Composite resin bond strength to caries-affected dentin contaminated with 3 different hemostatic agents.

Bonding of composite resins to sound and caries-affected dentin in cervical areas may necessitate the use of hemostatic agents to control sulcular fluid and hemorrhage. The aim of this in vitro study was to evaluate the bond strengths of a self-etching adhesive system to sound and caries-affected dentin after the use of 3 different hemostatic agents. Composite resin cylinders were bonded to 48 caries-affected and 48 sound dentin surfaces in 8 groups. Groups 1-4 utilized caries-affected dentin: group 1, uncontaminated control; 2, ViscoStat; 3, ViscoStat Clear; and 4, trichloroacetic acid (TCA). Groups 5-8 utilized sound dentin: group 5, uncontaminated control; 6, ViscoStat; 7, ViscoStat Clear; and 8, TCA. The hemostatic agents were applied for 2 minutes and rinsed. After 500 rounds of thermocycling, shear bond strength tests were carried out. Data were analyzed with 1- and 2-way analyses of variance, t test, and post hoc Tukey tests at a significance level of P < 0.05. Bond strength was significantly influenced by dentin type (F = 38.23; P = 0.0001) and hemostatic agent (F = 6.32; P = 0.001). Furthermore, groups 2 and 6 (ViscoStat) showed significantly lower bond strength values than the control groups (groups 1 and 5) in both affected and sound dentin (P = 0.043 and P = 0.009, respectively). Within the limitations of this study, the bond strength of composite resin to caries-affected dentin was significantly reduced compared to that with sound dentin. Among the studied hemostatic agents, ViscoStat resulted in a greater decrease in dentin bond strength. Contamination of both sound and caries-affected dentin with hemostatic agents decreased composite resin bond strength. Of the 3 hemostatic agents used, ViscoStat Clear appeared to have the least detrimental effect on bond strength.

Resin bonding using etch-and-rinse and self-etch adhesives to decalcified deciduous enamel after bioactive glass air abrasion.

PURPOSE: Bioactive glass air abrasion is a conservative technique for removal of initial decalcified enamel superficial layer and caries vs alumina air abrasion. This study evaluated shear bond strength of composite resin to sound and decalcified deciduous enamel using etch-and-rinse and self-etch adhesives after alumina and bioactive glass air abrasion. MATERIALS AND METHODS: Ninety-six fat enamel surfaces, mounted in acrylic resin, were prepared from 48 deciduous molars. Half of the specimens were decalcified with a demineralizing solution. Both intact and decalcified specimens were assigned to two groups for alumina and bioactive glass air abrasion. In each group, the specimens were subdivided into two groups for application of Clearfil SE Bond or Optibond FL adhesives (n = 12). After composite resin bonding, the specimens underwent shear bond test. Data were analyzed using three-way analysis of variance (ANOVA), linear regression model and independent-sample t-test (α = 0.05). RESULTS: No significant differences were noted in bond strength of composite resin after alumina or bioactive glass air abrasion (p = 0.272). Optibond FL adhesive and enamel decalcification produced higher bond strength (p = 0.000, p = 0.001 respectively). CONCLUSION: In this study, bioactive glass air abrasion produced bond strength comparable to the conventional method. This technique might be an alternative method for preparation of normal and/or decalcified enamel of deciduous teeth for resin bonding.

Effect of preoperative systemic capsaicin on tooth sensitivity after in-office bleaching: A pilot study.

Background: Tooth bleaching sensitivity (TBS) after bleaching procedures is a common problem. This study was undertaken to determine the effect of preoperative systemic capsaicin on tooth sensitivity (TS) after in-office bleaching procedures. Materials and Methods: Thirty participants received the treatment in this clinical trial. The subjects were randomly assigned to two groups (n = 15). Placebo and 0.25% capsaicin were administered three times daily for 24 h, with the first dose being administrated 1 h before the bleaching procedure. The subjects underwent two bleaching sessions at a 2-week interval by applying 40% hydrogen peroxide gel on six upper anterior teeth. A visual analog scale (VAS) was used to evaluate TS. Data were analyzed with SPSS 24. Statistical analyses were carried out with the Wilcoxon test and paired t-test. Statistical significance was set at P ≤ 0.05. Results: In the capsaicin group, there was a significant increase in TBS between the immediate and 1-h postoperative intervals and a significant decrease between 1- and 24-h postoperative intervals (P = 0.01 and P = 0.000, respectively). In the placebo group, there was a significant decrease between immediate and 24-h and between 1- and 24-h postoperative intervals (P = 0.007, P = 0.02). Milder TS was detected in the placebo group 24 h after bleaching (P < 0.05). Conclusion: Under the limitations of this study, preoperative use of systemic capsaicin did not significantly affect TS after the in-office bleaching procedure.

