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Atlas AM, Janyavula S, Elsabee R, Alper E, Isleem WF, Bergler M, Setzer FC. Comparison of loupes versus microscope-enhanced CAD-CAM crown preparations: A microcomputed tomography analysis of marginal gaps. J Prosthet Dent 2024; 131:643-651. [PMID: 35643825 DOI: 10.1016/j.prosdent.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Long-term restoration success depends on a precision marginal fit to prevent marginal leakage and caries. The successful fit of a computer-aided design and computer-aided manufactured (CAD-CAM) crown may be affected by different workflow variables, including preparation, scanning, crown design, milling, sintering, and cementation. Discrepancies in any of these steps may result in poor marginal and internal fit. Evidence suggests that tooth preparation may be the most important step in the workflow for a successful outcome. Compared with the traditional means of crown preparation using the naked eye or loupes, the dental operating microscope provides higher magnification and more direct illumination. However, the impact of high magnification during preparation on the marginal quality of CAD-CAM crowns is unclear. PURPOSE The purpose of this in vitro study was to compare marginal fits of CAD-CAM crowns fabricated after initial preparation with loupes and subsequent preparation refinement with either loupes or a microscope. The null hypothesis was that no significant difference would be found in the marginal gap between the preparations with loupes and those with a microscope. MATERIAL AND METHODS Mounted extracted molars (N=18) received initial crown preparations with a coarse grit, rounded shoulder, diamond rotary instrument with loupes of ×3.0 magnification. The teeth were then randomly divided into 2 groups and refined for an additional 2 minutes with fine grit, rounded shoulder, diamond rotary instruments with either loupes (LOUP) or a microscope up to ×10.0 magnification (DOM). The prepared teeth were scanned with an intraoral scanner to fabricate zirconia-reinforced lithium silicate crowns manufactured with a 4-axis milling machine, sintered in a dental furnace in accordance with the manufacturer's instructions, and cemented with self-adhesive resin cement. All teeth with crowns were mounted and scanned with a microcomputed tomography (μCT) system at 21-μm nominal voxel size. The resulting Digital Imaging and Communications in Medicine (DICOM) images were imported into a semiautomatic segmentation software program. Marginal and absolute gaps were measured at 24 consistent circumferential points per specimen. Absolute gaps were labeled, and the total volume was calculated. Paired and unpaired t tests were used for statistical analysis (α=.05). RESULTS The mean marginal gap was 145.0 ±259.6 μm for LOUP and 35.6 ±110.6 μm for DOM, with a statistically significant difference (P<.001). The mean gap volume for LOUP was 0.975 ±0.811 mm3, and 0.250 ±0.477 mm3 for DOM, also statistically significantly different (P=.023). A significant difference was found between the absolute and marginal gaps for LOUP (P=.007), but for DOM, the difference was not significant (P=.063). CONCLUSIONS This study demonstrated that the higher magnification used during tooth preparation played a significant role in the size of marginal gaps present around CAD-CAM crowns. Crown preparations finished by using fine grit diamond rotary instruments with a microscope at higher magnification than loupes resulted in a more precise marginal fit with smaller gaps.
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Affiliation(s)
- Alan M Atlas
- Private practice, Philadelphia, Pa; and Clinical Professor, Department of Endodontics, Department of Preventive; Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.
| | - Sridhar Janyavula
- Director of Clinical Affairs & Education, Geistlich Pharma, Princeton, NJ
| | - Rami Elsabee
- Private practice, Philadelphia, Pa; and Clinical Associate, Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | | | - Wael F Isleem
- Post-Doctoral Resident Periodontal Prosthesis Program, Department of Periodontics, Periodontal Prosthesis Program, Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa; Private practice, Philadelphia, Pa
| | - Michael Bergler
- Director, Center for Virtual Treatment Planning, Faculty, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Frank C Setzer
- Assistant Professor, Director of Pre-Doctoral Endodontics Program, Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
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Bailey O, Shand B, Ellis I. Class II composite restoration technique teaching: A randomised controlled crossover laboratory-based trial involving a novel ringless sectional matrix technique. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:963-973. [PMID: 36539980 DOI: 10.1111/eje.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/11/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Objectives were to assess how different techniques (including a novel ringless sectional matrix approach) affect students' restorative outcomes, and their preferences for and preparedness to clinically implement new techniques with the aim of introducing appropriate techniques to the undergraduate curriculum. MATERIALS AND METHODS Students performed two class II composite restorations in plastic teeth using two sectional matrix techniques (separating ring vs. without [ringless]), and two composite restorative techniques (incremental vs. injection-moulded bulk-fill). Restorations were assessed on multiple parameters which were combined to rate them as "good" or not. Online surveys assessed students' preferences for and preparedness to clinically implement new techniques. RESULTS Contact area concavity (OR = 106, p < .001) and cervical marginal overhang (OR = 7.4, p < .001) were much more likely with the separating ring compared to the ringless sectional matrix technique. "Good" restorations were 29.5 times more likely when using ringless compared to separating ring techniques and 3.3 times more likely when using the injection-moulding bulk-fill compared to layered composite technique. A majority of students preferred the ringless to separating ring sectional matrix technique and the injection-moulding bulk-fill to layered composite technique. Large majorities felt prepared to implement the new techniques clinically with no or minimal guidance. CONCLUSIONS A classic sectional matrix technique with separating ring resulted in a much greater occurrence of contact area concavity and cervical marginal overhang than a novel ringless approach. When allied with student preferences and clinical preparedness, inclusion of the novel ringless approach in the undergraduate curriculum can be supported alongside bulk-fill injection-moulding techniques.
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Affiliation(s)
- Oliver Bailey
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Bonnie Shand
- Dental Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Ellis
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger R, Cadenaro M, Burgess J, Peschke A, Heintze SD, Kühnisch J. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin Oral Investig 2023; 27:2573-2592. [PMID: 36504246 PMCID: PMC10264483 DOI: 10.1007/s00784-022-04814-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use increased steadily, but several questions from users justified some clarification and improvement of the living document. MATERIALS AND METHODS An expert panel (N = 10) initiated the revision and consensus process that included a kick-off workshop and multiple online meetings by using the Delphi method. During and after each round of discussion, all opinions were collected, and the aggregated summary was presented to the experts aiming to adjust the wording of the criteria as precisely as possible. Finally, the expert panel agreed on the revision. RESULTS Some categories were redefined, ambiguities were cleared, and the descriptions of all scores were harmonized to cross-link different clinical situations with possible management strategies: reviewing/monitoring (score 1-4), refurbishment/reseal (score 3), repair (score 4), and replacement (score 5). Functional properties (domain F: fracture of material and retention, marginal adaptation, proximal contact, form and contour, occlusion and wear) were now placed at the beginning followed by biological (domain B: caries at restoration margin, hard tissue defects, postoperative hypersensitivity) and aesthetic characteristics (domain A: surface luster and texture, marginal staining, color match). CONCLUSION The most frequently used eleven categories of the FDI criteria set were revised for better understanding and handling. CLINICAL RELEVANCE The improved description and structuring of the criteria may help to standardize the evaluation of direct and indirect restorations and may enhance their acceptance by researchers, teachers, and dental practitioners.
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Affiliation(s)
- Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Sabine Mesinger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Niek Opdam
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Loomans
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Trieste, Italy and Children's Hospital "Burlo Garofolo," Institute for Maternal and Child Health, Trieste, Italy
| | - John Burgess
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Arnd Peschke
- IvoclarVivadent AG, Research & Development, Schaan, Liechtenstein
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
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Albelasy EH, Hamama HH, Chew HP, Montaser M, Mahmoud SH. Secondary caries and marginal adaptation of ion-releasing versus resin composite restorations: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2022; 12:19244. [PMID: 36357453 PMCID: PMC9649593 DOI: 10.1038/s41598-022-19622-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/31/2022] [Indexed: 11/12/2022] Open
Abstract
This systematic review was aimed to evaluate occurrence of secondary caries and marginal adaptation in ion-releasing materials versus resin composite. Electronic search of PubMed, Scopus, and Open Grey databases with no date or language restrictions until May 21st, 2021, was conducted. Randomized clinical trials that compared ion-releasing restorations versus resin composite were included. For quantitative analysis, a random-effects meta-analysis with risk difference as an effect measure and a 95% confidence interval was used. Quality of evidence was assessed using The Grading of Recommendations, Assessment, Development, and Evaluation criteria. The risk of bias was evaluated using the Cochran Collaboration Risk of Bias tool. The inclusion criteria were met by 22 studies, and 10 studies were included in the meta-analysis. Three follow-up periods (1 year, 18 months-2 years, and 3 years) were evaluated. The overall quality of evidence for secondary caries and marginal adaptation outcomes was low. The results of the meta-analysis showed no significant difference (p > 0.05) in both outcomes between ion-releasing materials and resin composite. The occurrence of secondary caries was not dependent on the nature of the restorative material. It is more likely a complex process that involves the same risk factors as primary carious lesions.
