Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals.

OBJECTIVE: To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS: Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS: After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION: GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE: After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Long-term clinical comparison of a resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions.

This 72-month study compared the clinical effectiveness of a resin-based composite (RBC) (Spectrum TPH3, Dentsply Sirona) with a resin-modified glass ionomer cement (RMGIC) (Riva Light Cure, SDI) in restoring cervical caries lesions (CCLs). Thirty-three patients, each with at least two CCLs, were enrolled. After caries removal, the dimensions of the cavities were recorded. In a split-mouth study design, a total of 110 restorations were randomly placed. Fifty-five restorations were placed with RBC using an etch-and-rinse adhesive system (Prime&Bond NT, Dentsply Sirona), while the remaining 55 were restored with RMGIC. The restorations were assessed at baseline, 6, 12, 18, 24, 36, 60, and 72 months according to modified USPHS criteria. Statistical analysis included Pearson Chi-square, Friedman tests, Kaplan Meier, and Logistic Regression analysis (p < 0.05). After 72 months, 47 restorations in 19 patients were evaluated (55% follow-up rate). Seventy-five percent of the RBC (n = 26) and 74% (n = 21) of the RMGIC restorations were fully retained. There were no significant differences between materials regarding retention and marginal adaptation (p > 0.05). Cavity dimensions, caries activity, and retention exhibited no correlation (p > 0.05). The increase in marginal staining in both groups over time was significant (p < 0.001). RMGIC restorations exhibited higher discoloration than RBC restorations (p = 0.014). At 72 months, three secondary caries lesions were detected in both restoration groups: two RMGIC and one RBC. There were no reports of sensitivity. After 72 months, both RBC and RMGIC restorations were clinically successful, with similar retention and marginal adaptation scores. However, it is noteworthy that RMGIC restorations tend to discoloration over time compared to RBC. The trial is registered in the database of "Clinical Trials". The registration number is NCT0372-2758, October 29, 2018.

Do effervescent vitamin tablets affect the surface roughness, microhardness, and color of human enamel and contemporary composite resins?

PURPOSE: To compare the impact of four effervescent vitamin tablets on the surface roughness, microhardness, and color of human enamel and contemporary composite resins. MATERIAL AND METHODS: Sixty enamel and a total of 240 anterior (Gradia Direct Anterior), posterior (Gradia Direct Posterior), and universal composite resin (Filtek Ultimate) specimens (n = 60 per group) were fabricated. Each group was subdivided into five subgroups (n = 12, per subgroup). The specimens were subsequently immersed in YOUPLUS, Redoxon, Sunlife Immuvit, and Sambucol effervescent vitamin solutions for 2 min per day over 30 days. Distilled water was used as control. Subsequently, surface roughness (Ra) was detected using a profilometer, and microhardness (VHN) was measured using a microhardness tester. A spectrophotometer device was used to record the L,a,b color coordinates of the specimens after 24 h, 7 days, and 30 days, and the color changes (ΔE00) of the groups were calculated. The data were analyzed by ANOVA, two-way ANOVA, Kruskal-Wallis, Levene's, and Fisher's least significant difference (LSD) tests (p < 0.05). SEM analysis was conducted on one randomly selected specimen per group (×1000). RESULTS: In terms of surface roughness, material X vitamin interactions were found significant (p < 0.05). The increase in Ra from 24 h to 30 days was found significant (p < 0.05) except for Gradia Direct Anterior X Redoxon, Sunlife Immuvit and Sambucol, Filtek Ultimate X Sunlife Immuvit and Sambucol, and all control groups. Ra changes were also concluded by SEM. Regarding VHNs, material X vitamin interactions were significant (p < 0.005), except for all Filtek Ultimate subgroups. The changes in VHNs of the groups from 24 h to 30 days were significant for all enamel and Gradia Direct Anterior X YOUPLUS, Gradia Posterior X YOUPLUS, Sunlife Immuvit, and Sambucol groups (p < 0.05). In terms of ΔE00, significant differences were observed between the 7 days and 30 days in the enamel (p = 0.047), Gradia Direct Anterior (p = 0.019), and Gradia Direct Posterior groups (p = 0.038). CONCLUSIONS: Daily consumption of effervescent vitamin tablets can increase surface roughness, decrease microhardness, and influence the color of human enamel and contemporary anterior, posterior, and universal composite resins after a 30-day period.