Bond Strength Evaluation of Ceramic Restorations with Immediate Dentin Sealing: A Systematic Review and Meta-Analysis.

Statement of the Problem: Immediate dentin sealing (IDS) was introduced to overcome the disadvantages of delayed dentin sealing like pollution of dentin tubules, microleakage, and bond strength destruction over time. The effect of IDS on the bond strength of indirect restorations is still debatable. Purpose: This study was conducted to determine the effect of IDS on the bond strength of ceramic restorations to dentin. Materials and Method: In this systematic review and meta-analysis, the study protocol was registered on the PROSPERO database under the registration number CRD420202014 27. MEDLINE (PubMed), Web of Science, Scopus, and ProQuest databases were searched until January 2021 and updated in January 2022. Worldcat.org and Opengrey.eu, ProQuest dissertation and thesis, and Google Scholar were searched to explore the grey literature. The in vitro studies evaluating the bond strength of ceramic restoration to dentin with and without IDS were included. Seven criteria were assessed to evaluate the risk of bias in the study. Statistical analyses were conducted using RevMan 5.3. The inverse variance method was used to determine the mean difference of micro-tensile bond strength (µTBS) and shear bond strength (SBS). Results: A total of 10 studies (20 datasets) were included in the meta-analysis. Regarding the µTBS analysis, IDS had a significantly higher bond strength than Delayed Dentin Sealing (DDS) (MD:1.16, 95%CI:0.28_2.03, I2=0%). However, no significant difference was found between them in the SBS analysis (MD:0.25, 95%CI: -0.56-1.06, I2=96%). All studies were categorized to have a moderate or high risk of bias. Conclusion: Most in vitro evidence showed favorable results for the effect of IDS on the bond strength and durability of indirect restorations. The adhesive system and the type of ceramic and its treatment before cementation are determining factors. Due to the heterogeneity of the outcomes and studies with a moderate/high risk of bias, the quality of the evidence was low.

Effect of trichloroacetic acid hydrogel on self-etch adhesive bond strength to dental tissues.

INTRODUCTION: Trichloroacetic acid (TCA) is a soft tissue cauterizing agent applied to gingival margins prior to cervical tooth-colored restorations. The present in vitro study evaluated the effects of two different concentrations of TCA hydrogel as a hemostatic/preconditioning agent on the shear bond strength (SBS) of a self-etch adhesive to tooth structures. MATERIALS AND METHODS: Thirty-six flat enamel and 36 flat dentin surfaces were prepared using human molars; each group was subdivided into three subgroups (n = 12). The groups were made ready as follows: In groups 1 (E1 and D1), the enamel (E) and dentin (D) surfaces were designated as control groups and remained intact. In groups 2 (E2 and D2), 35% TCA gel was applied to enamel and dentin surfaces for 30 seconds. In groups 3 (E3 and D3), 50% TCA gel was applied to enamel and dentin surfaces for 30 seconds. Clearfil SE Bond and Z100 composite resin were applied to the surfaces according to manufacturers' instructions. After 24 hours of incubation and thermocycling, the composite cylinders underwent an SBS test in a DARTEC test machine. Data were analyzed using the ANOVA and Scheffe's test (α=0.05). RESULTS: The mean SBS±SD in the study groups were 34.73±5.66, 35.32±7.3, 23.75±9.67, 20.94±9.84, 19.32±6.20, 23.50±6.63 MPa in the E1, E2, E3, D1, D2 and D3 groups, respectively. ANOVA revealed significant differences between the SBS values of enamel groups (p=0.001). There were no significant differences between the dentin groups (p=0.425). CONCLUSION: Application of 35 and 50% concentrations of TCA to dentin had no detrimental effect on the bond produced by two-step self-etch adhesive under study; however, application of only 35% TCA to enamel did not result in a detrimental effect on the same adhesive.

A new solvent-free one-step self-etch adhesive: bond strength to tooth structures.

