Investigating the role of chlorogenic acids and coffee type in coffee-induced teeth discoloration.

OBJECTIVE: Coffee is one of the most popular beverages in the world, with millions of people consuming it every day. The effect of coffee on teeth discoloration has long been a concern for both coffee drinkers and dental professionals. To address this concern, this study aimed to investigate the role of chlorogenic acids (CGAs) and the type of coffee in coffee-induced teeth discoloration. MATERIALS AND METHODS: High-performance liquid chromatography with a photodiode array detector was used to determine the CGA contents of instant coffee produced by five manufacturers (Starbucks, Dunkin' Donuts, Kanu, Ediya, Coffee Bean). A total of 180 bovine tooth specimens were immersed in the coffee samples for varying durations (3, 9, 24, 48, and 72 h), and the discoloration levels were measured using a spectrophotometer. A linear mixed-effects model analysis was used to determine the significance of L*, a*, and b* values in relation to the duration of coffee immersion and coffee type. RESULTS: Both immersion time and coffee type had significant effects on tooth discoloration (p < 0.001), with some types of coffee being more strongly associated with tooth discoloration than others. The amount of CGAs present in coffee was found to be positively correlated with the degree of discoloration (p = 0.030). CONCLUSIONS: Prolonged exposure to coffee can exacerbate teeth staining, and different types of coffee can cause varying degrees of discoloration. Furthermore, coffee with higher levels of CGAs may lead to greater tooth discoloration.

Shear bond strength of orthodontic brackets bonded with primer-incorporated orthodontic adhesives and unpolymerized 3-dimensional printing materials on 3-dimensional-printed crowns.

INTRODUCTION: The use of 3-dimensional (3D) printing techniques in fabricating crowns has increased the demand for bracket bonding onto these surfaces. The objective was to evaluate the shear bond strength (SBS) of orthodontic brackets bonded onto 3D-printed crowns using primer-incorporated orthodontic adhesives and 3D printing materials as orthodontic adhesives. METHODS: A total of 160 crowns were printed with two 3D printing materials, DentaTOOTH (Asiga, Sydney, Australia) (group A) and NextDent C&B Micro Filled Hybrid (3D Systems, Soesterberg, Netherlands) (group N). Each group was randomly divided into 4 adhesive subgroups (n = 20): Transbond XT (for groups A [ATX] and N [NTX]; 3M Unitek, Monrovia, Calif), Ortho Connect (for groups A [AOC] and N [NOC]; GC Corporation., Tokyo, Japan), Orthomite LC (for groups A [AOM] and N [NOM]; Sun Medical, Co Ltd, Moriyama, Shiga, Japan), and unpolymerized liquid state of 3D printing resin (for groups A [AA] and N [NN]). SBS was measured with a universal testing machine at a crosshead speed of 0.5 mm/min. The adhesive remnant index and the mode of failure were analyzed under the microscope. Statistical analysis was performed at a significance level of α = 0.05. RESULTS: When used as adhesives (AA and NN), 3D printing materials showed no statistically significant difference in SBS compared with Transbond XT (ATX and NTX, respectively). In group N, NN showed a significantly higher SBS than primer-incorporated orthodontic adhesives (NOC and NOM; P <0.001). Adhesive failures were only observed in primer-incorporated orthodontic adhesives (AOC, NOC, AOM, and NOM). CONCLUSIONS: Primer-incorporated orthodontic adhesives, as well as unpolymerized 3D printing materials employed as orthodontic adhesives on 3D-printed crowns, exhibited comparable bonding strength to Transbond XT without surface modification. Despite variations in adhesive-related factors, all measurements stayed within clinically acceptable ranges, highlighting the potential of these materials for orthodontic bonding on 3D-printed crowns, simplifying clinical procedures without compromising bond strength.

Cytotoxicity and reactive oxygen species production induced by different co-monomer eluted from nanohybrid dental composites.

