributes, while accounting for non-attendance to the cost attribute. RESULTS: The EAA model revealed that almost every second respondent had ignored the cost attribute when making choices, indicating that patients were very sensitive to other characteristics of dental care. Dental care providers should pay particular attention to providing a detailed explanation of treatment to their patients, as this was the most valued attribute of dental care. The welfare estimates from the EAA model, which accounted for non-attendance to the cost attribute, were more than two times lower than welfare estimates from a traditional multinomial logit model and mixed logit model estimated in WTP space. CONCLUSIONS: The findings raise concerns for derived WTP estimates in DCE studies that did not consider non-attendance to the cost attribute during the estimation process. Non-attendance to the cost attribute overestimates WTP values, even if being motivated by the true preferences of respondents.

Valuing the delivery of dental care: Heterogeneity in patients' preferences and willingness-to-pay for dental care attributes.

OBJECTIVES: To examine the amount of heterogeneity in patients' preferences for dental care, what factors affect their preferences, and how much they would be willing to pay for improvement in specific dental care attributes. METHODS: A discrete choice experiment (DCE) was used to elicit patients' preferences. Three alternative dental care services that differed in the type of care provider, treatment explanation, dental staff behavior, waiting time and treatment cost were described to patients. Patients (n=265) were asked to choose their preferred alternative. The study was conducted at a public dental clinic of the School of Dental Medicine, University of Zagreb. Mixed logit and latent class models were used for analysis. RESULTS: On average, the patients would be willing to pay €45 for getting a detailed explanation of treatment over no explanation. This was the most valued attribute of dental care, followed by dental staff behavior with marginal willingness-to-pay (WTP) of €28. Dental care provided by the faculty members and private dental care were valued similarly, while student-provided care was valued €23 less. Patients also disliked longer waiting time in the office, but this was the least important attribute. Four classes of patients with distinct preferences for dental care were identified. Older and/or more educated patients tended to give relatively less importance to treatment explanation. Higher education was also associated with a higher propensity to substitute faculty dental care with the private care providers. CONCLUSIONS: Large heterogeneity in patients' preferences was detected. Understanding their preferences may improve the delivery of dental care. CLINICAL SIGNIFICANCE: Dental care providers should pay particular attention to providing a detailed treatment explanation to their patients. Dental care for older and/or more educated patients should be more attentive to interpersonal characteristics. Faculty dental care provided by faculty members could be price competitive to private care, and student-provided care more affordable.

Attitudes of Students of Differenet Schools of University of Zagreb on Tooth Bleaching.

OBJECTIVE: To compare the awareness that students from four different faculties within the University of Zagreb have of oral health and tooth bleaching procedure. MATERIALS AND METHODS: The study included 158 subjects (both male and female) - 38 students from the School of Dental Medicine and 40 students from each of the following faculties: the School of Medicine, the Faculty of Economics and the Faculty of Civil Engineering. The respondents were asked to fill out the survey with multiple choices by marking the answers they considered correct. RESULTS: Only 12% of the respondents followed the information on oral health. More than two thirds of all subjects brush their teeth twice a day, but there were no statistically significant differences between the subjects with respect to college or gender. More than half of the participants (55%) were satisfied, and 12% were completely satisfied with their dental appearance. About 80% of the respondents were aware of differences between teeth bleaching and teeth polishing procedures, with greater prevalence among Dental Medicine and Medicine students. 80% of all subjects would go to a dental office if they decided to whiten their teeth while less than a half (46%) of all the subjects believed that a tooth bleaching has some adverse side-effects. CONCLUSIONS: There is a difference in knowledge on oral hygiene and tooth bleaching between the students from the School of Dental Medicine, the School of Medicine, the Faculty of Economics and those from the Faculty of Civil Engineering. Dental students have the best knowledge on tooth bleaching and oral health, which was in accordance with their educational guidance and level of education.