Does a new formula have an input in the clinical success of posterior composite restorations? A chat study.

OBJECTIVE: To compare the clinical behavior of a universal light-curing, ultra-fine particle hybrid composite and successor of this material in class I and II cavities after 60 months. MATERIALS AND METHODS: Forty patients (21 females, 19 males) with ages ranging between 18 and 38 years (23.15 ± 5.15) received 80 (13 Cl I and 67 Cl II) resin composite restorations (Charisma/Charisma Classic, Kulzer GmbH) in combination with an etch and rinse adhesive system (Gluma 2Bond) under rubber dam isolation. Two experienced operators performed all the restorations. Restorations were evaluated by the other two examiners according to the FDI criteria at baseline and at 6, 12, 18, 24, 36, 48 and 60 months. Surface characteristics of one restoration selected randomly were examined under a scanning electron microscope (SEM) at each recall. Data were analyzed statistically (p < 0.05). RESULTS: After 60 months, recall rate was 90%. None of the restorations failed. Three restorations from Charisma and 4 from the Charisma Classic group showed minor surface staining. Twelve Charisma and 14 Charisma Classic restorations were scored as 2 for margin staining. Four restorations from both groups showed minor shade deviations but no significant difference was observed between the two restorative materials for any criteria evaluated after 60 months (p > 0.05). SEM evaluations were in accordance with the clinical findings. CONCLUSIONS: Both materials exhibited clinically similar and successful performance over the 60-month observation period. CLINICAL RELEVANCE: A new formulation of resin composite may not always perform better clinical performances. TRIAL REGISTRATION: ClinicalTrials.gov : NCT02888873.

Effects of charcoal-based whitening toothpastes on human enamel in terms of color, surface roughness, and microhardness: an in vitro study.

OBJECTIVE: Charcoal based oral care products have gained popularity in the last few years. The aim of this in vitro study was to compare the effects of different charcoal based whitening toothpastes on color, surface roughness and microhardness of human enamel. MATERIALS AND METHODS: Forty-eight specimens obtained from human permanent upper incisor teeth were randomly divided into 4 groups(n=12):Group-1:Colgate Total 12(CT); Group-2:Body Kingdom(BK); Group-3:Black is White(BW), Group-4:Colgate optic white(COW). Following 4 days cycle of darkening(2-min chlorhexidine and 60-min black tea per day), a 12- week brushing(twice daily for 1 min)was performed. Color of specimens was measured using a spectrophotometer. A contact type profilometer was used to measure surface roughness (Ra) and Vicker's hardness tester was used for the changes in microhardness(VHN). A representative sample from each group was visualized by SEM. Data were analyzed by One-way ANOVA, Welch, Fisher's, Kruskall-Wallis, Wilcoxon Sign Rank and Paired t-tests(p<0.05). RESULTS: After 12- week brushing, no differences were found among the groups in terms of color change(p=0.989). All toothpastes tested showed no clinically acceptable whitening performances. A substantial increase in surface roughness was found in all groups, except BW(p<0.05). An increase was found in microhardness with CT(p=0.013), while no changes were found with BK, BW and COW(p>0.05).Only few scratches were observed on the enamel surfaces by SEM evaluations. CONCLUSION: Twelve week brushing with charcoal based whitening toothpastes and a regular fluoridated toothpaste presented similar effects in color of enamel. Surface roughness was increased(except BW) while microhardness was not affected(except CT) with charcoal based whitening toothpastes. CLINICAL RELEVANCE: Charcoal based whitening toothpastes do not promise to whiten the human permanent teeth and their effects on enamel abrasion should not be disregarded.

Clinical comparison of a micro-hybride resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions: 36-month, split-mouth, randomized clinical trial.

