Influence of light exposure techniques on in vitro pulp temperature rise during bulk fill composite Class I restorations.

This in vitro study assessed peak temperature and temperature increase (ΔT) within the pulp chamber during different extended photoactivation techniques (EPT-applying similar radiant exposure values) to resin-based composites (RBCs) placed in a Class I cavity preparation in an extracted human lower third molar. A T-type thermocouple was placed in the pulp chamber and connected to a temperature analysis device (Thermes, Physitemp). The tooth was attached to an assembly simulating the in vivo environment (controlled baseline pulp chamber temperature and fluid flow). The real-time pulp chamber temperature was evaluated throughout the photoactivation (Bluephase N, Ivoclar Vivadent) of two bulk-fill RBCs: Tetric N Ceram Bulk Fill (TBF; shade: IVA; Ivoclar Vivadent); Surefill SDR flow + (SDR, shade: Universal; Dentsply Sirona), which were exposed to different curing techniques: 40 s-occlusal surface; 20 s-occlusal + 10 s-buccal + 10 s-lingual surfaces; 10 s-buccal + 10 s + lingual + 20 s-occlusal surfaces. Each EPT delivered 42.4 J/cm2. Vickers hardness (VHN) was measured on the removed, sectioned RBC restorations at the top and bottom middle areas after curing. ΔT and VHN data were analyzed using 2-way ANOVA followed by Bonferroni post-hoc test (α = 0.05). Peak temperature data were analyzed using one-way ANOVA and Dunnett's post-hoc test (α = 0.05). SDR showed higher ΔT values than TBF (p = 0.008) in some EPTs. Neither technique resulted in ΔT values greater than 5.5 °C. Both composites had acceptable bottom/top hardness ratios (greater than 80%), regardless of the photoactivation technique. The evaluated EPTs may be considered safe as a low-temperature increase was noticed within the pulp chamber.

In vitro temperature changes in the pulp chamber caused by laser and Quadwave LED-light curing units.

The study evaluated the pulp temperature (PT) increase in Class I and V preparations when exposed to the Monet Laser (for 1 and 3 s), the PinkWave (for 3 and 10 s), the Valo Grand (for 3 and 10 s), the PowerCure, (for 3 and 10 s) and the SmartLite Pro (for 10 s). Non-retentive Class I and Class V cavities were prepared in one molar fixed in an acrylic plate and positioned in a warm water bath. The PT baseline was kept at 32 °C to simulate physiological conditions. Two T-type thermocouples were inserted through the roots into the pulp chamber in two positions: close to the pulp horn and the buccal wall close to the Class V cavity. The water flow was adjusted to 0.026 mL/min, and real-time temperature data were collected every 0.5 s. PT measurements were made with the tip of the LCU 0 and 6 mm away from the tooth surface. The radiant exitance (mW/cm2) and radiant exposure (J/cm2) were calculated. One-way ANOVA compared the effect of the pulpal flow, and ΔT values were subjected to two-way ANOVA, followed by Scheffe's post hoc tests. The Monet Laser used for 3 s and the PinkWave used for 10 s produced the greatest PT rise in the Class I cavity. The simulated pulpal flow did not influence the PT rise. Overall, cavities exposed at the 0 mm distance had higher ΔT values than groups at 6 mm distance. The placement of a rubber dam for Class V restorations may prevent positioning LCUs directly over the cavity, which may affect the rise in PT.

Temperature changes and hardness of resin-based composites light-cured with laser diode or light-emitting diode curing lights.