INTRODUCTION: In recent years some new solvent-free dental adhesives have been marketed. This study evaluated bonding effectiveness of a new one-step solvent-free self-etch adhesive in comparison with a common two-step self-etch adhesive used as gold standard. MATERIALS AND METHODS: Flat enamel and dentin surfaces were prepared on 60 incisors using silicon carbide papers. Clearfil SE Bond (CSEB) and Bond 1SF (B1SF) adhesives were applied on enamel/dentin surfaces in four groups (n = 15): (1) Enamel surface and CSEB, (2) dentin surface and CSEB, (3) enamel surface and B1SF, (4) dentin surface and B1SF. Composite resin buildups were carried out using Z100 composite resin. All the specimens were stored for 24 hours at 37°C and 100% relative humidity. After 500 rounds of thermocycling, shear bond strength (SBS) test was performed using a universal testing machine at 1 mm/min crosshead speed. Data were analyzed with one-way ANOVA and a post hoc Tukey test (α = 0.05). In each experimental group, two additional specimens were prepared for scanning electron microscopy evaluation. RESULTS: Significant differences were observed between the study groups (p < 0.001). The highest enamel/dentin bond strengths were recorded in group 1 (CSEB) (p < 0.001). The SBS of the two-step self-etch adhesive to enamel and dentin was significantly higher than that of the one-step self-etch adhesive (p < 0.001). There was no significant difference between enamel and dentin SBS with B1SF (p = 0.559). CONCLUSION: Within the limitations of the present study, when bonded to enamel and dentin the solvent-free adhesive B1SF underperforms as compared to CSEB as the control gold standard.

Dentin extracellular matrix loaded bioactive glass/GelMA support rapid bone mineralization for potential pulp regeneration.

The study aims to develop a novel dentin extracellular matrix (dECM) loaded gelatin methacrylate (GelMA)-5 wt% bioactive glass (BG) (Gel-BG) hydrogel for dental pulp regeneration. We investigate the role of dECM content (2.5, 5, and 10 wt%) on the physicochemical characteristics and biological responses of Gel-BG hydrogel in contact with stem cells isolated from human exfoliated deciduous teeth (SHED). Results showed that the compressive strength of Gel-BG/dECM hydrogel significantly enhanced from 18.9 ± 0.5 kPa (at Gel-BG) to 79.8 ± 3.0 kPa after incorporation of 10 wt% dECM. Moreover, we found that in vitro bioactivity of Gel-BG improved and the degradation rate and swelling ratio reduced with increasing dECM content. The hybrid hydrogels also revealed effectual biocompatibility, >138 % cell viability after 7 days of culture; where Gel-BG/5%dECM was most suitable. In addition, the incorporation of 5 wt% dECM within Gel-BG considerably improved alkaline phosphatase (ALP) activity and osteogenic differentiation of SHED cells. Taken together, the novel bioengineered Gel-BG/dECM hydrogels having appropriate bioactivity, degradation rate, osteoconductive and mechanical properties represent the potential applications for clinical practice in the future.

Repair strength of dimethacrylate-based composites resins: Effect of sandblasting, adhesive bonding, and thermocycling.

Background: The goal of this study is to determine the effect of different sandblasting particles and dental adhesive systems on the repair strength of dimethacrylate-based composite resins. Materials and Methods: In this in-vitro study, 96 specimens of X-trafil composite blocks were prepared and divided into eight groups (n = 12). Four groups were sandblasted with Aluminum Oxide (AL) and four other groups with Bio-Active Glass particles (BAG). A two-component silane was applied on the surface of all the samples after phosphoric acid etching and rinsing. Two groups of the sandblasted specimens were treated with Clearfil SE Bond (CSB) and the other two groups were treated with Single Bond Universal (SBU) and new composite was bonded to the prepared surfaces. Half of the specimens in each group were thermocycled. Shear force was applied to the bonded composite using a universal testing machine with a crosshead speed of 0.5 mm/min and mean shear bond strength (MSBS) was calculated (MPa). The data was analyzed using Kruskal-Wallis and Man-Whitney U-tests with the significance level of 0.05. Results: Significant differences were observed between different groups (P < 0.001). The highest and the lowest MSBS of the thermocycled samples were reported 18.88 MPa with application of AL and SBU and 11.46 MPa with the application of AL and CSB, respectively. No significant difference was observed with application of BAG particles after thermocycling. Conclusion: Effect of AL on repair shear bond strength of composite resins is affected by bonding type. Bonding type did not affect repair shear bond strength of BAG. Thermocycling reduced bond strength in all groups.

