Comparative Analysis of Techniques for Pit and Fissure Sealant Application to Reduce Microleakage.

Introduction In modern dentistry, the focus is more on preventing caries than on treating it, which helps preserve the tooth structure. Pit and fissure sealants (PFS) are the most effective methods for providing a mechanical barrier and avoiding the accumulation of dental plaque in deep pits and fissures, thereby preventing occlusal caries. The present study was conducted to compare the efficiency of dentin bonding agents (DBA) with or without fissurotomy in reducing microleakage before PFS placement. Materials and methods A total of 48 freshly extracted premolars were randomly divided into four groups as follows: Group 1, the conventional technique of PFS (Clinpro, 3M ESPE sealant); Group 2, fissurotomy performed before PFS placement; Group 3, Scotchbond Universal Adhesive (3M ESPE DBA) applied before PFS placement; and Group 4, fissurotomy along with DBA was used before PFS placement. The teeth were subjected to thermocycling followed by dye penetration using a 1% solution of methylene blue for 24 hours. All teeth were then assessed for microleakage by a qualitative method using a stereomicroscope at 40X and depth of dye penetration by image analysis. The Kruskal-Wallis test followed by Dunn's test was used for intergroup comparisons of microleakage scores, and ANOVA followed by Tukey's test was used for intergroup comparisons of the depth of dye penetration. These analyses were conducted using statistical software (SPSS version 22, Chicago, IL, USA). Results Statistically significant differences were observed between the groups in terms of the microleakage scores and depth of dye penetration (p<0.05). The group 4 showed a minimum microleakage score (0.50±0.52), and maximum scores were observed in Group 1 (2.16±0.71). Group 2 showed insignificant differences with groups 3 and 4 for depth of dye penetration (p>0.05). Statistically significant differences were observed between groups 1 and 2, groups 1 and 4, and groups 3 and 4 for the microleakage score (p<0.05). Conclusion Fissurotomy with or without DBA significantly reduced microleakage before the PFS placement. Prior use of fourth-generation DBA significantly reduced microleakage compared with PFS placement without the use of DBA.

Exploring the role of flavonoids in caries-affected dentin adhesion: A comprehensive scoping review.

OBJECTIVES: The aim of this scoping review was to evaluate the available scientific evidence regarding the use of flavonoids in the treatment of caries-affected dentin focusing on bonding to dentin. METHODS: A comprehensive literature search was performed in five databases from March 2022 and updated in April 2023: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Additionally, the references of included studies were manually searched. Gray literature was excluded from the review. STUDY SELECTION: Inclusion criteria included in vitro, in situ, and in vivo studies (animal or human) published in English. Abstracts, reviews, case reports, book chapters, doctoral dissertations, guidelines, and studies using pure plant extracts were excluded. Data collected from the selected studies were summarized and subjected to narrative and descriptive analysis. Out of the 91 studies identified, only 16 studies met the inclusion criteria. RESULTS: The review analyzed eight different flavonoids (hesperidin, galardin, proanthocyanidin, genipin, quercetin, naringin, epigallocatechin-3-gallate, and other catechins subtypes) used as pretreatment or loaded into adhesive systems, primers, and phosphoric acid. The use of flavonoids improved the mechanical properties of the materials and modified the biological properties of the dentin, reducing collagen loss by the inhibition of proteolytic activity of matrix metalloproteinases (MMPs). CONCLUSIONS: Based on the findings of this scoping review, it can be concluded that the use of flavonoids as pretreatment or incorporation into dental materials preserves collagen in the hybrid layer, inhibiting the MMPs activities, modifying the collagen fibrils of the dentin matrix and improving the mechanical properties of the dental adhesive systems. Therefore, it represents a promising approach for promoting dentin biomodification. This can result in more stable bonding of adhesive restorations to caries-affected dentin.

Adhesion and sealing of different universal adhesive systems associated with bulk-fill resins after using endodontic irrigation solutions: An in vitro study.

This study aimed to evaluate the interface of universal adhesive (UA) with bulk-fill resin (BF) and dentin, after endodontic irrigation. The pulp chamber of 96 molars was irrigated with chlorhexidine 2% (CHX) or sodium hypochlorite 5.25% (NaOCl) and restored according to three restorative protocols. Microtensile bond strength (µTBS) and nanoleakage tests were performed after 24 h of thermocycling. Kruskal Wallis, Mann-Whitney and Wilcoxon were performed (p < 0.05). Comparing restorative systems, a difference was found only when irrigated with CHX after 24 h. CHX provided higher µTBS than NaOCl after 24 h for two restorative protocols; after thermocycling, NaOCl provided the greatest µTBS than CHX for one group. Decreased µTBS was observed for all restorative systems when CHX was used after thermocycling. NaOCl demonstrated the highest nanoleakage. The composition of UA influenced the immediate adhesion and sealing to BF when CHX was used; ageing has a deteriorating effect on adhesion and sealing for all restorative systems.

