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Lehmann A, Nijakowski K, Jankowski J, Donnermeyer D, Ramos JC, Drobac M, Martins JFB, Hatipoğlu Ö, Omarova B, Javed MQ, Alharkan HM, Bekjanova O, Wyzga S, Alkhawas MBAM, Kudenga R, Surdacka A. Clinical Difficulties Related to Direct Composite Restorations: A Multinational Survey. Int Dent J 2024:S0020-6539(24)00164-3. [PMID: 39048490 DOI: 10.1016/j.identj.2024.06.012] [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: 03/26/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
AIMS Composite materials are widely used in dentistry for direct tooth restorations. However, they are highly sensitive to the working technique employed during the restorative procedure. Even minor procedural errors can have a significant impact on the quality including the longevity of the restoration. Hence the aim of this study was to determine the material preferences and analyse the clinical problems associated with direct composite restorations in a cohort of dentists. METHODS A 20-item online questionnaire was created in English and administered 1830 general dentists and specialists in 13 countries. The first section of the questionnaire included four questions to elicit demographic data, and the second section comprised 16 questions focused on material preferences for conservative restorations, durability of composite restorations, and the most challenging stages the dentists faced during the composite restorative procedures. RESULTS Respondents decided most often to use composite materials for the tooth restorations (OR 997.4, 95% CI 233.8-4254.8, P value <.001). Most respondents indicated that the durability of composite restorations was approximately 7 to 10 years (41.5%). Among the factors affecting durability, maintenance of a dry cavity was the most often reported reason (47.1%) and the foremost challenge faced by dentists (61.0%) during the composite restorative procedures. CONCLUSIONS Our study confirmed that resin-based composites are the most popular material for direct restoration in many countries. Although working with this material is difficult and involves multiple steps, maintaining a dry cavity during bonding, and material application may affect the therapeutic success and durability of these restorations. Clinicians need to be attentive to this issue and be prepared to adapt their decision-making and consider opting for alternative restorative materials, if appropriate.
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Affiliation(s)
- Anna Lehmann
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland.
| | - Jakub Jankowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, University Münster, Münster, Germany
| | - João Carlos Ramos
- Center for Innovation and Research in Oral Sciences (CIROS) and Institute of Operative Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Milan Drobac
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - João Filipe Brochado Martins
- Departments of Endodontology Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Niğde Ömer Halisdemir University, Niğde, Turkiye
| | - Bakhyt Omarova
- Department of Therapeutic Dentistry, Kazakh National Medical University by S.D. Asfendiyarov, Almaty, Kazakhstan
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Hamad Mohammad Alharkan
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Olga Bekjanova
- Department of Faculty Therapeutic Dentistry, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Sylvia Wyzga
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Rutendo Kudenga
- Department of Odontology, University of Pretoria, Riviera, Pretoria, Republic of South Africa
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
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Jrady A, Ragab H, Algahtani FN, Osman E. In vitro study on the impact of various polishing systems and coffee staining on the color stability of bleach-shaded resin composite. BMC Oral Health 2024; 24:712. [PMID: 38902697 PMCID: PMC11191283 DOI: 10.1186/s12903-024-04474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 06/11/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVE To evaluate the effects of different polishing techniques and coffee staining on the color stability of four commercially available bleach-shade composite resins, namely microhybrid, nanohybrid, nanofilled, and injectable nanohybrids. MATERIAL AND METHODS A total of 224 discs (8 mm diameter and 2 mm thickness) were fabricated from four different bleach-shade composite resins, namely microhybrid (Gradia Direct Anterior), nanohybrid (Palfique LX5), nanofilled (Filtek Universal), and injectable nanohybrid (flowable G-aenial universal injectable). The composite resin groups were polished via four techniques: no polishing, 4-step polishing using aluminum oxide discs, 3-step polishing using silicon rubber diamond discs, and one-step polishing. Half of each group was immersed in water, while the other half was immersed in coffee for 12 days (n = 7). Colors were measured using a clinical spectrophotometer, and color differences were calculated (ΔE). The results were analyzed statistically. RESULTS The alterations in color were significantly influenced by the techniques employed for finishing and polishing techniques, composite resin type, and degree of coffee staining. Regardless of the polishing technique and storage medium, different material types showed a significant color change (ΔE) at P < 0.001. Filtek exhibited the most significant color change, followed by Gradia and Palfique, with no significant differences between them. In addition, Different polishing techniques resulted in significant color changes (P < 0.001). The highest degree of color change was seen in the no-polishing group, followed by the 4-step and 1-step polishing groups, with negligible differences between each other. Also, Storage media had a significant effect on ΔE values. CONCLUSION Appropriate finishing and polishing procedures can improve the color stability of bleach-shaded composite resins. Coffee has a deleterious effect on color; however, injectable flowable nanohybrid composites are more resistant to staining.