BACKGROUND: Safety issues for dental restorative composites are critical to material selection, but, limited information is available to dental practitioners. This study aimed to compare the chemical and biological characteristics of three nanohybrid dental composites by assessing filler particle analysis, monomer degree of conversion (DC), the composition of eluates, and cytotoxicity and reactive oxygen species (ROS) production in fibroblasts. METHODS: Three nanohybrid composites (TN, Tetric N-Ceram; CX, Ceram X Sphere Tec One; and DN, DenFil NX) were used. The size distribution and morphology of the filler particles were analysed using scanning electron microscopy (n = 5). The DC was measured via micro-Raman spectroscopy (n = 5). For the component analysis, methanol eluates from the light-polymerised composites were evaluated by gas chromatography/mass spectrometry (n = 3). The eluates were prepared from the polymerised composites after 24 h in a cell culture medium. A live/dead assay (n = 9) and Water-Soluble Tetrazolium-1 assay (n = 9) were performed and compared with negative and positive controls. The ROS in composites were compared with NC. Statistical significance in differences was assessed using a t-test and ANOVA (α = 0.05). RESULTS: Morphological variations in different-sized fillers were observed in the composites. The DC values were not significantly different among the composites. The amounts of 2-hydroxyethyl methacrylate (HEMA) were higher in TN than DN (p = 0.0022) and triethylene glycol dimethacrylate (TEGDMA) in CX was higher than in others (p < 0.0001). The lowest cell viability was shown in CX (p < 0.0001) and the highest ROS formation was detected in TN (p < 0.0001). CONCLUSIONS: Three nanohybrid dental composites exhibited various compositions of filler sizes and resin components, resulting in different levels of cytotoxicity and ROS production. Chemical compositions of dental composites can be considered with their biological impact on safety issues in the intraoral use of dental restorative composites. CX with the highest TEGDMA showed the highest cytotoxicity induced by ROS accumulation. DN with lower TEGDMA and HEMA presented the highest cell viability.

Multiple proliferation signaling pathways are modulated by octacalcium phosphate in osteoblasts.

Octacalcium phosphate (OCP), a type of bioactive ceramics, may be associated with dentine, tooth apatite, and especially bone generation, and promotes wound healing after fracture. Recently, commercial bone grafting products containing a large amount of OCP material have been released because OCP can be synthesized in large quantities. It is reported to increase cell proliferation, but the interaction between OCP and cell signaling pathways is still unclear. In this study, first, we demonstrated OCP mediated cell signaling pathways with only purified OCP materials. OCP regulated P38, JNK (c-Jun N-terminal kinase), Src, and AKT (protein kinase B) signaling pathways. OCP crystals appeared in the characteristic ribbon shape but varied by several tens of micrometers in size. The X-ray diffraction pattern was the same as previously reported. We studied two concentrations of OCP (10 mg/ml and 20 mg/ml) to understand whether the effect of OCP on cell signaling pathways is dose dependent. We confirmed that OCP treatment affected cell proliferation and alkaline phosphatase and disrupted Src phosphorylation but did not change the total protein level. P38 phosphorylation was activated with OCP treatment and inhibited by SB203580, but P38 total protein level did not change. OCP inhibited JNK phosphorylation signaling, whereas PD98509 inhibited JNK phosphorylation with or without OCP. Interestingly, the AKT total level decreased after OCP treatment, but AKT phosphorylation increased considerably. Our results demonstrate that OCP materials modulate cell signaling pathways and increase cell proliferation.

Impact of postpolymerization devices and locations on the color, translucency, and mechanical properties of 3D-printed interim resin materials.

STATEMENT OF PROBLEM: How postpolymerization conditions affect the color and mechanical properties of 3-dimensional (3D)-printed prostheses is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the color, microhardness, and flexural strength of 3D-printed interim resin materials and to assess the effect of postpolymerization devices, polymerizing locations, and thermocycling on those properties. MATERIAL AND METHODS: A total of 270 disk-shaped specimens and 180 bar-shaped specimens were designed and 3D-printed with interim resin material (NextDent C&B). The specimens were postpolymerized in 1 of 3 devices (Group ND; NextDent, Group CR; Carima, and Group FL; Formlabs). Each group was divided into 3 circular zones of the polymerizing plate (central, medial, and lateral). Half of the specimens were subjected to 10 000 thermocycles. Color measurement, Vickers microhardness test, and 3-point flexural strength test were performed. Data were statistically analyzed by using the Kruskal-Wallis and Mann-Whitney tests (α=.05). RESULTS: The L∗a∗b∗ color coordinates exhibited significant differences among the 3 zones (P<.05). The color and translucency differences according to CIELab and CIEDE among the zones exceeded the clinically perceptible levels in group CR. ΔE and ΔTP between with and without thermocycling were significantly different among the devices (P<.05). Microhardness and flexural strength were significantly different among the zones for those affected by thermocycling (P<.05). CONCLUSIONS: Different locations in postpolymerization devices influenced the color, translucency, and mechanical properties of 3D-printed interim resin materials. Thermocycling induced color and translucency changes and the mechanical weakening of postpolymerized resins, and the impact differed according to the device type.