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Affiliation(s)
- Eman H. Albelasy
- grid.10251.370000000103426662Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia 35516 Egypt ,grid.17635.360000000419368657Research Visiting Scholar, Minnesota Dental Research Centre for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN 55455 USA
| | - Hamdi H. Hamama
- grid.10251.370000000103426662Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia 35516 Egypt ,grid.10251.370000000103426662Restorative Dentistry Department, Faculty of Dentistry, New-Mansoura University, New-Mansoura, Egypt
| | - Hooi Pin Chew
- grid.17635.360000000419368657Minnesota Dental Research Centre for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN 55455 USA
| | - Marmar Montaser
- grid.10251.370000000103426662Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia 35516 Egypt
| | - Salah H. Mahmoud
- grid.10251.370000000103426662Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria Street, Mansoura, Aldakhlia 35516 Egypt ,Conservative Dentistry Department, Faculty of Dentistry, Horus University, New-Damietta, Egypt
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Ozan G, Sancakli HS, Erdemir U, Yaman BC, Yildiz SO, Yildiz E. COMPARATIVE EVALUATION OF A FISSURE SEALANT AND A FLOWABLE COMPOSITE: A 36-MONTH SPLIT-MOUTH, RANDOMIZED CLINICAL STUDY. J Dent 2022; 123:104205. [PMID: 35724939 DOI: 10.1016/j.jdent.2022.104205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The purpose of the present clinical evaluation was to investigate the effect of a fissure sealant and a flowable composite at fissures of permanent molars in terms of retention and caries-incidence rates over a 36-month period. METHODS Thirty-four patients, ages varied from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were involved in the study. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. Teeth were sealed with either a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F)(n=110). Each restoration was evaluated in terms of retention and caries incidence at 6, 12, 24 and 36 months according to their location as well. Data were analyzed using Mann-Whitney U, Friedman and 1-way ANOVA tests at p < 0.05. RESULTS Tetric Evo Flow showed total retention with 95.5%, 93.8%, 88.5% and 80.2% at 6, 12, 24 and 36-month follow-ups respectively, while Helioseal F had retention rates of 95.5%, 94.8%, 85.4% and 80.2% respectively. After 36-months, there were 6 subjects totally lost in Helioseal F group, whereas 7 of the Tetric Evo Flow sunjects were totally lost. Caries development was firstly detected at 12-month evaluation for both of the materials however, no significant differences were observed among materials in retention rates or caries incidence after 36-month follow-ups (p>0.05). SIGNIFICANCE Using the flowable composite found as effective as the fissure sealant after 36-months regarding retention and caries incidence rates.
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Affiliation(s)
- Gunce Ozan
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry
| | - Hande Sar Sancakli
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry.
| | - Ugur Erdemir
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry
| | - Batu Can Yaman
- Osmangazi University Faculty of Dentistry Dept. of Restorative Dentistry
| | | | - Esra Yildiz
- Istanbul University Faculty of Dentistry Dept. of Restorative Dentistry
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Comparison of a resin-based sealant with a nano-filled flowable resin composite on sealing performance of marginal defects in resin composites restorations: a 36-months clinical evaluation. Clin Oral Investig 2022; 26:6087-6095. [PMID: 35608683 DOI: 10.1007/s00784-022-04557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Our goal was to evaluate the clinical behavior of resin-based composite (RBC) restorations with sealed marginal defects using nano-filled flowable RBCs (FRS) compared with resin-based sealant (RBS); this work used marginal adaptation, marginal staining, and secondary caries according to the World Dental Federation (FDI) criteria. MATERIALS AND METHODS This was a prospective, randomized, double-blind, controlled trial. Fifty-four patients who met the inclusion criteria (older than 18 years old; with high cariogenic risk determined by Cariogram software; and restorations with marginal defects, 3 and 4 according to FDI criteria) were randomly divided into three groups. There were three defective RBC restorations per patient and were repaired (n = 162). The groups were RBS-marginal sealing using a resin-based sealant (Clinpro Sealant, 3 M ESPE, MN, USA) plus adhesive (Single Bond Universal, 3 M ESPE, MN, USA); FRS-sealing using flowable resin (Filtek Flow Z350XT, 3 M ESPE, MN, USA) plus adhesive (Single Bond Universal, 3 M ESPE, MN, USA); and control-no repair treatment. All procedures were performed under complete isolation. Evaluations were evaluated at 1-week post treatment (baseline) as well as at 18 and 36 months after treatment regarding marginal adaptation, marginal staining, and secondary caries according to FDI criteria. The data were analyzed using the Wilcoxon test (α = 0.05) to compare the differences in each treatment group at different evaluation times. RESULTS Marginal adaptation of micro-repaired RBC restorations were seen in patients with a high risk of caries using flowable resin composite or resin-based sealants. There were differences (P < 0.001) when baseline was compared at 18 and 36 months. Marginal staining showed differences when baseline was compared to 18 months (P < 0.001) and 36 months (P = 0.001) for both treatments. Secondary caries parameters for RBS treatment showed differences when baseline was compared to 36 months (P = 0.025) and when 18 months was compared to 36 months (P = 0.046). CONCLUSIONS Micro-repair of RBC restorations resulted in clinical deterioration of marginal adaptation and marginal staining. Nano-filled flowable resin composites were sealed on defective restorations; 3 and 4 FDI marginal defects have better clinical performance to prevent secondary caries than resin-based sealants after 36 months. CLINICAL RELEVANCE Micro-repair with RBS does not seem to be an effective treatment to prevent secondary caries.
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Comparison of two clinical approaches based on visual criteria for secondary caries assessments and treatment decisions in permanent posterior teeth. BMC Oral Health 2022; 22:77. [PMID: 35300657 PMCID: PMC8931988 DOI: 10.1186/s12903-022-02112-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/10/2022] [Indexed: 12/14/2022] Open
Abstract
Background This cross-sectional study aimed to compare two clinical approaches based on visual criteria for secondary caries assessments and treatment decisions in permanent posterior teeth. Methods The two clinical visual criteria tested for the assessments of restored teeth were: FDI criteria—based on the caries presence, marginal adaptation and staining criteria, adapted from the FDI (International Dental Federation) criteria and CARS criteria—"Caries Associated with Restorations or Sealants" (CARS) criteria described by the International Caries Classification and Management System. Adults were randomized according to the criteria. One calibrated examiner assessed the restorations and assigned the treatment according to the criteria. The primary outcome was replacement indication. Results A total of 185 patients were included, totalling 718 restorations. The strongest correlation founded between the methods was for the presence of caries lesions (Rho = 0.829). A moderate correlation (Rho = 0.420) was founded between the treatment decisions proposed by the CARS and by the FDI criteria. The multilevel regression analysis showed that the FDI criteria indicated five times more replacements when compared to the CARS (< 0.001). Also, using the FDI criteria restorations were 2.7 times more related to caries around restorations (p < 0.001) compared to the other criterion. Conclusions The visual criteria used on the restoration's assessment directly influences the treatment decision to intervene or not on the restoration. The use of a minimally invasive based approach for assessing secondary caries may prevent overtreatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02112-6.
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Rechmann P, Le CQ, Chaffee BW, Rechmann BMT. Demineralization prevention with a new antibacterial restorative composite containing QASi nanoparticles: an in situ study. Clin Oral Investig 2021; 25:5293-5305. [PMID: 33608748 PMCID: PMC7895509 DOI: 10.1007/s00784-021-03837-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 02/09/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate whether a newly developed dental composite with quaternary ammonium silica dioxide (QASi) nanoparticles incorporated with other fillers into the restorative material demonstrates antibacterial activity by reducing enamel demineralization in an in situ gap model. MATERIALS AND METHODS Twenty subjects wearing a lower removable partial denture (RPD) with acrylic flanges on both sides of the mouth were recruited into the 4-week in situ study. The gap model consisted of an enamel slab placed next to a composite, separated by a 38-μm space. In the split-mouth design on one side of the RPD, the composite was the Nobio Infinix composite (Nobio Ltd., Kadima, Israel), and the contralateral side used a control composite. Each participant received enamel slabs from one tooth. The gap model was recessed into the RPD buccal flange, allowing microbial plaque to accumulate within the gap. After 4 weeks of continuous wearing, decalcification (∆Z mineral loss) of the enamel slabs adjacent to the gap was determined by cross-sectional microhardness testing in the laboratory. RESULTS The ∆Z for the antibacterial composite test side was 235±354 (mean±standard deviation [SD]; data reported from 17 participants) and statistically significantly lower compared to ∆Z of the control side (774±556; mean±SD) (paired t-test, P<0.0001; mean of test minus control -539 (SD=392), 95% confidence interval of difference: -741, -338). CONCLUSIONS This in situ clinical study showed that composites with QASi antibacterial particles significantly reduced demineralization in enamel adjacent to a 38-μm gap over a 4-week period in comparison to a conventional composite. CLINICAL RELEVANCE Composites with QASi nanoparticle technology have the potential to reduce the occurrence of secondary caries. TRIAL REGISTRATION ClinicalTrials.gov #NCT04059250.
