Effectiveness of Different Cleaning Solutions in Removing Residual Caries-Detector Dyes.

OBJECTIVE: Caries-detector dyes (CDDs) have proven useful in the identification and removal of carious dentin. However, residues of these cleaning agents may remain in the oral cavity. This study conducted spectrophotomectric analyses to evaluate the effectiveness of different cleaning agents in removing residual CDDs from the oral cavity. MATERIAL AND METHOD: Ninety freshly extracted human third-molar teeth were used in the study. Tooth occlusal surfaces were ground to expose dentin. Specimens were randomly distributed into 3 groups according to CDD [Seek Caries Indicator (SCI), Caries Detector (CD), Caries Marker (CM)], and each group was further divided into 3 sub-groups according to cleaning solution [distilled water (DW), 3% NaOCl, and 3% H2 O2 )]. CDDs were applied to dentin surfaces according to the manufacturer's instructions and then rinsed with a cleansing solution. The effectiveness of cleaning solutions in removing CDD residues was determined according to color change by comparing spectrophotometric measurements of tooth color before CDD application and after cleaning. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey's HSD test (α = 0.05). RESULT: For all CDDs groups, the smallest color differences were observed in the 3% NaOCl sub-groups (P < .05), and the largest in the distilled water sub-groups (P > .05). When compared to the other CDD groups, the SCI group yielded the greatest color differences for all cleaning-agent sub-groups. CONCLUSION: Cleaning solutions such as 3% NaOCl or 3% H2 O2 can be used to remove residual CDD from dentin surfaces. CLINICAL SIGNIFICANCE: This study compared the effectiveness of three different cleaning agents in caries removal process.

Examination of the Knowledge Levels of Family Medicine Residents in Turkey about Oral and Dental Health.

PURPOSE: To measure the general oral and dental health knowledge level of family medicine residents who are receiving full-time specialty training in Turkey. Primary care physicians can contribute to improving the oral and dental health of patients during general health services. MATERIALS AND METHODS: The fundamentals of oral and dental health that the family medicine physicians should know about were determined, and questionnaire items on these fundamentals were prepared. The sample size was calculated as 296 individuals. The survey was conducted online. The collected data were analysed employing the following tests: chi-squared, Fisher, Kolmogorov-Smirnov, Spearman, ANOVA, Mann-Whitney U, Kruskal-Wallis, and Bonferroni. RESULTS: 302 family medicine residents in various clinics in Turkey participated in the study. The mean age of the participants was 29.6 ± 5.1. The mean knowledge scores of the resident physicians were calculated as 65.2 ± 10.9 (lowest: 27; highest: 92). The majority of resident physicians stated that they did not receive training on oral and dental health during their residency training, and that they agreed with the idea of integrating it into the residency training curriculum. CONCLUSIONS: The general knowledge level of family medicine residents in Turkey about oral and dental health was found to be moderate.

Effect of filler ratio in adhesive systems on the shear bond strength of resin composite to porcelains.

This in vitro study evaluated the effect of six different adhesive systems on the shear bond strength of resin composite to feldspathic and low-fusing porcelains. Sixty porcelain blocks were prepared for each low-fusing (Matchmaker) and feldspathic (MVK95) porcelain specimen. After surface preparation, the porcelain specimens were divided into six groups (n = 10) for different adhesive systems (Adper Prompt L-Pop, QuadrantUnil Bond, Te-Econom, PQ1, One-StepPlus and Prime&Bond NT). After adhesive application, a universal resin composite (FiltekZ250) was condensed on the specimens. The prepared specimens were then stored in distilled water at 37 degrees C for 24 hours, then all the samples were thermal cycled 1000 times between 5 degrees C and 55 degrees C. Shear testing was performed on a universal test machine using a crosshead speed of 0.5 mm/minute. The statistical analysis of the bond strength data included two-way ANOVA. Then, the means were compared by Tukey HSD test (alpha = 0.05). The lowest bond strength was observed in Adper Prompt L-Pop. No statistically significant difference was observed between One-Step Plus and Prime&Bond NT. The highest bond strength was observed in PQ1. When low-fusing or feldspathic porcelain restorations are repaired with resin composite, self-etching adhesive systems may not be indicated. If maximum bond strength is the goal in porcelain resin bonding, adhesive systems that have a high filler ratio should be used.

Nonsurgical endodontic retreatment of geminated teeth: a case report.

