Evaluation of Microbiological Susceptibility and Long-term Adhesive Properties to Dentin of Primers with Terminalia catappa Linn.

PURPOSE: To investigate the antibacterial effects of Terminalia catappa Linn (TCL) leaf extracts at different concentrations and the effects of these extracts used as primers on the long-term adhesive properties of two universal adhesives. MATERIALS AND METHODS: After extract preparation, the antimicrobial and antibacterial activities of TCL against Streptococcus mutans (UA 159) were assessed in microdilution assays to provide the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Additionally, to provide quantitative data on the ability of TCL extract to reduce cell viability, colony forming units (CFU) were counted. To examine adhesive properties, 288 human molars were randomly assigned to 32 experimental conditions (n = 9) according to the following variables: (1) treatment agent: negative control (untreated surface), and primers at concentrations of 1xMIC, 5xMIC, and 10xMIC; (2) adhesives: Scotchbond Universal (SBU) and Futurabond Universal (FBU); (3) adhesive strategy: etch-and-rinse (ER) or self-etch (SE); and (4) storage time: 24 h or after 2 years. Primers were applied for 60 s, upon which the teeth were incrementally restored and sectioned into adhesive-dentin bonded sticks. These were tested for microtensile bond strength (µTBS) and nanoleakage (NL) after 24-h and 2-year water storage, as well as in-situ degree of conversion (DC) at 24 h. The chemical profile of the hybrid layer was determined via micro-Raman spectroscopy. Biofilm assay data were analyzed using the Kruskal-Wallis test; the pH of culture media and the chemical profile were analyzed by one-way ANOVA. The adhesive properties (µTBS, NL, DC) were evaluated using a four-way ANOVA and Tukey's test. Significance was set at 5%. RESULTS: Similar values of MIC and MBC were observed (2 mg/ml), showing bactericidal potential. CFU analysis demonstrated that concentrations of 5xMIC and 10xMIC significantly inhibited biofilm formation (p < 0.001). The application of the TCL primer at all concentrations significantly increased the immediate µTBS and DC, and decreased the immediate NL values when compared to the control group (p < 0.05), regardless of the adhesive and adhesive strategies. Despite an increase in the NL values for all groups after 2 years (p > 0.05), in groups where the TCL primer was applied, the µTBS remained constant after 2 years for both adhesives, while a decrease in the µTBS was observed in the control groups (p < 0.05). Usually, 10xMIC showed better results than 1xMIC and 5xMIC (p < 0.05). The application of TCL promoted cross-linking; cross-linking rates increased proportionally to the concentration of TCL (p < 0.05). CONCLUSION: Primers containing TCL promoted bactericidal and bacteriostatic action, as well as cross-linking with dentin, while maintaining the adhesive properties of the adhesive-dentin interface after 2 years of water storage.

Effect of pH on the solubility and volumetric change of ready-to-use Bio-C Repair bioceramic material.

Acidic pH can modify the properties of repair cements. In this study, volumetric change and solubility of the ready-to-use bioceramic repair cement Bio-C Repair (BCR, Angelus, Londrina, PR, Brazil) were evaluated after immersion in phosphate-buffered saline (PBS) (pH 7.0) or butyric acid (pH 4.5). Solubility was determined by the difference in initial and final mass using polyethylene tubes measuring 4 mm high and 6.70 mm in internal diameter that were filled with BCR and immersed in 7.5 mL of PBS or butyric acid for 7 days. The volumetric change was established by using bovine dentin tubes measuring 4 mm long with an internal diameter of 1.5 mm. The dentin tubes were filled with BCR at 37°C for 24 hours. Scanning was performed with micro-computed tomography (micro-CT; SkyScan 1176, Bruker, Kontich, Belgium) with a voxel size of 8.74 µm. Then, the specimens were immersed in 1.5 mL of PBS or butyric acid at and 37 °C for 7 days. After this period, a new micro-CT scan was performed. Bio-C Repair showed greater mass loss after immersion in butyric acid when compared with immersion in PBS (p<0.05). Bio-C Repair showed volumetric loss after immersion in butyric acid and increase in volume after immersion in PBS (p<0.05). The acidic pH influenced the solubility and dimensional stability of the Bio-C Repair bioceramic cement, promoting a higher percentage of solubility and decrease in volumetric values.

Assessment of physical properties of bioactive glass-modified universal multimode adhesive and its bonding potential to artificially induced caries affected dentin.

