Effect of different adhesive strategies on the post-operative sensitivity of class I composite restorations

Clinical performance of different bulk-fill composite resin systems in class II cavities: A 2-year randomized clinical trial

OBJECTIVES

This study evaluated the clinical performance of bulk-fill resin composite systems with different viscosities in class II cavities.

MATERIALS AND METHODS

A total of 80 class II restorations were performed with a single operator in 50 patients using four different bulk-fill resin composite materials: Filtek™ Bulk Fill, Heated Filtek™ Bulk Fill, G-ænial™ BULK Injectable, and SonicFill3. A double-blinded randomized clinical trial was designed to evaluate the two-year clinical performance of the four bulk-fill composite resins using modified FDI criteria. Data were analyzed descriptively. Level of significance was set at 0.05. Differences between groups were tested using Wilcoxon-signed-rank and Mann-Whitney-U test as nonparametric tests.

RESULTS

Data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests (p < 0.05). Eighty restorations were available for evaluation, with a survival function of 100%. No statistically significant differences were observed between the four groups regarding assessing esthetic, functional, and biological properties during different follow-up periods.

CONCLUSIONS

After 2 years of clinical follow-up, the bulk-fill composite systems with different viscosities seem to be esthetically, functionally, and biologically acceptable, with a promising clinical performance in class II cavities.

EFFECT OF LOW-LEVEL DIODE LASER ON DENTIN TOPOGRAPHY AND SYMPTOMATIC NONCARIOUS CERVICAL LESIONS PRIOR TO COMPOSITE RESTORATIONS: A SPLIT-MOUTH RANDOMIZED CONTROLLED TRIAL

OBJECTIVES

This study assessed alterations in sensitivity among symptomatic noncarious cervical lesions (NCCLs) following the application of 3 low-level diode laser wavelengths before composite restoration. It analyzed the changes in dentin topography using a scanning electron microscope (SEM).

MATERIALS AND METHODS

Nine patients with 36 NCCLs were randomly assigned intra-individually to 4 groups based on the laser wavelength: laser simulation, 445 nm, 660 nm, and 970 nm. Cavity preparation, irradiation, and composite restoration were performed for each lesion. Sensitivity to cold stimuli was recorded using a visual analog scale (VAS) before the intervention (baseline) and at 1 day, 14 days, 1-, 3-, and 6-month. Pulp sensibility was recorded using an electrical pulp tester (EPT) at baseline, before treatment, and at 3- and 6-month. Additionally, an in vitro examination was performed on 12 extracted human molars to yield 12 dentin discs. Each disc was randomly divided into 4 quadrants to receive the same laser wavelengths to determine the diameters of the tubules using SEM. Results were analyzed statistically for clinical studies by the Friedman test, while ANOVA (RM-ANOVA) was conducted in-vitro, followed by the Bonferroni test in the case of significance (P < .05).

RESULTS

VAS readings decreased across all groups, with a significant decrease observed for 660 nm and 970 nm from 14 days to 6-month, while at 445 nm there was a significant decrease at 6-month compared to the control (P < .05). EPT showed a significant decrease in pain threshold levels at 660 nm and 970 nm at 3- and 6-month, while 445 nm showed a significant decrease at 6-month compared to the control (P < .05). The mean tubular diameter at 445 nm decreased, with no significant difference from the control, whereas a significant decrease was found at 660 nm and 970 nm compared to the control (P < .05).

CONCLUSIONS

Prior to composite restoration in symptomatic NCCLs, diode lasers with a wavelength of 660 nm showed the highest reduction in sensitivity, followed by 970 nm, whereas 445 nm diode lasers showed the least reduction. Additionally, diode lasers with wavelengths of 660 and 970 nm reduced the width of the dentinal tubules (DT) without inducing melting, as viewed under SEM.

Comparison of postoperative hypersensitivity between Total-etch and Universal adhesive system: a randomized clinical trial

The objective was to determine the postoperative hypersensitivity of two-step Total-etch as compared to one-step Universal adhesives followed by composite restorations on 100 patients by applying Total-etch on one tooth and Universal adhesive on another tooth. The bonds and teeth were randomly selected. Postoperative hypersensitivity was recorded by visual analog scale before, immediately after, and 24 h after the restoration using cold stimulus. The Mann-Whitney test was applied for statistical comparison of postoperative hypersensitivity between the two bonds as well as for any significant difference in genders with each bond. No significant difference was found between postoperative hypersensitivity of the two adhesives before (p-value = 0.57), immediately after (p-value = 0.604), and 24 h after (p-value = 0.728) the restoration. Males showed more hypersensitivity with Total-etch as compared to females before (p-value = 0.037), immediately after (p-value = 0.047), and 24 h after the restoration (p-value = 0.022). No significant difference was found between gender and Universal adhesive at all three stages (p-value > 0.05). The results suggest no significant difference in postoperative hypersensitivity between the two materials when good sample size and proper technique were observed along with the removal of bias like different patients having different pain perceptions and multiple operators having different operating skills. Males showed more hypersensitivity to Total-etch.Trial registration number: Australian New Zealand Clinical Trials. Registry number: ACTRN12622001213730. (Retrospectively registered: 09/09/2022).

