An 18-month clinical evaluation of prolonged polymerization of a universal adhesive in non-carious cervical lesions: A double-blind randomized clinical trial.

OBJECTIVE: This study aimed to evaluate the effect of prolonging polymerization time on the 18 months clinical performance of a universal adhesive system used as etch-and-rinse (ER) and self-etch (SE). METHODS: 140 restorations were randomly placed in 35 subjects according to the following groups: ER10 (light-curing for 10 s); ER40 (light-curing for 40 s); SE10 (light-curing for 10 s) and; SE40 (light-curing for 40 s/1200 mW/cm2). A resin composite was placed incrementally. The restorations were evaluated at baseline and after 18 months by using the FDI criteria. The following outcomes were evaluated: marginal staining, marginal adaptation, spontaneous post-operative sensitivity and recurrence of caries. The differences among the groups were calculated using Friedman repeated measures analysis of variance rank (α = 0.05). RESULTS: After 18 months the retention/fracture rates were 88.9% (95%CI 74.1-95.6%) for ER10, 94.3% (95%CI 91.4-98.5%) for ER40, 77.2% (95%CI 60.1-87.9) for SE10 and 97.2% (95%CI 85.5-99.9%) for SE40. A significant difference was detected in the retention rate when SE10 was compared to the SE40 (p = 0.01). Also, ER40 showed a significant improvement of the marginal adaptation when compared to ER10 (p = 0.01). SIGNIFICANCE: This is the first study that demonstrates an improvement in the clinical performance of universal adhesive systems in non-carious cervical lesions when prolonged light-cured was applied.

Influence of Application of Dimethyl Sulfoxide on the Bonding Properties to Eroded Dentin.

PURPOSE: To evaluate the effect of dimethyl sulfoxide (DMSO) on the microtensile bond strength (µTBS), nanoleakage (NL), and degree of conversion (DC) of universal adhesives on eroded dentin. MATERIALS AND METHODS: One hundred thirty-four extracted (134) human third molars were selected for the study. After the dentin surface was exposed, 128 teeth were randomly assigned to 16 experimental groups as follows: dentin surfaces (sound dentin and eroded dentin), application of DMSO (without or with the application of DMSO), and adhesive strategies (etch-and-rinse [ER] and self-etch [SE]). The universal adhesive systems iBond Universal (IBU) and Scotchbond Universal (SBU) were applied and the teeth were restored using a resin composite. After 24 h in distilled water at 37°C, the samples were sectioned and evaluated for µTBS. Selected sticks from each tooth were used for evaluating NL and DC. The remaining six teeth were used to measure the thickness of the collagen layer of the artificially eroded dentin using scanning electron microscopy. Data on µTBS, NL, and DC (%) were analyzed using three-way ANOVA and Tukey's test (α = 0.05). RESULTS: Significantly lower µTBS (p = 0.0001) and DC (p = 0.01) were observed for eroded dentin than for sound dentin. However, a significant increase in the µTBS (p = 0.0007) and DC (p = 0.001) was observed for both substrates when DMSO was applied. Moreover, the application of DMSO decreased the concentration of silver nitrate at the bottom of the hybrid layer for both sound and eroded dentin (p = 0.002). Eroded dentin showed enlarged tubules with the presence of a collapsed collagen fibril layer approximately 5.0 ± 2.0 mm of thickness. CONCLUSION: The bonding performance of both tested universal adhesives improved on both sound and eroded dentin with DMSO pretreatment.