BACKGROUND: To evaluate the physical properties of bioactive glass-modified universal multimode adhesive and its micro-tensile bond strength (µTBS) to artificially induced caries-affected dentin. METHODS: All bond universal adhesive was used in the study. Specimens were divided into 2 main groups: control unmodified adhesive and 5 wt% BAG modified adhesive. The degree of conversion, pH, bioactivity, and viscosity of the adhesives were tested with n = 5 for each test. Micro-tensile bond strength evaluation was done in etch & rinse (ER) and selective-etch (SE) modes, where 24 human molar teeth were used (n = 3), 12 teeth for immediate bond strength, and the other 12 were tested after 6 months of storage in simulated body fluid (SBF). RESULTS: No significant difference was found between the control and the 5wt% BAG groups regarding the degree of conversion (61.01 ± 0.43 and 60.44 ± 0.61 respectively) and the viscosity (109.77 ± 22.3 and 124.3 ± 9.92 respectively). The control group revealed significantly lower pH values than the 5wt% BAG group (3.16 ± 0.5 and 4.26 ± 0.09 respectively). Immediate bond strength results revealed that the 5wt% BAG in the ER mode had the highest bond strength followed by the control group in the ER mode (44.16 ± 7.53 and 44.00 ± 7.96 respectively). SE groups showed that the immediate strength of the 5wt% BAG group was higher than the control group (42.09 ± 6.02 and 39.29 ± 6.64 respectively). After 6 months of storage, bond strength results revealed a decrease in bond strength values for the control groups but not for the 5wt% BAG in both application modes. CONCLUSIONS: The incorporation of BAG (5wt%) improved the universal adhesive micro-tensile bond strength and bond durability for both adhesive application modes without affecting its degree of conversion or viscosity.

Evaluation of enamel surface integrity after orthodontic bracket debonding: comparison of three different system.

OBJECTIVE: This study aimed to evaluate enamel surface integrity and time consumed during residual cement removal after bracket debonding using different adhesive removal burs with and without a dental loupe. MATERIAL AND METHODS: Sixty human-extracted premolars were collected, cleaned, mounted, and prepared for orthodontic bracket bonding. Teeth were randomly divided into three main groups (n = 20) based on the adhesive removal method: tungsten carbide system (TC), sof-lex discs system (SD), and diamond system (DB) groups. Then, each group was subdivided into two subgroups (naked eye and magnifying loupe subgroups). The brackets were bonded and then debonded after 24 h, and the Adhesive Remnant Index (ARI) was assessed. The adhesive remnants were removed by different systems, and the final polishing was performed by Silicone OneGloss. The enamel surface roughness was evaluated before bracketing (T0), after residual cement removal (T1), and finally after polishing (T2) using surface Mitutoyo SJ-210 profilometry and Scanning Electron Microscopy (SEM) to determine the Enamel Damage Index (EDI) score. The time consumed for adhesive removal was recorded in seconds. RESULTS: The Kruskal Wallis test showed a statistically significant difference in roughness values at T1 compared to T2 between subgroups (p < 0.001). When comparing EDI at T1 and T2, the Kruskal-Wallis H-test showed statistically significant differences in all subgroups. The pairwise comparisons revealed that EDI scores showed a statistically significant difference at T1 and T2 between DB vs. TC and SD (p = 0.015) but not between TC vs. SD (p = 1.000), indicating the highest roughness value observed in the DB group. The time for cement removal was significantly shorter in the magnifying loupe group than in the naked eye group and was shortest with the TC group, whereas the time was the longest with the DB group (p < 0.05). CONCLUSION: All three systems were clinically satisfactory for residual orthodontic adhesive removal. However, TC system produced the lowest enamel roughness, while the DB system created the greatest. The polishing step created smoother surfaces regardless of the systems used for resin removal.

Adhesion of glass ionomer cements to primary dentin using a universal adhesive.