Impact of endodontic case difficulty on operating time of single visit nonsurgical endodontic treatment under general anesthesia.

BACKGROUND: A Case Difficulty Assessment Form was designed for use in endodontic curricula, and to assist practitioners with treatment planning, referral and recording. The aim of this study was to determine how endodontic case difficulty factors influence the operating time of single-visit nonsurgical endodontic treatments under general anesthesia. METHODS: Data on 198 single-visit endodontic treatments (80 anterior teeth, 43 premolars, and 75 molars) performed under general anesthesia by a specialized practitioner were obtained from 119 special needs patients (mean [SD] age = 30.7 [14.7] years). Total duration of operation was analyzed with relation to demographic and dental factors and American Association of Endodontists (AAE) Case Difficulty Assessment factors. Mann-Whitney U test, t-test, and Kruskal-Wallis test were used to assess relationships between operating time and confounding factors (p < 0.05). RESULTS: High difficulty cases required significantly longer time to complete operations than treatments of minimal-to-moderate difficulty regardless of tooth type (p < 0.05). Demographic factors of the patients rarely influenced operating time length. Among variables included in the AAE Case Difficulty Assessment Form, tooth position, crown morphology, root morphology, canal appearance, and periodontal condition were significantly associated with increased operating time (p < 0.05). CONCLUSIONS: A higher level of case difficulty contributed to increased duration of endodontic treatment under general anesthesia indicating that Endodontic Case Difficulty Assessment Form is useful for predicting the duration of nonsurgical endodontic treatment. Among many factors, complicated anatomic features of the treated teeth increased case complexity and extended operating time.

Root canals shaped by nickel-titanium instrumentation with automated computerized numerical control systems.

BACKGROUND: To investigate the efficacy of a nickel-titanium (NiTi) file with an automated computerized numerical control (CNC) system for root canal shaping. METHODS: The movement of the automated device and the insertion angle were investigated. In Experiment 1, simulated resin root canals were randomly divided into four groups (n = 20): manual downward movement using a handpiece (Group 1), vertical downward movement by CNC (Group 2), reciprocating up and down movement by CNC (Group 3), and spiral up and down movement by CNC (Group 4). In Experiment 2, five different insertion angles of the NiTi file were evaluated (n = 20). Four parameters were used to evaluate the shaping ability: change in the working length, central axis offset, curvature variation, and preparation time. Groups were compared using one-way analysis of variance (ANOVA) with significance was set at P < 0.05. RESULTS: The change in central axis position in the curved part of the root canal was found to be smaller in Group 4 than in other groups (P < 0.05). The curvature changes and preparation time of Groups 1 and 4 were significantly reduced compared with Groups 2 and 3 (P < 0.05). The variation in working length and curvature in the 5° insertion angle group was significantly smaller than in the other groups (P < 0.05). CONCLUSIONS: A spiral up and down movement, controlled by the CNC machine, and 5° insertion angle, maintained original root canal shape more precisely than other methods.

Shear Bond Strength of Different MDP-Containing Adhesive Systems on Enamel and Dentin from Primary Teeth.