Chemical analysis of n-propyl gallate used as pre-treatment for resin-dentin bond strength: In vitro study.

This study aimed to evaluate the effect of n-propyl gallate as pre-treatment for resin-dentin bond strength. The dentin pre-treatments evaluated included propyl gallate of concentrations 0.1% (w/v), 1.0% (w/v), and 10.0% (w/v), as well as glutaraldehyde 5.0% (v/v), and distilled water as a control treatment. Dentin specimens were prepared for Fourier Transformed Infrared Spectroscopy (FT-IR) (n = 3/pre-treatment). Pre-treatments were actively applied to dentin blocks before performing the adhesive procedure to composite resin. Microtensile bond strength to dentin (µTBS) (n = 8/pre-treatment) was determined after 24 h and 6 months of storage. Data were submitted to a two-way ANOVA, followed by Tukey's post hoc test. As for FT-IR, propyl gallate 1%-treated specimens presented higher water, carbonate, collagen, and amide absorbance rates compared to other tested groups, while specimens pre-treated with glutaraldehyde and distilled water presented similar absorbance curves. Regarding µTBS, all concentrations of propyl gallate resulted in statistically significant higher bond strength values than distilled water at 24 h. After 6 months of storage, propyl gallate 0.1% was the only group that maintained µTBS over time. Propyl gallate 0.1% might be a suitable dentinal pre-treatment due to being able to present chemical bonds with demineralized dentin and providing resin-dentin bond stability after 6 months of storage.

Medium-term evaluation of the bond strength and dentin penetration of self-adhesive resin cements to root dentin.

BACKGROUND: Medium-term evaluate the bond strength and tag formation in root dentin using self-adhesive cements Maxcem Elite (MCE), Relyx U200 (RU2), SeT PP (SPP) and Megalink (MGL) compared to conventional cement Relyx ARC (ARC) for glass fibre post cementation. MATERIALS AND METHODS: One hundred bovine incisors roots were endodontically treated and divided into 5 groups (n = 20) according to the cementation system: MCE, RU2, SPP, MGL and ARC. All cementation systems were evaluated at 24 h (1) and 12 months (2) after post cementation. Specimens from the cervical, middle and apical thirds of the root were submitted to push-out bond strength test and confocal laser microscopy to verify the dentin penetration. The adhesive failure mode was classified as adhesive, cohesive and mixed. Data were analysed by one-way ANOVA and Tukey tests (α = 5%). RESULTS: ARC-1 and ARC-12 showed the highest bond strength (P < 0.05). ARC showed the greatest tag extension, regardless of the third (P < 0.05). The most frequent failure mode in the 24-h analysis was cohesive, regardless of the cement used. For the 12-month analysis, mixed failure was the most frequent. CONCLUSION: Conventional cement (ARC) showed the highest bond strength and tag extension, regardless of the evaluation period. In all cementation systems, the bond strength decreased after 12 months. © 2023 Australian Dental Association.

Developing Bioactive Dental Resins for Restorative Dentistry.

Despite its reputation as the most widely used restorative dental material currently, resin-based materials have acknowledged shortcomings. As most systematic survival studies of resin composites and dental adhesives indicate, secondary caries is the foremost reason for resin-based restoration failure and life span reduction. In subjects with high caries risk, the microbial community dominated by acidogenic and acid-tolerant bacteria triggers acid-induced deterioration of the bonding interface and/or bulk material and mineral loss around the restorations. In addition, resin-based materials undergo biodegradation in the oral cavity. As a result, the past decades have seen exponential growth in developing restorative dental materials for antimicrobial applications addressing secondary caries prevention and progression. Currently, the main challenge of bioactive resin development is the identification of efficient and safe anticaries agents that are detrimental free to final material properties and show satisfactory long-term performance and favorable clinical translation. This review centers on the continuous efforts to formulate novel bioactive resins employing 1 or multiple agents to enhance the antibiofilm efficacy or achieve multiple functionalities, such as remineralization and antimicrobial activity antidegradation. We present a comprehensive synthesis of the constraints and challenges encountered in the formulation process, the clinical performance-related prerequisites, the materials' intended applicability, and the current advancements in clinical implementation. Moreover, we identify crucial vulnerabilities that arise during the development of dental materials, including particle aggregation, alterations in color, susceptibility to hydrolysis, and loss of physicomechanical core properties of the targeted materials.

Effect of matrix metalloproteinase inhibitors on bonding durability of universal adhesives.