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Affiliation(s)
- Peter Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Charles Q Le
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Benjamin W Chaffee
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Beate M T Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA
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Tosco V, Vitiello F, Furlani M, Gatto ML, Monterubbianesi R, Giuliani A, Orsini G, Putignano A. Microleakage Analysis of Different Bulk-Filling Techniques for Class II Restorations: µ-CT, SEM and EDS Evaluations. MATERIALS (BASEL, SWITZERLAND) 2020; 14:E31. [PMID: 33374708 PMCID: PMC7793523 DOI: 10.3390/ma14010031] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/29/2022]
Abstract
This study aimed to compare two different bulk-filling techniques, evaluating the internal and external adaptation of class II resin-composite restorations, by analysing the gap formation using microcomputed tomography (µ-CT) and scanning electronic microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Two standardized mesio/disto-occlusal (MO/DO) cavities were prepared in eight extracted human third molars that were divided, according to the filling technique used, in the following two groups (n = 4): BG (Bulk&Go group) and BT (Bulk Traditional group). After universal bonding application, followed by the light curing, all teeth were restored using a bulk-fill composite. Specimens were scanned with µ-CT to evaluate 3D interfacial gaps. Acquired µ-CT data were analysed to quantify the gap formation. Complementary information to the µ-CT analysis were obtained by SEM. Thereafter, the chemical composition of tooth-restoration interface was analysed using EDS. The µ-CT analysis revealed gaps formation at the tooth-restoration interface for both the BG and BT groups, while within the restoration, only in the BT group there was evidence of microleakage formation. The scanning electron micrographs of both groups showed that the external marginal integrity of the restoration was preserved, while EDS showed the three different structures (tooth surface, adhesive layer and resin composite) of the tooth-restoration interface, highlighting the absence of gap formation. In both BG and BT, the two filling techniques did not show significant differences regarding the internal and external marginal adaptation of the restoration. To achieve a successful restoration, the clinician could be advised to restore a class II cavity using a single increment bulk-filling technique (BG), thus treating it as a class I cavity.
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Affiliation(s)
- Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Michele Furlani
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Maria Laura Gatto
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU), Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Alessandra Giuliani
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
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Sampaio CS, Garcés GA, Kolakarnprasert N, Atria PJ, Giannini M, Hirata R. External Marginal Gap Evaluation of Different Resin-filling Techniques for Class II Restorations-A Micro-CT and SEM Analysis. Oper Dent 2020; 45:E167-E175. [PMID: 32216725 DOI: 10.2341/19-053-l] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2019] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Secondary caries are the main reason for the failure of restorations, class II being the most affected. Techniques that promote less gap percentage are important. Flowable bulk fill composites used at such locations have been shown to decrease gap formation while being a faster procedure than an incremental technique. SUMMARY
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Balbinot GS, Leitune VCB, Ogliari FA, Collares FM. Niobium silicate particles promote in vitro mineral deposition on dental adhesive resins. J Dent 2020; 101:103449. [PMID: 32777240 DOI: 10.1016/j.jdent.2020.103449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aims to analyze the addition of niobium silicate particles to dental adhesive resins and evaluate its physicomechanical and biological properties. METHODS The SiNb particles were produced by the sol-gel route and presented a mean particle size of 2.1 μm and a specific surface area of 616,96m2/g. An experimental adhesive resin was formulated with 66 wt% Bisphenol A-Glycidyl Methacrylate and 33 wt% Hydroxyethyl methacrylate with diphenyl(2,4,6-trimethyl benzoyl)phosphine oxide as the photoinitiator. The SiNb particles were incorporated into the adhesive resins in 1 wt% (SiNb1%) and 2 wt% (SiNb2%) concentration. A control group (SiNb0%) without the addition of particles was used. The developed adhesives were evaluated by their polymerization kinetics, refractive index, softening in solvent, cytotoxicity, mineral deposition, ultimate tensile strength, and micro shear bond strength. RESULTS The refractive index range was increased by the addition of niobium silicate particles. No statistically significant difference was found between groups in the degree of conversion,.softening in solvent analysis, cytotoxicity and ultimate tensile strength. The deposition of minerals increased after immersion of specimens in SBF after 14 days on the SiNb2%. The SiNb2% group showed high micro shear bond strength values, reaching 33.87 MPa. CONCLUSION In the present study, the addition of 2 wt% of niobium silicate into dental adhesive resins promoted the mineral deposition with increased bond strength without affecting other material properties. CLINICAL SIGNIFICANCE Bioactive fillers must maintain the physical-chemical properties of dental adhesives, guaranteeing their clinical performance. Niobium silicate particles could promote the remineralization of dentin hard tissues without compromising the physico-mechanical properties on these materials.
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Affiliation(s)
- G S Balbinot
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - V C B Leitune
- Yller Biomaterials SA- Straumann Group, Pelotas, RS, Brazil.
| | - F A Ogliari
- Yller Biomaterials SA- Straumann Group, Pelotas, RS, Brazil.
| | - F M Collares
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Askar H, Krois J, Göstemeyer G, Bottenberg P, Zero D, Banerjee A, Schwendicke F. Secondary caries: what is it, and how it can be controlled, detected, and managed? Clin Oral Investig 2020; 24:1869-1876. [PMID: 32300980 DOI: 10.1007/s00784-020-03268-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess how to control, detect, and treat secondary caries. This review serves to inform a joint ORCA/EFCD consensus process. METHODS Systematic and non-systematic reviews were performed or consulted and narratively synthesized. RESULTS Secondary (or recurrent) caries is defined as a lesion associated with restorations or sealants. While the restorative material itself has some influence on secondary caries, further factors like the presence and size of restoration gaps, patients' caries risk, and the placing dentist's experience seem more relevant. Current detection methods for secondary caries are only sparsely validated and likely prone for the risk of over-detection. In many patients, it might be prudent to prioritize specific detection methods to avoid invasive overtreatment. Detected secondary caries can be managed either by repair of the defective part of the restoration or its complete replacement. CONCLUSIONS There is sparse data towards the nature of secondary caries and how to control, detect, and treat it. CLINICAL SIGNIFICANCE Despite often claimed to be a major complication of restorations, there is surprisingly little data on secondary caries. Longer-term studies may be needed to identify differences in secondary caries risk between materials and to identify characteristic features of progressive lesions (i.e., those in need of treatment).
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Affiliation(s)
- Haitham Askar
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Peter Bottenberg
- Oral Health Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Domenick Zero
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University, School of Dentistry, Indianapolis, IN, USA
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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Hollanders ACC, Kuper NK, Huysmans MCDNJM, Versluis A. The effect of occlusal loading on cervical gap deformation: A 3D finite element analysis. Dent Mater 2020; 36:681-686. [PMID: 32238272 DOI: 10.1016/j.dental.2020.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/24/2020] [Accepted: 03/12/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Secondary caries can be accelerated by hydrodynamic flow in a gap between the tooth and restorative material. This study investigated whether occlusal loading can lead to increased hydrodynamic flow by deforming a gap between tooth and restorative material. METHODS 3D finite element analysis was employed to model a molar containing a restoration with an interfacial gap. The model was loaded using direct cusp-to-restoration contact and using a rubber tube model simulating a food bolus. The object exerting pressure was moved across the molar from buccal to lingual side. The applied forces were 50, 100, 200 and 400N. The elastic modulus of the restoration material was varied between 5, 10, 15.9 and 25GPa to resemble different kinds of composite. The primary outcome parameter was the volume of the gap under occlusal pressure. RESULTS Occlusal loading resulted in deformation of the gap area. Maximum deformation was seen when loading was applied in the middle of the restoration. Higher forces and lower restoration stiffness led to more deformation of the gap. Maximum deformation with a force of 100N and composite modulus of 15.9GPa was -0.0083mm3 (1.12%). SIGNIFICANCE Deformation of the gap between tooth and restorative material could lead to increased hydrodynamic flow and faster secondary caries lesion formation. The measured deformation is small. Further research needs to show whether gap compression through occlusal loading affects secondary caries formation to a clinically relevant degree.