BACKGROUND: Glass ionomers are widely used for restoring carious primary teeth. However, their ability to bond to primary dentin is considered a challenge in pediatric dentistry. OBJECTIVES: The study aimed to evaluate the microshear bond strength (µSBS) of a resin-modified glass ionomer (RMGI) and a high-viscosity glass ionomer cement (Hv-GIC) to primary dentin using a universal adhesive. MATERIAL AND METHODS: Thirty human primary maxillary canines were cut in half and prepared for the µSBS test. The specimens (N = 60) were assigned to 6 groups. Three groups were defined for RMGI (FUJI II LC) and 3 groups for Hv-GIC (EQUIA Forte): with an immediately curing adhesive (G-Premio); with a delayed curing adhesive; and without an adhesive (control group). After preparing the dentin surfaces, the glass ionomers were bonded using Tygon® tubes with an internal diameter of 0.7 mm. The µSBS test was performed, and the data was analyzed using two-way analysis of variance (ANOVA) followed by Tukey's post hoc test. Additionally, the failure modes were determined using a stereomicroscope. Six specimens, one for each study group, were prepared for scanning electron microscopy (SEM) analysis to observe the glass ionomer-dentin interface. RESULTS: The type of glass ionomer did not have a significant effect on the µSBS (p = 0.305). Groups that received universal adhesive application prior to glass ionomer exhibited a significantly higher µSBS (p < 0.0001). However, there was no significant difference between the immediately curing and delayed curing groups (p = 0.157). The predominant failure mode was mixed failure. CONCLUSIONS: Higher bond strength of glass ionomers to primary teeth can be achieved by using universal adhesives, which, in addition to the proven benefits of glass ionomers, can improve their clinical success.

How the repair bonding strength of hybrid ceramic CAD/CAM blocks is influenced by the use of surface treatments and universal adhesives.

We examined how different methods of surface treatment and different universal adhesives with or without extra silane affected the repair bonding strength of hybrid ceramic CAD/CAM restorations. Cerasmart specimens (n=320) were subjected to thermocycling and assigned to the following surface pretreatment protocols: control, diamond bur (DB), hydrofluoric acid (HF), and tribochemical silica coating (TSC). Half the specimens received a coating of silane, followed by application of the universal adhesives Futurabond M+ (FMU), Tokuyama Universal Bond (TUB), Single Bond Universal (SBU), or Clearfil Universal Bond Quick (CUQ) (n=10). A hybrid composite resin was used to simulate repair; then the specimens underwent further thermocycling. Shear bond strength (SBS) was determined and modes of failure were examined. The TSC-CUQ silane (-) group showed the highest SBS values. The best repairs were obtained when the surface was treated with TSC, with the exception of the DB-TUB silane (-) group. TUB increased SBS more than the other adhesives. Additional silane decreased SBS in the HF-TUB and TSC-CUQ groups, while increasing it in the TSC-TUB and DB-FMU groups (p<0.05).

Comparative bonding performance of coronal dentin disks and CAD/CAM resin composite disks for biological restoration: The impact of resin-coating technique.

This study evaluated the bonding performance of coronal dentin disks, designed for biological restoration, and CAD/CAM resin composite disks when bonded to flat dentin surfaces using dual-cure resin cements, with and without a resin-coating (RC) technique. Three distinct groups were established within the non-RC group, each using one of the two types of resin cements in a self-adhesive mode: one-step self-etch adhesive (1-SEA) without light-cure, 1-SEA with light-cure, and a separate group using an alternate cement. Within the RC group, a subgroup was established for each cement. The microtensile bond strength (µTBS) of the disk-dentin beam was tested after 0 and 10,000 thermocycles in a 5°C/55°C. No significant µTBS difference was observed among the non-RC groups. However, when using RC, the µTBSs of coronal dentin disks significantly exceeded those of CAD/CAM resin composite disks. Thermocycle aging did not affect µTBS in any of the bonding methods, except in self-adhesive mode.

Effects of vehicles on the physical properties and biocompatibility of premixed calcium silicate cements.

Premixed calcium silicate cements (pCSCs) contain vehicles which endow fluidity and viscosity to CSCs. This study aimed to investigate the effects of three vehicles, namely, polyethylene glycol (PEG), propylene glycol (PG), and dimethyl sulfoxide (DMSO), on the physicochemical properties and biocompatibility of pCSCs. The setting time, solubility, expansion rate, and mechanical strength of the pCSCs were evaluated, and the formation of calcium phosphate precipitates was assessed in phosphate-buffered saline (PBS). The effects of pCSC extracts on the osteogenic differentiation of mesenchymal stem cells (MSCs) were investigated. Finally, the tissue compatibility of pCSCs in rat femurs was observed. CSC containing PEG (CSC-PEG) exhibited higher solubility and setting time, and CSC-DMSO showed the highest expansion rate and mechanical strength. All pCSCs generated calcium phosphate precipitates. The extract of CSC-PG induced the highest expressions of osteogenic markers along with the greatest calcium deposites. When implanted in rat femurs, CSC-PEG was absorbed considerably, whereas CSC-PG remained relatively unaltered inside the femur.