OBJECTIVE: To compare the shear bond strength (SBS) after thermocycling of four universal adhesives applied in self-etch mode on dentin and etch-and-rinse mode on enamel. STUDY DESIGN: Flat 144 buccal or lingual dentin and enamel surfaces from 72 non-carious primary molars were prepared. Samples were segregated into 12 groups (n=12): Adper Single Bond 2 etch-and-rinse (SB_T) and Clearfil SE Bond self-etch (SE_S) applied to enamel and dentin served as controls. Scotch Bond Universal Adhesive (SBU), Clearfil S3 Bond Universal Adhesive (SEU), Tetric N-Bond Universal Adhesive (TEN), and All Bond Universal (BIS) were applied in etch-and-rinse mode to enamel and in self-etch mode to dentin. They were thermocycled for 5000 cycles. SBS testing and the evaluation of fracture mode were performed. RESULTS: SB_T showed statistically higher SBS than other adhesive groups using etch-and-rinse mode on enamel. SE_S and BIS had statistically higher SBS than other adhesive groups using self-etch mode on dentin. Mixed failure was the most common failure mode in each group. CONCLUSION: The universal adhesives did not show higher SBS than SB_T when using etch-and-rinse on enamel. All universal adhesives showed higher SBS than SB_T and had SBS similar to SE_S, except SBU when using self-etch mode on dentin.

Induction of sestrin 2 is associated with fisetin-mediated apoptosis in human head and neck cancer cell lines.

Fisetin was reported to have an anti-proliferative and apoptotic activity as a novel anti-cancer agent in various cancer cell lines. However, the possible molecular targets for the anti-cancer effect of fisetin in human head and neck cancer (HNCC) have not yet been clarified. In this study, the influence of fisetin on the growth and apoptosis of HNCCs were examined. In HSC3 cells, fisetin treatment reduced the viability and induced apoptosis. Through the results from the screening of the expression profile of apoptosis-related genes, sestrin 2 (SESN2) was functionally involved in fisetin-mediated apoptosis showing the knockdown of SESN2 by siRNA clearly restored fisetin-induced apoptosis. In addition, fisetin reduced the protein expression levels of phospho-mTOR (p-mTOR) and Mcl-1, which are the downstream molecules of SESN2. It also induced PARP cleavage by inducing an increase in the expression levels of SESN2 together with reducing mTOR and Mcl-1 proteins in other three HNCCs (MC3, Ca9.22, and HN22). Taken together, our findings suggest that the anti-cancer effect of fisetin on HNCCs is associated with SESN2/mTOR/Mcl-1 signaling axis.

Cytotoxicity of four denture adhesives on human gingival fibroblast cells.

OBJECTIVE: The purpose of this study was to compare the cytotoxicity of four denture adhesives on human gingival fibroblast cells. MATERIALS AND METHODS: Immortalized human gingival fibroblasts were cultured with one of four different denture adhesives, Polident, Protefix, Staydent or Denfix-A, which was placed in insert dishes (10% w/v concentration) for 48 h. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay and flow cytometric apoptosis assay were used to evaluate cell viability and apoptosis rates. The fibroblasts were also examined under a scanning electron microscope. RESULTS: The MTT assay showed that all denture adhesives resulted in a significantly lower cell viability compared to the control cells propagated in normal culture medium (p < 0.05), with Staydent demonstrating the lowest cell viability. According to the flow cytometric apoptosis assay, Staydent and Protefix showed significantly higher apoptosis rates than the control group (p < 0.05), whereas Polident and Denfix-A did not demonstrate any significant differences (p > 0.05). Staydent showed the highest apoptosis rate. Scanning electron microscopy showed that the cells of the Staydent group underwent cytoplasmic membrane shrinkage, with cell free areas containing residual fragments of the membrane of dead cells. CONCLUSIONS: The four denture adhesives evaluated in this study imparted cytotoxic effects on human gingival fibroblast cells. Staydent showed the highest toxicity.

Peri-implant bone formation of non-thermal atmospheric pressure plasma-treated zirconia implants with different surface roughness in rabbit tibiae.