PURPOSE: The aim of the study was to compare the 36-month clinical performances of a micro-hybride resin based composites (RBC) and a type II resin modified glass ionomer cement (RMGIC) in the treatment of cervical caries lesions. METHODS: Thirty-three patients (23 females,  10 males) with at least two cervical caries lesions participated in this study. A total of 110 restorations were randomly placed, half using RBC (Spectrum TPH3, Dentsply Sirona) with respective adhesive system (Prime & Bond NT, Dentsply Sirona) the other half using the RMGIC (Riva Light Cure, SDI, Bayswater, Victoria, Australia). Restorations were assessed at baseline, and after 6, 12, 18, 24 and 36 months using modified USPHS criteria. The data were analyzed statistically (p < 0.05). RESULTS: Recall rate was 90.91% at 36 months. Of the RBC lesions 84.3% (n = 43) and of the RMGIC restorations 92.2% (n = 47) were fully retained at 36 months. There was no significant difference between two materials in terms of retention and marginal adaptation (p > 0.05). No relation was found between caries activity, cavity dimensions and marginal adaptation (p > 0.05) but RMGIC restorations showed significantly more discoloration than RBC restorations after 36 months (p < 0.001). CONCLUSIONS: Considering the middle-term outcomes, both materials showed clinically successful performance in the treatment of cervical caries lesions.

Effect of cavity lining on the restoration of root surface carious lesions: a split-mouth, 5-year randomized controlled clinical trial.

OBJECTIVE: To compare the clinical performance of cavities with no lining and lining with resin-modified glass ionomer (RMGIC) for the treatment of root surface carious lesions. MATERIALS AND METHODS: The study included 39 patients (mean age, 39.6 years) who visited the university hospital for the treatment of at least 2 root surface carious lesions. After caries removal, the depth, length, and height of the cavities were measured. Using a paired-tooth design and simple randomization technique, the cavities were assigned to one of two groups that were either unlined or lined with RMGIC (Glass Liner II). All cavities were restored with a nanohybrid resin-based composite (Clearfil Majesty Esthetic). One hundred restorations (50 lined, 50 unlined) were placed. Two examiners other than the operator blindly evaluated the restorations at the follow-ups according to the modified Havemann criteria for marginal adaptation, anatomic form, marginal staining, caries in the adjacent tooth structure, caries at the cavosurface margin, and tooth sensitivity. Chi-square, Fisher's exact, Mann-Whitney U, and Cochran Q tests were used for the analysis (p < 0.05). RESULTS: At the 5-year follow-up, 12 restorations were failed. However, there was no significant difference between the marginal adaptation and marginal staining of the materials (p = 0.526 and p = 0.893, respectively). Four caries lesions were detected in the adjacent tooth structure and at the cavosurface margin at the 5-year assessment. CONCLUSION: There was no significant difference in the clinical performance of the lined and unlined restorations. CLINICAL RELEVANCE: The clinical performance of both unlined and RMGIC-lined cavities at the 5-year post-restoration assessment was acceptable. TRIAL REGISTRATION: NCT03802539.

Twenty-four-month clinical performance of a glass hybrid restorative in non-carious cervical lesions of patients with bruxism: a split-mouth, randomized clinical trial.

AIM: The aim of the present study was to evaluate the clinical performance of a glass hybrid restorative compared with a nano-ceramic composite resin in non-carious cervical lesions (NCCLs) of patients with bruxism. MATERIALS AND METHODS: Twenty-five patients with NCCLs and bruxism were enrolled in the present study. Before treatment, the dimensions of the NCCLs (depth, cervico-incisal height, and mesio-distal width) and internal angles were measured. Degree of tooth wear (TWI) and gingival conditions were recorded. A total of 148 NCCLs were randomly restored with a glass hybrid restorative system (GH) (Equia Forte Fil, GC, Tokyo, Japan) or a nano-ceramic composite resin (RBC) (Ceram.X One Universal, Dentsply, DeTrey, Konstanz, Germany). The restorations were evaluated at baseline and after 6, 12, and 24 months according to the modified USPHS criteria. Data were analyzed with Pearson's chi-square, Fisher's exact, Mann-Whitney U, and Cochran's Q tests (P < 0.05). RESULTS: At the 24-month recall, 126 restorations in 22 patients were evaluated. The recall rate was 88.0%. No significant difference was found between the materials for retention (P = 0.285), and no relationships were found between internal angle, depth, cervico-incisal height, or mesio-distal width and retention of the restorations (P > 0.05). A significant difference was observed between the materials for marginal adaptation (P = 0.002), but no relationships were found among depth, cervico-incisal height, and mesio-distal width and marginal adaptation (P > 0.05). RBC showed better results for marginal adaptation. Between marginal adaptation, TWI, and the gingival index, correlations were significant (P < 0.001, P = 0.002). A significant change was found in marginal discoloration in GH and RBC over time (P = 0.039 and P = 0.004, respectively). Neither secondary caries nor tooth sensitivity was observed on any of the restorations at any evaluation. CONCLUSION: Although nano-ceramic RBC showed better marginal adaptation than GH, both tested restoratives showed clinically acceptable performance for the restoration of NCCLs of patients with bruxism after 24 months of clinical service. TRIAL REGISTRATION: This study is registered on http://clinicaltrials.gov under protocol record KA-16020, Clinical Performance of a Glass Hybrid Restorative in NCCL's of Patients With Bruxism.