This study aimed to evaluate the effect of different matrix metalloproteinase inhibitors (MMPIs) on the microtensile bond strength (µTBS) and nanoleakage of universal adhesives. One hundred twenty non-carious human molars were prepared and randomly assigned to two groups: Scotchbond Bond Universal (SBU) and Gluma Bond Universal (GBU). The samples in each group were assigned to five subgroups (n=12) based on one control (water) and four MMPIs (Benzalkonium-chloride (BAC), Batimastat (BB94), Chlorhexidine (CHX), and Epigallocatechin-gallate (EGCG)). Each adhesive was applied in self-etch (SE) mode or etch-and-rinse (ER) mode. Dentin/composite sticks were fabricated and subjected to the µTBS test after 24 h or 6 months. At 6 months, MMPIs did not affect the µTBS of the adhesives, regardless of etching mode. Nanoleakage was more pronounced in ER mode than in SE mode for all subgroups. All MMPIs, with the exception of CHX, decreased the nanoleakage of GBU in ER mode.

Microtensile Bond Strength of Different Bonding Agents to Superficial and Deep Dentin in Etch-and-Rinse and Self-Etch Modes.

Objectives: This study aimed to assess the microtensile bond strength (µTBS) of etch-and-rinse (E&R), self-etch (SE), and universal adhesives to superficial and deep dentin. Materials and Methods: In this in vitro study, 40 sound third molars were randomly divided into two main groups of superficial and deep dentin. Based on our classification, superficial dentin was right beneath the deepest occlusal groove, and deep dentin was 2mm beneath the deepest occlusal groove. Each group was divided into 4 subgroups (n=20) for application of Adper Single Bond 2 (ASB), Clearfil SE Bond (CSE), and Scotchbond Universal (SBU) in E&R and SE modes along with Charisma Smart composite resin on dentin. The specimens were incubated in distilled water at 37°C for 24 hours and their µTBS was then measured. The mode of failure was determined under a stereomicroscope at ×40 magnification. Data were analyzed by one-way ANOVA (alpha=0.05). Results: The highest µTBS belonged to the superficial dentin/SBU/E&R group. The µTBS was significantly higher in superficial dentin than deep dentin for all adhesives (P=0.005). There was no significant difference in mode of failure among the groups. Conclusion: Based on the results obtained in the present study, type of bonding agent and application mode affected µTBS. In use of universal adhesive, E&R mode can improve µTBS.

Five-year clinical evaluation of universal adhesive applied following different bonding techniques: A randomized multicenter clinical trial.

OBJECTIVES: To evaluate the clinical performance of a universal adhesive system (Futurabond U, Voco) when applied following different adhesive strategies in non-carious cervical lesions (NCCLs) after 5 years. METHODS: Fifty participants were included. Futurabond U (Voco) was applied in NCCLs using four adhesive strategies (n = 50 each): only self-etch (SE); selective enamel etching + self-etch (SET + SE); etch-and-rinse with dry dentin (ERD); and etch-and-rinse with wet dentin (ERW). All cavities were restored with Admira Fusion composite resin (Voco). Restorations were evaluated after 1, 3, and 5 years using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria. RESULTS: After 5 years, retention rates were 81 % (65.8-90.5) for SE, 87 % (73.2-94.4) for SET + SE, 84 % (69.6-92.6) for ERD, and 78 % (63.6-88.9) for ERW (p > 0.05). Thirty-five restorations were considered to have minor discrepancies in marginal adaptation at the 5-year recall (14 for SE, 9 for SET + SE, 6 for ERD, and 6 for ERW; p > 0.05). Sixteen restorations were detected as a minor marginal discoloration (6 for SE, 4 for SET + SE, 1 for ERD, and 5 for ERW; p > 0.05) and one restoration showed a recurrence of caries (1 for ERW; p > 0.05) at the 5-year recall. No restorations showed postoperative sensitivity after 5 years. SIGNIFICANCE: NCCLs restorations using a universal adhesive showed satisfactory clinical performance after 5 years, regardless of the adhesive strategy.

Fatores que influenciam o perfil de conhecimento dos cirurgiões-dentistas brasileiros sobre sistemas adesivos / Factores que influyen en el perfil de conocimiento de los odontólogos brasileños sobre los sistemas adhesivos / Factors that influence the knowledge profile of Brazilian dental professionals about dental adhesive systems

Os sistemas adesivos estão diretamente envolvidos nos procedimentos mais corriqueiros da prática clínica odontológica, o que torna o seu conhecimentoindispensável para os profissionais. O objetivo do presente estudo foi avaliar o perfil de conhecimento sobre sistemas adesivos e verificar os fatores que influenciam nesse desfecho, com ênfase na formação profissional. A coleta de dados foi realizada pormeio de um questionário levando em consideração: I. Perfil do profissional; II. Conhecimento, uso e preferências sobre os sistemas adesivos. A amostra foi composta por 501 cirurgiões-dentistas brasileiros e os dados foram analisados no programa Sigma Stat5.0 (p<0,05). O percentual mínimo de acertos das questões considerado adequado foi definido como 80%. Os resultados mostraram que apenas 46,3% dos profissionais demonstraram conhecimento adequado sobre o assunto. Além disso, verificou-se associação estatisticamente significativa entre o baixo nível de acertos e profissionais com preferência por sistemas adesivos simplificados (p=0,046), especialistas em ortodontia [OR=0,24 (0,08-0,67)] e cirurgiões-dentistas graduados em instituições privadas [OR=1,58 (1,03-2,42)]. Esse cenário alerta para a necessidade iminente de sanar essa fragilidade por meio de melhorias nas matrizes curriculares, além da educação continuada de docentes e constante atualização dos profissionais (AU).