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Affiliation(s)
- Ali Jrady
- Beirut Arab University, Beirut, Lebanon
| | - Hala Ragab
- Operative and Esthetic Dentistry, Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdul Rahman University, P.O. Box 84428, 11671, Riyadh, Saudi Arabia
| | - Fahda N Algahtani
- Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdul Rahman University, P.O. Box 84428, 11671, Riyadh, Saudi Arabia.
| | - Essam Osman
- Dental BioMaterials, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Melo M, Dumitrache B, Ghilotti J, Sanz JL, Llena C. Effect of Bleaching Agents on Composite Resins with and without Bis-GMA: An In Vitro Study. J Funct Biomater 2024; 15:144. [PMID: 38921518 PMCID: PMC11204896 DOI: 10.3390/jfb15060144] [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: 04/24/2024] [Revised: 05/07/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
The objective was to evaluate the change in color, hardness, and roughness produced by carbamide peroxide (CP) at two different concentrations on two resins. The 16% or 45% CP was applied to 66 resin discs with and without Bis-GMA. The color was measured with a spectrophotometer, and ΔEab and ΔE00 were calculated. Microhardness tester and SEM were used. In both composites, the a* and b* coordinates tended to be red and yellow, respectively, and were significant in the Bis-GMA group (p < 0.05). The ΔEab and ΔE00 were higher in the composite with Bis-GMA, regardless of the treatment received (p < 0.05). The microhardness was reduced in both composites regardless of the PC concentration compared to the control (p < 0.05). The 45% CP reduced the microhardness in the resin group with Bis-GMA compared to 16% CP (p < 0.001) but was not significant in the resin without Bis-GMA (p = 1). An increase in roughness was directly proportional to the concentration of CP, and it was more notable in the composite without Bis-GMA. The composite with Bis-GMA showed a greater tendency to darken than the one without Bis-GMA. The surface hardness of the composite was reduced in both composites and was not influenced by CP concentration in the composite without Bis-GMA. Bleaching is a common procedure nowadays. It is important to know how CP affects composites to establish a prognosis of the treatments in terms of color change, roughness, and hardness.
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Affiliation(s)
| | | | - James Ghilotti
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, Gascó Oliag, 46010 Valencia, Spain
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Lippert VF, Bresciani E, Mota EG, Bittencourt HR, Kramer PF, Spohr AM. In vitro comparison of one-step, two-step, and three-step polishing systems on the surface roughness and gloss of different resin composites. J ESTHET RESTOR DENT 2024; 36:785-795. [PMID: 38130085 DOI: 10.1111/jerd.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites. MATERIALS AND METHODS Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi-peak LED curing unit (VALO-Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one-step (1S) (OneGloss), two-step (2S) (EVE Diacomp Twist Basic CA), or 3-step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two-way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre-set alpha of 0.05. RESULTS The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations. CONCLUSIONS The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification. CLINICAL SIGNIFICANCE The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite.
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Affiliation(s)
- Vinícius Funghetto Lippert
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, São José dos Campos, Brazil
| | - Eduardo Gonçalves Mota
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Hélio Radke Bittencourt
- Department of Statistics, Polytechnic School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Paulo Floriani Kramer
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ana Maria Spohr
- Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Bernaldo-Faustino JL, Dulanto-Vargas JA, Carranza-Samanez KM. In Vitro Effect of Mouthrinses on the Microhardness of Three Different Nanohybrid Composite Resins. Int J Dent 2023; 2023:9161639. [PMID: 38021349 PMCID: PMC10645498 DOI: 10.1155/2023/9161639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/20/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Daily use of different mouthrinses at home or in the dental office can alter the properties of resin hardness. The present study aimed to compare Vickers microhardness (VHN) in vitro of nanohybrid composite resins (NCRs) immersed in mouthrinses. Materials and Methods In total, 120 discs (10 ⨯ 2 mm) were prepared from three NCR shade A2 (n = 40/group) with FiltekTM Z350 XT (Z350XT), Tetric EvoCeram (TEC), and Polofil NHT (PNHT). The specimens were incubated in artificial saliva (37°C ⨯ 24 hr). Specimens were distributed into four mouthrinses (n = 10/group) of artificial saliva (control), chlorhexidine (CHX 0.12%, pH 5.6), cetylpyridine chloride (CPC 0.075%, pH 5.84), and CHX 0.12% + CPC 0.05% (pH 6.2) (2 times/day, 2' ⨯ 12 hr). The VHN (300 gf/10") was measured after 24 hr, 14, and 21 days. Data were analyzed by three-way analysis of variance, followed by post hoc Tukey analysis at 0.05 level of significance. Results The results revealed a global effect of the interaction of the mouthrinses ⨯ time between NRC evaluated (P=0.001). Baseline VHN in PNHT and Z350XT was higher than TEC. Within each group of NCR, VHN of CHX + CPC > other mouthrinses (PNHT/14 days; Z350XT/21 days), and >CPC (Z350XT/14 days). In mouthrinses-intragroups, VHN of PNHT and Z350XT decreased at 14 days (CHX, CPC) and was maintained over time in NCR (CHX + CPC). VHN-TEC was similar among groups. Conclusion Microhardness showed differences due to the interaction of the type of NCR, the composition of the mouthrinses, and time. VHN decreased after 14 days and was more affected in composite resins with lower filler content and in mouthrinses with a lower pH.