Comparative analysis of stress distribution in residual roots with different canal morphologies: evaluating CAD/CAM glass fiber and other post-core materials.

BACKGROUND: The selection of post-core material holds significant importance in endodontically treated teeth, influencing stress distribution in the dental structure after restoration. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) glass fiber post-core possesses a better adaptation for different root canal morphologies, but whether this results in a more favorable stress distribution has not been clearly established. MATERIALS AND METHODS: This study employed finite element analysis to establish three models of post-core crown restoration with normal, oversized, and dumbbell-shaped root canals. The three models were restored using three different materials: CAD/CAM glass fiber post-core (CGF), prefabricated glass fiber post and resin core (PGF), and cobalt-chromium integrated metal post-core (Co-Cr), followed by zirconia crown restoration. A static load was applied and the maximum equivalent von Mises stress, maximum principal stress, stress distribution plots, and the peak of maximum displacement were calculated for dentin, post-core, crown, and the cement acting as the interface between the post-core and the dentin. RESULTS: In dentin of three different root canal morphology, it was observed that PGF exhibited the lowest von Mises stresses, while Co-Cr exhibited the highest ones under a static load. CGF showed similar stress distribution to that of Co-Cr, but the stresses were more homogeneous and concentrated apically. In oversized and dumbbell-shaped root canal remnants, the equivalent von Mises stress in the cement layer using CGF was significantly lower than that of PGF. CONCLUSIONS: In oversized root canals and dumbbell-shaped root canals, CGF has shown good performance for restoration of endodontically treated teeth. CLINICAL RELEVANCE: This study provides a theoretical basis for clinicians to select post-core materials for residual roots with different root canal morphologies and should help to reduce the occurrence of complications such as root fracture and post-core debonding.

Effects of Nd:YAG laser irradiation at different energy densities on dentin bond durability under simulated pulpal pressure.

OBJECTIVES: To evaluate the effects of Nd:YAG laser irradiation on the microstructures of dentin surfaces and the long-term bond strength of dentin under simulated pulpal pressure. MATERIALS AND METHODS: Under simulated pulp pressure, 30 freshly extracted caries-free third molars were cut into 2-mm-thick dentin samples and then divided into five groups: the control and laser groups (93.3 J/cm2; 124.4 J/cm2; 155.5 J/cm2; 186.6 J/cm2). Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR), and Vickers hardness were used to analyze the surface morphology, composition, and mechanical properties of the dentin before and after laser irradiation. Another 80 caries-free third molars were removed and treated as described above, and the resin was bonded to the dentin surface with Single Bond Universal (SBU) adhesive in self-etch mode to make stick specimens. Microtensile bond strength (µTBS), confocal laser scanning microscopy (CLSM), and interfacial silver nanoleakage tests before and after 10,000 times thermocycling were then performed to analyze the bonding properties and interfacial durability of each group. RESULTS: SEM observations revealed that the surfaces of all laser group specimens were rough with open dentin tubules. Laser irradiation altered the surface composition of dentin while removing some collagen fibers but did not affect its surface hardness or crystallographic characteristics. Furthermore, laser irradiation with an energy density of 124.4 J/cm2 significantly promoted the immediate and aging bond strengths and reduced nanoleakage compared to those of the control group. CONCLUSIONS: Under simulated pulp pressure, Nd:YAG laser pretreatment altered the chemical composition of dentin and improved the immediate and long-term bond strength. CLINICAL RELEVANCE: This study investigated the optimal parameters for Nd:YAG laser pretreatment of dentin, which has potential as a clinical method to strengthen bonding.

Promoting bond durability by a novel fabricated bioactive dentin adhesive.