The purpose of this case presentation is to describe nonsurgical retreatment of anterior teeth with gemination. A 21-year-old male patient was referred for endodontic treatment of his maxillary left lateral incisor. In the clinical examination, a large crown was observed in the left maxillary incisor region when compared with the right maxillary lateral incisor. In the present case, a tooth gemination of a maxillary lateral incisor has been described. A periapical radiograph showed that the tooth had partially separated two crowns having a single root and one root canal, but the access cavity of the distal crown had not been opened, and the root canal had been obturated with single cone technique. Nonsurgical endodontic retreatment was decided for geminated lateral incisor. At the 6-month follow-up, the tooth was asymptomatic and there was no radiolucency around the apical region.

Bacterial penetration after obturation with four different root canal sealers.

The aim of this study was to compare bacterial penetration after obturation with lateral compaction technique using four different root canal sealers. This study was performed on 100 teeth including negative control (n = 10), positive control (n = 10), and experimental groups (n = 80). 80 teeth were randomly divided into five groups of 20 teeth each and obturated with AH 26 (A), AH Plus (AP), Sealapex (S), Ketac-Endo (K) root canal sealers. Evaluation was carried out for 60 days. After 30 days of comparing the bacterial penetration values, total penetration was observed in 85% of the Group AP, and group K, 80% of the group S, and 75% of the group A. According to the results of chi(2) test, there was no statistically significant difference observed between any groups (p > 0.05). After 60 days of comparing the bacterial penetration values, total penetration was observed in 100% of the group AP, group K, and group S and 95% of the group A. It may be concluded that under the conditions of this study, there was no difference in the bacterial penetration of the four root canal sealers tested at 30 and 60 days.

Effect of acid etching time and a self-etching adhesive on the shear bond strength of composite resin to porcelain.

UNLABELLED: PURPOSE The purpose of this study was to evaluate the effect of different acid etching times with 9.6% hydrofluoric acid gel and two adhesive systems on shear bond strengths of resin composite to porcelain. MATERIALS AND METHODS: Ninety-eight 7 x 7 x 2 mm feldspathic porcelain blocks (VMK 95, Vita) were prepared. The specimens were divided into 7 groups: 1 control (no surface treatment) and 6 groups acid etched with 9.6% hydrofluoric acid gel for different etching times, including 30 s, 30+30 s, 60 s, 60+60 s, 120 s, and 180 s. Each of the etching time groups was divided into two bonding agent (Single Bond, AdheSE) subgroups (n = 7). Microhybrid composite (Filtek Z250) was condensed using a teflon mold and light polymerized for 20 s on the porcelain specimens. The prepared specimens were then stored in distilled water at 37 degrees C for 24 h before mechanical testing. Shear testing of all groups was performed on a universal testing machine (Lloyd LRX) at a crosshead speed of 0.5 mm/min. The bond strength data were analyzed with two-way ANOVA. The means were compared using the Tukey HSD test (alpha = 0.05). RESULTS: Acid etching time and bonding agent statistically significantly influenced bond strength (p < 0.05). In the Single Bond group, the bond strengths between group 0 (10.48 MPa) and Group 30 (11.17 MPa) did not differ significantly, with these groups exhibiting the lowest bond strength values. The highest bond strength in Single Bond group was observed in group 120 (15.07 MPa) and group 60+60 (15.42 MPa), which did not differ significantly from each other. In the AdheSE group, the bond strengths of group 0 (9.33 MPa) and group 30 (9.49 MPa) did not differ significantly, and these groups exhibited the lowest bond strength values. The highest bond strengths in the AdheSE subgroup were observed in group 120 (14.84 MPa) and group 60+60 (14.96 MPa), which were not significantly different. Comparing the two different adhesive systems, Single Bond exhibited higher bond strength values than did the self-etching adhesive AdheSE. CONCLUSIONS: Acid etching of porcelain with 9.6% hydrofluoric acid gel for 120 s provided adequate bond strength for composite repair with a microhybrid composite. When a porcelain restoration is repaired with composite, Single Bond adhesive should be preferred to the AdheSE self-etching adhesive system.

Color stability of resin composites after immersion in different drinks.