The effect of pre-warming and delayed irradiation on marginal integrity of a resin-modified glass-ionomer.

Recent studies have indicated that the acid-base reactions and polymerization of resin-modified glass-ionomers (RMGIs) compete with and inhibit each other; however, external energy can also influence the properties of RMGIs. This in vitro study evaluated the effect of pre-warming and/or delayed light irradiation on marginal integrity of RMGIs in cervical restorations. Standard Class V cavities were prepared on the buccal aspects of 60 human maxillary premolars. Each cavity was treated with a cavity conditioner for 10 seconds, rinsed, and gently air-dried. An RMGI was applied to the prepared cavities as dictated by the study protocol. Group 1 samples were treated per manufacturers' instructions. Group 2 samples were photocured after a delay of 2 minutes. For samples in Group 3, the encapsulated material was pre-warmed (at 40° C) for 90 seconds; for Group 4 samples, capsules were pre-warmed and photocuring was delayed for 2.4 minutes. Microleakage scores were determined using dye penetration technique; Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis (α = 0.05). The enamel groups exhibited statistically significant differences (P = 0.036), while the dentin groups did not (P = 0.122); however, in both cases, Group 2 demonstrated the highest marginal integrity. Based on the results of this study, pre-warming could jeopardize the marginal integrity of RMGIs in cervical restorations, while delaying the curing process might improve it (particularly for enamel).

Effect of postbleaching application of an antioxidant on enamel bond strength of three different adhesives.

OBJECTIVES: The aim of this study was to compare the shear bond strength (sbs) of three different adhesives on bleached enamel immediately after bleaching, bleached/delayed for 1 week, and bleached/applied antioxidizing agent. STUDY DESIGN: The enamel surfaces of 144 freshly extracted incisors without any caries and restorations were flattened and divided into 12 groups. The following adhesives were investigated: Optibond FL (OFL) (three-step etch&rinse), Optibond Solo Plus (OSP) (two-step etch&rinse), Optibond All-in-One (OA) (one-step self-etch), (Kerr, Orange, USA). Unbleached enamel groups were prepared as negative controls. The remainder surfaces were bleached with 20% Opalescent PF (Ultradent, USA) 6 h/d for 5 consecutive days. Specimens were bonded immediately after bleaching, after 1 week or after using 10% sodium ascorbate gel for 6 hours. After 500 rounds of thermocycling, sbs was measured and data was analyzed with Kruskall-Wallis and Mann-Whitney U-tests ( = 0.05). RESULTS: The sbs decreased for the adhesives after bleaching except for OFL. The effect of applying sodium ascorbate subsequent to bleaching was not equal for the studied adhesives. While for OFL, sbs of the sodium ascorbate group was significantly higher than the unbleached control group, for OSP, the sodium ascorbate group had no statistically significant difference with the unbleached control group and for OA, sbs was significantly lower than the unbleached control group. CONCLUSIONS: Different adhesives demonstrate different degrees of reversed bond strength subsequent to applying antioxidant. It seems the method of application and the chemical composition of the adhesives could affect the antioxidant as a reducing agent.

Flexural strength and morphological characteristics of resin-modified glass-ionomer containing bioactive glass.

INTRODUCTION: Recent advances in dental materials have led to the production of smart materials. Recently, addition of bioactive materials to glass-ionomer cements has resulted in new capabilities beyond the beneficial effects of fluoride release. This in vitro study compared the flexural strengths (FS) of a resin-modified glass-ionomer containing bioactive glass (RMGIBAG) with that of a commonly used resin-modified glass-ionomer (RMGI). METHODS AND MATERIALS: A total of forty RMGI and RMGI-BAG bars (20 × 4 × 4 mm) were prepared in stainless steel molds. Each of the RMGI and RMGI-BAG bars was set for FS test. FS values of the specimens were measured using three-point bending test at a crosshead speed of 0.5 mm/min. The surface changes and the amounts of elements on the materials' surfaces were also evaluated by SEM/EDS analyses. Data were analyzed using SPSS 11.5 and t-test (α = 0.05). RESULTS: The means ± SD in the study groups were 61.46 ± 22.52 and 39.90 ± 9.11 MPa respectively. There were significant differences between FS of the two study groups (p = 0.003). CONCLUSION: While adding 20 wt% of BAG to the RMGI powder evaluated in this study decreases FS of the material significantly, the mean value of FS is in the acceptable range of the reported FS values for conventional GIs and RMGIs that are commercially available for clinical use. CLINICAL SIGNIFICANCE: While flexural strength of RMGI decreases subsequent to addition of bioactive glass, it is still clinically acceptable considering the flexural strength values reported for clinically used GIs and RMGIs. Further studies are recommended.