OBJECTIVE: To prepare a bioactive dentin adhesive and investigate its effect on promoting bonding durability of dentin. METHODS: The mineralization of the bioactive glass with high phosphorus (10.8 mol% P2O5-54.2 mol% SiO2-35 mol% CaO, named PSC) and its ability to induce type I collagen mineralization were observed by SEM and TEM. The Control-Bond and the bioactive dentin adhesive containing 20 wt% PSC particles (PSC-Bond) were prepared, and their degree of conversion (DC), microtensile bond strength (µTBS), film thickness and mineralization performance were evaluated. To evaluate the bonding durability, dentin bonding samples were prepared by Control-Bond and PSC-Bond, and mineralizated in simulated body fluid for 24 h, 3 months, and 6 months. Then, the long-term bond strength and microleakage at the adhesive interface of dentin bonding samples were evaluated by microtensile testing and semiquantitative ELIASA respectively. RESULTS: The PSC showed superior mineralization at 24 h and induced type I collagen mineralization to some extent under weakly alkaline conditions. For PSC-Bond, DC was 62.65 ± 1.20%, µTBS was 39.25 ± 4.24 MPa and film thickness was 17.00 ± 2.61 µm. PSC-Bond also formed hydroxyapatite and maintained good mineralization at the bonding interface. At 24 h, no significant differences in µTBS and interface microleakage were observed between the Control-Bond and PSC-Bond groups. After 6 months of aging, the µTBS was significantly higher and the interface microleakage was significantly lower of PSC-Bond group than those of Control-Bond group. SIGNIFICANCE: PSC-Bond maintained bond strength stability and reduced interface microleakage to some extent, possibly reducing the occurrence of secondary caries, while maintaining long-term effectiveness of adhesive restorations.

The effect of three additives on properties of mineral trioxide aggregate cements: a systematic review and meta-analysis of in vitro studies.

BACKGROUND: Several efforts have been made to improve mechanical and biological properties of calcium silicate-based cements through changes in chemical composition of the materials. This study aimed to investigate the physical (including setting time and compressive strength) and chemical (including calcium ion release, pH level) properties as well as changes in cytotoxicity of mineral trioxide aggregate (MTA) after the addition of 3 substances including CaCl2, Na2HPO4, and propylene glycol (PG). METHODS: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Electronic searches were performed on PubMed, Embase, and Scopus databases, spanning from 1993 to October 2023 in addition to manual searches. Relevant laboratory studies were included. The quality of the included studies was assessed using modified ARRIVE criteria. Meta-analyses were performed by RevMan statistical software. RESULTS: From the total of 267 studies, 24 articles were included in this review. The results of the meta-analysis indicated that addition of PG increased final setting time and Ca2+ ion release. Addition of Na2HPO4 did not change pH and cytotoxicity but reduced the final setting time. Incorporation of 5% CaCl2 reduced the setting time but did not alter the cytotoxicity of the cement. However, addition of 10% CaCl2 reduced cell viability, setting time, and compressive strength. CONCLUSION: Inclusion of 2.5% wt. Na2HPO4 and 5% CaCl2 in MTA can be advisable for enhancing the physical, chemical, and cytotoxic characteristics of the admixture. Conversely, caution is advised against incorporating elevated concentrations of PG due to its retarding effect. TRIAL REGISTRATION: PROSPERO registration number: CRD42021253707.

Influence of screw channel angulation on reverse torque value and fracture resistance in monolithic zirconia restorations after thermomechanical cycling: an in-vitro study.

BACKGROUND: While the concept of angled screw channels has gained popularity, there remains a scarcity of research concerning the torque loss and fracture strength of monolithic zirconia restorations with various screw channel angulations when exposed to thermomechanical cycling. This in-vitro study aimed to evaluate the reverse torque value and fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations with angulated screw channels after thermomechanical cycling. METHODS: One-piece monolithic zirconia restorations, with angulated screw channels set at 0°, 15°, and 25° (n = 6 per angulation) were fabricated and bonded to titanium inserts using a dual-cure adhesive resin cement. These assemblies were then screwed to implant fixtures embedded in acrylic resin using an omnigrip screwdriver, and reverse torque values were recorded before and after thermomechanical cycles. Additionally, fracture modes were assessed subsequent to the application of compressive load. One-way ANOVA and Bonferroni post hoc test were used to compare the groups (α = 0.05). RESULTS: The study groups were significantly different regarding the fracture resistance (P = 0.0015), but only insignificantly different in the mean percentage torque loss (P = 0.4400). Specifically, the fracture resistance of the 15° group was insignificantly higher compared to the 0° group (P = 0.9037), but significantly higher compared to the 25° group (P = 0.0051). Furthermore, the fracture resistance of the 0° group was significantly higher than that of the 25° group (P = 0.0114). CONCLUSIONS: One-piece hybrid monolithic zirconia restorations with angulated screw channels can be considered an acceptable choice for angulated implants in esthetic areas, providing satisfactory fracture strength and torque loss.