The purpose of this study was to evaluate the discoloration of two nanohybrids, two microhybrids, and a posterior composite resin restorative material upon exposure to different drinks--namely tea, cola, coffee, red wine, and water. The colors of all specimens before and after storage in the solutions were measured by a colorimeter based on CIE Lab system, and the color differences thereby calculated. Data were analyzed by two-way analysis of variance (ANOVA) and Tukey's HSD test. According to ANOVA, the restorative material, staining agent, and their interaction were found to play a statistically significant role (P = 0.0001) in color change. Among the staining agents, water consistently showed the lowest deltaE* value for all materials, whereas red wine showed the highest deltaE* value. In other words, for all the materials tested, their color change in staining agents ranked in this increasing order: water < cola < tea < coffee < red wine. In terms of comparison among the five restorative materials, Filtek P60 and Z250 were observed to manifest less color change than the nanohybrids and Quadrant LC.

Marginal Adaptation of Class V Restorations with a New Universal Adhesive.

This study aimed to evaluate the microleakage of a new universal adhesive used in self-etch (Se) and etch-and-rinse (Er) mode compared with conventional adhesive systems. Fifty standard Class V caries lesions were prepared on the buccal and lingual surfaces of premolar teeth and randomly divided into five groups (n = 10): Group 1 (control), Adper Single Bond 2 (SB); Group 2, Single Bond Universal applied as Er (SBUEr); Group 3, Single Bond Universal applied as Se (SBUSe); Group 4 (control), Clearfil SE (CSE); and Group 5, Xeno V (XE). On both enamel and dentin, XE showed the highest microleakage scores, and SBU showed similar leakage with the control group.

Comparison of final irrigation techniques in removal of calcium hydroxide.

The aim of this study was to compare new irrigation systems with a conventional irrigation technique for the removal of inter-appointment calcium hydroxide [Ca(OH)2 ]. Forty-seven extracted human single-rooted teeth were instrumented, and Ca(OH)2 paste was placed into root canals by using a lentulo spiral at the apical third. Teeth were randomly divided into three groups according to different irrigation protocols using a 30-gauge slot-tipped needle, EndoVac system and ProUltra® PiezoFlow™ ultrasonic irrigation system. Scanning electron microscopic images of the selected root canal surfaces (cervical, middle and apical third) were evaluated using a 5-grade scale. The influence of the irrigation system was evaluated using a two-way analysis of variance test and Tukey's test. The EndoVac and PiezoFlow groups demonstrated the lowest scale values (cleanest canals); however, there was no statistical difference between these two groups. The conventional irrigation group exhibited significantly higher scores (P < 0.05). The conventional needle irrigation was not sufficient to remove Ca(OH)2 from the root canal system. Irrigation with EndoVac and PiezoFlow™ ultrasonic irrigation systems improved the removal of the intracanal medicament resulting in cleaner root canal walls.

Effect of sodium ascorbate on the bond strength of silorane and methacrylate composites after vital bleaching.

We investigated the effect of sodium ascorbate (SA) on the microtensile bond strengths (MTBSs) of different composites to bovine enamel after vital bleaching with hydrogen peroxide (HP) or carbamide peroxide (CP). Thirty bovine incisors were randomly divided into five groups and treated with no bleaching application (control), 35% HP alone, 35% HP+10% SA for 10 minutes (HP+SA), 16% CP alone, or 16% CP+10% SA for 10 minutes (CP+SA). Specimens were restored with Silorane adhesive and Filtek Silorane composite (designated as S/group) or with Clearfil SE bond and Filtek Supreme XT (designated as F/group). Composite build-up was created on the enamel. Sectioned specimens (n=10 per group; 1 mm2; cross-sectional area) were created and stressed in a universal testing machine at 1 mm/min crosshead speed. The application of 10% SA immediately after bleaching with 16% CP or 35% HP increased the enamel MTBS, regardless of the adhesive/composite resin used. The resulting MTBS values were similar to those of the control groups. Use of 16% CP and 35% HP alone decreased the enamel MTBS, regardless of the adhesive/composite resin used, with F/CP+SA=F/HP+SA=F/CP=S/CP+SA=S/HP+SA=S/C>S/CP=S/HP=F/CP=F/HP (p<0.05). We concluded that the application of SA for 10 minutes immediately after vital bleaching increases the enamel BS for dimethacrylate- and silorane-based composites.

Effects of polishing procedures on color stability of composite resins.