OBJECTIVES: The aim of this study was to evaluate and compare the osseointegration of powder-injection molded (PIM) zirconia implants in rabbit tibiae with or without He plasma treatment. MATERIAL AND METHODS: Twenty-five rabbits received 4 types of external hex implants with identical geometry in the tibiae: PIM zirconia implants, roughened PIM zirconia implants, plasma-treated PIM zirconia implants, and plasma-treated roughened PIM zirconia implants. The contact angles of the four types of implants were evaluated. Removal torque tests and histomorphometric analyses were performed. RESULTS: The plasma treatment markedly enhanced the hydrophilicity, but did not seem to change the surface topography of the PIM zirconia implants. There were statistically significant differences in the bone-to-implant contact (BIC) ratios, bone volume (BV/TV), and removal torque values (RTQ) among the tested implant types (P < 0.001). The plasma-treated implants exhibited significantly higher BIC and BV/TV values than the untreated implants. However, the removal torque values favored the rough surface. CONCLUSIONS: The He plasma treatments on PIM zirconia implants made the surface more hydrophilic and enhanced the osseointegration of the implants without changing the micro-topography.

Peri-implant bone formations around (Ti,Zr)O(2) -coated zirconia implants with different surface roughness.

AIM: The aim of this study was to evaluate and compare the osseointegration in rabbit tibiae of smooth and roughened powder injection moulded (PIM) zirconia implants with or without (Ti,Zr)O2 surface coatings. MATERIAL AND METHODS: Twenty-five rabbits received four types of external hex implants with identical geometry on the tibiae: PIM zirconia implants, roughened PIM zirconia implants, (Ti,Zr)O2 -coated PIM zirconia implants and (Ti,Zr)O2 -coated roughened PIM zirconia implants. The surface characteristics of the four types of implants were evaluated. Removal torque tests and histomorphometric analyses were performed. RESULTS: The (Ti,Zr)O2 coatings substantially changed the surface topography and chemical composition of the both type of PIM zirconia implants. There were statistically significant differences in the bone to implant contact ratios and removal torque values (RT) among the tested implant types (p < 0.001). The histological response favoured the coated surface at smooth PIM zirconia implants. The removal torque values favoured the rough surface whether coated or uncoated. CONCLUSIONS: Within the limit of this study, the (Ti,Zr)O2 coated PIM zirconia implants, both smooth and rough, showed enhanced histological response (bone to implant contact) compared with uncoated ones. On the other hand, the mechanical anchorage (RT) was higher for rough surface implants, coated or uncoated.

Peri-implant bone formation and surface characteristics of rough surface zirconia implants manufactured by powder injection molding technique in rabbit tibiae.

OBJECTIVE: To evaluate osseointegration in rabbit tibiae and to investigate surface characteristics of novel zirconia implants made by powder injection molding (PIM) technique, using molds with and without roughened inner surfaces. MATERIAL AND METHODS: A total of 20 rabbits received three types of external hex implants with identical geometry on the tibiae: machined titanium implants, PIM zirconia implants without mold etching, and PIM zirconia implants with mold etching. Surface characteristics of the three types of implant were evaluated. Removal torque tests and histomorphometric analyses were performed. RESULTS: The roughness of PIM zirconia implants was higher than that of machined titanium implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined titanium implants (P < 0.001). The PIM zirconia implants using roughened mold showed significantly higher removal torque values than PIM zirconia implants without using roughened mold (P < 0.001). CONCLUSIONS: It is concluded that the osseointegration of PIM zirconia implant is promising and PIM using roughened mold etching technique can produce substantially rough surfaces on zirconia implants.

Development of Cellular Signaling Pathways by Bioceramic Heat Treatment (Sintering) in Osteoblast Cells.

Bioceramics are calcium-phosphate-based materials used in medical and dental implants for replacing or repairing damaged bone tissues; however, the effect of bioceramic sintering on the intracellular signaling pathways remains unknown. In order to address this, we analyzed the impact of sintering on the cell signaling pathways of osteoblast cells using sintered and non-sintered hydroxyapatite (HA) and beta-tricalcium phosphate (ß-TCP). X-ray diffraction indicated that only the morphology of HA was affected by sintering; however, the sintered bioceramics were found to have elevated the calcium concentrations in relation to the non-sintered variants. Both bioceramics inhibited the JNK signaling pathway; the sintered HA exhibited half the value of the non-sintered variant, while the sintered ß-TCP rarely expressed a p-JNK value. The total Src and Raptor protein concentrations were unaffected by the sintering, while the p-Src concentrations were decreased. The p-EGFR signaling pathway was regulated by the non-sintered bioceramics, while the p-p38 concentrations were reduced by both the sintered ß-TCP and HA. All of the bioceramics attenuated the total AKT concentrations, particularly the non-sintered HA, and the AKT phosphorylation concentration, except for the non-sintered ß-TCP. Thus, the sintering of bioceramics affects several intracellular signaling pathways. These findings may elucidate the bioceramic function and expand their application scope as novel substrates in clinical applications.