Collagen cross-linking agents + dimethyl sulfoxide improving the adhesive properties of erosive lesion dentin

Abstract To investigate the effect of the dimethyl sulfoxide combined with cross-linking agents on microtensile bond strength, silver nitrate penetration and in situ degree of conversion analysis of adhesives to the erosive dentin treatment with Cola-based soft drink. One hundred and sixty-six molars were assigned to 20 groups: (1) Treatment: Sound dentin; Erosive dentin; Erosive dentin treated with primer of dimethyl sulfoxide; Erosive dentin treated with DMSO primer containing proanthocyanidin and rivoflavin; (2) Adhesive systems: iBond Universal and Scotchbond Universal; and (3) adhesive strategy: etch-and-rinse or self-etch strategy. After restoration, specimens were sectioned into sticks to be tested. The data from microtensile bond strength (MPa), silver nitrate penetration (%) and in situ degree of conversion (%) were analyzed by (three- and two-factor ANOVA; Tukey's test α=5%). The application of dimethyl sulfoxide combined of not with cross-linkers improved all properties evaluated when compared to only erosive dentin treatment with Cola-based soft drink. However, only when dimethyl sulfoxide was combined to cross-linkers, the values of the microtensile bond strength, silver nitrate penetration and in situ degree of conversion in erosive dentin treatment with Cola-based soft drink was similar to sound dentin, for both adhesives and adhesive strategies. The application of dimethyl sulfoxide combined with the collagen cross-linking agent contributed to increasing the bond strength and degree of conversion in erosive lesion dentin, at the same time that significantly reduction of nanoleakage in this substrate.

Resumo Este estudo investigou o efeito do dimetil sulfóxido combinado a agentes de reticulação de colágeno na resistência de união à microtração, infiltração de nitrato de prata e análise do grau de conversão por Micro-Raman de sistemas adesivos universais para a dentina erosionada por refrigerante a base de Cola. Cento e sessenta molares foram divididos em 20 grupos: (1) Tratamento: Dentina sadia; Dentina erosionada; Dentina erosionada tratada com primer de dimetil sulfóxido; Dentina erosionada tratada com primer contendo 6,5% de proantocianidina e; Dentina erosionada tratada com primer contendo 0,1% de rivoflavina; (2) Sistemas adesivos: iBond Universal e Scotchbond Universal; e (3) estratégia adesiva: estratégia condicionamento e lavagem ou autocondicionate. Após a restauração, os espécimes foram seccionados em palitos e testados. Os dados dos três testes foram analisados estatisticamente (ANOVA de 2 e 3 fatores e teste de Tukey; α = 5%). A aplicação de dimetil sulfóxido combinado ou não agentes de reticulação de colágeno melhorou todas as propriedades avaliadas quando comparado a dentina erosionada. Entretanto, apenas quando o dimetil sulfóxido foi combinado com agentes de reticulação de colágeno, os valores de adesão a dentina, infiltração de nitrato de prata e grau de conversão em dentina erosionada foi semelhante a dentina sadia, para os dois adesivos e estratégias adesivas. A aplicação de dimetil sulfóxido combinado com agentes de reticulação de colágeno contribuiu para aumentar a resistência de união e o grau de conversão dentro da camada híbrida na dentina erodida, ao mesmo tempo que reduziu significativamente a nanoinfiltração neste substrato.

Effect of Addition of Dimethyl Sulfoxide to Simplified Adhesives on Dentin Bond Durability after Three Years of Water Storage.

PURPOSE: To evaluate the effect of inclusion of two dimethyl sulfoxide (DMSO) concentrations in simplified etch-and-rinse adhesives on dentin bonding durability after three years of water storage. MATERIALS AND METHODS: Forty-two caries-free third molars were divided into six experimental groups (n = 7) according to the following factors: 1) adhesive (Adper Single Bond 2 [SB], 3M Oral Care; Prime&Bond 2.1 [PB], Dentsply Sirona); 2) concentration of DMSO (control group: 0.0% DMSO; addition of 0.2% DMSO [0.2] and 2% DMSO [2.0]). After completing restoration, specimens were stored in water (37°C) for 24 h, sectioned into adhesive-dentin sticks (0.8 mm2), tested for microtensile bond strength (µTBS) at 0.5 mm/min, and examined for nanoleakage (NL) using SEM immediately thereafter or after three years of water storage. Data were subjected to a three-way repeated-measures ANOVA and Tukey's test (α = 0.05) for each property evaluated. RESULTS: After three years of water storage, for both adhesives, the incorporation of 2% DMSO maintained the µTBS when compared to immediate µTBS (p > 0.05). In general, SB resulted in a statistically significantly higher mean of µTBS compared to PB, independent of the DMSO concentration after water storage (p < 0.05). Furthermore, the amount of NL was lower and practically limited to the hybrid layer given the concentrations of 0.2% and 2% DMSO for both tested adhesives after three years. CONCLUSION: The incorporation of DMSO in simplified etch-and-rinse adhesives maintains the long-term stability of the dentin bond.