Los sistemas adhesivos están directamente involucrados en los procedimientos más comunes de la práctica clínica dental, lo que hace que su conocimiento sea fundamental para los profesionales. El objetivo del presente estudio fue evaluar el perfil de conocimiento sobre sistemas adhesivos y verificar los factores que influyen en ese resultado, con énfasis en la formación profesional. La recolección de datos se realizó a través de un cuestionario teniendo en cuenta: I. Perfil del profesional; II. Conocimiento,uso y preferencias sobre los sistemas adhesivos. La muestra estuvo compuesta por 501 dentistas brasileños y los datos fueron analizados mediante el programa Sigma Stat 5.0 (p<0,05). El porcentaje mínimo de respuestas correctas a las preguntas considerado adecuado se definió en el 80%. Los resultados mostraron que sólo el 46,3% de los profesionales demostraron conocimientos adecuados sobre el tema. Además, hubo una asociación estadísticamente significativa entre el bajo nivel de aciertos y los profesionalescon preferencia por los sistemas adhesivos simplificados (p=0,046), especialistas en ortodoncia [OR=0,24 (0,08-0,67)] y odontólogos egresados de instituciones privadas [OR=1,58 (1,03-2,42)]. Este escenario advierte de la inminente necesidad de subsanar esta debilidad a través de mejoras en las matrices curriculares, además de la formación continua de los docentes y la constante actualización de los profesionales (AU).

Dental adhesive systems are directly involved in common procedures of clinical dentistry, which makes knowledge about this topic indispensable for professionals. The objectives of the current study are to analyze the knowledge profile of dental professionals about dental adhesive systems and verify factors that influence this closure, with emphasis on professional education. The data was collected using a list of questions that consider: I) Professional profile and II) Knowledge, use, and preferences of adhesive systems. The sample considers 501 Brazilian dentists and the data was analyzed using the software Sigma Stat 5.0 (p<0.05). The minimum percentual of correct questions considered adequate was defined as 80%. The results show that only 46.3% of the professionals demonstrated satisfactory knowledge on the subject. In addition, it verified relevant statistical association between low level of correct questions and professionals with preferences for simplified adhesive systems (p=0.046), orthodontic specialists [OR=0.24 (0.08­0.67)], and dentists with private education degrees [OR=1.58 (1.03­2.42)]. This context indicates the imminent necessity to resolve this weakness through improvements in the educational curriculum, as well as continuing education of faculty and constant updating of professionals (AU).

Some Myths in Dentin Bonding: An Evidence-Based Perspective.

Laboratory investigations are essential models responsible for science development. However, laboratory discoveries must be confirmed in a clinical environment where many known and unknown variables and complex mechanisms are involved. Using conclusions from laboratory studies to make clinical recommendations can lead to widespread "unreliable truths" or so-called myths in any field of knowledge. These myths may increase the costs (financial and time) or even cause harm (side effects) that would be unnecessary, given that the current protocol or conduct was previously evaluated in a more complex and complete clinical setting. This article will discuss certain myths in dentin bonding that may influence clinical decision-making, bringing some principles of evidence-based practice to allow a more critical evaluation of the literature findings.

Efecto de diferentes condiciones y modos de aplicación sobre la fuerza de unión de los adhesivos a la dentinaEffect of different conditions and modes of application on bond strength of adhesives to dentine / Effect of different conditions and modes of application on bond strength of adhesives to dentine

Objective: To evaluate the microtensile bond strength in different dentine conditions (etched-E, non-etched-N, dry-D and wet-W) of a multimode adhesive (Scotchbond Universal-SU, 3M/ESPE) and a total etching adhesive (Ambar-AB, FGM) using a sonic device (Smart Sonic Device-SD, FGM). Material and methods: In this in vitro study, ninety six sound extracted human molars were divided into 12 groups (n=8) according to different dentine conditions and adhesive systems. Enamel was removed and the middle dentine surfaces were polished. Each adhesive system was applied according to the different dentine conditions, and composite resin blocks were incrementally built up and stored for 24 hours. Specimens were sectioned into sticks and bond strength data were analyzed with the Kruskal-Wallis test and Mann-Whitney U tests. Results: No effects of sonic application and were observed. In general, AB showed lower results compared to the SU. E and N conditions did not statistically affect the bond strength of SU groups. Dry dentine presented statistically superior bond strength values when compared to wet dentine for SU/E/SD group. Conclusion: Adhesion of dry dentine with multimode adhesive system may be superior to wet dentine with sonic application. The modes of application had no influence in bond strength of studied adhesives.