The temperature and Vickers Hardness (VH) at the top and bottom surfaces of three resin-based composites (RBCs) were measured when light-cured using five light-curing units (LCUs). The spectrum, power, and energy delivered to the top of the RBCs and transmitted through the RBCs were measured. Starting at 32℃, the temperature rise produced by the Monet Laser (ML-1 s and 3 s), Valo Grand (VG-3 s and 10 s), DeepCure (DC-10 s), PowerCure, (PC-3 s and 10 s) and PinkWave (PW-10 s) were measured at the bottom of specimens 2 mm deep × 6 mm wide made of Filtek Universal A2, Tetric Evoceram A2 and an experimental RBC codenamed Transcend UB. The VH values measured at the top and bottom of these RBCs were analyzed using ANOVA and Scheffe's post hoc test (p < 0.05) to determine the effects of the LCUs on the RBCs. The transmitted power from the ML was reduced by 77.4% through 2 mm of Filtek Universal, whereas light from PW decreased by only 36.8% through Transcend. The highest temperature increases from the LCU combined with the exothermic reaction occurred for Transcend, and overall, no significant differences were detected between Filtek Universal and Tetric Evoceram (p = 0.9756). Transcend achieved the highest VH values at the top and bottom surfaces. The PinkWave used for 10 s produced the largest temperature increase (20.2℃) in Transcend. The Monet used for 1 s produced the smallest increase (7.8℃) and the lowest bottom:top VH ratios.

Irradiance from 12 LED light curing units measured using 5 brands of dental radiometers.

OBJECTIVE: To evaluate the accuracy of five brands of radiometers in reporting the irradiance (mW/cm2 ) from twelve brands of LCUs compared to a 'Gold Standard' (GS) reference obtained from a hand-held laboratory-grade radiometer. MATERIALS AND METHODS: The irradiance was measured from two examples of twelve brands of previously used LCUs on two examples of five brands of dental radiometers. The emission spectrum was also obtained. Irradiance data from each brand of LCU against each meter was analyzed using the Shapiro-Wilk test for normality. The irradiance values were subjected to a two-way ANOVA followed by Bonferroni tests for each LCU brand. Finally, a descriptive analysis was made using a 95% confidence interval around the mean irradiance. RESULTS: The power output from the LCUs ranged from 271 mW to 1005 mW. Among the tested radiometers, only the Bluephase Meter II could accurately report the irradiance from 11 out of the 12 brands of LCU evaluated in this study. When measured using the "GS" system, the mean irradiance values from the two examples of nine brands of previously used LCU were not always within ±10% of the irradiance values stated by the manufacturer. CONCLUSIONS: The mean irradiance values from 9 of the 12 brands of used LCUs were beyond ±10% of the irradiance values stated by the manufacturer. Only the Bluephase Meter II could accurately report the irradiance from 11 out of the 12 brands of LCU evaluated in this study. CLINICAL SIGNIFICANCE: There was a wide range in the power output from the LCUs tested. It was impossible to accurately measure the irradiance from all the LCUs using the dental radiometers examined. However, dental radiometers should still be used in dental offices to monitor the light output from LCUs and verify that they are working correctly before they are used on patients.

In-vitro pulpal temperature increases when photo-curing bulk-fill resin-based composites using laser or light-emitting diode light curing units.

OBJECTIVE: To evaluate the in vitro pulpal temperature rise (ΔT) within the pulp chamber when low- and high-viscosity bulk-fill resin composites are photo-cured using laser or contemporary light curing units (LCUs). MATERIALS AND METHODS: The light output from five LCUs was measured. Non-retentive Class I and V cavities were prepared in one upper molar. Two T-type thermocouples were inserted into the pulp chamber. After the PT values reached 32°C under simulated pulp flow (0.026 mL/min), both cavities were restored with: Filtek One Bulk Fill (3 M), Filtek Bulk Fill Flow (3 M), Tetric PowerFill (Ivoclar Vivadent), or Tetric PowerFlow (Ivoclar Vivadent). The tooth was exposed as follows: Monet Laser (1 and 3 s), PowerCure (3 and 20 s), PinkWave (3 and 20 s), Valo X (5 and 20 s) and SmartLite Pro (20 s). The ΔT data were subjected to one-way ANOVA followed by Scheffe's post hoc test. RESULTS: Monet 1 s (1.9 J) and PinkWave 20 s (30.1 J) delivered the least and the highest amount of energy, respectively. Valo X and PinkWave used for 20 s produced the highest ΔT values (3.4-4.1°C). Monet 1 s, PinkWave 3 s, PowerCure 3 s (except FB-Flow) and Monet 3 s for FB-One and TP-Fill produced the lowest ΔT values (0.9-1.7°C). No significant differences were found among composites. CONCLUSIONS: Short 1- to 3-s exposures produced acceptable temperature rises, regardless of the composite. CLINICAL SIGNIFICANCE: The energy delivered to the tooth by the LCUs affects the temperature rise inside the pulp. The short 1-3 s exposure times used in this study delivered the least amount of energy and produced a lower temperature rise. However, the RBC may not have received sufficient energy to be adequately photo-cured.