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Affiliation(s)
- A C C Hollanders
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
| | - N K Kuper
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
| | - M C D N J M Huysmans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
| | - A Versluis
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, 38163 Memphis, TN, USA.
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The Organic Matrix of Restorative Composites and Adhesives. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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Dennison JB, Yaman P, Fasbinder DJ, Herrero AA. Repair or Observation of Resin Margin Defects: Clinical Trial After Five Years. Oper Dent 2019; 44:355-364. [PMID: 31216247 DOI: 10.2341/17-232-c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the effectiveness of repair/resealing of stained composite margins as an alternative to controlled observation without treatment in a randomized clinical trial after five years. METHODS AND MATERIALS Each patient recruited had from one to three composite restorations with visible margin discoloration. Initially, the characteristics of each defect were recorded with direct vision through a surgical microscope at 20× magnification. Clinical evaluation was done by two independent examiners using modified USPHS criteria for color, margin discoloration, and margin adaptation. Each restoration was then randomly assigned to a control or treatment group. Control restorations were observed yearly for the presence of recurrent caries; treatment restorations were resealed by exposing the margin with a ¼ round bur, removing all interfacial stain, acid etching, placing an adhesive bonding agent, and a flowable composite to restore margin integrity. There were 152 patients recruited, with 360 restorations (180 control and 180 treatment). RESULTS At five years, 104 patients were recalled (68%) with 271 restorations (76%): 136 untreated control and 135 resealed restorations. At that time, 61 restorations had been lost or replaced for nonrelated reasons. Clinical evaluation of the remaining 210 restorations determined penetrating discoloration (control = 81%, resealed = 46%) and margin crevice formation (control = 21%, resealed = 11%). Recurrent caries was diagnosed cumulatively in only six control and five treatment restorations (<5%). Microscopically, 49 control restorations (49%) and 36 resealed restorations (33%) had crevice formation. Discoloration was distributed as follows: 9% vs 47% with no discoloration, 30% vs 33% in the composite, 49% vs 18% in the interface, and 12% vs 2% in tooth structure. CONCLUSIONS Resealing of restorations with margin discoloration reduced the occurrence of penetrating stain from 81% in controls to 46% in resealed margins and crevicing from 21% to 11% after five years. Both controlled observation and resealing of margins resulted in a similar very low incidence (<6%) of recurrent caries.
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Hetrodt F, Lausch J, Meyer-Lueckel H, Conrads G, Apel C. Evaluation of Restorative Materials Containing Preventive Additives in a Secondary Caries Model in vitro. Caries Res 2019; 53:447-456. [DOI: 10.1159/000496401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/19/2018] [Indexed: 11/19/2022] Open
Abstract
The incorporation of antibacterial agents into dental restorative materials is a promising strategy for secondary caries prevention. Previously, Carolacton affected Streptococcus mutans biofilm formation on composite materials in vitro. The present study evaluated secondary caries formation adjacent to Carolacton-containing composites and conventional restorative materials using an artificial biofilm model. Standardized cavities were prepared in bovine dentin-enamel samples (n = 175) and restored with various dental materials (Tetric EvoCeram [T], GrandioSo composite without [G] and with Carolacton [GC], Grandio Flow without [F] and with Carolacton [FC], GrandioSo containing sodium fluoride [GNaF], and Ketac Fil [K]). After artificial aging, S. mutans was grown on the samples for 7 days. The investigation of gap sizes and secondary caries formation was performed using confocal laser scanning microscopy and transversal microradiography. Median gap size in enamel was 9.4 µm (interquartile range 7.9–12.7). Compared to all other groups significant differences in gap sizes could be observed for Ketac Fil (p < 0.001; Mann-Whitney test). Only GrandioSo composite containing 30% sodium fluoride and Ketac Fil showed significantly smaller lesion areas in enamel (p < 0.001; Mann-Whitney test) than all other groups which was confirmed by the mineral loss data (p < 0.001; Mann-Whitney test). Based on the present in vitro results, it seems that Carolacton-containing composite in the current formulation within the shown simplified monoculture biofilm model is not able to prevent caries formation compared to fluoride-releasing restorative materials.
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DEGRAZIA FW, ALTMANN ASP, FERREIRA CJ, ARTHUR RA, LEITUNE VCB, SAMUEL SMW, COLLARES FM. Evaluation of an antibacterial orthodontic adhesive incorporated with niobium-based bioglass: an in situ study. Braz Oral Res 2019; 33:e010. [DOI: 10.1590/1807-3107bor-2019.vol33.0010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/09/2019] [Indexed: 11/22/2022] Open
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Maske TT, Hollanders ACC, Kuper NK, Bronkhorst EM, Cenci MS, Huysmans MCDNJM. A threshold gap size for in situ secondary caries lesion development. J Dent 2018; 80:36-40. [PMID: 30395875 DOI: 10.1016/j.jdent.2018.10.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES This study investigated the influence of very small gaps in secondary caries (SC) development and additionally linked the threshold gap size with the caries activity level from volunteers. METHODS For 21 days, 15 volunteers wore a modified occlusal splint loaded with dentin-composite samples restored with different interfaces: bonded (B = samples restored with complete adhesive procedure), no-bonded (NB = restored with composite resin without adhesive procedure), and 30, 60 and 90 μm (no adhesive procedure and with intentional gap). The splint was dipped in a 20% sucrose solution (10 min) 8 x per day. Samples were imaged with transversal wavelength independent microradiography (T-WIM) and lesion depth and mineral loss were calculated. Average wall lesion depth from each volunteer was determined and according to the values the volunteers were grouped as high, mid and low caries activity levels. RESULTS No wall lesion formation was observed in B and NB groups. In general, intentional gaps led to SC lesion depth progression independent of caries activity level of volunteers. No substantial wall lesions were found for two volunteers. A trend for deeper lesion in larger gaps was observed for the high activity group. CONCLUSION Very small gaps around or wider than 30 μm develop SC independent of the caries activity level of the patient and SC wall lesion progression seemed to be related to individual factors even in this standardized in situ model. SIGNIFICANCE Independently of caries activity level of the patient, the threshold gap size for secondary caries wall lesion seems to be 30 μm at most.
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Affiliation(s)
- T T Maske
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands.
| | - A C C Hollanders
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - N K Kuper
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - E M Bronkhorst
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - M S Cenci
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - M C D N J M Huysmans
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
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Huang B, Cvitkovitch DG, Santerre JP, Finer Y. Biodegradation of resin–dentin interfaces is dependent on the restorative material, mode of adhesion, esterase or MMP inhibition. Dent Mater 2018; 34:1253-1262. [DOI: 10.1016/j.dental.2018.05.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 04/02/2018] [Accepted: 05/08/2018] [Indexed: 10/16/2022]
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Kruzic JJ, Arsecularatne JA, Tanaka CB, Hoffman MJ, Cesar PF. Recent advances in understanding the fatigue and wear behavior of dental composites and ceramics. J Mech Behav Biomed Mater 2018; 88:504-533. [PMID: 30223214 DOI: 10.1016/j.jmbbm.2018.08.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 12/30/2022]
Abstract
Dental composite and ceramic restorative materials are designed to closely mimic the aesthetics and function of natural tooth tissue, and their longevity in the oral environment depends to a large degree on their fatigue and wear properties. The purpose of this review is to highlight some recent advances in our understanding of fatigue and wear mechanisms, and how they contribute to restoration failures in the complex oral environment. Overall, fatigue and wear processes are found to be closely related, with wear of dental ceramic occlusal surfaces providing initiation sites for fatigue failures, and subsurface fatigue crack propagation driving key wear mechanisms for composites, ceramics, and enamel. Furthermore, both fatigue and wear of composite restorations may be important in enabling secondary caries formation, which is the leading cause of composite restoration failures. Overall, developing a mechanistic description of fatigue, wear, and secondary caries formation, along with understanding the interconnectivity of all three processes, are together seen as essential keys to successfully using in vitro studies to predict in vivo outcomes and develop improved dental restorative materials.