The purpose of this study was to investigate the effect of different polishing methods on color stability of posterior, universal and nanohybrid composite resin restorative materials upon exposure to a staining agent. Twenty-five specimens were prepared for each of 5 different composite resins (Filtek Z250, Filtek P60, Quadrant LC, Grandio and Filtek Supreme). Specimens were divided into 5 groups and different polishing procedures, including polishing discs (Pd), polishing discs then diamond polishing paste (PdP), polishing discs then a liquid polishing system (Biscover) (PdB), and combinations of these (PdPB) were used. Unpolished specimens served as the control (C). The specimens were stored for 48 h in a coffee solution. The color of all specimens was measured before and after exposure with a colorimeter, and total color change (DeltaE*) were calculated. The data were analyzed with a two-way ANOVA and the means were compared by Tukey HSD test (alpha=0.05). The lowest color difference was observed in the groups PdP and C, while the highest color difference was observed in PdPB, and PdB. When comparing the five different restorative materials, no significant difference was observed between FiltekP60 and FiltekZ250, and these materials demonstrated significantly less color change than Quadrant LC and the nanohybrid materials (Grandio, Filtek Supreme). The posterior (Filtek P60) and universal (Filtek Z250) composite resin restorative materials, which do not contain tetraethyleneglycol dimethacrylate (TEGDMA), were found to be less stainable than the nanohybrid (Grandio, Filtek Supreme) and universal (Quadrant LC) composite resins, which contain TEGDMA. The use of diamond polishing paste after polishing with polishing discs significantly decreased staining when compared to the groups that used polishing discs alone, for all restorative materials tested. The highest color change values were obtained for the specimens that were polished with the Biscover liquid polish system (PdB and PdPB groups).

Effect of sodium ascorbate on the bond strength of silorane and methacrylate composites after vital bleaching

We investigated the effect of sodium ascorbate (SA) on the microtensile bond strengths (MTBSs) of different composites to bovine enamel after vital bleaching with hydrogen peroxide (HP) or carbamide peroxide (CP). Thirty bovine incisors were randomly divided into five groups and treated with no bleaching application (control), 35% HP alone, 35% HP + 10% SA for 10 minutes (HP + SA), 16% CP alone, or 16% CP + 10% SA for 10 minutes (CP + SA). Specimens were restored with Silorane adhesive and Filtek Silorane composite (designated as S / group) or with Clearfil SE bond and Filtek Supreme XT (designated as F / group). Composite build-up was created on the enamel. Sectioned specimens (n = 10 per group; 1 mm2; cross-sectional area) were created and stressed in a universal testing machine at 1 mm/min crosshead speed. The application of 10% SA immediately after bleaching with 16% CP or 35% HP increased the enamel MTBS, regardless of the adhesive / composite resin used. The resulting MTBS values were similar to those of the control groups. Use of 16% CP and 35% HP alone decreased the enamel MTBS, regardless of the adhesive / composite resin used, with F / CP + SA = F / HP + SA = F / CP = S / CP + SA = S / HP + SA = S / C > S / CP = S / HP = F / CP = F / HP (p < 0.05). We concluded that the application of SA for 10 minutes immediately after vital bleaching increases the enamel BS for dimethacrylate- and silorane-based composites.

Evaluation of 24-hour shear bond strength of resin composite to porcelain according to surface treatment.

PURPOSE: The purpose of the present in vitro study was to examine shear bond strengths of resin composite to porcelain according to surface treatment. MATERIALS AND METHODS: One hundred eight feldspathic porcelain blocks were prepared. Specimens were divided into nine surface treatment groups: sandblasting with 50- or 110-microm Al2O3, acid etching with hydrofluoric acid, applying silane agent, and combinations of these treatments. Microhybrid resin composite was condensed and light cured for 40 seconds on the porcelain specimens, which were then stored in distilled water at 37 degrees C for 24 hours before mechanical testing. RESULTS: The bond strengths were significantly different according to one-way ANOVA. The lowest bond strength was observed in the silane group (4.09 MPa); the highest bond strengths were observed with acid etching + silane (11.97 MPa) and sandblasting with 50-microm Al2O3 + acid etching + silane (12.34 MPa) (no significant difference between groups). CONCLUSION: Acid etching with 9.6% hydrofluoric acid gel or sandblasting with 50- or 110-microm Al2O3 particles alone did not provide adequate bond strength. Silane agent was effective in increasing the shear bond strength of resin composite to porcelain after sandblasting or acid etching. Porcelain treatment with a combination of 50-microm Al2O3 air abrasion, 9.6% hydrofluoric acid, and silane agent provided higher bond strengths than treatment with any of these procedures alone.