Glutaraldehyde-based desensitizer does not influence postoperative sensitivity and clinical performance of posterior restorations: A 24-month randomized clinical trial

OBJECTIVES

To evaluate the influence of a glutaraldehyde-based desensitizer (GL) on postoperative sensitivity (POS) in posterior bulk-fill resin composite restorations using an adhesive applied in the self-etch (SE) and etch-and-rinse (ER) strategies; and to assess the clinical performance of the restorations.

METHODS

Posterior resin composite restorations (n = 228) at least 3 mm deep were inserted in 57 subjects using a split-mouth design. The adhesive was applied with/without prior application of a GL. A resin composite was used for all restorations. Spontaneous POS (risk and intensity), as well as POS caused by stimulation with an air blast and assess the response to horizontal and vertical percussion was assessed using two scales in the baseline and after 7, 14, and 30 days. In addition, some parameters were evaluated using FDI criteria up to 24 months of clinical service.

RESULTS

No significant POS was observed (p > 0.05). A higher absolute risk and intensity of spontaneous POS was observed within 7 days (35.1%), without statistically significant differences among groups. At 24 months 5 restorations were considered clinically unsatisfactory, and 73 restorations showed minor discrepancies in adaptation, with no significant differences between groups (p > 0.05).

SIGNIFICANCE

A GL agent does not influence POS in posterior restorations with bulk-fill resin composite. It may be considered a dispensable clinical step in the restorative protocol.

Postoperative sensitivity in posterior restorations restored with self-adhesive and conventional bulk-fill resin composites: A randomized clinical split-mouth trial

OBJECTIVE

To compare the postoperative sensitivity (POS) of a self-adhesive bulk-fill resin composite with that of a conventional bulk-fill resin composite in posterior restorations.

METHODS

Class I and II (n = 166) cavities of at least 3 mm depth, in 83 participants were restored by: (TEST: Surefil one™ Self-Adhesive bulk-fill (n = 83); and CONTROL: Filtek™ Bulk-Fill posterior composites (n = 83). The presence and intensity of POS associated with the restorations was evaluated at 24 h, 1 week and 1 month intervals using the Visual Analogue Scale (VAS). Comparisons of POS presence between the two treatment groups were made using the Chi-square and Fisher exact tests, while Mann-Whitney and Friedman tests were used to compare the intensity of POS (α=0.05).

RESULTS

Forty-two of participants (25.3%; 95% CI 19.3 to 32.4) reported presence of POS after 24 h and none of the participants reported POS after 1 month. The presence of POS was not significantly affected by the restorative material after 24 h, 1 week and 1 month (p>0.05). After 1 week, the participants in the Surefil one™ group reported significantly less intensity of POS than the participants in the Filtek™ Bulk-Fill group (p = 0.02).

CONCLUSIONS

The use of Surefil one™ self-adhesive resin composite did not significantly increase the presence of POS compared to the use of the conventional bulk-fill resin composite. However, the intensity of POS was significantly less in the Surefil one ™ group after one week.

CLINICAL SIGNIFICANCE

The use of a self-adhesive bulk-fill resin composite in posterior restorations did not increase the presence of POS more than the use of a conventional bulk-fill resin composite. However, it decreased the intensity of POS after one week. This clinical trial was registered at ClinicalTrials.gov; the registration number is NCT05567263.

Effect of different adhesive systems on dental defects and sensitivity to teeth in composite resin restoration: a systematic review and meta-analysis

OBJECTIVES

This meta-analysis aimed to elucidate the effects of various acid etching patterns on the sensitivity of teeth and their clinical effectiveness following composite resin repair.

MATERIALS AND METHODS

PubMed, Cochrane Library, Web of Science, and Embase databases were searched for relevant studies on the postoperative sensitivity (POS) of composite resin restorations after using different bonding systems. The retrieval was from the inception of the databases to August 13, 2022, with no filter of written language. Literature screening was conducted by two independent researchers. The Cochrane risk-of-bias assessment tool was adopted for quality evaluation, and Stata 15.0 for analysis.

RESULTS

Twenty-five randomized controlled trials were included in the present study. Following resin composite restoration, 1309 restorations were bonded by self-etching (SE) adhesives, whereas 1271 restorations were bonded by total-etching (TE) adhesives. The meta-analyses showed that there is no evidence to prove the SE and TE will affect POS at present when measured using the modified United States Public Health Service (USPHS) criteria [RR = 1.00 (95% CI: 0.96, 1.04)], the World Dental Federation (FDI) [RR = 1.06 (95% CI: 0.98, 1.15)], or the visual analog scale (VAS) [SMD = 0.02 (95% CI: -0.15, 0.20)] scales. At a certain follow-up time, TE adhesives provide better outcomes in terms of color match, marginal staining, and marginal adaptation. In other words, TE adhesives have better esthetic results.