Which is the most effective biomaterial in indirect pulp capping? 4- year comparative randomized clinical trial.

Purpose: The aim of this study is to compare the clinical outcomes of Mineral Trioxide Aggregate (MTA) and calcium hydroxide pulp capping after complete caries removal. Materials and methods: In 73 regular patients (47 women, 26 men; age 20.65±3.02 years), having at least one deep carious lesion was recruited. Following complete caries removal, the pulp was indirectly capped with either MTA(n=51) or calcium hydroxide (n =49), randomly. Final restoration with a resin-based composite in a single session was performed. Clinical parameters including pulp vitality, sensitivity to cold or heat stimulants, percussion tests and discomfort during chewing and color were recorded after 6 months, 1 year, 2- year, 3- year and 4- year. Data were analysed statistically (p<0.05). Results: After 4- year, the survival rates were 86% (for MTA), and 82.9% (for calcium hydroxide). Totally, 8 teeth from calcium hydroxide group and 7 teeth from MTA group were endodontically treated. No significant difference was detected between the groups in terms of pulp vitality (p=0.613). Grey discoloration rate was 63% in MTA group. Conclusion: Both pulp-capping materials, MTA and calcium hydroxide showed similar clinically successful performance in terms of pulp vitality in the treatment of deep dentin caries lesions after 4- year.

Comparison of mechanical and optical properties of a newly marketed universal composite resin with contemporary universal composite resins: An in vitro study.

The purpose of this study was to evaluate the surface roughness, microhardness, color change, and translucency of a newly marketed universal nanohybrid composite resin (CR) (G-aenial A'CHORD) comparing with four contemporary universal CRs including two nanofilled (Filtek and Estelite Asteria) and two nanohybrid CRs (Charisma Dimond and Neo Spectra ST HV in vitro). Sixty-five specimens (8.0 mm × 2.0 mm) were fabricated (n = 13, per group). After finishing and polishing, specimens were subjected to surface roughness and microhardness tests. Color and translucency of the specimens were evaluated at baseline and after darkening with coffee solution at day 1 and day 7. A representative specimen from each group was investigated under scanning electron microscopy (SEM). Data was analyzed statistically (p < .05). There were significant differences among the groups in terms of surface roughness, microhardness, color, and translucency. The surface roughness was recorded as: Charisma Diamond > Neo Spectra ST HV, Filtek > Estelite Asteria, G-aenial A'CHORD, whereas Vickers Hardness number was as: Filtek, Charisma Diamond > Neo Spectra ST HV > G-aenial A'CHORD, Estelite Asteria. Color change was as: Charisma Diamond > Neo Spectra ST HV, Filtek, G-aenial A'CHORD > Estelite Asteria and the translucency was as: Neo Spectra ST HV > G-aenial A'CHORD, Filtek > Estelite Asteria, Charisma Diamond. SEM examinations revealed smooth surfaces for G-aenial A'CHORD, Neo Spectra ST HV and Estelite Asteria. Mechanical and optical properties of universal composite resins with different compositions show variations.

Shear bond strengths of two newly marketed self-adhesive resin cements to different substrates: A light and scanning electron microscopy evaluation.