How the translucency of direct anatomic fiber posts affects the bond strength and microhardness of a self-adhesive luting agent in flared roots.

OBJECTIVES: To evaluate the influence of the composite resin translucency used in direct anatomic fiber posts on the bond strength (BS) and microhardness (VHN) of a luting agent into flared roots. MATERIALS AND METHODS: The root canals of 70 single-rooted premolars were endodontically treated and prepared to simulate an oversized root canal. Prior to post cementation, composite resins with varying translucency (high translucent, HT; medium translucent, MT; high opacity, HO) were placed around the fiber posts to create anatomic fiber posts. The attenuation profile (%) of light passing either through the post or through the anatomic posts (n = 8) was obtained prior to the cementing procedures. A positive control group (PC) in which a prefabricated fiber post (PFP) with the diameter compatible with the root canal was cemented and a poorly adapted fiber post (negative control group, NC) were also evaluated. For both tests, the data were subjected to 2-way ANOVA and Bonferroni tests (α = 0.05). RESULTS: A more severe light attenuation through the post at the cervical (P < .001) and medium (P < 0.001) thirds was noted when less translucent composite resin surrounded the anatomic post. HO groups showed lower BS (P = .009) and VHN (P < .001) values than the other groups, regardless of root third. No significant difference in BS values was noted between PC and HT groups. CONCLUSION: The use of a more translucent composite resin in anatomic fiber posts increased the microhardness and bond strength of a dual polymerization self-adhesive RLA compared to the use of MT and HO composite. A well-adapted PFP showed the highest adhesive and mechanical behavior. CLINICAL RELEVANCE: Clinicians should choose more translucent composite resins to create direct anatomic fiber posts to be cemented in flared root canals. That choice may allow improved mechanical properties of self-adhesive RLA and higher bond strength to the root canal as a consequence.

Analysis of the interfacial micromorphology and bond strength of adhesive systems to Er:YAG laser-irradiated dentin.

UNLABELLED: This study evaluated the effects of different parameters of dentin irradiation with erbium -doped yttrium aluminum garnet (Er:YAG) laser on bond strength to dentin and analyzed the ultramorphological characteristics of resin-laser-irradiated dentin interfaces using a transmission electron microscope (TEM). Dentin surfaces were abraded with SiC paper (600 grit) or Er:YAG laser-irradiated (120/4, 140/6, 180/4, or 200/6 mJ/Hz). Three adhesive systems were tested: Single Bond Plus (3M ESPE), Clearfil Protect Bond (Kuraray Med.), and Clearfil Tri-S Bond (Kuraray Med.). Treatments were performed over flat dentin surfaces of human third molars. Specimens were stored in distilled water for 1 week or 6 months and prepared for a microtensile bond strength test and interfacial ultrastructure for analysis. Microtensile bond strength data (n = 5) were analyzed with three-way analysis of variance. Irradiation with Er:YAG laser did not reduce the bond strength values for self-etching adhesives even after 6 months of water storage. The hybrid layer formation was observed only when the adhesives were applied to non-irradiated dentin (control group). Nanoleakage occurred in all resin-dentin interfaces using Single Bond Plus for both periods. Nanoleakage pattern and bond strength of self-etching adhesives to dentin were less affected by Er:YAG laser irradiation and by the 6-month storage in water than was those of the etch-and-rinse adhesive. TEM analysis revealed no hybridization when dentin was laser-irradiated. CLINICAL SIGNIFICANCE: Minimally invasive caries removal has been proposed. Nevertheless, bonding mechanisms to lased dentin are not entirely described. Knowing the interaction between the treated dentin and bonding agents and its behavior over time is of utmost importance for new technologies. Regarding that, two-bottle self-etching adhesive system provided a more consistent evidence of its better behavior when bonding to lased substrate.

Influence of filler addition, storage medium and evaluation time on biaxial flexure strength and modulus of adhesive systems.