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Affiliation(s)
- Jamie J Kruzic
- School of Mechanical and Manufacturing Engineering, UNSW Sydney, Sydney, NSW 2052, Australia.
| | | | - Carina B Tanaka
- School of Mechanical and Manufacturing Engineering, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Mark J Hoffman
- School of Mechanical and Manufacturing Engineering, UNSW Sydney, Sydney, NSW 2052, Australia; School of Materials Science and Engineering, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Paulo F Cesar
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Faria-E-Silva AL, Dos Santos A, Tang A, Girotto EM, Pfeifer CS. Effect of thiourethane filler surface functionalization on stress, conversion and mechanical properties of restorative dental composites. Dent Mater 2018; 34:1351-1358. [PMID: 29934126 DOI: 10.1016/j.dental.2018.06.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/12/2018] [Accepted: 06/07/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study evaluated the efficacy of a thiourethane(TU)-modified silane agent in improving properties in filled composites. METHODS The TU-silane agent was synthesized by combining 1,3-bis(1-isocyanato-1-methylethyl)benzene and 3-(triethoxysilyl)propyl isocyanate with trimethylol-tris-3-mercaptopropionate (TMP), at 1:2 isocyanate:thiol, leaving pendant thiol and alkoxy silane groups. Barium glass fillers (1μm average particle size) were functionalized with 5wt% TU-silane in an acidic ethanol solution. Commercially available 3-(trimethoxysilyl)propyl methacrylate (MA-silane) and (3-mercaptopropyl)trimethoxysilane (SH-silane), as well as no silane treatment (NO-silane), were used as controls. Composites were made with BisGMA-UDMA-TEGDMA (5:3:2), camphorquinone/ethyl-4-dimethylaminobenzoate (0.2/0.8wt%) and di-tert-butyl hydroxytoluene (0.3wt%) and 70wt% silanated inorganic fillers. Polymerization stress (PS) was measured using a cantilever beam apparatus (Bioman). Methacrylate conversion (DC) and rate of polymerization (RP) during photoactivation (800mW/cm2) were followed in real-time with near-IR. Flexural strength/modulus (FS/FM) were evaluated in three-point bending with 2×2×25 mm. STATISTICAL ANALYSIS 2-way ANOVA/Tukey's test (α=5%). RESULTS DC, Rpmax and E were similar for all groups tested. FS was similar for the TU- and MA-silane, which were statistically higher than the untreated and SH-silane groups. Stress reductions in relation to the MA-silane were observed for all groups, but statistically more markedly for the TU-silane material. This is likely due to stress relaxation and/or toughening provided at the filler interface by the oligomeric TU structure. SIGNIFICANCE TU-silane oligomers favorably modified conventional dimethacrylate networks with minimal disruption to existing curing chemistry, in filled composites. For the same conversion values, stress reductions of up to 50% were observed, without compromise to mechanical properties or handling characteristics.
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Affiliation(s)
- André L Faria-E-Silva
- Department of Dentistry, Federal University of Sergipe, Rua Claudio Batista s/n, Bairro Sanatório, Aracaju, SE, 49060-100, Brazil.
| | - Andressa Dos Santos
- Graduate Program in Chemistry, State University of Maringa, Av. Colombo 5790, Jardim Universitário, Maringá, PR, 87020-900, Brazil.
| | - Angela Tang
- Phillips Academy, 180 Main St., Andover, MA, USA.
| | - Emerson M Girotto
- Department of Chemistry, State University of Maringa, Av. Colombo 5790, Jardim Universitário, Maringá, PR, 87020-900, Brazil.
| | - Carmem S Pfeifer
- Department of Restorative Dentistry, Division of Biomaterials and Biomechanics, Oregon Health & Science University, 2730 SW Moody Ave, 97201, Portland, OR, USA.
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Hollanders ACC, Kuper NK, Maske TT, Huysmans MCDNJM. Secondary Caries in situ Models: A Systematic Review. Caries Res 2018; 52:454-462. [PMID: 29621757 DOI: 10.1159/000487200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/22/2018] [Indexed: 11/19/2022] Open
Abstract
In situ caries research serves as a bridge between clinical research and laboratory studies. In this kind of research, volunteers wear a removable intraoral splint or prosthesis containing research samples. Many different in situ models exist to investigate secondary caries. This systematic review compared currently existing secondary caries models and their lesion progression per day values. MATERIALS AND METHODS Three databases (Medline, Embase, and Cochrane) were searched for relevant literature. Bias risk was assessed and model parameters and caries-related outcomes were extracted by 2 independent researchers. Where possible, caries-related outcomes were normalized by estimating lesion progression per day by dividing lesion depth extracted from microradiographic or microhardness data by the number of days the study lasted. RESULTS The literature search identified 335 articles. After eliminating duplicates and selection, 31 articles were included. The models differed greatly on factors such as sample location, presence of fluoride in the model, and analysis methods. Three main groups could be identified by sample placement; 68% of models placed samples palatally in the upper jaw, and the lower jaw model could be divided into the buccal (26%) and approximal (6%) areas. Average lesion progression in enamel next to composite was 4.3 ± 2.8 µm (range1.1-8.8 µm/day). DISCUSSION Studies conducted with palatal models showed caries progression rates 2-5 times higher than the estimated clinical progression rates. Lesion progression per day could be a useful tool for future comparison of models and establishing a standardized model.
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Affiliation(s)
- Audrey C C Hollanders
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the
| | - Nicolien K Kuper
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tamires T Maske
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Hetrodt F, Lausch J, Meyer-Lueckel H, Apel C, Conrads G. Natural saliva as an adjuvant in a secondary caries model based on Streptococcus mutans. Arch Oral Biol 2018; 90:138-143. [PMID: 29614462 DOI: 10.1016/j.archoralbio.2018.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/21/2018] [Accepted: 03/23/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Two factors for secondary caries formation were evaluated using an artificial biofilm model, saliva as additive in culture medium and bonding procedures of composite materials for artificial gap creation. DESIGN Standardized cavities were prepared in bovine tooth samples (n = 44), treated with two different bonding pretreatments, restored and after artificial ageing incubated with Streptococcus mutans in a Mueller-Hinton-Broth-Sugar medium with or without human saliva for seven days. Secondary caries formation was analyzed using confocal laser scanning microscopy and transversal microradiography. RESULTS Lesions were significantly pronounced in groups using saliva, but were not influenced by the bonding pretreatments. CONCLUSIONS The results indicate that the addition of saliva, but not the type of bonding procedure influences the outcome in the present biofilm-based secondary caries model.
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Affiliation(s)
- Franziska Hetrodt
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Julian Lausch
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Hendrik Meyer-Lueckel
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Christian Apel
- Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, Helmholtz Institute of RWTH Aachen University & Hospital, Pauwelsstraße 20, 52074, Aachen, Germany.
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
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Maske TT, Kuper NK, Hollanders ACC, Bronkhorst EM, Cenci MS, Huysmans MCDNJM. Secondary caries development and the role of a matrix metalloproteinase inhibitor: A clinical in situ study. J Dent 2018; 71:49-53. [PMID: 29391181 DOI: 10.1016/j.jdent.2018.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/06/2018] [Accepted: 01/26/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES This in situ study aimed to investigate whether the dentin treatment with MMPs inhibitor (CHX 2%) could influence the development of secondary caries wall lesions in different dentin-composite interfaces. MATERIAL AND METHODS For 21 days, 15 volunteers wore a modified-occlusal splint loaded with dentin-composite samples treated or not with CHX and restored according 4 different interface conditions: Bonding (B = samples restored with complete adhesive procedure), no bonding (NB = restored with composite resin without adhesive procedure), 100 μm (no adhesive procedure and with intentional gap) and 100 μm + B (adhesive material on composite side and intentional gap). Eight times per day, the splint with samples was dipped in a 20% sucrose solution for 10 min. Before and after caries development, samples were imaged with T-WIM and lesion depth (LD) and mineral loss (ML) were calculated. RESULTS Linear mixed effect analysis showed that dentin treatment with CHX did not significantly affect the caries lesion progression (LD and ML; p ≤ 0.797). Dentin wall lesions were observed in the 100 μm and 100 μm + B groups independently of MMP inhibitor treatment. CONCLUSION The treatment of dentin with MMP inhibitor was not able to slow down the secondary caries wall lesion development in this in situ study. SIGNIFICANCE The dentin treatment with 2% CHX did not prevent secondary caries wall lesion initiation.