The purpose of this in vitro study was to compare the shear bond strengths (SBSs) of two newly marketed self-adhesive resin cements (RCs) to enamel, dentin, and lithium disilicate (LiSi) glass ceramic block. Forty-eight enamel and 48 dentin substrates were obtained from sound human molars. Additionally, 6 × 7 × 5 -mm- sized 24 specimens were produced from LiSi glass ceramic blocks. The tooth specimens were randomly assigned into four groups (n = 12) according to the surface treatments: (1) G-CEM ONE (GCO), (2) G-CEM ONE Adhesive Enhancing Primer (GCO-AEP) + GCO, (3) RelyX Universal (RXU), and (4) Scotchbond Universal Plus (SUP) + RXU. LiSi specimens were randomly divided into two groups (n = 12): (1) G-MultiPrimer (GMP) + GCO and (2) SUP + RXU. Following the RC applications, all specimens were kept in 100% humidity at 37°C for 24 hr and then submitted for SBS testing in a universal testing machine (1 mm/min). Data were analyzed by Welch's, one-way analysis of variance and two independent samples t tests. The nature of failures was examined under a light microscope, and scanning electron microscopy analyses were also performed for interfaces. GCO and RXU showed similar SBS to enamel (p > .05), and the use of adhesives resulted in improved SBS (p < .05). No difference was detected between GCO-AEP + GCO and SUP + RXU. The GCO-AEP + GCO exhibited the highest SBS to dentin (p < .05), followed by GCO ≥ SUP + RXU > RXU (p < .05). There was no significant difference between SBSs of two RCs to LiSi blocks (p > .05). No cohesive failure was determined for the tested groups by light microscope. The use of adhesives prior to the application of self-adhesive RCs improved their bonding to tooth tissues. GCO demonstrated superior SBS to dentin, whereas both self-adhesive RCs generated similar SBS to enamel and LiSi glass ceramic surfaces.

The effects of resin infiltration on demineralized root surface: an experimental study.

Purpose: The objective of this experimental invitro study was to investigate the effects of resin infiltration (RI) on surface roughness, microhardness, color and surface characteristics of artificially demineralized root surfaces. Materials and methods: Forty-two root specimens prepared from freshly extracted intact human upper incisors were subjected to surface roughness, microhardness, and color tests. Profilometer was used to measure surface roughness and Vicker's Hardness tester was used to measure the changes in microhardness. The color measurements were performed by a spectrophotometer using the CIELAB parameters. Following measurements, specimens were divided into 3 groups (n=14): G1: intact root surfaces, G2: demineralized root surfaces and G3: Resin infiltrated root surfaces (Icon, DMG) following demineralization. Surface roughness, microhardness and color measurements were repeated in G2 and G3 after demineralization and RI. One specimen from each group was examined by SEM. Data were analyzed statistically (p<0.05). Results: Application of RI to artificially demineralized root surfaces significantly decreased the surface roughness (p<0.001) and increased the microhardness (p=0.023). RI also affected the color of demineralized root surfaces. SEM examinations revealed that the porosities on demineralized root surfaces seemed to be sealed after RI. Conclusion: RI affected the surface roughness, microhardness, color and surface appearance of artificially demineralized root surfaces.

A comparison of cuspal movement of premolar teeth restored with bulk-filled composite resins combined with universal adhesives.

BACKGROUND: The aim of the present study was to compare bulk-filled composite resins with conventional composites in terms of cuspal movement and micro-leakage scores. METHODS: Ninety-six maxillary premolar teeth with mesial-occclusal-distal cavities were allocated to four groups. Twelve teeth in each group was treated etch-and-rinse, self-etch or selective-etch (N.=8) protocols with respective adhesive system. Bucco-palatal cusp measurements were performed before and after preparation, and 180s after curing and then subjected to 5000 thermocyclws. After immersed in 0.2% basic fuchsin dye for 24h, cervical micro-leakage was evaluated. The data was analyzed by One-way ANOVA and post-hoc Tukey's honest Test (P<0.05). RESULTS: All groups and bonding protocols revealed no significant differences in total cuspal deflection measurement and micro-leakage scores. After preparation, a significant increase was found in bucco-palatal width of the teeth compared to baseline (P=0.002). There were no significant relationship among composite resins and adhesives (P>0.05). CONCLUSIONS: Cuspal relief after cavity preparation should be taken into account when evaluating deflection.