Objetivo: Evaluar la resistencia de la unión microtensil en diferentes condiciones de dentina (grabado-E, sin grabado-N, seco-D y húmedo-W) de un adhesivo multimodo (Scotchbond Universal-SU, 3M/ESPE) y un adhesivo de grabado total (Ambar-AB, FGM) utilizando un dispositivo sónico (Smart Sonic Device-SD, FGM). Material y Métodos: En este estudio in vitro, noventa y seis molares humanos extraídos sanos se dividieron en 12 grupos (n=8) de acuerdo con diferentes condiciones de dentina y sistemas adhesivos. Se eliminó el esmalte y se pulieron las superficies centrales de la dentina. Cada sistema adhesivo se aplicó de acuerdo con las diferentes condiciones de dentina, y los bloques de resina compuesta se acumularon de forma incremental y se almacenaron durante 24h. Las muestras se seccionaron en barras y los datos de resistencia de la unión se analizaron con la prueba de Kruskal-Wallis y la prueba de U de Mann-Whitney. Resultado: No se observaron efectos de la aplicación sónica. En general, AB mostró resultados más bajos en comparación con el SU. Las condiciones E y N no afectaron estadísticamente la fuerza de unión de los grupos SU. La dentina seca presentó valores de fuerza de adhesión estadísticamente superiores en comparación con la dentina húmeda para el grupo SU/E/SD. Conclusión: La adhesión de la dentina seca con un sistema adhesivo multimodo puede ser superior a la dentina húmeda con aplicación sónica. Los modos de aplicación no tuvieron influencia en la resistencia de la unión de los adhesivos estudiados.

Effect of Collagen-Reactive Functional Monomer on Etch-and-Rinse Adhesives.

In this study, we evaluated a novel functional monomer (4-formylphenyl acrylate [FA]) that can specifically and covalently bind to the dentin collagen matrix as a potential alternative hydrophobic diluent-like monomer for improving the durability of dentin bonding. Experimental adhesives with different FA contents (0%, 10%, 20%, and 30%) were evaluated as partial substituents for the hydrophilic monomer 2-hydroxyethyl methacrylate, with the commercial adhesive One-Step (Bisco, Inc.) employed as the positive control. Their degree of conversion, viscosity, hydrophobicity, mechanical properties, and water absorption/solubility were measured as the comprehensive characterization. In situ zymographic assays were performed to determine the extent to which FA inhibits the endogenous hydrolytic activity of dentin. Finally, the bonding performances of the novel adhesives were evaluated with microtensile strength tests and scanning electron microscopy. The results showed that the incorporation of FA significantly improved the mobility of experimental adhesives attributable to the dilution property of FA. In contrast to the possible compromised rate of polymerization by hydroxyethyl methacrylate, FA exhibited typical characteristics of favorable copolymerization with polymerizable monomers in adhesives and improved the degree of conversion of experimental adhesives. The rigidity and hydrophobic properties of the phenyl framework of the FA molecule conferred superior mechanical properties and hydrolysis resistance to the novel experimental adhesives. An inhibitory effect on gelatinolytic activities within the hybrid layer was also observed in the in situ zymographic assays, even at a low FA concentration (10%). In conjunction with the significantly improved infiltration found via scanning electron microscopy, the experimental adhesives containing FA possessed significantly better-maintained microtensile strength, even after aging. Thus, the incorporation of this novel monomer endowed the experimental adhesives with multiple enhanced functionalities. These remarkable advantages highlight the suitability of the monomer for further applications in clinical practice.

Application of proanthocyanidin in the treatment and repair of deep caries / 口腔疾病防治

@#Proanthocyanidin (PA), as a kind of natural plant polyphenol, have a variety of biological functions, such as promoting remineralization, inducing collagen cross-linking, inhibiting protease activity and inhibiting bacteria. Therefore, PA could be broadly used in the clinical application of treatment and repair of deep caries in the future; for example, PA could promote dentin remineralization, improve resin-dentin bonding durability and improve the dentin acid erosion effect. This application potential of PA arises from several features, firstly, PA can not only promote dentin remineralization on its own or with other remineralizers but also exhibits antibacterial effects, which can inhibit acid production while reducing the formation of cariogenic pathogens and their biofilms. Based on the above features, PA can reduce the incidence of caries disease; thus, PA improves deep caries and long-term effects after treatment. In addition, PA added to adhesives or etch agents can improve the etching and bonding effect of dentin by inducing collagen cross-linking and inhibiting protease activity, thus achieving the ultimate goal of improving the bonding performance of deep caries. This paper summarizes recent progress of research on PA for the treatment and repair of deep caries, including the promotion of dentin remineralization and antibacterial activity as well as the improvement in dentin bonding and acid etching effect, to provide a more comprehensive reference for treating and restoring deep caries in clinical practice.