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Affiliation(s)
- T T Maske
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands.
| | - N K Kuper
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - A C C Hollanders
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - E M Bronkhorst
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - M S Cenci
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - M C D N J M Huysmans
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
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Ranjkesh B, Ding M, Dalstra M, Nyengaard JR, Chevallier J, Isidor F, Løvschall H. Calcium phosphate precipitation in experimental gaps between fluoride-containing fast-setting calcium silicate cement and dentin. Eur J Oral Sci 2018; 126:118-125. [PMID: 29334137 DOI: 10.1111/eos.12399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A novel fast-setting calcium silicate cement containing fluoride (novel-CSC) has been developed for applications in tooth crowns. The aim of this study was to assess the ability of the novel-CSC to close the experimental gaps at the dentin-cement interface. The novel-CSC was tested against Vitrebond and GC Fuji II LC. Experimental gaps of 50 or 300 μm width were created between the materials and dentin. Specimens with the 300-μm-wide gap were immersed in phosphate-buffered saline and the closed gap area was measured during 96 h. All specimens with 50 or 300 μm gap width were analyzed by scanning electron microscopy equipped with energy dispersive X-ray spectroscopy (SEM/EDX) to assess the morphology and chemical composition of the precipitates after 96 h immersion in phosphate-buffered saline. High-resolution micro-computed tomography (μCT) was used to evaluate the integrity and continuity of the precipitiates after 96 h and 180 d. In all novel-CSC samples, precipitates closed the gap area completely after 96 h. The SEM/EDX revealed that the globular precipitates closing the gap area were mainly composed of calcium and phosphorus. After 180 d, μCT indicated thicker precipitates compared with initial precipitates only in the novel-CSC group, whereas no precipitates were observed in resin-modified glass ionomers. Novel-CSC promoted continuous precipitation of calcium phosphate, including apatite, and closed the experimental gaps.
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Affiliation(s)
- Bahram Ranjkesh
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ming Ding
- Department of Orthopedic Surgery & Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Michel Dalstra
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory Centre for Stochastic Geometry and Advanced Bioimaging, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Flemming Isidor
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Henrik Løvschall
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Estay J, Martín J, Viera V, Valdivieso J, Bersezio C, Vildosola P, Mjor IA, Andrade MF, Moraes RR, Moncada G, Gordan VV, Fernández E. 12 Years of Repair of Amalgam and Composite Resins: A Clinical Study. Oper Dent 2017; 43:12-21. [PMID: 28976841 DOI: 10.2341/16-313-c] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this study was to clinically evaluate repaired posterior amalgam and composite restorations over a 12 year period, investigate the influence of repair in the survival of restorations, and compare their behavior with respect to controls. METHODS Thirty-four patients, 18 to 80 years of age with 167 restorations, 67 composite resin (RC), and 100 amalgam (AM) restorations, participated. Restorations with localized, marginal, anatomical deficiencies and/or secondary caries, and "clinically judged" suitable for repair or replacement according to US Public Health Service (USPHS) criteria, were randomly assigned to four groups: repair (n=35, 20 AM, 15 RC), replacement (n=43, 21 AM, 22 RC), positive control (n=71, 49 AM, 22 RC), or negative control (n=18, 10 AM, 8 RC). The quality of the restorations was blind scored according to the modified USPHS criteria. Two examiners scored them at initial status (κ=0.74) and after one to five, 10, and 12 years (κ=0.88). Wilcoxon and Mann-Whitney tests provided for comparisons within the same group and between years, respectively. RESULTS After 12 years, all groups behaved similarly in marginal adaptation, marginal stain, teeth sensitivity, anatomic form, and luster ( p≥0.05). Better behavior in roughness was observed in replaced RC ( p=0.049). CONCLUSIONS Given that most clinical parameters investigated were similar between all groups during the follow-up, the repair of RC and AM restorations is a good clinical option because it is minimally invasive and can consistently increase the longevity of restorations.
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Maske TT, Kuper NK, Cenci MS, Huysmans MCD. Minimal Gap Size and Dentin Wall Lesion Development Next to Resin Composite in a Microcosm Biofilm Model. Caries Res 2017; 51:475-481. [DOI: 10.1159/000478536] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 06/09/2017] [Indexed: 11/19/2022] Open
Abstract
This in vitro study investigated the development of dentin wall lesions next to resin composite containing very small gap sizes using an in vitro biofilm model, and evaluated whether a relevant threshold for the gap size could be established. Microcosm biofilms were grown for 14 days within small interfacial gaps between dentin-resin composite discs under intermittent cariogenic challenge. The factor under study was gap size: samples were either restored with composite resin without adhesive procedure (no intentional gap; no bonding [NB] group) or with intentional gaps of 30, 60, or 90 µm, or with complete adhesive procedure (no gap; bonding [B] group). Secondary caries wall lesion progression was measured in lesion depth (LD) and mineral loss (ML) using transversal wavelength independent microradiography at 3 locations: outer surface lesion and wall lesions at 200 and 500 µm distance from gap entrance. Results from linear regression analysis showed that the presence of an intentional gap (30, 60, and 90 µm) affected the secondary caries progression at 200 µm from the gap entrance (p ≤ 0.013). The NB group did not show significant wall lesion development (ML and LD, p ≥ 0.529). At 500 µm distance almost no wall caries development was observed. In conclusion, dentin wall lesions developed in minimal gap sizes, and the threshold for secondary wall lesion development was a gap of around 30 µm in this microcosm biofilm model.
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Demarco FF, Collares K, Correa MB, Cenci MS, Moraes RRD, Opdam NJ. Should my composite restorations last forever? Why are they failing? Braz Oral Res 2017; 31:e56. [PMID: 28902236 DOI: 10.1590/1807-3107bor-2017.vol31.0056] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/22/2017] [Indexed: 11/22/2022] Open
Abstract
Composites resins have become the first choice for direct anterior and posterior restorations. The great popularity is related to their esthetic appearance and reduced need of sound tissue removal as compared with former treatments. Several studies have demonstrated that composite restorations may last long in clinical service. In this review we discuss the factors playing a role on the long-term longevity. Composite restorations have demonstrated a good clinical performance with annual failure rates varying from 1% to 3% in posterior teeth and 1% to 5% in anterior teeth. Factors related to the patients such as caries risk and occlusal stress risk, in addition to socioeconomic factors, may affect the survival significantly. Characteristics of the clinical operators, particularly their decision making when it comes to observing or approaching an existing restoration, are decisive for longevity. Cavity features such as the number of restored walls, composite volume, and presence of endodontic treatment are of major importance and may dictate the service time of the restorative approach. The choice of restorative composite seems to have a minor effect on longevity provided that appropriate technical procedures are used. The main reasons for failure in posterior teeth are secondary caries and fracture (restoration or tooth/restoration), while in anterior teeth esthetic concerns are the main reasons leading to restoration failures. Composite resin restorations can be considered a reliable treatment as long as both the professional and the patient are aware of the factors involved in restoration failures.
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Affiliation(s)
- Flávio Fernando Demarco
- Universidade Federal de Pelotas - Unipel, School of Dentistry, Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Kauê Collares
- Universidade Federal de Pelotas - Unipel, School of Dentistry, Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Marcos Britto Correa
- Universidade Federal de Pelotas - Unipel, School of Dentistry, Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Maximiliano Sergio Cenci
- Universidade Federal de Pelotas - Unipel, School of Dentistry, Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Rafael Ratto de Moraes
- Universidade Federal de Pelotas - Unipel, School of Dentistry, Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Niek Johannes Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
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Kasraei S, Shokri A, Poorolajal J, Khajeh S, Rahmani H. Comparison of Cone-Beam Computed Tomography and Intraoral Radiography in Detection of Recurrent Caries under Composite Restorations. Braz Dent J 2017; 28:85-91. [DOI: 10.1590/0103-6440201701248] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/17/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract Secondary caries is the most common cause of dental restoration failures. This study aimed to compare the diagnostic accuracy of conventional and digital intraoral radiography and cone beam computed tomography (CBCT) for detection of recurrent caries around composite restorations. mesio-occluso-distal (MOD) cavities were prepared using bur on 45 extracted sound human molar teeth. The teeth were divided into 3 groups. In the control group, cavities were restored with composite resin after etching and bonding (n=15). In Group 2, 500-μm thick wax was placed over the buccal, lingual and gingival walls and the cavities were restored with composite resin. Group 3 specimens were subjected to pH cycling and artificial caries were created on the buccal, lingual and gingival walls. The cavities were restored with composite. Conventional and digital photo-stimulable phosphor (PSP; Optime) radiographs and two CBCTs images (NewTom 3G and Cranex 3D) were obtained from them. Presence or absence of caries in the cavity walls was assessed on these images. Data were analyzed using Kappa statistic. The diagnostic accuracy of CBCT was significantly higher than that of digital and conventional intraoral radiography (p<0.05). The accuracy was 0.83, 0.78, 0.55 and 0.49 for CBCT Cranex 3D, CBCT NewTom 3G, conventional and digital intraoral radiography, respectively. CBCT has a higher diagnostic accuracy than digital and conventional intraoral radiography for detection of secondary caries around composite restorations.