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Mulic A, Ruud A, Stenhagen IR, Bruzell E, Tulek A. Deterioration of direct restorative materials under erosive conditions with impact of abrasion and attrition in vitro. Biomater Investig Dent 2023; 10:2202211. [PMID: 37313433 PMCID: PMC10259295 DOI: 10.1080/26415275.2023.2202211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/07/2023] [Indexed: 06/15/2023] Open
Abstract
Objective To compare the cumulative impact of sequential wear on mechanical properties and appearance of a composite resin (CR), Filtek Z250®, a glass ionomer GI, Fuji IX GP®, and a glass hybrid (GH), Equia Forte®. Material and Methods Six equally sized specimens of each material were subjected to wear tests, i.e., simulation of brushing, chewing and acidic liquid exposure, mimicking at least 6 months of clinical exposure. Surface roughness, hardness, substance loss and degree of shade lightness were determined. Results Following wear tests, significant increase in surface roughness and decrease in hardness values were observed for all materials (p < .05). Significantly larger substance loss was found in Equia Forte® specimens compared to Filtek Z250® (p < .05), while that of Fuji IX® exceeded the measurement capacity of the instrument. Opposite to the two other materials, the shade of Filtek Z250® became darker. Conclusions Sequential wear exposure mimicking abrasion, erosion and attrition to products representing CR, GI and GH, caused weakening and change in appearance of the materials. The composite resin was the most mechanically resistant to the sequential wear.
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Affiliation(s)
- Aida Mulic
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Amund Ruud
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | | | - Ellen Bruzell
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Amela Tulek
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
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Popescu AD, Tuculina MJ, Diaconu OA, Gheorghiță LM, Nicolicescu C, Cumpătă CN, Petcu C, Abdul-Razzak J, Rîcă AM, Voinea-Georgescu R. Effects of Dental Bleaching Agents on the Surface Roughness of Dental Restoration Materials. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1067. [PMID: 37374271 DOI: 10.3390/medicina59061067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: This study aimed to evaluate the surface roughness evolution of several finished and polished composites when bleaching materials are applied. The research was conducted on four microhybrid or nanofilled composites that are used in dental restorations. Materials and Methods: For each composite type, 5 samples were selected for control, 5 samples were subjected to the bleaching protocol "office bleach" with 40% hydrogen peroxide, and 5 other samples were subjected to the "home bleach" protocol with 16% carbamide peroxide, resulting in a total number of 60 samples. The surfaces of all the samples were tested for roughness, and the values of the most relevant parameter (Ra), were collected. Comparisons between composites and samples were performed using one-way ANOVA (in Statistical Package for Social Sciences). Results: After the bleaching protocol with 40% hydrogen peroxide gel, it was found that the roughness of the group increased considerably compared to the control group, so the highest roughness was found at GC Gradia direct anterior group, and the lowest value was registered for the 3M ESPE Valux Plus group. Following the bleaching protocol with 16% carbamide peroxide (home bleach), it was noted that the sample surfaces were not as affected. In this case, the lowest roughness was found at 3M ESPE Valux Plus group, and the highest roughness was registered for the GC G-aenial anterior group. Following the interpretation of the results, all four types of dental composites tested showed significant surface roughness differences between the groups subjected to bleaching protocols and those kept as control (p < 0.05). Conclusions: The surfaces of the samples were affected by the bleaching protocols by increasing the roughness compared to the control samples.