Collagen cross-linking agents + dimethyl sulfoxide improving the adhesive properties of erosive lesion dentin.

To investigate the effect of the dimethyl sulfoxide combined with cross-linking agents on microtensile bond strength, silver nitrate penetration and in situ degree of conversion analysis of adhesives to the erosive dentin treatment with Cola-based soft drink. One hundred and sixty-six molars were assigned to 20 groups: (1) Treatment: Sound dentin; Erosive dentin; Erosive dentin treated with primer of dimethyl sulfoxide; Erosive dentin treated with DMSO primer containing proanthocyanidin and rivoflavin; (2) Adhesive systems: iBond Universal and Scotchbond Universal; and (3) adhesive strategy: etch-and-rinse or self-etch strategy. After restoration, specimens were sectioned into sticks to be tested. The data from microtensile bond strength (MPa), silver nitrate penetration (%) and in situ degree of conversion (%) were analyzed by (three- and two-factor ANOVA; Tukey's test α=5%). The application of dimethyl sulfoxide combined of not with cross-linkers improved all properties evaluated when compared to only erosive dentin treatment with Cola-based soft drink. However, only when dimethyl sulfoxide was combined to cross-linkers, the values of the microtensile bond strength, silver nitrate penetration and in situ degree of conversion in erosive dentin treatment with Cola-based soft drink was similar to sound dentin, for both adhesives and adhesive strategies. The application of dimethyl sulfoxide combined with the collagen cross-linking agent contributed to increasing the bond strength and degree of conversion in erosive lesion dentin, at the same time that significantly reduction of nanoleakage in this substrate.

Clinical Evaluation of the Effectiveness of Whitening Dentifrices / Avaliação Clínica da Eficácia de Dentifrícios Clareadores

O objetivo deste estudo clínico foi avaliar, por 7 semanas, a eficácia de dentifrícios clareadores e a satisfação dos pacientes após o uso. Foram selecionados 30 pacientes que possuíssem todos os dentes anteriores nas arcadas superior e inferior, apresentando cor inicial A2, avaliados através da escala de cores Vita Classical (Vita Zahnfabrik, Bad Säckingen, Alemanha). Os participantes foram aleatoriamente divididos em 3 grupos (n=10): GA - Colgate® Máxima Proteção Anticáries (controle negativo), GB - Colgate® Luminous White e GC - Colgate® Luminous White Advanced. Os dentifrícios foram distribuídos em bisnagas idênticas e aleatorizados. As avaliações de cor foram realizadas inicialmente ao uso (baseline), após 7, 15, 30 e 60 dias, utilizando dois métodos: avaliação subjetiva com as escalas de cor Vita Classical (Vita Zahnfabrik, Bad Säckingen, Alemanha) e Vita Bleachedguide 3D-MASTER (Vita Zahnfabrik, Bad Säckingen, Alemanha), e avaliação objetiva através do espectrofotômetro VITA Easyshade Compact®, Vident, Brea, CA, USA). Foi considerada a satisfação do paciente quanto a mudança de cor dos dentes. Os dados foram submetidos à análise estatística, utilizando análise de variância (ANOVA) de três critérios e pós-teste de Tukey (α=0.05). Os resultados demonstraram que houve diferença de cor estatisticamente significante nos grupos em que se utilizou os dentifrícios clareadores (GB e GC), nos períodos entre 15 e 30 dias. Conclui-se que ambos os dentifrícios GB e GC apresentaram ação clareadora, observado através das escalas subjetiva e objetiva. Porém, na percepção do paciente apenas no grupo GC houve mudança de cor. (AU).