Synergistic effects of arginine-glycine-aspartic acid and phosphatidylserine on the surface immunomodulation and osseointegration of titanium implants.

The control of macrophage polarization is important in bone tissue regeneration such as osseointegration. In this study, a coating method was developed to improve the osseointegration of titanium (Ti) implants by generating an immunomodulatory effect. The surface of the Ti discs was coated with a poly(lactide-co-glycolide)(PLGA) polymer, phosphatidylserine (PS), and arginine-glycine-aspartic acid (RGD) peptide conjugated phospholipid. In in vitro assay using mouse bone marrow-derived macrophages (BMDMs), the most significant expression of the M2 marker genes (Arg-1, YM-1, FIZZ1) and CD206, an M2 surface marker, was obtained with coatings containing 6 mol% RGD conjugates and phospholipids consisting of 50 mol% PS. The M2-inducing effect of RGD and PS was also verified in rat femurs where coated Ti rods were implanted. The RGD and PS coating significantly enhanced the osseointegration of the Ti implants. Moreover, a biomechanical push-out test showed that the RGD and PS coating increased the interfacial binding force between the bone and implants. These results indicate that PS and RGD can be applied to the solid surface of implantable biomedical devices to improve immunomodulation and tissue regeneration.

Comparison of Fit and Stability Between 3D-Printed and Milled Implant Abutments with Titanium-6Al-4V and Co-Cr Metal Alloys.

PURPOSE: To compare the fit of 3D-printed titanium (Ti) and cobalt-chromium (Co-Cr) abutments with implants to computer numerical control (CNC)-milled, ready-made abutment-implant assemblies. Their clinical applicability was also evaluated by measuring removal torque values (RTVs) and percentage torque loss of abutment screws. MATERIALS AND METHODS: A total of 138 abutments were included in the study: 92 abutments were fabricated with Ti and Co-Cr alloys using computer-assisted design (CAD) through selective laser melting, and 46 ready-made abutments were prepared. The fit of interfaces between 90 abutments from the three groups (30 ready-made, 30 3D-printed Ti, and 30 3D-printed Co-Cr abutments) and implant assemblies was demonstrated by scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). After 30-Ncm torque tightening of Ti abutment screws twice within 10 minutes, the RTVs and percentage torque loss of screws of 48 abutments (16 ready-made, 16 3D-printed Ti, and 16 3D-printed Co-Cr) were evaluated after 10 minutes of thermocycling and cyclic loading. RESULTS: The fits of 3D-printed Co-Cr abutments were not statistically different from those of ready-made abutments (P = .383), while the fit of 3D-printed Ti abutments was inadequate (P < .001). The RTVs of 3D-printed abutments after cyclic loading were significantly decreased compared with those of CNC-milled abutments (P < .001). CONCLUSION: The fit of interfaces between 3D-printed Co-Cr abutments and implants was adequate. The RTVs of 3D-printed Co-Cr abutments were not significantly different from those of CNC-milled abutments after 10 minutes of 30-Ncm torque tightening and thermocycling.

The effects of primer precuring on the shear bond strength between gold alloy surfaces and metal brackets.

The objective of this study was to investigate the effects of precuring of primer coated on bracket bases on the strength of bonds between metal brackets and gold alloy. Square type III gold alloy plates were sandblasted with 30 µm silicon dioxide. After silica coating, excessive particles were removed gently with air. Silane was then applied, and maxillary central incisor metal brackets were bonded to each conditioned alloy surface with Transbond XT. Half of the specimens were precured at the bracket base after primer coating and the other half was not precured before bonding to the alloy surface. After bracket positioning, samples were cured using a light emitting diode (LED) for 40 seconds. Shear bond strengths were tested and adhesive remnant index (ARI) was evaluated after 1 hour and 24 hours. The primer precuring and 24 hours group exhibited highest bond strength (12.53 MPa) and the no precuring and 1 hour group showed lowest bond strength (5.58 MPa). Precured groups showed lower ARI scores. Due to the shallow curing depth of LED light and inhibition of transillumination at the metal surface, primer precuring at the bracket base is required for secure bracket bonding on gold alloy surfaces using LED curing units.