Effect of Calcium Hypochlorite and Sodium Hypochlorite as Root Canal Irrigants on Push-out Bond Strength of Fiber Post Cemented with Etch-and-Rinse Resin Cement: An in Vitro Study.

Objectives: Calcium hypochlorite (CH) has been recently used as a root canal irrigant. The aim of the present study was to compare the effect of CH and sodium hypochlorite (SH), as root canal irrigants, on the push-out bond strength of fiber posts cemented with an etch-and-rinse resin cement. Materials and Methods: In this experimental in-vitro study, 40 human anterior teeth with similar root lengths were randomly divided into five groups (N=8) according to the protocol of root canal irrigation as follows: group 1: saline (control); group 2: 2.5% SH; group 3: 5.25% SH; group 4: 2.5% CH; group 5: 5% CH. Before post placement, the post space was irrigated using the same irrigation protocol, and after that, they were irrigated by distilled water. Fiber posts were cemented with All-Bond 3 bonding and Dou-Link Universal cement. After thermocycling (1000 cycles, 5-55°C), a push-out test was performed, and data were analyzed using one-way analysis of variance and Tukey's post-hoc test with SPSS version 23 (α=0.05). Results: The highest and lowest mean bond strengths were detected in groups 2 and 5, respectively. There was no significant difference between group 1 and the SH groups (P>0.05), but the difference between group 1 and the CH groups was significant (P<0.001). There was a significant difference between SH groups and CH groups (P<0.001). Conclusion: Compared to SH, as a root canal irrigant, CH decreased the push-out bond strength of fiber posts cemented with an etch-and-rinse resin cement.

The effect of trichloracetic acid as a hemostatic and etching agent on the morphological characteristics and shear bond strength of resin composite to enamel.

INTRODUCTION: Trichloracetic acid (TCA) is a soft tissue chemical cauterizing agent that is used on gingival margins prior to restoring cervical cavities with resin materials. This study evaluated the effect of TCA gel as an etchant, its use before etchant on the shear bond strength between resin composite and enamel and also its effect on enamel surface morphological characteristics. MATERIALS AND METHODS: Seventy-five sound, extracted human anterior maxillary teeth were selected for the purpose of this in vitro study. The teeth were equally divided into five groups prior to enamel surface preparation with silicone carbide papers. In Group 1, the enamel surfaces were etched with 35% phosphoric acid for 30 seconds. In Groups 2 and 3, a 35% TCA gel and 50% TCA gel, respectively, were used on the enamel surfaces for 30 seconds. The enamel surfaces were then rinsed with water for 10 seconds. In Groups 4 and 5, the specimens were prepared in the same manner as Groups 2 and 3 and the enamel surfaces were then etched with 35% phosphoric acid for 30 seconds. In all the experimental groups, after rinsing and drying the samples, Single Bond adhesive (3M ESPE) was used to bond Z250 composite cylinders onto the enamel surfaces. After 500 rounds of thermocycling, the composite cylinders were loaded to failure in shear in a DARTEC test machine and the data were analyzed using the ANOVA and Scheffé's tests (alpha = 0.05). Two specimens from each group were prepared for surface morphology evaluation under SEM. RESULTS: The mean bond strengths and standard deviations in Groups 1 through 5 were 23.77 +/- 1.64, 22.43 +/- 3.02, 23.48 +/- 3.48, 25.31 +/- 1.42 and 28.68 +/- 1.28 MPa, respectively. Analysis of the variances demonstrated statistically significant differences in the study groups (p < 0.05). Pairwise testing showed statistically higher bond strength in Group 5 than all the other groups (p < 0.05). The morphology of surfaces etched with TCA in Groups 2 and 3 was similar to that of surfaces etched with phosphoric acid alone (Group 1). CONCLUSION: TCA is capable of etching enamel surfaces in a manner similar to phosphoric acid. Although the inadvertent contact of TCA with enamel prior to conventional etching with phosphoric acid may have a positive effect on bond strength between enamel and resin composite, microscopical evaluations also show an overetching pattern that is more prominent with 50% TCA.