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Affiliation(s)
- Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Jana Tuculina
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Oana Andreea Diaconu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Lelia Mihaela Gheorghiță
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Claudiu Nicolicescu
- Department of Engineering and Management of the Technological Systems, Faculty of Mechanics, University of Craiova, 1 Calugareni, 220037 Drobeta-Turnu Severin, Romania
| | - Cristian Niky Cumpătă
- Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 031593 Bucharest, Romania
| | - Cristiana Petcu
- Department of Prosthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Jaqueline Abdul-Razzak
- Department of Infant Care-Pediatrics-Neonatology & Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ana Maria Rîcă
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Paradowska-Stolarz A, Mikulewicz M, Wieckiewicz M, Wezgowiec J. The Influence of Polishing and Artificial Aging on BioMed Amber ® Resin's Mechanical Properties. J Funct Biomater 2023; 14:254. [PMID: 37233364 PMCID: PMC10219233 DOI: 10.3390/jfb14050254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
Currently, 3D print is becoming more common in all branches of medicine, including dentistry. Some novel resins, such as BioMed Amber (Formlabs), are used and incorporated to more advanced techniques. The aims of the study were to check whether or not polishing and/or artificial aging influences the properties of the 3D-printed resin. A total of 240 specimens of BioMed Resin were printed. Two shapes (rectangular and dumbbell) were prepared. Of each shape, 120 specimens were divided into four groups each (with no influence, after polishing only, after artificial aging only, and after both polishing and artificial aging). Artificial aging took place in water at the temperature of 37 °C for 90 days. For testing, the universal testing machine (Z10-X700, AML Instruments, Lincoln, UK) was used. The axial compression was performed with the speed of 1mm/min. The tensile modulus was measured with the constant speed of 5 mm/min. The highest resistance to compression and tensile test were observed in the specimens that were neither polished nor aged (0.88 ± 0.03 and 2.88 ± 0.26, respectively). The lowest resistance to compression was observed in the specimens that were not polished, but aged (0.70 ± 0.02). The lowest results of the tensile test were observed when specimens were both polished and aged (2.05 ± 0.28). Both polishing and artificial aging weakened the mechanical properties of the BioMed Amber resin. The compressive modulus changed much with or without polishing. The tensile modulus differed in specimens that were either polished or aged. The application of both did not change the properties when compared to the polished or aged probes only.
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Affiliation(s)
- Anna Paradowska-Stolarz
- Division of Dentofacial Anomalies, Department of Orthodontics and Dentofacial Orthopedics, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| | - Marcin Mikulewicz
- Division of Dentofacial Anomalies, Department of Orthodontics and Dentofacial Orthopedics, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| | - Joanna Wezgowiec
- Department of Experimental Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
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Mesallum EE, Abd El Aziz PM, Swelem AA. Performance of bulk-fill versus conventional nanocomposite resin restorations supporting the occlusal rests of removable partial dentures: An in vitro investigation. J Prosthet Dent 2023:S0022-3913(23)00190-7. [PMID: 37100650 DOI: 10.1016/j.prosdent.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/28/2023]
Abstract
STATEMENT OF PROBLEM Placing removable partial denture (RPD) rests on composite resin restorations has long been a debatable issue. Despite developments in composite resins such as nanotechnology and bulk-filling techniques, studies investigating the performance of composite resin restorations when used to support occlusal rests remain scarce. PURPOSE The purpose of this in vitro study was to investigate the performance of bulk-fill versus incremental (conventional) nanocomposite resin restorations when they are used to support RPD rests under functional loading. MATERIAL AND METHODS Thirty-five caries-free intact maxillary molars of similar coronal size were collected and divided into 5 equal groups (n=7): Enamel (Control) group: rest seats prepared entirely in enamel; Class I Incremental group: Class I cavities restored with incrementally placed nanohybrid resin composite resin (Tetric N-Ceram); Class II Incremental group: Mesio-occlusal (MO) Class II cavities restored with Tetric N-Ceram; Class I Bulk-fill group: Class I cavities restored with high-viscosity bulk-fill hybrid resin composite (Tetric N-Ceram Bulk-Fill); and Class II Bulk-fill group: MO Class II cavities restored with Tetric N-Ceram Bulk-Fill. Occlusal rest seats were prepared mesially in all groups, and clasp assemblies were fabricated and cast in cobalt-chromium alloy. Specimens with their clasp assemblies were subjected to thermomechanical cycling using a mechanical cycling machine (250 000 masticatory cycles) and 5000 thermal cycles (5 °C to 50 °C). Surface roughness (Ra) was measured with a contact profilometer before and after cycling. Fracture analysis was done using stereomicroscopy, and margin analysis was done with a scanning electron microscope (SEM) before and after cycling. Statistical analysis of Ra was conducted using ANOVA followed by the Scheffé test for between-group comparison and paired t test for within-group comparison. The Fisher exact probability test was used for fracture analysis. The Mann-Whitney test was used for between-group comparison and Wilcoxon signed rank test for within-group comparison for the SEM images (α=.05). RESULTS Mean Ra increased significantly after cycling in all groups. Significant differences in Ra were found between enamel and all 4 resin groups (P<.001), with no significant differences between incremental and bulk-fill resin groups for both Class I and II specimens (P>.05). No significant differences were found between the 2 resin groups with regard to fracture and margin analysis (P>.05). CONCLUSIONS The surface roughness of enamel was significantly lower than that of both incremental and bulk-fill nanocomposite resins before and after functional loading. Incremental and bulk-fill nanocomposite resins showed comparable performance in terms of surface roughness, fracture behavior, and marginal adaptation.