CONCLUSIONS

The type of bonding technique (ER and SE) does not affect the risk and degree of POS in class I/II and class V restorations. Further research is required to verify whether these findings apply to different forms of composite resin restorations.

CLINICAL RELEVANCE

Besides the fact that TE barely increase postoperative sensitivity, it also yields superior cosmetic results.

Clinical Efficacy of Two Different Desensitizers in Reducing Postoperative Sensitivity Following Composite Restorations

Objective: The objective is to evaluate the efficacy of different desensitizing agents in the reduction of postoperative sensitivity after composite restoration.

Materials and methods: Class I cavities were prepared in 39 patients by the same operator. The patients included in the study were between 20 and 45 years with vital pulp and a remaining dentin thickness of 1mm. Previously restored, nonvital and tooth with periodical changes were excluded. Patients were randomly assigned into three groups of 13 each - Group I (Control); Group II (Gluma desensitizer) and Group III (shield active desensitizer [SAD]). After the surface treatment, the teeth were restored with composite. The patients were assessed for postoperative sensitivity at 24 hours and one week with a visual analog scale (VAS).

Statistical Analysis: Data were analyzed using SPSS v23 software. Data were analyzed using one-way ANOVA and post-hoc Tukey test.

Results: Gluma and SAD on comparison with control group i.e. composite group showed statistical significance difference at day 1 (P-value 0.003), but on comparing the sensitivity after one week, there is no significant difference in sensitivity score between all three groups (P-value 0.073). There was no statistically significant difference between day 1 and one week when comparing Gluma desensitizer and SAD.

Conclusion: The application of the desensitizer led to a statistically significant reduction in postoperative sensitivity on day 1 and a clinically significant reduction was observed at one week.

Bonding CAD/CAM materials with current adhesive systems: An overview

Objective

Data sources

Results

Conclusion

Efficacy of Three Commercially Available Desensitizers in Reducing Post-Operative Sensitivity Following Composite Restorations: A Randomized Controlled Clinical Trial

One of the most widely used esthetic restorations in dentistry is composite. The widespread application of composites can be related to advancements in biomaterials. However, due to various factors, composites are commonly associated with dental sensitivity. Hence, the present study evaluates and compares the effectiveness of three desensitizing agents in reducing post-treatment sensitivity for Class I composite restoration. Eighty subjects with Class I cavities were selected according to the inclusion criteria, and a randomized, double-blind, controlled clinical trial was carried out. Twenty patients were randomly assigned to four groups: Group C (Control group), Group GL (Gluma group), Group SF (Shield Force Plus group), and Group TC (Telio CS group). The desensitizers were applied after Class 1 cavity preparation and acid etching in all the groups, except the Control group, and thereafter, composite restoration was completed in a conventional manner. Questionnaires were provided to all the participants to record the post-operative pain/sensitivity level according to the visual analogue scale (VAS) on intake of cold drinks, intake of hot drinks, and intake of sugar for different periods of time. Significant variation was observed between the three desensitizers for all three stimuli. However, no significant variations were seen with the various age groups and between the maxillary and the mandibular teeth at the different time periods. Group GL performed better than Group SF and Group TC. It can be proposed that the application of the desensitizers reduced the post-restorative sensitivity in the composite restorations and improved acceptance.

Dentin conditioned with a metal salt-based conditioner

OBJECTIVES

Universal adhesives (UAs) can optionally be applied in either an etch-and-rinse (E&R) or self-etch (SE) bonding mode. As the preferred bonding mode differs for enamel versus dentin, a universal conditioner for both enamel and dentin in replacement of the relatively aggressive phosphoric-acid etchant remains desirable. This study aimed to test if a metal salt-based etchant (ZrO(NO₃)₂) provides as durable bonding to dentin as a classic E&R or SE bonding mode METHODS: Before applying the UA Adhese Universal ('AdU'; Ivoclar Vivadent) to bur-cut dentin of 24 teeth (n = 8), dentin was conditioned with either (1) an experimental metal salt-based conditioner ('ZON'; Ivoclar Vivadent) or (2) 37% phosphoric acid (Total Etch gel, Ivoclar Vivadent), representing a classic 'E&R' mode; (3) a third experimental group involved AdU applied in SE mode. Bonding effectiveness was determined in terms of immediate ('1w') and aged ('50k' TC) micro-tensile bond strength (μTBS) to bur-cut dentin. Adhesive-conditioned dentin interfacial interactions were characterized by S/TEM.