OBJECTIVE: This study evaluated the effects of filler addition, storage medium and time on biaxial flexural strength and flexural modulus of six adhesive systems. MATERIALS AND METHODS: The adhesives were either unfilled resins: Single Bond, Prime&Bond 2.1 and One-Step; or filled resins: Single Bond Plus, Prime&Bond NT and One-Step Plus. Resin discs of each product (0.5 mm thick × 6.0 mm diameter) were prepared using silicon molds (n = 10). The discs were stored dry, in water, mineral oil or ethanol for 1 week or 3 months before biaxial flexural testing. Data were statistically analyzed by 3-way ANOVA and Tukey's post-hoc test (α = 0.05). The specimens were tested in a universal testing machine at 1.27 mm/min until failure occurred. RESULTS: In general, the storage in ethanol led to significantly lower flexural strength and flexural modulus values than the other storage conditions for all adhesives in both storage periods. Filler addition increased flexural strength and flexural modulus for Prime&Bond NT, when it was stored dry or in water for 1 week. For Single Bond Plus, the filler addition resulted in higher flexural modulus, when it was stored for 1 week in oil and in ethanol. No significant differences in flexural modulus were observed between One-Step and One-Step Plus in any storage medium. CONCLUSIONS: Results suggested that filler addition does not necessarily have to increase the flexural strength and flexural modulus. Ethanol and oil storages tended to yield opposite effects.

Effect of bioactive glasses used as dentin desensitizers on the dentin-pulp complex in rats.

Bioactive glasses have been recommended for the occlusion of dentinal tubules in treating cervical dentin hypersensitivity. This study evaluates an in vivo model of dentin exposure, and tests the efficacy of bioglass treatments. Thirty male Wistar rats received gingival recession surgery on the upper left first molar. The treatments were applied over the surface of the exposed dentin every 4 days for 28 days. The groups were as follows: Naive; Gingival recession; Cavity varnish; Biosilicate®; Strontium bioglass; and Potassium bioglass. Changes in the dentin-pulp complex, and the presence of substance P, were evaluated through hematoxylin-eosin and immunohistochemical staining. The groups had similar results. Teeth with exposed dentinal tubules in rats showed a typical pattern in the dentin-pulp complex and immunotracing for substance P. The materials did not cause pulp damage. The effects of gingival recession and open dentinal tubules on pulp tissue require further clarification.

Effect of Bonding Protocols on the Performance of Luting Agents Applied to CAD-CAM Composites.

This in vitro study aimed to evaluate the effect of different bonding strategies on the micro-shear bond strength (µSBS) of luting agents to CAD−CAM composites. Surface scanning electron microscopy (SEM) and spectroscopy by energy-dispersive X-ray spectroscopy (EDS) were performed to analyze the surfaces of the composite before and after bonding treatment. Three CAD−CAM composites were evaluated: Lava Ultimate restorative (LU), Brava Blocks (BR), and Vita Enamic (VE). The LU and BR surfaces were sandblasted using aluminum oxide, while the VE surfaces were etched using a 5% hydrofluoric acid gel according to the manufacturers' recommendations. All surfaces were subjected to the following bonding strategies (n = 15): adhesive with silane and MDP (ScotchBond Universal, 3M Oral Care, St Paul, MI, USA); adhesive with MDP (Ambar Universal, FGM, Joinville, Brazil); adhesive without silane or MDP (Prime&Bond Elect, Dentsply Sirona, Charlotte, NC, USA), pure silane without MDP (Angelus, Londrina, Brazil), and pure silane with MDP (Monobond N, Ivoclar Vivadent, Schaan, Liechtenstei). Afterwards, tygons were filled with RelyX Ultimate (3M Oral Care), AllCem (FGM), or Enforce (Dentsply Sirona), which were light-cured and subjected to the µSBS test. Data were analyzed using two-way ANOVA and Bonferroni's post hoc test (α = 0.05). Additional blocks (n = 15) were subjected to scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) before and after the surface treatment. The µSBS values on VE surfaces were higher than those observed on LU and BR surfaces (p < 0.001). Silane without MDP (Allcem) promoted the highest µSBS values, while silane with MDP (RelyX Ultimate) provided the highest values among all bonding strategies (p < 0.001). Enforce promoted no significant difference in µSBS values. SEM and EDS analyses detected noticeable changes to the surface morphology and composition after the surface treatment. The effectiveness of the bonding strategy may vary according not only to the CAD−CAM composite but also to resin cement/bonding agent/silane used.