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Affiliation(s)
- Enas E Mesallum
- Assistant Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Possy M Abd El Aziz
- Lecturer, Conservative Dentistry, Faculty of Dentistry, Conservative Dentistry Department, Cairo University, Cairo, Egypt
| | - Amal A Swelem
- Professor, Prosthodontic Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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10
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Allccahuaman-Avalos R, Medina-Sánchez R, Castro-Ramirez L, Ladera-Castañeda M, Cervantes-Ganoza L, Martínez-Campos R, Solís-Dante F, Aliaga-Mariñas A, Verástegui-Sandoval A, Cayo-Rojas C. In Vitro Color Stability Evaluation of Three Polished and Unpolished Nanohybrid Resin Composites Immersed in a 0.12% Chlorhexidine-Based Mouthwash at Different Times. Polymers (Basel) 2023; 15:1339. [PMID: 36987120 PMCID: PMC10055837 DOI: 10.3390/polym15061339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
The use of chlorhexidine-based mouthwashes on resin composites with rough surfaces can cause discoloration which compromises the esthetic of patients. The present study aimed to evaluate the in vitro color stability of Forma (Ultradent Products, Inc., South Jordan), Tetric N-Ceram (Ivoclar Vivadent, Schaan, Liechtenstein) and Filtek Z350XT (3M, ESPE, St. Paul, MN, USA) resin composites, with and without polishing, after being immersed in a 0.12% chlorhexidine (CHX)-based mouthwash at different times. The present in vitro experimental and longitudinal study used 96 nanohybrid resin composite blocks (Forma, Tetric N-Ceram and Filtek Z350XT) 8 mm in diameter and 2 mm thick, evenly distributed. Each resin composite group was divided into two subgroups (n = 16) with and without polishing and then immersed in a 0.12% CHX-based mouthwash for 7, 14, 21 and 28 days. Color measurements were performed with a calibrated digital spectrophotometer. Nonparametric tests were used to compare independent (Mann-Whitney U and Kruskal-Wallis) and related (Friedman) measures. In addition, the Bonferroni post hoc correction was used considering a significance level of p < 0.05. All polished and unpolished resin composites presented color variation < 3.3 when immersed for up to 14 days in 0.12% CHX-based mouthwash. The polished resin composite with the lowest color variation (ΔE) values over time was Forma, and the one with the highest values was Tetric N-Ceram. When comparing the color variation (ΔE) over time, it was observed that the three resin composites, with and without polishing, presented a significant change (p < 0.001), although these changes in color variation (ΔE) were evident from 14 days between each color acquisition (p < 0.05). The unpolished Forma and Filtek Z350XT resin composites showed significantly more color variation than the same polished ones at all times when immersed in a 0.12% CHX-based mouthwash for 30 s daily. In addition, every 14 days, all three resin composites with and without polishing showed a significant color change, while, every 7 days, color stability was maintained. All the resin composites showed clinically acceptable color stability when exposed for up to 14 days to the above-mentioned mouthwash.