Microhardness and shear bond-strength of carious dentin after fluorescence-aided or conventionally excavation: (An in-vitro comparison).

BACKGROUND: To compare the fluorescence-aided and conventionally excavated dentin with microhardness and shear bond strength(SBS) tests. MATERIAL AND METHODS: Twenty-four teeth with dentin caries were bisected through the center of the lesion into two halves. Forty-eight dentin specimens were embedded and mounted in an acrylic resin. All carious tissue was removed and classified as caries free using conventional visual tactile criteria. Then half of the specimens(n=24) were reinspected with fluorescence-aided caries excavation light(FACE) (FaceLight, W&H Dentalwerk, Bürmoos GmbH, Austria). Specimens were subjected to microhardness and shear bond strength testings. The fracture mode analysis was also performed. The data were compared with Student's t test and Chi-square test. RESULTS: Residual caries was observed in 2 out of 24 conventionally excavated specimens with FACE inspection(p>0.05). Mean Vickers hardness of the dentin was 61.5±5 in the FACE group and 70.3±3 kg/mm2 in the conventionally excavated group(p>0.05). The mean SBS value of FACE group was 11.42±1.63 MPa and 18.27±1.43 MPa in conventionally excavated group. There was no statistically significant difference between conventional and FACE groups for microhardness and SBS tests(p>0.05). There were also no significant differences on the fracture mode distributions of the groups(p>0.05). CONCLUSIONS: FACE method could be considered as a promising technique for removing infected dentin. Key words:FACE, conventional excavation, residual caries detection, shear bond strength, microhardness.

Color stability of bulk-fill and incremental-fill resin-based composites polished with aluminum-oxide impregnated disks.

OBJECTIVES: This study aimed to evaluate the color stability of bulk-fill and nanohybrid resin-based composites polished with 3 different, multistep, aluminum-oxide impregnated finishing and polishing disks. MATERIALS AND METHODS: Disk-shaped specimens (8 mm in diameter and 4 mm in thickness) were light-cured between two glass slabs using one nanohybid bulk-fill (Tetric EvoCeram, Ivoclar Vivadent), one micro-hybrid bulk-fill (Quixfil, Dentsply), and two nanohybrid incremental-fill (Filtek Ultimate, 3M ESPE; Herculite XRV Ultra, Kerr) resin-based composites, and aged by thermocycling (between 5 - 55℃, 3,000 cycles). Then, they were divided into subgroups according to the polishing procedure as SwissFlex (Coltène/Whaledent), Optidisc (Kerr), and Praxis TDV (TDV Dental) (n = 12 per subgroup). One surface of each specimen was left unpolished. All specimens were immersed in coffee solution at 37℃. The color differences (ΔE) were measured after 1 and 7 days of storage using a colorimeter based on CIE Lab system. The data were analyzed by univariate ANOVA, Mann-Whitney U test, and Friedmann tests (α = 0.05). RESULTS: Univariate ANOVA detected significant interactions between polishing procedure and composite resin and polishing procedure and storage time (p < 0.05). Significant color changes were detected after 1 day storage in coffee solution (p < 0.05), except Quixfil/Optidisc which was color-stable after 7 days (p > 0.05). Polishing reduced the discoloration resistance of Tetric EvoCeram/SwissFlex, Tetric EvoCeram/Praxis TDV, Quixfil-SwissFlex, and all Herculite XRV Ultra groups after 7 days storage (p < 0.05). CONCLUSIONS: Discoloration resistance of bulk-fill resin-based composites can be significantly affected by the polishing procedures.

Bond strength of dental nanocomposites repaired with a bulkfill composite.