Fracture resistance of endodontically-treated teeth: effect of combination bleaching and an antioxidant.

UNLABELLED: This in vitro study assessed the fracture resistance of endodontically-treated teeth undergoing combination bleaching with 38% and 9.5% hydrogen peroxide gels as in-office and at-home bleaching techniques, respectively. In addition, the effect of an antioxidizing agent, sodium ascorbate, was investigated. METHODS AND MATERIALS: Sixty maxillary premolars were endodontically-treated, received a glass ionomer barrier as a mechanical seal and were embedded in acrylic resin up to the cemento-enamel junction. The specimens were divided into four groups (n = 15) as follows: G I: no bleaching, access cavity restored with resin composite (negative control); G II: bleached for three weeks daily using 9.5% hydrogen peroxide for two hours and three sessions of in-office bleaching using 38% hydrogen peroxide every seven days, then restored (positive control); G III: bleached similar to G II and restored after one week; G IV: bleached similar to G II, along with the use of an antioxidizing agent for 24 hours, then restored. In each in-office and at-home bleaching session, the whitening gels were applied to the buccal surface of the tooth and placed inside the pulp chamber (inside/outside bleaching technique). Finally, the specimens underwent fracture resistance testing; the data were analyzed using ANOVA and Scheffé's test (alpha = 0.05). RESULTS: Significant differences were observed among the study groups (p < 0.05). Groups I and II demonstrated the highest and lowest fracture resistance, respectively. The samples that were not bleached (Group I) and the 10% sodium ascorbate gel group (Group IV) demonstrated significantly higher fracture resistance than the positive control group (p < 0.05). No significant differences were found between Groups III and II (p > 0.05). CONCLUSION: Within the limitations of the current study, it can be concluded that the fracture resistance of endodontically-treated teeth decreases after combination bleaching. The use of sodium ascorbate can reverse decreased fracture resistance.

Effect of light-activated bleaching on the microleakage of Class V tooth-colored restorations.

OBJECTIVE: In-office bleaching procedures utilizing highly concentrated 30%-35% hydrogen peroxide solutions or hydrogen peroxide releasing agents are used for tooth whitening. Some recommend that, to enhance the whitening process, light-activation of the bleaching agent should be performed. The current study evaluated the effect of plasma arc bleaching on the microleakage of Class V restorations restored with resin composite, compomer and resin-modified glass ionomer (RMGI). MATERIALS AND METHODS: The buccal surfaces of 72 freshly extracted premolars were prepared with Class V cavities (4 x 2.5 x 1.5 mm) extended 1 mm apical to the CEJ. The prepared teethwere randomly divided into six groups. The cavities were restored with Single Bond and Z100 resin composite (Groups 1 and 2), Prompt L-Pop and F2000 compomer (Groups 3 and 4) and Vitremer RMGI (Groups 5 and 6), respectively. They were then thermocycled for 500 cycles. The samples from Groups 1, 3 and 5 were incubated at 37 degrees C and 100% humidity. Groups 2, 4 and 6 were bleached using in-office bleaching gel and the plasma arc bleaching unit, then incubated. All samples were sealed with nail varnish and immersed in 2% basic fuschin for 24 hours. The restorations were sectioned longitudinally and microleakage was evaluated using a scale ranging from 0 to 3. The data were analyzed using the Kruskal-Wallis test (alpha = 0.05). RESULTS: No statistically significant differences between study groups were observed in both the enamel and dentinal margins (p > 0.05). CONCLUSION: Plasma arc bleaching did not significantly affect the microleakage of existing tooth-colored restorations restored with Z100 resin composite, F2000 compomer and Vitremer RMGI.

Effects of Calcium Hypochlorite and Sodium Hypochlorite, as Root Canal Irrigants, on the Bond Strength of Glass Fiber Posts Cemented with Self-Adhesive Resin Cement.