The objective of this clinical study was to evaluate, for 7 weeks, the efficacy of whitening dentifrices and the patients' satisfaction after use. 30 patients were selected who had all the anterior teeth in the upper and lower arches, presenting an initial color A2, evaluated through the Vita Classical color scale (Vita Zahnfabrik, Bad Säckingen, Germany). The participants were randomly divided into 3 groups (n = 10): GA - Colgate® Maximum Antibody Protection (Negative Control), GB - Colgate® Luminous White and GC - Colgate® Luminous White Advanced. The dentifrices were distributed in identical and randomized tubes. The color evaluations were performed at baseline after 7, 15, 30 and 60 days using two methods: subjective evaluation with the Vita Classical (Vita Zahnfabrik, Bad Säckingen, Germany) and Vita Bleachedguide 3D- MASTER (Vita Zahnfabrik, Bad Säckingen, Germany), and objective evaluation using VITA Easyshade Compact® spectrophotometer, Vident, Brea, CA, USA). The patient's satisfaction with the teeth color change was considered. The data were submitted to statistical analysis using ANOVA of three criteria and Tukey post-test (α = 0.05). The results showed that there was a statistically significant difference in color in the groups in which the whitening dentifrices were used (GB and GC), in periods between 15 and 30 days. It was concluded that both GB and CG dentifrices presented a whitening action, observed through the subjective and objective scales. However, in the perception of the patient only in the CG group there was a change of color. (AU).

Effect of an experimental desensitizing agent on reduction of bleaching-induced tooth sensitivity: A triple-blind randomized clinical trial.

BACKGROUND: In this randomized study, split-mouth, triple-blind clinical trial, the authors evaluated the efficacy of a desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde applied before in-office bleaching with 35% hydrogen peroxide (HP). METHODS: Treatment with the desensitizing or placebo control gels was randomly assigned to one-half of the maxillary teeth of 42 patients in a split-mouth design. The desensitizing gels were applied and maintained in contact with the tooth enamel for 10 minutes, followed by 2 HP bleaching sessions separated by 1 week. The primary outcome variable was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a value-oriented shade guide. RESULTS: The difference in risk of developing tooth sensitivity between the desensitizing gel group (31.7%, 95% confidence interval [CI], 19.6 to 46.9) and the control group (70.7%; 95% CI, 55.5 to 82.3%) was statistically significant (P < .0001), as well as the difference in pain intensity in the first 24 hours (P < .001). No statistically significant difference was found in color change between teeth that received the desensitizing gel and those that received the placebo gel. CONCLUSIONS: Application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde before HP whitening reduced the risk and severity of dental sensitivity, without altering the effectiveness of whitening. PRACTICAL IMPLICATIONS: A single application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde can reduce tooth sensitivity after dental bleaching systems.

Effects of Dentin Moisture on Cementation of Fiber Posts to Root Canals.

PURPOSE: Achieving optimal moisture inside the root canal is a challenge during bonding of fiberglass posts. This study evaluated the effect of different moisture patterns on the push-out bond strength (PBS) and nanoleakage (NL) of fiber posts bonded to the root canal of two simplified etch-and-rinse adhesives. MATERIALS AND METHODS: The roots of 72 human premolars were endodontically prepared and divided into 6 groups according to the combination of the main factors: adhesive (Ambar and Adper Single Bond 2) and moisture (dry, wet, and overwet). The posts were cemented and after 1 week, the roots were cross sectioned into 6 disks. Two disks each were obtained from the cervical, middle, and apical thirds, and the PBS test was carried out (0.5 mm/min; n = 8). The NL was evaluated by scanning electron microscopy after the immersion of specimens in 50% silver nitrate (n = 4). The failure pattern was examined on all debonded specimens. Data were analyzed by three-way repeated measures ANOVA and Tukey's test (5%). RESULTS: For both adhesives, higher PBS values and lower NL were observed in the wet groups, and lower PBS and higher NL in the dry group. In general, the overwet condition showed intermediate results. CONCLUSIONS: The root dentin walls should be left slightly moist before performing fiber post cementation procedures.

Dentin bond optimization using the dimethyl sulfoxide-wet bonding strategy: A 2-year in vitro study.