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Abstract
The main reason cited for the replacement of dental composite restorations is the recurrence of caries. Numerous models-both in vitro, with acid gels or bacterial biofilms, and in situ, with dental appliances-have been used to study caries formation around dental composites. The literature shows that many factors may affect caries formation, including marginal gap formation, gap size, the local chemical environment, the durability of the bonded interface, the extent of bacterial penetration, and the presence of mechanical loading. Studies have also shown that what have been called wall lesions may form independent of surface lesions, though not likely due to microleakage through very small gap spaces in the clinical situation. Gap size and mechanical loading have been shown to be related to lesion severity within in vitro models, but these results do not correspond exactly with those obtained from in situ studies using restorations in dental appliances. Though not conclusive, some in vitro models have shown that certain materials possessing antimicrobial characteristics may reduce the severity of lesion formation, suggesting possible pathways for developing new composite and adhesive materials for restorations with potentially enhanced longevity.
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Affiliation(s)
- J L Ferracane
- 1 Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, Oregon Health & Science University, Portland, OR, USA
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31
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Loomans B, Hilton T. Extended Resin Composite Restorations: Techniques and Procedures. Oper Dent 2016; 41:S58-S67. [DOI: 10.2341/15-212-lit] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This article gives an overview of the state of the art of different restorative treatment procedures and techniques needed for placing extended posterior resin composite restorations. Clinical aspects related to the procedure are discussed and reviewed based on the current literature, such as the use of proper adhesive restorative materials, use of liners and bases, moisture control, reconstruction of proximal contacts, extended resin composite restorations, and techniques to address restoring teeth with deep subgingival margins.
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Affiliation(s)
- B Loomans
- Bas Loomans, DDS, PhD, Radboud Institute for Molecular Life Sciences, Department of Dentistry, Radboud university medical center, Nijmegen, PO Box 9101, Nijmegen 6500 HB, The Netherlands
| | - T Hilton
- Thomas Hilton, DMD, MS, Department of Restorative Dentistry, Oregon Health and Science University, 2730 S.W. Moody Ave. Portland, OR 97201-0007, USA
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Montagner AF, Maske TT, Opdam NJ, de Soet JJ, Cenci MS, Huysmans MC. Failed bonded interfaces submitted to microcosm biofilm caries development. J Dent 2016; 52:63-9. [PMID: 27443239 DOI: 10.1016/j.jdent.2016.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 06/30/2016] [Accepted: 07/16/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the dentin wall carious lesion development of different composite-dentin interfaces in the presence of two adhesive bonding materials in the gaps, using a microcosm biofilm model. METHODS Dentin samples were prepared (10.4mm(2)) and restored with a composite resin using two adhesive systems (etch-and-rinse and self-etch techniques). Different conditions with respect to composite-dentin interfaces were produced with a 200μm gap: failed bonded without ageing or after mechanical ageing, or non-bonded with or without the presence of adhesive material on the dentin wall. For cariogenic challenge, specimens were subjected to a biofilm microcosm model for 14days to create caries-like wall lesions. Before and after caries development, transverse wavelength-independent microradiography images were taken, and lesion depth and mineral loss were measured. Data were analysed with linear regression models (p<0.05). RESULTS The composite-dentin interface conditions significant influenced the caries development: lesion development was reduced by the presence of the adhesive material on dentin wall, while lesion development was increased by the mechanical ageing (p=0.019). There was no difference between the adhesive materials (p values>0.05). CONCLUSION Different composite-dentin interfaces influence wall lesion development in gaps, with the interfaces submitted to ageing showing less carious protection than those interfaces with the presence of adhesive covering the dentin. CLINICAL SIGNIFICANCE The presence of adhesive bonding material in the gaps plays a role on the wall caries lesion development.
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Affiliation(s)
- Anelise F Montagner
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Tamires T Maske
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Niek J Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Johannes J de Soet
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
| | - Maximiliano S Cenci
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Marie-Charlotte Huysmans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
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Signori C, van de Sande FH, Maske TT, de Oliveira EF, Cenci MS. Influence of the Inoculum Source on the Cariogenicity of in vitro Microcosm Biofilms. Caries Res 2016; 50:97-103. [DOI: 10.1159/000443537] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/20/2015] [Indexed: 11/19/2022] Open
Abstract
This study investigated the cariogenic potential of biofilms originating from different types of inoculum (saliva and dental plaque) from caries-active and caries-free individuals. Ten volunteers were selected from each caries condition for the paired collection of saliva and dental plaque. Microcosm biofilms were grown in triplicate from each inoculum on enamel specimens in 24-well plates under cariogenic challenge. After 10 days, the biofilms were collected for analysis of outcome variables: percentage of surface hardness change (%SHC) and microbiological composition of biofilms. Statistical analysis was performed using the t test, the linear multivariate analysis model and Pearson's correlation coefficients (α = 0.05). A comparative analysis between microbiological baseline data showed higher counts of mutans streptococci in plaque samples within caries-active individuals; a comparative analysis of colony-forming unit (CFU) counts between individuals with different caries status showed higher counts of acid-tolerant microorganisms and mutans streptococci in dental plaque and of acid-tolerant microorganisms in saliva. After 10 days of biofilm growth, the CFU values for total microorganisms, lactobacilli, mutans streptococci and acid-tolerant bacteria, as well as for SHC, were not statistically significant, considering the type of inoculum and caries condition (p > 0.05). A positive correlation was found for %SHC and CFU counts of acid-tolerant bacteria (r = 0.406) and lactobacilli (r = 0.379). Under the limits of this study, the cariogenic potential of biofilms, formed under identical conditions in vitro, is similar, regardless of baseline differences between the source and type of inoculum.
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Jokstad A. Secondary caries and microleakage. Dent Mater 2016; 32:11-25. [DOI: 10.1016/j.dental.2015.09.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 08/24/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
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Nedeljkovic I, Teughels W, De Munck J, Van Meerbeek B, Van Landuyt KL. Is secondary caries with composites a material-based problem? Dent Mater 2015; 31:e247-77. [DOI: 10.1016/j.dental.2015.09.001] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/28/2015] [Accepted: 09/01/2015] [Indexed: 12/22/2022]
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Kuper NK, Montagner AF, van de Sande FH, Bronkhorst EM, Opdam NJM, Huysmans MCDJNM. Secondary Caries Development in in situ Gaps next to Composite and Amalgam. Caries Res 2015; 49:557-63. [PMID: 26407050 DOI: 10.1159/000438728] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/13/2015] [Indexed: 11/19/2022] Open
Abstract
This in situ study investigated the secondary caries development in dentin in gaps next to composite and amalgam. For 21 days, 14 volunteers wore a modified occlusal splint containing human dentin samples with an average gap of 215 µm (SD=55 µm) restored with three different materials: Filtek Supreme composite, Clearfil AP-X composite and Tytin amalgam. Eight times a day, the splint with samples was dipped in a 20% sucrose solution for 10 min. Before and after caries development, specimens were imaged with transversal wavelength independent microradiography, and lesion depth (LD) and mineral loss (ML) were calculated. The LD and ML of the three restoration materials were compared within patients using paired t tests (α=5%). In total 38 composite samples (Filtek n=19 and AP-X n=19) and 19 amalgam samples could be used for data analysis. AP-X composite presented the highest mean values of LD and ML of the three restorative materials. Amalgam showed statistically significantly less ML (Δ=452 µm×vol%) than the combined composite materials (p=0.036). When comparing amalgam to the separate composite materials, only AP-X composite showed higher ML (Δ=515 µm×vol%) than amalgam (p=0.034). Analysis of LD showed the same trends, but these were not statistically significant. In conclusion, amalgam showed reduced secondary caries progression in dentin in gaps compared to composite materials tested in this in situ model.
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Affiliation(s)
- Nicolien K Kuper
- Department of Preventive and Restorative Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Turkistani A, Nakashima S, Shimada Y, Tagami J, Sadr A. Microgaps and Demineralization Progress around Composite Restorations. J Dent Res 2015; 94:1070-7. [PMID: 26082389 DOI: 10.1177/0022034515589713] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the influence of adhesives and marginal sealing on demineralization progress using optical coherence tomography (OCT). Cavities (4 × 2 mm) were prepared in bovine incisors and restored using Clearfil SE Protect (SP), Bond Force (BF), Scotchbond Universal (SB), or G-Bond Plus (GB), followed by Estelite Flow Quick flowable composite. The control group received no adhesive (n = 10). After 3-d incubation in artificial saliva and 10,000 thermal cycles, gaps at enamel and dentin margins were measured at 8 locations on cross-sectional images obtained from each restoration using swept-source OCT at 1310-nm wavelength. Specimens were demineralized using acidified gel (pH = 4.5) for 5 wk and scanned every week to monitor the lesion progress at the same marginal locations. Repeated-measures analysis of variance showed that demineralization period and adhesive type and their interaction had a significant effect on the lesion size in both substrates (P < 0.001). SP, BF, and SB had significantly lower enamel and dentin initial gaps than the control and GB (P < 0.05). Enamel lesion progress was slower in the fluoride-releasing adhesives SP and BF and significantly different from SB, GB, and the control (P < 0.001). SP and BF dentin lesions were significantly different from GB and the control (P < 0.001), but not from SB (P > 0.05). A significant positive correlation (P < 0.05) was found between initial gap length and formed lesion size in both substrates, which was stronger in enamel (r = 0.63) than dentin (r = 0.35). Microgaps forming at the margins of restorations depend on adhesives and significantly contribute to the progress of demineralization around the margins, while fluoride release may decrease the rate of progression.