OBJECTIVES: Calcium hypochlorite (Ca(OCl)2) is currently used as a root canal irrigant. The aim of this study was to compare the effects of calcium hypochlorite and sodium hypochlorite (NaOCl), as root canal irrigants, on the bond strength of posts cemented with a self-adhesive resin cement. MATERIALS AND METHODS: In this in-vitro study, 40 maxillary central incisors with similar root lengths were decoronated. The teeth were randomly divided into five groups based on the irrigant used: Group 1: normal saline (control), Group 2: 2.5% sodium hypochlorite, Group 3: 5.25% sodium hypochlorite, Group 4: 2.5% calcium hypochlorite, and Group 5: 5% calcium hypochlorite. Root canal treatments were performed with Gates-Glidden drills and the irrigant corresponding to each group was used upon changing the file and for irrigating the post space. Then, glass fiber posts were cemented by BisCem self-adhesive cement. After applying 1,000 thermocycles at 5-55°C, three samples of the mid-section of each root were prepared: one for scanning electron microscopy (SEM), and the rest for push-out testing. Data were analyzed with SPSS 23 software using one-way analysis of variance and post-hoc Tukey's test. RESULTS: The highest and lowest mean bond strengths were recorded in groups 5 and 1, respectively. There was a significant difference between the 5% calcium hypochlorite group and the other groups (P<0.001). The difference between the other groups was not significant. CONCLUSION: The use of 5% calcium hypochlorite with self-adhesive cements increases the push-out bond strength of fiber posts to radicular dentin.

Effect of Delayed Light-Curing Through a Zirconia Disc on Microhardness and Fracture Toughness of Two Types of Dual-Cure Cement.

OBJECTIVES: Photopolymerization immediately sets dual-cure cements and prevents the continuation of chemical polymerization. Delayed light-curing allows the chemical process to continue up to the point before starting irradiation; however, there is a controversy in this respect. The present study evaluates the effect of delayed light-curing through a zirconia disc on the microhardness and fracture toughness (KIC) of two types of dual-cure cement. MATERIALS AND METHODS: Samples measuring 25×5×3 mm3 were prepared for fracture toughness test, and discs measuring 5 mm in diameter and 3 mm in thickness were prepared for microhardness test using Bifix and BisCem cements. Light-curing protocols were as follows: immediate light-curing (group A), a 2-minute delay (group B), a 5-minute delay (group C), direct irradiation (group D), and no irradiation (group E). In groups A to C, light-curing was carried out through a zirconia disc. Data were analyzed by two-way and one-way analysis of variance (ANOVA), post-hoc Tukey's test, and Kruskal-Wallis test at 95% confidence interval. RESULTS: There was a significant difference in the microhardness of the cements (P=0.00). Delayed light-curing had no effect on microhardness (P=0.080). The microhardness of BisCem in group E was significantly lower than that in group D (P=0.015). The fracture toughness of Bifix in groups B and C was significantly different than that in group E and BisCem groups. CONCLUSIONS: Under the limitations of our study, delayed light-curing had different effects on microhardness and fracture toughness. Differences in light-curing protocols resulted in different effects based on the cement type. Light-curing is recommended to achieve optimal mechanical properties.

Effect of Intracanal Irrigants on Coronal Fracture Resistance of Endodontically Treated Teeth Undergoing Combined Bleaching Protocol: An In Vitro Study.

OBJECTIVES: Irrigation plays a critical role in endodontic treatment. Various single and combined irrigants and irrigation protocols are available. The aim of this study was to evaluate the effect of some common irrigation protocols on the coronal fracture resistance of endodontically treated teeth undergoing bleaching. MATERIALS AND METHODS: After preparation of access cavities in 120 maxillary premolars, the teeth were divided into five groups (n=24) based on the irrigation protocol; G1:2.5% sodium hypochlorite (NaOCl), G2: 2% chlorhexidine (CHX), G3: NaOCl+CHX, G4: NaOCl+ethylenediaminetetraacetic acid (EDTA), G5: NaOCl+EDTA+CHX. Each group was subdivided into 2 subgroups of A: non-bleached (NB) and B: bleached (B). In subgroup B, the teeth underwent in-office and at-home bleaching techniques using 38% hydrogen peroxide and 20% carbamide peroxide gels for 3 weeks. The teeth were restored with composite resin, thermocycled, incubated for 24 hours, and underwent fracture resistance tests. Data were analyzed with one-way analysis of variance (ANOVA) and t-test (α=0.05). RESULTS: T-test showed significant differences between every two corresponding groups (P<0.0001). In subgroup A, the minimum fracture resistance was recorded in G1. Also, G2 specimens exhibited a significantly higher fracture resistance compared to G1, G4, and G5. In subgroup B, G2 specimens exhibited a significantly higher fracture resistance compared to G1 and G4 that were irrigated using NaOCl and NaOCl+EDTA. CONCLUSIONS: It can be concluded that irrigation protocols can affect the coronal fracture resistance of bleached endodontically treated teeth, and specific irrigation protocols can be recommended for teeth undergoing bleaching.