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Affiliation(s)
| | | | | | - Marysela Ladera-Castañeda
- Research Team “Salud Pública—Salud Integral”, Faculty of Dentistry, Postgraduate School, Universidad Nacional Federico Villarreal, Lima 15001, Peru
| | | | - Reynaldo Martínez-Campos
- Oral Rehabilitation Department, School of Stomatology, Universidad Científica del Sur, Lima 15067, Peru
| | | | - Ana Aliaga-Mariñas
- Research Team “Salud Pública—Salud Integral”, Faculty of Dentistry, Postgraduate School, Universidad Nacional Federico Villarreal, Lima 15001, Peru
| | - Arturo Verástegui-Sandoval
- Faculty of Health Sciences, Professional Academic School of Dentistry, Universidad Privada Norbert Wiener, Lima 15046, Peru
| | - César Cayo-Rojas
- School of Stomatology, Universidad Privada San Juan Bautista, Lima 15067, Peru
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11
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Babina K, Polyakova M, Sokhova I, Doroshina V, Zaytsev A, Nikonova EE, Budylin GS, Shirshin EA, Tantardini C, Novozhilova N. Translucency and Color Stability of a Simplified Shade Nanohybrid Composite after Ultrasonic Scaling and Air-Powder Polishing. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4465. [PMID: 36558318 PMCID: PMC9782865 DOI: 10.3390/nano12244465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
We aimed to assess the influence of professional dental prophylaxis on the translucency and color stability of a novel simplified shade nanohybrid composite material. Sixty composite disks (5 mm in diameter and 2 mm thick) of light (n = 30) and dark (n = 30) shades were prepared. The specimens were randomly divided into the following three groups (n = 10) according to the prophylaxis procedure used: ultrasonic scaling, air-powder polishing with sodium bicarbonate, and controls. The specimens were submitted to translucency and color analysis based on the CIELab system. Two measurements were performed before and after 48-h storage in coffee. Translucency values of untreated light and dark specimens were 9.15 ± 0.38 and 5.28 ± 1.10, respectively. Air-powder polishing decreased the translucency of the light composite specimens. Storage in coffee resulted in color changes (∆E) ranging between 2.69 and 12.05 and a mean translucency decrease ranging between -0.88 and -6.91. The samples in the light group tended to exhibit greater staining; the treatment method had no effect on ∆E. It can be concluded that light-shade composite restorations are more prone to translucency and color changes resulting from air-powder polishing and contact with staining media. However, further research using other composites and powders is required.
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Affiliation(s)
- Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Vladlena Doroshina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Elena E. Nikonova
- Laboratory of Clinical Biophotonics, Biomedical Science and Technology Park, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Faculty of Physics, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Gleb S. Budylin
- Laboratory of Clinical Biophotonics, Biomedical Science and Technology Park, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Institute of Spectroscopy of the Russian Academy of Sciences, 108840 Moscow, Russia
| | - Evgeny A. Shirshin
- Faculty of Physics, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Christian Tantardini
- Hylleraas Center, Department of Chemistry, UiT The Arctic University of Norway, 9037 Tromso, Norway
- Institute of Solid State Chemistry and Mechanochemistry SB RAS, 630128 Novosibirsk, Russia
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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12
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Carrillo-Marcos A, Salazar-Correa G, Castro-Ramirez L, Ladera-Castañeda M, López-Gurreonero C, Cachay-Criado H, Aliaga-Mariñas A, Cornejo-Pinto A, Cervantes-Ganoza L, Cayo-Rojas CF. The Microhardness and Surface Roughness Assessment of Bulk-Fill Resin Composites Treated with and without the Application of an Oxygen-Inhibited Layer and a Polishing System: An In Vitro Study. Polymers (Basel) 2022; 14:polym14153053. [PMID: 35956567 PMCID: PMC9370367 DOI: 10.3390/polym14153053] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the microhardness and surface roughness of bulk-fill resin composites treated with and without the application of an oxygen-inhibited layer (OIL) and a polishing system. This in vitro experimental study consisted of 72 resin composite blocks divided into three groups: Tetric N-Ceram Bulk Fill, Opus Bulk Fill APS, and Filtek Bulk Fill. Each resin composite group was further divided into two subgroups: with and without OIL control. Subsequently, surface roughness and microhardness were measured before and after polishing. A t-test was used to compare independent and related measures. For the intergroup comparison of variation before and after polishing, the Kruskal−Wallis test with Bonferroni post hoc was used considering a significance level of p < 0.05. When comparing surface roughness, significant differences were observed between Opus Bulk Fill resin composite with and without OIL control (p = 0.003) before polishing. The same occurred when comparing Tetric N-Ceram resin composite with and without OIL control (p = 0.039) after polishing. In addition, the surface roughness of Filtek Bulk Fill, Opus Bulk Fill, and Tetric N-Ceram Bulk Fill resin composites, with and without OIL control, decreased significantly after polishing (p < 0.001), while surface microhardness significantly increased (p < 0.05), with the exception of Opus Bulk Fill resin with OIL control (p = 0.413). In conclusion, OIL control and polishing significantly improved the surface roughness and surface microhardness of Filtek Bulk Fill and Tetric N-Ceram Bulk Fill resin composites. However, in the case of Opus Bulk Fill resin composite, only its surface roughness was significantly improved.