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Affiliation(s)
- A Turkistani
- Operative Dentistry Division, Conservative Dental Sciences, King Abdulaziz University, Jeddah, Saudi Arabia Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - S Nakashima
- Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Shimada
- Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - J Tagami
- Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - A Sadr
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA
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van de Sande FH, Da Rosa Rodolpho PA, Basso GR, Patias R, da Rosa QF, Demarco FF, Opdam NJ, Cenci MS. 18-year survival of posterior composite resin restorations with and without glass ionomer cement as base. Dent Mater 2015; 31:669-75. [DOI: 10.1016/j.dental.2015.03.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/11/2015] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
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39
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Montagner AF, Kuper NK, Opdam NJM, Bronkhorst EM, Cenci MS, Huysmans MCDNJM. Wall-lesion development in gaps: The role of the adhesive bonding material. J Dent 2015; 43:1007-12. [PMID: 25917166 DOI: 10.1016/j.jdent.2015.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/28/2015] [Accepted: 04/14/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study evaluated the caries wall lesion development in different composite-dentin interfaces to investigate if the presence and location of two bonding materials in the gaps influence wall caries lesion development. METHODS Fourteen volunteers wore a modified occlusal splint containing samples with four different interfaces: perfect bonding/no gap, or with a fixed gap (234±30 μm) with either no bonding material, bonding material (Clearfil Protect Bond-PB and Clearfil SE Bond-SE) on dentin or on composite. Eight times a day, the samples were dipped in 20% sucrose solution for 10 min, during 3 weeks. The samples were imaged with microradiography (T-WIM), and lesion depth (LD) and mineral loss (ML) were measured. The data were analysed with paired t-test. RESULTS The perfect bonding group did not show any caries wall lesion development, whereas all other interfaces did. The interface with bonding on dentin did not show significantly different wall lesion development from the interface with no material. However, when bonding was present on composite, both LD and ML were significantly higher than both other gap conditions (p-values<0.05). A difference between the bonding material was only seen when applied on composite: PB showed less ML than SE (p=0.01). CONCLUSIONS The presence of bonding on the composite side of a composite-dentin gap increased wall lesion development in situ. CLINICAL SIGNIFICANCE The presence and location of an adhesive bonding material in the composite-dentin gaps plays a role on the wall caries lesion development.
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Affiliation(s)
- Anelise F Montagner
- School of Dentistry, Federal University of Pelotas, Department of Restorative Dentistry, Pelotas, Brazil; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Nicolien K Kuper
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Niek J M Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Ewald M Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
| | - Maximiliano S Cenci
- School of Dentistry, Federal University of Pelotas, Department of Restorative Dentistry, Pelotas, Brazil.
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40
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Fernández E, Martin J, Vildósola P, Estay J, de Oliveira Júnior OB, Gordan V, Mjor I, Gonzalez J, Loguercio AD, Moncada G. Sealing Composite With Defective Margins, Good Care or Over Treatment? Results of a 10-year Clinical Trial. Oper Dent 2015; 40:144-52. [PMID: 25535778 DOI: 10.2341/14-143-c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Purpose
The objective of this study was to clinically evaluate sealed composite restorations after 10 years and compare their behavior with respect to controls.
Methods and Materials
The cohort consisted of 20 patients aged 18 to 80 years with 80 composite restorations. All participants in the sealing and no-treatment groups presented with clinical features for the marginal adaptation that deviated from the ideal and were rated Bravo (United States Public Health Service criteria). Composites with Alfa values for the marginal adaptation were used as the positive control.
Results
The marginal adaptation behavior was similar between the sealing and control (+) groups, with a high frequency of Bravo values in the 10th year (80% and 51%, respectively). Most of the no-treatment (-) group maintained the Bravo values (91%) for 10 years, although some restorations (9%) progressed to Charlie values. The anatomy parameter differed significantly between the first and 10th years, with deterioration in all three groups (p<0.05). The secondary caries parameter had a similar behavior in the three groups (p>0.05).
Conclusions
Sealing the margins of the composite resin restorations had no significant effect compared with the control groups, under the conditions of this study. Sealing the restorations substantially improved the marginal staining and marginal adaptation parameters, although by the tenth year they were similar to the group without intervention.
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Affiliation(s)
- E Fernández
- Eduardo Fernández, PhD (c), associate professor, Restorative Dentistry, University of Chile, Santiago, Chile
| | - J Martin
- Javier Martin, DDS, professor, Restorative Dentistry, University of Chile, Santiago, Chile
| | - P Vildósola
- Patricio Vildósola, DDS, professor, Restorative Dentistry, University of Chile, Santiago, Chile
| | - J Estay
- Juan Estay, DDS, professor, Restorative Dentistry, University of Chile, Santiago, Chile
| | | | - V Gordan
- Valeria V Gordan, DDS, MS, MS-CI professor, Restorative Dental Sciences Department, Division of Operative Dentistry, University of Florida, College of Dentistry
| | - I Mjor
- Ivar A Mjor, professor emeritus, Restorative Dental Sciences Department, Division of Operative Dentistry, University of Florida, College of Dentistry
| | - J Gonzalez
- Jeannette Gonzalez, University of Chile, Santiago, Chile
| | - AD Loguercio
- Alessandro D Loguercio, DDS, Ms, PhD, professor, Restorative Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - G Moncada
- Gustavo Moncada, PhD (c) professor, Restorative Dentistry, Universidad Mayor, Santiago, Chile
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41
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Kuper NK, van de Sande FH, Opdam NJM, Bronkhorst EM, de Soet JJ, Cenci MS, Huysmans MCDJNM. Restoration materials and secondary caries using an in vitro biofilm model. J Dent Res 2014; 94:62-8. [PMID: 25297114 DOI: 10.1177/0022034514553245] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This in vitro study investigated whether restoration materials and adhesives influence secondary caries formation in gaps using a short-term in vitro biofilm model. Sixty enamel-dentin blocks were restored with 6 different restoration materials with or without adhesives (n = 10 per group) with a gap: 1) Clearfil AP-X composite, 2) Clearfil AP-X composite + SE Bond, 3) Clearfil AP-X composite + ProtectBond, 4) Filtek Silorane composite, 5) Filtek Silorane composite + Silorane System adhesive, or 6) Tytin amalgam. Specimens were subjected to an intermittent 1% sucrose biofilm model for 20 days to create artificial caries lesions. Lesion progression in the enamel-dentin next to the different materials was measured in lesion depth (LD) and mineral loss (ML) using transversal wavelength independent microradiography (T-WIM). A regression analysis was used to compare the LD and ML of the different restoration materials at 4 measurement locations: 1 location at the surface of the enamel, 1 location at the wall of the enamel, and 2 locations at the wall of the dentin. A statistically significant effect of AP-X composite with Protect Bond was found for LD and ML at the WallDentin1 location, leading to less advanced wall lesions. An additional finding was that gap size was also statistically significant at the 2 wall locations in dentin, leading to increasing lesion progression with wider gaps. In conclusion, adhesives can influence wall lesion development in gaps. Protect Bond showed significantly less caries progression compared to bare restoration materials or other adhesives in this short-term in vitro biofilm model.
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Affiliation(s)
- N K Kuper
- College of Dental Sciences, Department of Preventive and Restorative Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - F H van de Sande
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - N J M Opdam
- College of Dental Sciences, Department of Preventive and Restorative Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - E M Bronkhorst
- College of Dental Sciences, Department of Preventive and Restorative Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J J de Soet
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, the Netherlands
| | - M S Cenci
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - M C D J N M Huysmans
- College of Dental Sciences, Department of Preventive and Restorative Dentistry, Radboud University Medical Center, Nijmegen, the Netherlands
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42
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Innes NPT, Giannobile WV. The Breadth of Oral Health Research: Translating to Clinical Practice. J Dent Res 2014; 93:616-7. [PMID: 24947200 DOI: 10.1177/0022034514537648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- N P T Innes
- Division of Oral Health Sciences, School of Dentistry, University of Dundee, Scotland, UK
| | - W V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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