Effects of Dentine Pretreatment Solutions Containing Flavonoids on the Resin Polymer-Dentine Interface Created Using a Modern Universal Adhesive.

The aim of the present study was to evaluate the influence of several experimental pretreatment crosslinker solutions on the resin polymer-dentine interface created using a representative universal adhesive system, by means of microtensile bond strength testing (µTBS), nanomechanical properties and ultramorphology confocal laser scanning microscopy (CLSM). Five experimental solutions containing different flavonoids were applied as dentine pretreatment after acid etching. A control pretreatment group containing no flavonoid was also employed. A representative modern universal adhesive was then applied, followed by a 3 mm thick composite built up. Specimens were sectioned into sticks and submitted to a µTBS test or nanoindentation analysis along the interface (24 h or 25,000 thermocycles). The ultramorphology of the polymer-resin interface was also evaluated using CLSM. The results were analyzed using two-way ANOVA and Bonferroni's post hoc test (α = 0.05). All flavonoids improved short- and long-term µTBS values (p < 0.01), while only some specific such solutions improved the nanomechanical properties (p < 0.05) and preserved the structural morphology of the interface after aging. Pretreatment of acid-etched dentine using specific flavonoid-containing solutions may be a promising approach to improve both the nanomechanical properties and the durability of modern universal adhesive systems.

Micromorphology of resin-dentin interfaces using one-bottle etch&rinse and self-etching adhesive systems on laser-treated dentin surfaces: a confocal laser scanning microscope analysis.

BACKGROUND AND OBJECTIVES: This study evaluated the hybrid layer (HL) morphology created by three adhesive systems (AS) on dentin surfaces treated with Er:YAG laser using two irradiation parameters. STUDY DESIGN: Occlusal flat dentin surfaces of 36 human third molars were assigned into nine groups (n = 4) according to the following ASs: one bottle etch&rinse Single Bond Plus (3M ESPE), two-step Clearfil Protect Bond (Kuraray), and all-in-one S(3) Bond (Kuraray) self-etching, which were labeled with rhodamine B or fluorescein isothiocyanate-dextran and were applied to dentin surfaces that were irradiated with Er:YAG laser at either 120 (38.7 J/cm(2)) or 200 mJ/pulse (64.5 J/cm(2)), or were applied to untreated dentin surfaces (control group). The ASs were light-activated following MI and the bonded surfaces were restored with resin composite Z250 (3M ESPE). After 24 hours of storage in vegetable oil, the restored teeth were vertically, serially sectioned into 1-mm thick slabs, which had the adhesive interfaces analyzed with confocal laser microscope (CLSM-LSM 510 Meta). CLSM images were recorded in the fluorescent mode from three different regions along each bonded interface. RESULTS: Non-uniform HL was created on laser-irradiated dentin surfaces regardless of laser irradiation protocol for all AS, while regular and uniform HL was observed in the control groups. "Stretch mark"-like red lines were found within the HL as a result of resin infiltration into dentin microfissures, which were predominantly observed in 200 mJ/pulse groups regardless of AS. Poor resin infiltration into peritubular dentin was observed in most regions of adhesive interfaces created by all ASs on laser-irradiated dentin, resulting in thin resin tags with neither funnel-shaped morphology nor lateral resin projections. CONCLUSION: Laser irradiation of dentin surfaces at 120 or 200 mJ/pulse resulted in morphological changes in HL and resin tags for all ASs evaluated in the study.

Influence of flavonoids on long-term bonding stability on caries-affected dentin.