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Affiliation(s)
- Ann Carrillo-Marcos
- School of Stomatology, Universidad Privada San Juan Bautista, 15066 Lima, Peru; (A.C.-M.); (G.S.-C.); (L.C.-R.); (H.C.-C.); (A.C.-P.)
| | - Giuliany Salazar-Correa
- School of Stomatology, Universidad Privada San Juan Bautista, 15066 Lima, Peru; (A.C.-M.); (G.S.-C.); (L.C.-R.); (H.C.-C.); (A.C.-P.)
| | - Leonor Castro-Ramirez
- School of Stomatology, Universidad Privada San Juan Bautista, 15066 Lima, Peru; (A.C.-M.); (G.S.-C.); (L.C.-R.); (H.C.-C.); (A.C.-P.)
| | - Marysela Ladera-Castañeda
- “Grupo de Investigación Salud y Bienestar Global”, Faculty of Dentistry and Postgraduate School, Universidad Nacional Federico Villarreal, 15001 Lima, Peru; (M.L.-C.); (A.A.-M.)
| | | | - Hernán Cachay-Criado
- School of Stomatology, Universidad Privada San Juan Bautista, 15066 Lima, Peru; (A.C.-M.); (G.S.-C.); (L.C.-R.); (H.C.-C.); (A.C.-P.)
| | - Ana Aliaga-Mariñas
- “Grupo de Investigación Salud y Bienestar Global”, Faculty of Dentistry and Postgraduate School, Universidad Nacional Federico Villarreal, 15001 Lima, Peru; (M.L.-C.); (A.A.-M.)
| | - Alberto Cornejo-Pinto
- School of Stomatology, Universidad Privada San Juan Bautista, 15066 Lima, Peru; (A.C.-M.); (G.S.-C.); (L.C.-R.); (H.C.-C.); (A.C.-P.)
- “Grupo de Investigación Salud y Bienestar Global”, Faculty of Dentistry and Postgraduate School, Universidad Nacional Federico Villarreal, 15001 Lima, Peru; (M.L.-C.); (A.A.-M.)
| | | | - César Félix Cayo-Rojas
- School of Stomatology, Universidad Privada San Juan Bautista, 15066 Lima, Peru; (A.C.-M.); (G.S.-C.); (L.C.-R.); (H.C.-C.); (A.C.-P.)
- Correspondence:
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13
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Comparison of Polishing Systems on the Surface Roughness of Resin Based Composites Containing Different Monomers. JOURNAL OF COMPOSITES SCIENCE 2022. [DOI: 10.3390/jcs6050146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Changes in the organic matrix of composite resins have been proposed to improve their surface properties. However, polishing systems may perform differently in different materials. This study compared the effect of polishing systems on the surface roughness of four composite resins containing different resin monomers: Admira Fusion (nanohybrid containing pure ormocer), Aura Bulkfill (nanohybrid containing Bis-GMA, UDMA), Charisma Diamond (nanohybrid containing TCD-DI-HEA) and Vittra APS (nanofilled containing UDMA). Cylinders (N = 120, n = 10) were prepared from each material and the top surface of each specimen was grounded using a diamond finishing bur. Baseline measurements of surface roughness (Ra) were recorded using a contact profilometer and the specimens of each composite were divided into three subgroups according to the polishing system: one-step, two-step, three-step. Ra measurements were recorded also after polishing. Data were analyzed using three-way ANOVA and Tukey’s test (p < 0.05). The baseline roughness of all composites was significantly reduced after polishing (p < 0.001). The two-step polishing system provided the smoothest surface for Admira Fusion (0.0770 ± 0.0171) and Charisma (0.1091 ± 0.0090), whereas for Aura and Vittra no significantly differences were found for the three polishing systems tested. The surface smoothness seems to be more material dependent than step dependent, but all tested systems provided clinically acceptable results.
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14
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Németh KD, Haluszka D, Seress L, Lovász BV, Szalma J, Lempel E. Effect of Air-Polishing and Different Post-Polishing Methods on Surface Roughness of Nanofill and Microhybrid Resin Composites. Polymers (Basel) 2022; 14:polym14091643. [PMID: 35566812 PMCID: PMC9100913 DOI: 10.3390/polym14091643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/27/2022] Open
Abstract
Air-abrasion is a popular prophylactic procedure to maintain oral hygiene. However, depending on the applied air-abrasive powder, it can damage the surface of the tooth and restorations, making it susceptible to plaque accumulation. The purpose of this study was to investigate the effect of 5 s and 10 s air-abrasion of calcium carbonate on surface roughness (Ra) of enamel, nanofill, and microhybrid resin-composites and the effect of post-polishing with two-step rubber- (RP) or one-step brush polisher (BP) to re-establish the surface smoothness. Surface topography was visualized by scanning-electron-microscopy. The quantitative measurement of the Ra was carried out with atomic-force-microscopy. Air-abrasion for 10 s decreased the Ra of enamel as a result of abrasion of the natural surface texture. Post-polishing with RP after 10 s air-abrasion did not change the Ra or BP; however, Ra was increased significantly by scratching the surface. Air-abrasion increased the Ra of resin composites significantly, irrespective of the application time. While RP provided a similarly smooth surface to the control in the case of microhybrid resin composite, BP increased the Ra significantly. The Ra for the control group of the nanofill-resin composite was initially high, which was further increased by air-abrasion. RP and BP re-established the initial Ra with deeper and shallower scratches after BP. Both the material and treatment type showed a large effect on Ra.