Sonic irrigation for removal of calcium hydroxide in the apical root canal: A micro-CT and light-coupled tracking analysis.

OBJECTIVE: This study aimed to evaluate the efficacy of three sonic irrigation systems for removal of calcium hydroxide dressing from the apical root canal. MATERIALS AND METHODS: A total of 96 single-rooted teeth in three categories of root canal curvatures (straight: 0-5°, moderate: 6-20°, and severe: > 20°) were allocated to four groups: conventional needle irrigation, EndoActivator, EQ-S, and Vibringe. The root canals were instrumented using Protaper NEXT and filled with calcium hydroxide. After removal of calcium hydroxide, the remaining volume of calcium hydroxide was measured by micro-CT analysis. Data were compared among root canal curvatures and irrigation systems using the Kruskal-Wallis test and Mann-Whitney test (p < .05). The oscillating range of each irrigation system was measured using light-coupled motion tracking. RESULTS: The volumes of calcium hydroxide remaining in the canals with severe curvature were significantly higher than in those of straight curvature (p < .05). In the canals of moderate or severe curvature, EQ-S showed the highest removal percentage, followed by EndoActivator, Vibringe, and needle irrigation (p < .05). Light-coupled tracking showed the largest oscillating range in EQ-S (p < .05). CONCLUSIONS: Sonically activated irrigation systems with a flexible tip can be beneficial for calcium hydroxide intracanal dressing removal in the curved apical canals.

Mechanical evaluation of dental trauma splints fabricated using recently-developed photo-polymerizable composites.

This study aimed to determine functionality and mechanical properties of dental splints. Five splints were tested: a control splint Filtek Z350XT (ZF), two splints with G-Fix (GF) and Light Fix (LF), and two wire-composite splints with ZF (ZW) and Ortho Connect Flow (CW). Periotest values, elastic modulus, flexural, compressive, and diametral tensile strength were measured. ZW and CW showed no significant differences in flexibility in labial or occlusal pressure of upper central incisors. LF, GF, and ZF did not differ in labial or palatal pressure. ZW and CW had higher flexibility than LF, GF, and ZF. LF had the lowest flexural and compressive strength but the highest diametral tensile strength. This study showed that ZW and CW might be options for flexible splints, whereas LF and GF would be options for rigid splints. Additionally, CW and LF/GF might be simpler alternatives to ZW and ZF, respectively.

Performance of Universal Adhesives in Composite Resin Repair.

Aim: The objective of this in vitro study was to evaluate the bond strength of universal adhesive systems in self-etch and etch-and-rinse modes at the repair interface between aged and new composite resins. Materials and Methods: Composite resin (Filtek Z250) was thermocycled to represent aged composite resin to be repaired. New composite resin was placed over the aged substrate after surface conditioning: NC (negative control, no surface treatment), A (adhesive only), SBM (Scotchbond Multi-Purpose in etch-and-rinse mode), CSE (Clearfil SE Bond in self-etch mode), SBU (Single Bond Universal), ABU (All Bond Universal), and TBU (Tetric N-Bond Universal). Universal adhesives (SBU, ABU, and TBU) were applied both in etch-and-rinse and self-etch modes. 1 mm × 1 mm × 8 mm beams were sectioned, and microtensile bond strength was measured after 24 hours of water storage and 10,000 thermocycling processes (n = 20/group). The fracture surfaces were observed with a scanning electron microscope to evaluate the failure pattern. Results: The repair bond strength between the old and new composite resins was material-dependent. Universal adhesives significantly improved the repair bond strength (p < 0.05), while no significant difference was observed between the etch modes (self-etch or etch-and-rinse) for each universal adhesive (p > 0.05). Thermocycling significantly reduced the bond strength in all groups (p < 0.05). Conclusion: Universal adhesives in both etch-and-rinse and self-etch modes outperformed the conventional 3-step etch-and-rinse and 2-step self-etch adhesive systems in terms of resin repair bond strength.