OBJECTIVES: To evaluate the effect of experimental dentin pre-treatment solutions formulated with different flavonoids on microtensile bond strength (µTBS), nanohardness (NH) and ultra-morphological characteristics of artificial caries-affected dentin (CAD) bonded using a universal bonding system. METHODS: A microbiological method was used to create an artificial CAD in 91 human molars. Five experimental pre-treatment solutions were created using the following flavonoids: quercetin (QUE); hesperidin (HES); rutin (RUT); naringin (NAR), or proanthocyanidin (PRO). A placebo solution (PLA) with no flavonoids added was also evaluated. The flavonoids or placebo solutions were applied to the CAD prior to the application and photoactivation of a universal adhesive (Scotchbond Universal, 3M Oral Care). A control group (CON), in which only the bonding agent was applied without any flavonoid solution, was also evaluated. A 3-mm-thick block of resin composite (Opallis, FGM) was built up on the flat bonded CAD surfaces and was light-cured following the manufacturer's instructions. Specimens were sectioned to obtain resin-dentin slices and sticks (cross-sectional area of 0.8 mm2). The µTBS, NH, and confocal ultramorphology analysis of resin-dentin interface was evaluated at 24 h and after thermo-cycling aging (25,000 cycles). The results were analyzed using 2-way ANOVA followed by Bonferroni's post hoc test (pre-set α = 0.05). RESULTS: The specimens from groups QUE, NAR, and RUT presented greater µTBS values than those from CON group (p<0.05). Specimens from some of these experimental groups presented greater nanomechanical properties (p<0.05), and no morphological degradation at the resin-dentin interface after aging. SIGNIFICANCE: The use of exogenous cross-linkers as dentin pre-treatment before bonding procedures may represent a suitable strategy to improve the longevity of universal adhesive systems applied to caries-affected dentin.

In vivo temperature rise and acute inflammatory response in anesthetized human pulp tissue of premolars having Class V preparations after exposure to Polywave® LED light curing units.

OBJECTIVE: To evaluate the influence of light emitted from two Polywave®, LED light-curing units (LCU) on in vivo pulp temperature (PT) rise and signs of acute inflammatory response in pulps of human premolar having deep Class V preparations. METHODS: Sixty intact, first premolars from 15 volunteers requiring extraction received infiltrative anesthesia. A sterile thermocouple probe was inserted within the pulp tissue through a minute occlusal pulp exposure in only 45 teeth (n = 9) to continuously monitor PT (°C). A deep buccal Class V preparation was created, and the surface was exposed to light from a commercial Polywave LCU (Bluephase 20i (20i), Ivoclar Vivadent) or from an experimental LCU (Exp) using the exposure modes (EM): 1s/Exp and 2s/Exp, 10s/20i, 20s/20i, and 60s/20i. Peak PT and PT rise values above baseline (ΔT) data were evaluated using a one-way ANOVA followed by Tukey's post-hoc test (α = 5%). Teeth used for histological and immunohistochemical analyses (n = 3) were extracted approximately 2 h after exposure to the LCU. RESULTS: No significant difference in peak PT and ΔT values was noted between 2s/Exp and 20s/20i groups, which both exhibited higher values than 1s/Exp and 10s/20i groups (p < 0.001). Dilated and congested blood vessels were seen after exposure to 1s/Exp, 2s/Exp, or 60s/20i EMs. The expression of IL-1ß and TNF-α tended to be more intense when higher irradiance was delivered. SIGNIFICANCE: Although higher irradiance delivered over a short exposure caused lower PT rise than 5.5 °C, such EMs should be used with caution, as they have more potential to harm the pulp tissue.

Superficial distribution and identification of antifungal/antimicrobial agents on a modified tissue conditioner by SEM-EDS microanalysis: a preliminary study.