Influence of self-etching adhesive on the bond strength of irradiated teeth / Influência do adesivo autocondicionante na resistência de união em dentes submetidos à radiação

ABSTRACT This study aimed to conduct a literature review about the influence of self-etching adhesives on the bond strength of restorative procedures for irradiated teeth. The search for articles was carried out on six databases (PubMed, Scopus, Web of Science, Embase, LILACS, Cochrane). Gray literature (Google Scholar) and reference lists of included studies were evaluated. The keywords used were: "Radiotherapy" OR "Radiation Therapy" OR "Radiation Treatment" OR "Radiation Effects" OR "Radioterapia" OR "Terapia por radiação" OR "Tratamento por radiação" OR "Efeitos da Radiação" OR "Terapia por Radiación" OR "Tratamiento por Radiación" OR "Efectos de Radiación" AND "Dentin-Bonding agent" OR "Adesivos Dentinários" OR "Recubrimientos Dentinarios". The inclusion criteria were laboratory and clinical studies, dissertations, literary and systematic reviews, and no time and language restrictions. Three hundred and eighteen studies were identified in the databases, 30 in the gray literature, and 5 from the reference list of included articles. 40 were excluded for being duplicates. After reading the title and abstract, 28 articles remained for complete analysis. In the end, 21 articles were included in this study. Self-etching could be a good option for irradiated teeth restorations. However, further clinical studies are needed.

RESUMO O objetivo deste trabalho foi realizar uma revisão integrativa da literatura sobre a influência de adesivos autocondicionantes na resistência de união de restaurações de dentes submetidos à radiação. A busca da literatura foi realizada em seis bases de dados (PubMed, Scopus, Web of Science, Embase, LILACS, Cochrane). A literatura cinza (Google Scholar) e as listas de referências dos estudos incluídos foram avaliadas. A pesquisa foi realizada com as palavras-chave: "Radiotherapy" OR "Radiation Therapy" OR "Radiation Treatment" OR "Radiation Effects" OR "Radioterapia" OR "Terapia por radiação" OR "Tratamento por radiação" OR "Efeitos da Radiação" OR "Terapia por Radiación" OR "Tratamiento por Radiación" OR "Efectos de Radiación" AND "Dentin-Bonding agent" OR "Adesivos Dentinários" OR "Recubrimientos Dentinarios". Os critérios de inclusão foram estudos in vitro e clínicos, dissertações, revisões sistemáticas e literárias, sem restrições de período e de idiomas. Foram identificados 318 estudos nas diferentes bases de dados, 30 na literatura cinzenta e 5 da lista de referências dos artigos incluídos, dos quais 40 foram excluídos por serem duplicatas. Após a leitura do título e do resumo, permaneceram 28 artigos para análise completa. Ao final, 21 artigos foram incluídos neste trabalho. Os adesivos autocondicionantes podem ser uma boa alternativa em restaurações de dentes submetidos à radiação. Todavia, ainda existem poucos trabalhos sobre o tema e ratifica-se a necessidade de mais estudos clínicos.

Dentin permeability after pretreatment with titanium tetrafluoride and self-etching or universal adhesive systems

Aim: To evaluate dentin permeability after pretreatment with 2.5% aqueous solution of titanium tetrafluoride (TiF4), followed by a self-etching universal adhesive system. Methods: Forty dentin discs (1.5 mm thick) were randomly divided into groups according to the application or non-application of a pretreatment, and the type of adhesive system to be tested (two-step self-etching/ Clearfil SE Bond/ Kuraray Medical, or universal adhesive system/ Single Bond Universal/ 3M ESPE). Both sides of the discs were conditioned with 37% phosphoric acid to remove the smear layer. The first hydraulic conductivity measurement (L1) was performed in a permeability machine, under 5 PSI pressure. The samples were sanded again to form a standardized smear layer. The teeth designated for pre-treatment with TiF4 received the TiF4 solutions applied actively for 60 seconds, and the adhesive systems were applied according to the manufacturer's instructions. Then, a new hydraulic conductivity measurement (L2) was performed for the purpose of calculating the hydraulic conductance at a later time, considering the water viscosity and the thickness of the specimen. The percentage (L) of dentin permeability after application of the adhesive system was obtained (L (%) = [(L1-L2) x100] / L1). The Mann-Whitney non-parametric test was applied. Results: There was no difference between the two adhesive systems, or between the groups with or without pretreatment, as regards dentin permeability (p>0.05). Conclusion: Pretreatment with 2.5% TiF4 did not influence dentin permeability, irrespective of the adhesive system used

Do different adhesives influence the color stability and fluorescence of composite restorations after aging?