OBJECTIVE: This study evaluated a new approach, named dimethyl sulfoxide (DMSO)-wet bonding, to produce more desirable long-term prospects for the ultrafine interactions between synthetic polymeric biomaterials and the inherently hydrated dentin substrate. METHODS: Sound third molars were randomly restored with/without DMSO pretreatment using a total-etch (Scocthbond Multipurpose: SBMP) and a self-etch (Clearfil SE Bond: CF) adhesive systems. Restored teeth (n=10)/group were sectioned into sticks and submitted to different analyses: micro-Raman determined the degree of conversion inside the hybrid layer (DC); resin-dentin microtensile bond strength and fracture pattern analysis at 24h, 1year and 2 years of aging; and nanoleakage evaluation at 24h and 2 years. RESULTS: DMSO-wet bonding produced significantly higher 24h bond strengths for SBMP that were sustained over the two-year period, with significantly less adhesive failures. Similarly, DMSO-treated CF samples presented significantly higher bond strength than untreated samples at two years. Both adhesives had significant less adhesive failures at 2 years with DMSO. DMSO had no effect on DC of SBMP, but significantly increased the DC of CF. DMSO-treated SBMP samples presented reduced silver uptake compared to untreated samples after aging. SIGNIFICANCE: Biomodification of the dentin substrate by the proposed strategy using DMSO is a suitable approach to produce more durable hybrid layers with superior ability to withstand hydrolytic degradation over time. Although the active role of DMSO on dentin bond improvement may vary according to monomer composition, its use seems to be effective on both self-etch and etch-and-rinse bonding mechanisms.

Influence of a hydrophobic resin coating on the bonding efficacy of three universal adhesives.

OBJECTIVES: To evaluate the effect of an additional hydrophobic resin coating (HE) on the resin-dentine microtensile bond strengths (µTBS), nanoleakage (NL), and in situ degree of conversion (DC) of three universal adhesives used in the etch-and-rinse (ER) and the self-etch (SE) modes. METHODS: Sixty caries-free extracted third molars were divided into 12 groups according to the combination of the factors adhesive (All-Bond Universal [ABU]; G-Bond Plus [GBP] and Scotchbond Universal [SBU]), adhesive strategy (ER and SE), and the use of HE (Heliobond; yes or no). After restorations were constructed, specimens were stored in water (37°C/24h) and sectioned into resin-dentine beams (0.8mm(2)) to be tested under tension (0.5mm/min). Selected beams from each tooth were used for DC quantification and for NL evaluation. Data from each adhesive were analyzed with two-way ANOVA and Tukey's test (α=0.05). RESULTS: ABU and GBP resulted in higher µTBS in the ER mode. The use of HE increased the µTBS of ABU and GBP only in the SE mode. Lower NL was observed for SBU and ABU in the ER mode+HE, and for GBP in the SE mode+HE. SBU and GBP showed higher DC when used in the ER mode, which was increased with HE application. The DC of ABU was similar in all conditions. CONCLUSIONS: The conversion of 1-step SE to 2-step SE may increase the µTBS and DC of current universal adhesives. The reduction in the NL is more dependent on the adhesive composition than on the bonding strategy.

Influência do polimento após manchamento de uma resina composta submetida a diferentes bebidas / Influence of polishing after staining of a composite subjected to different drinks

Objetivo: avaliar se o polimento pode minimizar ou resolver o manchamento ocasionado porcorantes de diferentes bebidas em resina composta. Material e Métodos: Confeccionou-se 40corpos-de-prova (CP)de resina composta microhíbrida Opallis (FGM), cor B1,em matriz plástica (5mm de diâmetro e 2 mm de espessura). A fotoativação foi realizada por 30s com LEDmetron I.Aseguir os CP's foram submetidos à avaliação inicial de cor em espectrofotômetro VITA EasyshadeCompact" obtendo-se valores correspondentes da escala CIEL*a*b*. Os CP foram divididos em 4grupos (n=10): água destilada (controle), café, Coca-Colaw e vinho tinto. Realizou-se avaliaçãoinicial da cor, após imersão por 60 dias para promover o manchamento e, após o procedimentode polimento com discos de feltro e pasta diamantada. Os dados foram analisados pela ANOVA2 fatores e pós-teste de Tukey (o=O,OS).Resultados: As médias ± desvio padrão de L* mostraramque a resina composta apresentou manchamento (p>O,OOl) após 60 dias de imersão em vinho(S7,96±7,98) e no café (61,89±3,S9) quando comparado a água destilada (73,49± 1,20) e a Coca--Cola" (70,SO±1,30). O polimento não conseguiu melhoria no manchamento (p