Effects of different drinks on stainability of resin composite provisional restorative materials.

STATEMENT OF PROBLEM: The ability of tooth-colored restorative materials for provisional restorations to resist stains is important when interim prostheses are worn for a long period. Discoloration of provisional restorative materials may result in patient dissatisfaction and additional time and expense for replacement. However, the effect of different staining agents on the color difference of resin composite restorative materials has not been completely clarified. PURPOSE: The purpose of this study was to evaluate the stainability of auto- and light-polymerized composite provisional restorative materials, reinforced microfill, and microhybrid resin composite restorative materials upon exposure to different staining agents. MATERIAL AND METHODS: Forty-five cylindrical specimens (15 x 2 mm) were prepared for each of an autopolymerized bis-acryl composite provisional restorative material (Protemp II), a light-polymerized composite provisional restorative material (Revotek LC), a reinforced microfill (Micronew), and a microhybrid composite (Filtek Z250, Herculite XRV) restorative material, using a brass mold. The specimens were wet-ground with 1000-grit silicon carbide abrasive paper for 10 seconds. The 5 restorative material specimens were divided into 9 groups (n = 5) and stored for 24 hours at 37 degrees C in different types of solutions: water, coffee, coffee with sugar, tea, tea with sugar, coffee with artificial creamer and sugar, cola, red wine, or sour cherry juice. Color of all specimens was measured before and after exposure with a colorimeter using CIE L * a * b * relative, and color changes (DeltaE * ) were then calculated. The data were analyzed with a 2-way analysis of variance (ANOVA), and mean values were compared by the Tukey HSD test (alpha = .05). RESULTS: The interaction of provisional restorative materials and staining agents was statistically significant ( P = .0001). For the 5 restorative materials tested, the lowest DeltaE * values were observed in the water, cola, and sour cherry juice groups. The highest color difference for all restorative materials was observed in the red wine groups. For microhybrid composite materials and light-polymerized composite provisional material, when tea and coffee groups with and without sugar were compared, both groups with sugar demonstrated a higher color difference than without sugar. When comparing the 5 different restorative materials, the reinforced microfill material group (Micronew) demonstrated significantly less color change than the other materials tested. The highest color difference in this study was observed for specimens in the light-polymerized composite provisional material group (Revotek LC). CONCLUSION: The reinforced microfill restorative material tested was found significantly more color stable than the autopolymerized bis-acryl, light-polymerized composite provisional restorative materials, and microhybrid composites tested. The largest color difference was observed in the light-polymerized composite provisional material. The presence of sugar in coffee and tea increased the color difference compared to coffee or tea without sugar for light-polymerized composite provisional material and microhybrid composites.

Effects of polishing procedures on color stability of composite resins

The purpose of this study was to investigate the effect of different polishing methods on color stability of posterior, universal and nanohybrid composite resin restorative materials upon exposure to a staining agent. Twenty-five specimens were prepared for each of 5 different composite resins (Filtek Z250, Filtek P60, Quadrant LC, Grandio and Filtek Supreme). Specimens were divided into 5 groups and different polishing procedures, including polishing discs (Pd), polishing discs then diamond polishing paste (PdP), polishing discs then a liquid polishing system (Biscover) (PdB), and combinations of these (PdPB) were used. Unpolished specimens served as the control (C). The specimens were stored for 48 h in a coffee solution. The color of all specimens was measured before and after exposure with a colorimeter, and total color change (DE*) were calculated. The data were analyzed with a two-way ANOVA and the means were compared by Tukey HSD test (a=0.05). The lowest color difference was observed in the groups PdP and C, while the highest color difference was observed in PdPB, and PdB. When comparing the five different restorative materials, no significant difference was observed between FiltekP60 and FiltekZ250, and these materials demonstrated significantly less color change than Quadrant LC and the nanohybrid materials (Grandio, Filtek Supreme). The posterior (Filtek P60) and universal (Filtek Z250) composite resin restorative materials, which do not contain tetraethyleneglycol dimethacrylate (TEGDMA), were found to be less stainable than the nanohybrid (Grandio, Filtek Supreme) and universal (Quadrant LC) composite resins, which contain TEGDMA. The use of diamond polishing paste after polishing with polishing discs significantly decreased staining when compared to the groups that used polishing discs alone, for all restorative materials tested. The highest color change values were obtained for the specimens that were polished with the...