Abstract This study aimed to evaluate the influence of dental adhesive color on the chromatic stability and fluorescence intensity of composite resin restorations of different thicknesses. Ninety bovine enamel samples were obtained and restored with resin composite varying thicknesses of restorative material and enamel (1.0 mm enamel and 1.0 mm composite; 1.5 mm enamel and 0.5 mm composite; 0.5 mm enamel and 1.5 mm composite). The restorations were made of composite resin (Opallis E-bleach H) using different types of dental adhesives: Ambar, Ambar APS, and Single Bond Universal (n=10). The samples were subjected to color measurement tests in a spectrophotometer using CIEDE2000 and fluorescence intensity measurements before and after aging in a red wine coloring solution. Data were subjected to analysis of variance (ANOVA) and Tukey's test (α = 0.05). There were no statistically significant changes in color stability or fluorescence intensity for restorations made of different materials or thicknesses (p>0.05). Single Bond Universal showed greater color stability at 0.5 mm thickness (ΔE00 = 4.4 ± 1.6) compared to other thicknesses of the same material (p=0.003), as well as a greater difference in fluorescence intensity after aging at 1.5 mm thickness (-414.9 ± 103.8) compared to other materials (p=0.0002). Overall, it was concluded that the different adhesive systems did not influence the color stability and fluorescence of restorations of different thicknesses.

Resumo O objetivo deste estudo foi avaliar a influência da cor do adesivo dental na estabilidade cromática e intensidade de fluorescência das restaurações de resina composta de diferentes espessuras. Foram obtidos noventa amostras de esmalte bovino que foram restaurados com resina composta, variando a espessura do material restaurador e do esmalte (1,0 mm de esmalte e 1,0 mm de compósito; 1,5 mm de esmalte e 0,5 mm de compósito; 0,5 mm de esmalte e 1,5 mm de compósito). As restaurações foram feitas de resina composta (Opallis E-bleach H) utilizando diferentes tipos de adesivos odontológicos: Ambar, Ambar APS, e Single Bond Universal (n=10). As amostras foram submetidas a testes de medição de cor em um espectrofotômetro usando CIEDE2000 e medições de intensidade de fluorescência antes e depois do envelhecimento em uma solução de coloração de vinho tinto. Os dados foram submetidos à análise de variância (ANOVA) e ao teste de Tukey (α = 0,05). Não houve mudanças estatisticamente significativas na estabilidade da cor ou intensidade de fluorescência para restaurações feitas de diferentes materiais ou espessuras (p>0,05). O Single Bond Universal mostrou maior estabilidade de cor a 0,5 mm de espessura (ΔE00 = 4,4 ± 1,6) em comparação com outras espessuras do mesmo material (p=0,03), bem como uma maior diferença na intensidade de fluorescência após o envelhecimento a 1,5 mm de espessura (-414,9 ± 103,8) em comparação com outros materiais (p=0,0002). Em geral, concluiu-se que os diferentes sistemas adesivos não influenciaram a estabilidade de cor e a intensidade de fluorescência das restaurações de diferentes espessuras.

Effect of endodontic sealers on push-out bond strength of CAD-CAM or prefabricated fiber glass posts

Abstract This study aimed to evaluate the effect of endodontic sealer (ES) on bond strength (BS) of prefabricated or milled-CAD-CAM (computer-aided design and computer-aided manufacturing) glass-fiber-posts (GFP). Canals of 90 single-rooted teeth were prepared for filling by the single-cone technique with gutta-percha and one of the following ES: AH Plus (epoxy resin), Endofill (zinc-oxide and eugenol), and Bio-C Sealer (calcium-silicate). After post-space preparation, tooth-specimens were equally divided in half according to type of GFP to be used. In the half to receive milled-CAD-CAM posts, tooth specimens were molded with acrylic resin to obtain replicas. These were scanned to enable the laboratory to produce the milled-CAD-CAM GFPs (Fiber CAD Lab, Angelus) by the subtractive technique. The other half of samples received prefabricated GFPs (Exacto, Angelus) (n=15). The GFPs were cemented with dual-cure resin cement (Panavia F2.0, Kuraray). Each root was sectioned into two slices per root region (cervical, middle, apical) that were subjected to the push-out BS test, in a universal testing machine. Failure mode (FM) was classified by scores. The BS data were submitted to generalized linear model analyses, while FM was analyzed using the chi-square test (a=0.05). BS showed no significant difference among the three ES (p > 0.05). BS was significantly higher for prefabricated (mean 10.84 MPa) versus milled-CAD-CAM GFPs (mean 6.94 MPa) (p <0.0001), irrespective of ES. The majority showed mixed failures. It could be concluded that type of ES did not affect BS of GFPs to dentin, and prefabricated-GFPs had higher bond-strength than customized-milled-CAD-CAM GFPs.