Longitudinal bond strength of a universal adhesive and chemical dentin characterization under different acid etching protocols.

OBJECTIVE: This study aimed to analyze the longitudinal bond strength of a universal adhesive and chemically characterize the dentin substrate under different acid etching protocols. METHODOLOGY: Dentin samples were etched with polyacrylic acid 25% (PAA) for 10 seconds (n=3) and phosphoric acid 32% (PA) for 15 seconds (n=3) and analyzed by Fourier transform infrared spectroscopy - attenuated total reflectance (FTIR-ATR) before and after treatment. For collagen degradation, samples (n=12) were divided into 3 groups: PAA, PA, and Deionized water (control), and analyzed by the quantity of solubilized type I collagen C-terminal cross-linked telopeptides and solubilized C-terminal peptide in relation to total protein concentration (ICTPtp and CTXtp) and by their ultimate tensile strength (UTS). For the adhesive interface analysis, dentin samples (n=72) were divided into 3 groups: PAA, PA, and Self-etch (SE), and subdivided into 2 groups: 24 h (baseline) and 1 year. The following tests were performed: microtensile bond strength (µTBS) (n=48), scanning electron microscopy (SEM) (n=12), and nanoleakage (n=12). RESULTS: The FTIR of PAA showed lower reduction of the peaks in the phosphate group when compared to PA. For ICTPtp, PA showed a significantly higher value. For CTXtp, PA and PAA groups failed to statically differ from each other. UTS was significantly lower for PA. For µTBS, storage time significantly affected bond strength. The results were unaffected by the etching protocol. For SEM, after 1 year, PA had little evidence of degradation in the upper third of the adhesive interface in comparison to the other groups. Nanoleakage showed no considerable silver impregnation after 1 year in the SE group. CONCLUSION: The use of PAA prior to a universal adhesive (when compared to PA) represents a less aggressive type of etching to dentin. However, self-etching still seems to be the best option for universal adhesive systems that have functional monomers in their composition.

Use of Vital Pulp Therapies in Primary Teeth 2024.

Purpose: The purpose of this study was to present an evidence-based guideline for primary teeth with deep caries or trauma requiring vital pulp therapies (VPT). Methods: A systematic review/meta-analysis on vital primary teeth resulting from trauma or caries was conducted using GRADE to assess the certainty of evidence for clinical recommendations. A decision tree was provided for choosing VPTs. Results: No articles on trauma VPT were found. For VPT in primary teeth with deep caries, indirect pulp treatment (IPT) or pulpotomy using the calcium silicate cement (mineral trioxide aggregate [MTA] or Biodentine®) show increased success over using direct pulp capping (DPC) and other pulpotomies. Different liners do not affect IPT success (high certainty) or DPC capping agents' success (very low certainty) after 24 months. It is strongly recommended, with high certainty from 24-month data, that calcium silicate cement pulpotomy is preferred over formocresol, ferric sulfate, zinc oxide eugenol pulpotomy, and other pulpotomies. Using selective caries removal and IPT for deep caries is strongly recommended with moderate certainty over complete and stepwise removal. Statistically, this results in significantly fewer pulp exposures. No caries removal and Hall technique crown may be used when indicated (moderate certainty at 24 months). For vital primary incisors with deep caries, pulpotomy was significantly better statistically than pulpectomy. Teeth diagnosed with/without reversible pulpitis pain showed comparable success after 12 months of treatment by IPT or calcium silicate cement pulpotomy. The following had little or no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; anterior or posterior teeth. Conclusions: Indirect pulp treatment or calcium silicate cement pulpotomy is likely to increase vital pulp therapy success over other VPTs such as direct pulp capping and other pulpotomies after 24 months (moderate certainty).

Marginal adaptation of two-step self-etch versus universal adhesives for Class V restorations: Effect of Er:YAG laser vs. bur prepared cavities.