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Affiliation(s)
- Kinga Dorottya Németh
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
| | - Dóra Haluszka
- Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó Street 37–47, 1094 Budapest, Hungary;
| | - László Seress
- Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary;
| | - Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
- Correspondence: ; Tel.: +36-72-535926
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15
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Cayo-Rojas C, Ramírez-Vargas G, Ladera-Castañeda M, López-Gurreonero C, Cornejo-Pinto A, Cachay-Criado H, Cervantes-Ganoza L. Surface roughness in nanoparticle resin composites subjected to two polishing systems: An in vitro comparative study. J Int Soc Prev Community Dent 2022; 13:114-123. [DOI: 10.4103/jispcd.jispcd_279_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/29/2021] [Accepted: 12/05/2021] [Indexed: 11/11/2022] Open
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16
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Effect of Surface Polishing on Nano-Hardness and Elastic Modulus of Different Resin Composites after Immersion in Alcoholic Medium. JOURNAL OF COMPOSITES SCIENCE 2021. [DOI: 10.3390/jcs5120327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There has been a great tendency toward using resin composite in dentistry and exploring nano-hardness, elastic modulus, and effect of polishing on its mechanical properties after its artificial ageing. This study aimed to evaluate the effect of surface polishing of four different resin composites on their nano-hardness and elastic modulus. This effect was tested right after light curing of composite resin and after its artificial ageing (immersion in alcoholic medium). Nanoindentation test preparations, surface roughness, surface hardness, and scanning electron microscope were conducted across the four different resin composites: Clearfil AP-X (APX), Estelite Sigma Quick (ESQ), Beautifil II (BE2), and FiltekTM Supreme Ultra Universal restorative (FSU). We found that difference in fillers load and particle size are amongst the factors influencing hardness and modulus of elasticity. The APX is the highest in term of hardness due to fillers load and size while the ESQ is the lowest because all fillers in nano size and distributed homogenously. The significance of surface polishing of the studied resin composite restorations was highlighted. Future research may focus on exploring survival rate of polished and non-polished composite surfaces with emphasis on measuring degree of conversion and impacts of polished and non-polished surfaces on the individuals’ oral health quality of life.
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17
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Babina K, Polyakova M, Sokhova I, Doroshina V, Arakelyan M, Zaytsev A, Novozhilova N. The Effect of Ultrasonic Scaling and Air-Powder Polishing on the Roughness of the Enamel, Three Different Nanocomposites, and Composite/Enamel and Composite/Cementum Interfaces. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:3072. [PMID: 34835835 PMCID: PMC8623571 DOI: 10.3390/nano11113072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/06/2021] [Accepted: 11/13/2021] [Indexed: 11/20/2022]
Abstract
We aimed to assess the effects of ultrasonic scaling and air-powder polishing on the roughness of enamel, three nanocomposites (Premise, Herculite Ultra, Harmonize), and composite/enamel and composite/cementum interfaces. Class V cavities were restored in 99 extracted third molars with one of the three nanocomposites and treated with ultrasonic scaler or air-powder polishing device (calcium carbonate or sodium bicarbonate powders). The roughness (Ra) of the investigated surfaces was measured with contact profilometer before and after treatment. The data were analyzed using repeated measures ANOVA. Specimens' Ra values before instrumentation were near the clinically acceptable 0.2 μm threshold. All techniques increased the roughness of the tested surfaces; however, the enamel was slightly affected. The mean Ra values after prophylaxis for composite, composite/cementum and composite/enamel surfaces were 0.32-0.55, 1.33-1.73, and 1.25-1.36, respectively. The extent of composite surface damage was material dependent. Premise surface was not altered by ultrasonic scaling significantly. Air-powder polishing with both powders produced a greater increase in surface roughness of composite resin and restorations margins than ultrasonic scaling. The Ra values after both types of air polishing for Herculite Ultra and Harmonize were approximately 1.5 and 2 times higher, respectively, than those after ultrasonic scaling (p < 0.05).
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Affiliation(s)
- Ksenia Babina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Maria Polyakova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Inna Sokhova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Vladlena Doroshina
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Marianna Arakelyan
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
| | - Alexandr Zaytsev
- Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
| | - Nina Novozhilova
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.); (I.S.); (V.D.); (M.A.); (N.N.)
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