PURPOSE: This study evaluated the incorporation pattern of antifungal/antimicrobial agents added to a tissue conditioner by scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) analysis. MATERIALS AND METHODS: The nystatin dosages incorporated into the tissue conditioner (Softone, Bosworth Co., Skokie, IL) powder were 500,000 U (G1) and 1,000,000 U (G2). The addition of miconazole was at 125 mg (G3) and 250 mg (G4), and ketoconazole was at 100 mg (G5) and 200 mg (G6). Chlorhexidine diacetate was blended at levels of 5% (G7) and 10% (G8) w/w of the total amount (6.35 g) of the tissue conditioner. The drug powder concentrations were blended with the tissue conditioner powder at different concentrations before the addition of the tissue conditioner liquid (5 mL) to the mixture. One group (G0) without any drug incorporation was used as control. Specimens (n = 5) (36 x 7 x 6 mm(3)) were plasticized at room temperature for 10 minutes and carbon sputter coated. All specimens were submitted to SEM-EDS analysis. RESULTS: Nystatin and miconazole specimens exhibited particles with irregular shapes and sizes uniformly distributed. Ketoconazole specimens showed small spherical particles with a slight distribution throughout the matrix. Chlorhexidine specimens exhibited irregular particles up to approximately 50 mum in size randomly dispersed within the matrix. CONCLUSIONS: Within the limitations of this in vitro study, the modified tissue conditioner showed differences in the particle distribution and size of the antifungal/antimicrobial agent added to the plasticized matrix. Further studies would discriminate the most important particle features that may influence the drug leaching from the plasticized matrix.

Optimizing the composite resin stratification technique with prefabricated templates: a case report.

Direct freehand veneers with composite resin (CR) require high clinician ability and a long chair time. Although CR restorations remain the most-used technique for meeting high esthetic demands, and new technologies mean that materials are nowadays more similar to tooth structure, layering techniques for natural results are still considered difficult to achieve. Through advances in adhesive dentistry, systems of prefabricated veneers using conventional techniques have been launched onto the market as an option for the clinician. This case report presents complete step-by-step descriptions of two techniques using prefabricated templates for directly built-up veneers. Both maxillary lateral incisors were simultaneously reconstructed with direct CR veneers with different layering techniques to achieve esthetic results in a shorter chair time. Simple stratification techniques using prefabricated templates may allow clinicians to optimize both time and clinical outcome while obtaining predictable results.

Comparison of in vivo and in vitro models to evaluate pulp temperature rise during exposure to a Polywave® LED light curing unit.

OBJECTIVES: To measure and compare in vivo and in vitro pulp temperature (PT) increase (ΔTEMP) over baseline, physiologic temperature using the same intact upper premolars exposed to the same Polywave® LED curing light. METHODOLOGY: After local Ethics Committee approval (#255,945), local anesthesia, rubber dam isolation, small occlusal preparations/minute pulp exposure (n=15) were performed in teeth requiring extraction for orthodontic reasons. A sterile probe of a temperature measurement system (Temperature Data Acquisition, Physitemp) was placed within the pulp chamber and the buccal surface was sequentially exposed to a LED LCU (Bluephase 20i, Ivoclar Vivadent) using the following exposure modes: 10-s low or high, 5-s Turbo, and 60-s high. Afterwards, the teeth were extracted and K-type thermocouples were placed within the pulp chamber through the original access. The teeth were attached to an assembly simulating the in vivo environment, being similarly exposed while real-time temperature (°C) was recorded. ΔTEMP values and time for temperature to reach maximum (ΔTIME) were subjected to two-way ANOVA and Bonferroni's post-hoc tests (pre-set alpha 0.05). RESULTS: Higher ΔTEMP was observed in vitro than in vivo. No significant difference in ΔTIME was observed between test conditions. A significant, positive relationship was observed between radiant exposure and ΔTEMP for both conditions (in vivo: r2=0.917; p<0.001; in vitro: r2=0.919; p<0.001). CONCLUSION: Although the in vitro model overestimated in vivo PT increase, in vitro PT rise was close to in vivo values for clinically relevant exposure modes.

Bond Strength of Methacrylate-based Blends Containing Elastomeric Monomers and Alternative Initiators after Thermomechanical Cycling.