Objective: To assesswhether the polishing can minimize or solve the staining caused by dyes ofdifferent beverages in composite resins. Methods: 40 specimens were fabricated with composite resinmicrohybrid Opallis (FGM), B1 color in the plastic matrix (S mm in diameter and 2 mm thickl Thepolymerization was carried out with 30 seconds LEDmetron I.Then the specimens underwent initialevaluation of color spectrophotometer VITA Easyshade ® Compact obtaining corresponding valuesof the scale CIEL*a*b", The specimens were divided into four groups (n = 10): distilled water (controllcoffee, Coca-Colae and red wine. The specimens were again subjected to color evaluation initial,after the immersion for 60 days to promote the staining, and after the polishing procedure (felt discwith diamond paste). Data were analyzed by two-away ANOVA and Tukev's HSD test (0= O.OS).Results:mean ± standard deviation of L* showed that the composite showed staining (p¼ 0.001) after60 days of immersion in wine (S7.96 ± 7.98) and coffee (61.89 ± 3.S9) when compared to distilledwater (73.49 ± 1.20) and Coca-Cola ® (70.S0 ± 1.30).The polishing could not improve the staining (p<0.001) caused by wine and coffee. Conclusion: the polishing didn't minimize the stains caused bywine and coffee and such changes considered clinically detectable to the human eye.

Influência de diferentes bebidas na estabilidade de cor da resina composta / Influence of different drinks on the resin composites' color stability

A maior preocupação dos pacientes na Odontologia é a estética do sorriso. Nesse sentido, os fabricantes de materiais odontológicos têm aprimorado as resinas compostas, para que apresentem excelente estética e boas propriedades mecânicas. O objetivo do presente estudo é avaliar a influência de diferentes bebidas (vinho, coca-cola e café) na estabilidade de cor da resina composta com e sem escovação com dentifrício. Foram confeccionados corpos de prova com resina composta, os quais foram submetidos à avaliação inicial da cor e divididos em grupos que foram imersos por 30 e 60 dias, nos respectivos líquidos, referentes aos grupos experimentais. Após esse período de imersão, a cor foi novamente avaliada, e os corpos de prova, submetidos à escovação, para avaliar se a escovação é um método eficaz para prevenir ou diminuir o manchamento na resina composta, ocasionado pelas bebidas em estudo. As bebidas em estudo afetaram a estabilidade de cor das resinas compostas, apresentando alterações de cores visíveis. A escovação não foi eficaz na remoção da pigmentação pelo vinho tinto, porém propiciou melhoria no manchamento ocasionado pela coca-cola.

The main concern of patients in dentistry is the aesthetics of the smile. In this sense, the manufacturers of dental materials have improved, like the resins that are used for restorations in anterior and posterior teeth and that have excellent aesthetics and good mechanical properties. The aim of this study is to evaluate the influence of different drinks (wine, Coke and coffee) on color stability of composite resin with and without brushing with toothpaste. Specimens were fabricated with composite resin, which underwent an initial assessment of color and divided into groups that were immersed for 30 and 60 days in their net regarding the experimental groups. After this period of immersion, the color was measured again, and the specimens were submitted to brushing, to assess whether toothbrushing is an effective method to prevent or reduce the staining in composite resin, caused by drinking in study. Drinks in the study affected the color stability of composite resins, with color changes visible. Brushing was not effective in removing the pigment in red wine, however, resulted in improved staining caused by Coke.