Impacto da irradiação com laser ND: YAG sobre primer de adesivo convencional na adesão à dentina / Impact of Nd: YAG laser irradiation on primer of conventional adhesive in adhesion to dentin

A irradiação da dentina com o laser Nd:YAG mostra-se promissora para a qualidade da adesão, desde que aplicada sob parâmetros específicos e em etapas definidas. O objetivo deste estudo é avaliar de forma comparativa, o impacto da irradiação com laser de Nd:YAG sobre a formação e estabilidade da camada híbrida em dentina humana, pré-tratada com ácido e primer de sistema adesivo convencional, "in vitro". Setenta molares hígidos tiveram suas raízes e porções coronárias seccionadas horizontalmente, até completa exposição de dentina oclusal. As amostras foram divididas em: G1 (controle n=20); G2 (experimental n=20), sendo 10 dentes de cada grupo destinados ao microcisalhamento (MC) e 10 dentes à microscopia eletrônica de varredura (MEV). Nos 30 dentes restantes analisou-se: textura por Tomografia Computadorizada de Feixe Cônico (AT=15); e Espectroscopia de Infravermelho por Transformada de Fourier (FTIR=15) em 3 momentos: dentina controle; após tratamento com ácido + primer; e posterior à irradiação a laser. Estatisticamente, optou-se por ANOVA 1 fator, Qui Quadrado de Pearson, teste T e múltiplas comparações de Tukey com significância de 5%. A FTIR evidenciou redução dos níveis de fosfato e carbonato nos momentos primer e após irradiação laser, porém não havendo desnaturação do colágeno exposto. A análise de textura evidenciou uma tendência à formação de um tecido mais padronizado após o uso do laser. O teste de MC evidenciou valores médios de 36,5 e 35,2MPa para G1 e G2 respectivamente (p>0,05) e portanto, de forma imediata, o laser não mostrou efeitos deletérios ao processo adesivo. Além disso, observou-se maior penetrabilidade do adesivo na avaliação em MEV após a aplicação do laser. Novas pesquisas com avaliação longitudinal mostram-se necessárias para verificar se o efeito do laser pode ter sido protetor da degradação hidrolítica, visto que há uma redução do conteúdo de água local durante a formação da camada híbrida (AU).

Irradiation of dentin with the Nd:YAG laser shows promise for the quality of adhesion, as long as it is applied under specific parameters and in defined steps. The objective of this study is to comparatively evaluate the impact of irradiation with Nd:YAG laser on the formation and stability of the hybrid layer in human dentin, pretreated with acid and primer of conventional adhesive system, "in vitro". Seventy healthy molars had their roots and coronal portions horizontally sectioned, until complete exposure of occlusal dentin. The samples were divided into: G1 (control n=20); G2 (experimental n=20), with 10 teeth from each group destined for microshearing (MC) and 10 teeth for scanning electron microscopy (SEM). In the 30 remaining teeth analyzed: texture by Cone Beam Computed Tomography (AT=15); and Fourier Transform Infrared Spectroscopy (FTIR=15) in 3 moments: dentin control; after treatment with acid + primer; and after laser irradiation. Statistically, we opted for 1-way ANOVA, Pearson's Chi Square, T test and Tukey's multiple comparisons with a significance of 5%. FTIR showed a reduction in phosphate and carbonate levels in the primer moments and after laser irradiation, but there was no denaturation of the exposed collagen. The texture analysis evidenced a trend towards the formation of a more expressive tissue after the use of the laser. The CM test showed mean values of 36.5 and 35.2MPa for G1 and G2 respectively (p>0.05) and therefore, immediately, the laser showed no deleterious effects on the adhesive process. In addition, greater penetrability of the adhesive was observed in the SEM evaluation after laser application. New studies with longitudinal evaluation are necessary to verify if the laser effect could have been protected from hydrolytic degradation, since there is a reduction in the local water content during the formation of the hybrid layer (AU).

In Search of Novel Degradation-Resistant Monomers for Adhesive Dentistry: A Systematic Review and Meta-Analysis.

This study aimed to assess whether degradation-resistant monomers included in experimental dental adhesives can improve long-term bond strength compared to conventional monomers. This study followed the latest PRISMA guidance (2020). The search for the systematic review was carried out in four electronic databases: PubMed/Medline, Scopus, SciELO and EMBASE, without restrictions on the year of publication and language. The last screening was conducted in July 2022. Interventions included were in vitro studies on experimental dental adhesives that tested short-term and long-term bond strength, but also water sorption and solubility data when available, in extracted human molars. Meta-analyses were performed using Rstudio v1.4.1106. A summary table analyzing the individual risk of bias was generated using the recent RoBDEMAT tool. Of the 177 potentially eligible studies, a total of 7 studies were included. Experimental monomers with acrylamides or methacrylamide−acrylamide hybrids in their composition showed better results of aged bond strength when compared to methacrylate controls (p < 0.05). The experimental monomers found better sorption and solubility compared to controls and were significantly different (p < 0.001). It is possible to achieve hydrolytically resistant formulations by adding novel experimental monomers, with chemical structures that bring benefit to degradation mechanisms.