PURPOSE: To evaluate the bond strength to dentin produced by experimental adhesives formulated with an elastomeric methacrylate monomer (EMM) and an alternative initiator system based on a Thioxanthone derivative (QTX). MATERIALS AND METHODS: A self-etching primer was used. For the bonding resin, a model adhesive (G1) was formulated containing bis-GMA/TEG-DMA/HEMA (co-monomeric blend) + CQ/EDAB (initiator system). The other groups were formulated by adding to this formulation: EMM only (G2), QTX (G3), or EMM and QTX (G4). Clearfil SE Bond was used as the commercial control group. Fifty bovine teeth (n = 5) were restored with each one of the five adhesives. After restorative procedures, half of the specimens were stored in distilled water at 37°C for 24 h. The other half was fixed on a metal stub and subjected to 200,000 mechanical (50 N loading at 2 Hz frequency) and 1000 thermal cycles (5°C and 55°C). Afterwards, specimens were serially sectioned into beams and tested in tension until fracture. Bond strengths were statistically analyzed by two-way ANOVA and Tukey's test (α = 5%). RESULTS: After 24 h, significantly higher µTBS was observed for the formulation containing EMM and QTX (G4) when compared to Clearfil SE Bond (p < 0.05). No significant differences in µTBS were detected among the experimental groups after 24 h (p>0.05). After thermomechanical cycling, no significant differences were observed among groups. CONCLUSION: The addition of EMM and QTX can be considered as possible alternative in dental adhesive formulations.

The effect of the presence and presentation mode of co-initiators on the microtensile bond strength of dual-cured adhesive systems used in indirect restorations.

This study compared the microtensile bond strength (microTBS) of indirect resin composite restorations to dentin when fifth-generation adhesive systems were either light-activated or left in the uncured state prior to cementation. The systems used in this study were Prime&Bond NT (NT-Dentsply) and Excite (EX-Ivoclar-Vivadent) or their dual-cured versions containing co-initiators with different presentation modes (as solution or salts) Prime&Bond NT Dual-cure (NTD-Dentsply) and Excite DSC (DSC-Ivoclar Vivadent). The bonding agents were applied to the flattened occlusal dentin surfaces of 40 human third molars according to the manufacturers' instructions and were light-activated (XL3000/3M ESPE) for 10 seconds (LP) or left in the uncured state (SP). The respective resin cements Calibra (Dentsply Caulk) and Variolink II (Ivoclar Vivadent) were applied to pre-cured resin composite discs (2 mm thick/Z-250/3M ESPE) that were fixed to the bonded dentin surfaces. The restored teeth were light-activated according to the manufacturers' instructions for five minutes after cementation and water-stored at 37 degrees C for 24 hours. The teeth were then both mesial-distally and buccal-lingually sectioned to obtain bonded specimens (0.8 mm2). Each specimen was tested in tension at a crosshead speed of 0.5 mm/minute until failure. The data (MPa [SD]) were analyzed by 3-way ANOVA and Tukey's post-hoc test (p < .05). The results showed that the presence of a co-initiator decreased microTBS for NT, while no significant difference in microTBS was noted between EX and DSC, regardless of the curing mode. All SP groups exhibited lower microTBS than the LP groups. The results suggest that coinitiators presented as a solution may decrease microTBS to dentin of the evaluated adhesive systems in indirect resin composite restorations. Light-activation of the adhesive layer prior to indirect cementation was crucial for higher microTBS on dentin.

Effects of the solvent evaporation technique on the degree of conversion of one-bottle adhesive systems.

This study evaluated the effect of four methods of solvent evaporation on the degree of conversion (DC) of seven one-bottle adhesive systems: Excite (EX), ONE-STEP (OS), Optibond Solo Plus (OB), Prime&Bond 2.1 (PB), Prime&Bond NT (NT), Single Bond (SB) and Single Bond Plus (SP) using Fourier Transform Infrared Analysis (FTIR). Adhesive resins were: 1) applied to KBr pellet surfaces and left undisturbed for 30 seconds (condition 1), 2) left undisturbed for 30 seconds and air-dried with an air stream for 10 seconds (condition 2), 3) left undisturbed for 60 seconds (condition 3) and 4) left undisturbed for 60 seconds and air-dried for 10 seconds (condition 4) before curing. FTIR spectra were obtained and the DC was calculated by comparing the ratio of aliphatic/aromatic double carbon bonds before and after light-activation for 10 seconds (XL 3000, 3M). The results of each product were analyzed by one-way repeated measure ANOVA and post-hoc Tukey's test (p<0.05). The DC of PB, NT, OB and SP adhesives was not affected by the four evaporation conditions, while the DC of EX, OS and SB changed according to the evaporation method. The results suggested that the DC of some adhesives was similar regardless of the evaporation method when no water from dentin or rinsing was involved. Other bonding agents showed higher DC after specific conditions of solvent evaporation.