Interfacial fracture toughness of universal adhesive systems treated with an antioxidant.

BACKGROUND: Secondary caries, degradation of the dentin-resin interface and fracture of the restoration are the most common forms of failure. The aim of this study was to assess the interfacial fracture toughness of three different adhesive approaches and to compare their fracture toughness after surface treatment with antioxidant. MATERIAL AND METHODS: Seventy two dentin blocks with 3×4mm dimension and 3mm thickness were prepared and attached to precured 3×4×12mm composite blocks from both sides. Six adhesive groups (N=12), All-bond universal, Scotchbond universal and Clearfil SE bond with or without antioxidant treatment (Sodium Ascorbate 10% )were applied to dentin surfaces, a 160µ polyethylene paper formed the chevron in adhesive-dentin interfaces. Chevron-notched beam fracture toughness was measured following a modified ISO 24370 standard. The uniform composite-dentin-composite block was subjected to a 4-point test in universal machine. Data were analyzed by Kruskal-Wallis, Wilcoxon signed-rank and Mann-Whitney tests (α =0.05). RESULTS: Different adhesive approaches yielded different significant in fracture toughness rates. A significant increase of fracture toughness was observed between adhesive groups after antioxidant surface treatment. The difference in fracture toughness between Scotchbond universal and All-bond universal were significant. CONCLUSIONS: The highest value of fracture toughness was reported for Clearfil SE bond and the lowest value was found for All-bond universal. Sodium ascorbate as antioxidant surface treatment had a significant effect in increasing the fracture toughness. Key words:Chevron-notched beam fracture toughness, fracture toughness, dentin, adhesive, antioxidant.

Cytotoxicity assessment of polyhydroxybutyrate/chitosan/nano- bioglass nanofiber scaffolds by stem cells from human exfoliated deciduous teeth stem cells from dental pulp of exfoliated deciduous tooth.

BACKGROUND: The aim of this study was to compare the cytotoxicity and the biocompatibility of three different nanofibers scaffolds after seeding of stem cells harvested from human deciduous dental pulp. Given the importance of scaffold and its features in tissue engineering, this study demonstrated the construction of polyhydroxybutyrate (PHB)/chitosan/nano-bioglass (nBG) nanocomposite scaffold using electrospinning method. MATERIALS AND METHODS: This experimental study was conducted on normal exfoliated deciduous incisors obtained from 6-year-old to 11-year-old healthy children. The dental pulp was extracted from primary incisor teeth which are falling aseptically. After digesting the tissue with 4 mg/ml of type I collagenase, the cells were cultured in medium solution. Identification of stem cells from human exfoliated deciduous teeth was performed by flowcytometry using CD19, CD14, CD146, and CD90 markers. Then, 1 × 104 stem cells were seeded on the scaffold with a diameter of 10 mm × 0.3 mm. Cell viability was evaluated on days 3, 5, and 7 through methyl thiazol tetrazolium techniques (P < 0.05) on different groups that they are groups included (1) PHB scaffold (G1), (2) PHB/chitosan scaffold (G2), (3) the optimal PHB/chitosan/nBG scaffold (G3), (4) mineral trioxide aggregate (MTA), and (5) the G3 + MTA scaffold (G3 + MTA). Data were analyzed with two-way ANOVA at significance level of P < 0.05. RESULTS: The results indicated that the PHB/chitosan/nBG scaffold and PHB/chitosan/nBG scaffold + MTA groups showed significant difference compared with the PHB/chitosan scaffold and PHB scaffold groups on the 7th day (P < 0.05). CONCLUSION: Thus, it can be concluded that the scaffold with nBG nanoparticles is more biocompatible than the other scaffolds and can be considered as a suitable scaffold for growth and proliferation of stem cells.