PURPOSE: To compare the in vitro effect of laser and bur preparation on marginal adaptation of Class V cavities restored with a 2-step self-etch and distinct universal one-component universal adhesives used in self-etching mode. METHODS: 96 Class V cavities were prepared with conventional burs or with an Er:YAG laser. Four universal self-etch (Unibond Extra Low Shrinkage, All Bond Universal, SKB-100 and Prime&Bond active) and a 2-step self-etch adhesive (Clearfil SE Bond) that served as control were used to restore the cavities with direct composite. The percentages of continuous margins were evaluated by quantitative SEM analysis before and after a fatigue test consisting of 240,000 occlusal loads and 600 warm/cold thermal cycles. RESULTS: The marginal adaptation of bur prepared restorations was statistically superior to laser-prepared ones. Class V cavities restored with Clearfil SE Bond and the one-component self-etching universal adhesives All Bond Universal and Prime&Bond active presented the highest and statistically similar percentages of continuous margins before and after loading under both bur and laser cavity preparation. The lowest percentages of continuous margins were observed in the groups restored with the low shrinking adhesive (Unibond ELS), with medians of 49 and 21 for bur and laser prepared cavities after loading. CLINICAL SIGNIFICANCE: Class V cavities presented smoother and higher percentages of continuous margins when prepared by bur rather than by laser. The 2-step self-etch adhesive Clearfil SE Bond and 1-step self-etch universal adhesives All Bond Universal and Prime&Bond active showed a comparable marginal performance.

Effect of ultrasonic and sonic instrumentation on shear bond strength of resin composite to enamel: An in vitro study.

PURPOSE: To assess and compare the effects of sonic and ultrasonic instrumentation on shear bond strength (SBS) and investigate the influence of adhesive system application modes (etch&rinse/self-etch) on SBS. METHODS: In this experimental study, 45 extracted sound human molars were selected. Mesial and distal surfaces of the teeth were abraded until 90 smooth enamel surfaces were obtained. Specimens were divided into two groups, with half (N= 45) conditioned in etch&rinse mode and the remaining (N= 45) in self-etch mode using Tetric N Bond Universal. Composite resin discs were produced on these surfaces by filling Teflon molds. All specimens were aged via thermocycling. Each group was further divided into three more groups (n= 15) according to the type of periodontal instrumentation (ultrasonic, sonic or none). SBS values were recorded and analyzed using two-way ANOVA. Fracture sites were examined under a stereomicroscope. RESULTS: The type of periodontal instrumentation had no significant effect on SBS values, whether sonic, ultrasonic or their absence (P= 0.945). The type of adhesive system mode had a significant influence on the shear bond strength values. Etch&rinse groups had significantly higher shear bond strength values than self-etch groups (P< 0.001). CLINICAL SIGNIFICANCE: This study reassures practitioners that sonic and ultrasonic instruments are safe for enamel bonding and highlights the importance of selecting adhesive techniques for optimal restorative outcomes.

[Bond strength of metal brackets to enamel with a Russian adhesive complex: an in vitro study]. / Sila adgezionnogo soedineniya emali zuba i metallicheskogo breketa, poluchennogo s pomoshch'yu otechestvennogo adgezivnogo kompleksa in vitro.

BACKGROUND: The era of using adhesives to fix brackets began in the 70s of the last century. There are eight generations of foreign-made adhesive systems for the restoration of teeth. However, until now, in orthodontics, the development of domestic adhesive systems with improved properties of adhesion of brackets to tooth enamel still important, especially in the posterior teeth. OBJECTIVE: The purpose of this work was to study the shear strength of fifth generation domestic adhesive between metal brackets and the enamel of molar teeth in laboratory conditions. MATERIAL AND METHODS: The study included 17 specimens of extracted maxillary molars embedded in acrylic resin blocks. Brackets from G&H Orthodontics (G&H Wire Company, USA) were fixed to the tooth enamel using the domestic Compofix (ortho) set. The enamel was treated with etching gel (37% phosphoric acid) for 30 seconds. Then the gel was washed off with water and the surface of the enamel was thoroughly dried. A primer was applied to the prepared surface with an applicator, inflated with a weak air flow for 5-10 seconds and photopolymerized for 20 seconds. The surface of the bracket was treated with degreaser, then a thin layer of adhesive was applied, and the sample was fixed to the enamel. Excess material was removed with an applicator. The samples were photopolymerized for 20 sec. Then, the shear bond strength of the adhesive was determined according to the method of GOST 31574-2012 on a (Zwick/Roell Z010 testing machine, Zwick, Germany). RESULTS: The shear strength of the adhesive joint obtained during the test is 13.54±1.01 MPa, the average value of the index of adhesive residues on the surface of the bracket was 23%±4%, which corresponds to the standard average values according to GOST. CONCLUSION: The tested domestic adhesive system of the fifth generation can be recommended for the practical work of an orthodontist.