BACKGROUND: The aim of this study was to analyze the bond strength of aged resin based nanocomposites repaired with the same and bulk fill composites. MATERIAL AND METHODS: Seventy-two disc shaped resin composites consisted of three different nanocomposite resins (Filtek Ultimate/FU, Herculite XRV Ultra/HXRV, and Reflectys/R) were produced. After storing the samples for 8 weeks in distilled water, each material was combined with the same material or the bulk-fill composite resin system (Filtek Ultimate+Filtek Ultimate/Group-1; Filtek Ultimate+Tetric BF/Group-2; Herculite XRV+Herculite XRV/Group-3; Herculite XRV+Tetric BF/ Group-4; Reflectys+Reflectys/Group 5; Reflectys+Tetric BF/Group-6), for repair. Then specimens were subjected to shear bond strength testing(SBS), and the debonded surfaces were examined. RESULTS: There was a significant difference among three materials(repaired with itself+bulk fill) for SBS testing values (p=0.001). FU and R were found to be similar, while HXRV was significantly different from them. A significant difference between group-1 and 2 (p=0.006) was detected, while there were no differences between group 3 and 4 (p= 0.142), and 5 and 6 (p=0.346). Among the six groups, repair SBS testing values with TBF were higher than repair with itself except for FU. CONCLUSIONS: The bulk-fill repaired materials showed higher bond strength except for FU, which showed the highest SBS value when repaired with itself. An increased incidence of adhesive fracture was observed at low strengths. Key words:Resin-based composites, nanofillers, surface treatment, macro-shear, repair.

Comparison of two different methods of detecting residual caries.

OBJECTIVES: The aim of this study was to investigate the ability of the fluorescence-aided caries excavation (FACE) device to detect residual caries by comparing conventional methods in vivo. MATERIALS AND METHODS: A total of 301 females and 202 males with carious teeth participated in this study. The cavity preparations were done by grade 4 (Group 1, 154 teeth), grade 5 (Group 2, 176 teeth), and postgraduate (Group 3, 173 teeth) students. After caries excavation using a handpiece and hand instruments, the presence of residual caries was evaluated by 2 investigators who were previously calibrated for visual-tactile assessment with and without magnifying glasses and trained in the use of a FACE device. The tooth number, cavity type, and presence or absence of residual caries were recorded. The data were analyzed using the Chi-square test, the Fisher's Exact test, or the McNemar test as appropriate. Kappa statistics was used for calibration. In all tests, the level of significance was set at p = 0.05. RESULTS: Almost half of the cavities prepared were Class II (Class I, 20.9%; Class II, 48.9%; Class III, 20.1%; Class IV, 3.4%; Class V, 6.8%). Higher numbers of cavities left with caries were observed in Groups 1 and 2 than in Group 3 for all examination methods. Significant differences were found between visual inspection with or without magnifying glasses and inspection with a FACE device for all groups (p < 0.001). More residual caries were detected through inspection with a FACE device (46.5%) than through either visual inspection (31.8%) or inspection with a magnifying glass (37.6%). CONCLUSIONS: Within the limitations of this study, the FACE device may be an effective method for the detection of residual caries.

Etiologic factors and clinical evaluation of restored fractured anterior teeth: an observational study.

PURPOSE: The aims of this study were to investigate the etiologic factors and to evaluate performance of composite resin on fractured crown in permanent anterior teeth at 6 and 12 months. SUBJECTS AND METHODS: Records from 51 patients were retrieved from a Dental School Clinic, comprising 73 fractured anterior teeth directly restored with a submicron hybrid composite (Spectrum TPH) resin and respective adhesive system (Prime and Bond NT) were evaluated. The United States Public Health Service criteria were used to assess the clinical evaluation. Data were analyzed using the Wilcoxon Signed Rank, Kruskal-Wallis, Mann-Whitney U, and Siegel and Castellan tests. RESULTS: Seventy-two maxillary incisors and one canine of 51 patients were evaluated. The patient's age at the time of therapy ranged from 14 to 64 years old (mean 25.47). Mostly observed crown fracture was seen in upper incisors (84.9%) and due to falls (58.8%). At the 6-month follow-up, one patient lost one restoration and at the 12-month, one patient lost one and one lost two restorations. A statistically significant difference was found in terms of marginal adaptation between 6 and 12 months. CONCLUSION: In this short-term observation period, remaining tooth structure was conserved and good patient compliance was achieved. Factors such as esthetic and/or cost should be considered to indicate the direct composite restorations.