RESULTS

Linear mixed-effects modeling revealed significantly higher immediate μTBS to dentin of ZON_AdU than E&R_AdU, while ZON_AdU performed not significantly different from SE_AdU. No significant differences were found between the three experimental groups after 50k TC (aged μTBS). S/TEM disclosed less exposure of dentinal collagen fibrils when AdU was bonded upon ZON etching than when applied in E&R mode. Moreover, ZON resulted in more hydroxyapatite (HAp) crystals remaining at the bottom of the hybrid layer, while dentinal tubule orifices remained nearly fully closed, by which hardly any resin tags were formed.

SIGNIFICANCE

The alternative metal salt-based conditioner revealed at dentin a more HAp-protected hybrid layer with less exposure of collagen fibrils, while a comparable bond strength was obtained to that with a phosphoric-acid E&R as well as with an SE (no conditioner) bonding mode. These findings confirm that the metal salt-based conditioner can be considered as a suitable alternative (enamel/)dentin conditioner to classic phosphoric acid employed in an E&R bonding mode.

The effect of ethanol wet bonding technique on postoperative hypersensitivity of Class II composite restorations: A randomized trial

Background

To evaluate the effect of Ethanol Wet Bonding Technique (EWBT) on postoperative hypersensitivity (POH) of composite restorations in premolar teeth.

Materials and Methods

In this randomized trial, 24 patients with at least three proximal carious lesions with similar axial depth and position of gingival floor in their premolars were enrolled. Following cavity preparation, the teeth were randomly assigned to one of three groups: (1) Class II resin-based composite (RBC) restoration using an etch-and-rinse adhesive + wet bonding technique (Control); (2) RBC restoration using EWBT + hydrophobic adhesive; and (3) RBC restoration using EWBT + hydrophilic adhesive. Tooth hypersensitivity was evaluated before and 1, 3, 7, 14 and 30 days after treatment according to the Visual Analog Scale. Data were analyzed statistically with Kruskal-Wallis and Friedman tests (P = 0.05).

Results

All teeth showed similar levels of hypersensitivity after treatment (both P > 0.05). Furthermore, there was no difference between POH levels of the test and control groups at any control period (P < 0.05). Friedman test indicated that the POH significantly reduced within time in all groups (P < 0.05).

Conclusion

Application of ethanol-wet bonding technique, either with hydrophobic or hydrophilic adhesives did not affect the POH of Class II composite restorations in premolars.

Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: A randomized clinical trial

OBJECTIVES

To evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy.

METHODS

Class I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer - GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months.

RESULTS

No significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05).

CONCLUSIONS

The previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used.

CLINICAL SIGNIFICANCE

The use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology

OBJECTIVES

This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies.

METHODS

A systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0-2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration's tool version 1.0.

RESULTS

A total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal's impact factor was not correlated with the overall CONSORT score (p = 0.36).

CONCLUSIONS

The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement.

CLINICAL RELEVANCE

Most RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.

One-Year Clinical Performance of the Fast-Modelling Bulk Technique and Composite-Up Layering Technique in Class I Cavities

The aim of this study was to assess the one year clinical performance of a new application method, the Fast-Modelling Bulk Technique (FMBT), in comparison to the Composite-Up Layering Technique (CULT) in posterior cavities. Thirty patients with two class I cavities on permanent human molars were enrolled in the present study. A total of sixty class I cavities were prepared and randomly divided according to the restoration technique used: 30 cavities restored by incremental layering technique and modelling of the last layer with Composite-Up Technique (CUT) using the composite Filtek Z250XT (3M ESPE; St. Paul, MN, USA) and the other 30 restored by Bulk Filling technique and modelling of the last layer by Fast-Modelling Technique (FMT) using the composite Filtek Bulk Fill Posterior Restorative (3M ESPE; St. Paul, MN, USA). Restorations were evaluated for up to one year by two observers according to Federation Dentaire Internationale (FDI) criteria, through clinical and radiological exams. Exact Fisher tests were used for statistical analysis. (p ≤ 0.05). From a biological perspective, at baseline, teeth restored with both techniques did not reveal any postoperative sensitivity. However, with time, FMBT showed less postoperative sensitivity and therefore more desirable results than CULT with a nonsignificant difference after one year (p > 0.05). Concerning secondary caries, fracture of the material, and marginal adaptation, no significant difference was noted between both techniques (p > 0.05). Regarding marginal staining, CULT resulted in more staining with a significant difference, as compared to FMBT (p < 0.05). Upon radiological examination, FMBT showed a good marginal fit during the first year, whereas CULT showed small empty voids from baseline with a nonsignificant difference (p = 1.00). After one year of clinical function, both techniques showed promising results. The present study indicates that the new FMBT could have a positive effect on the marginal staining of resin composite.

Effect of 940 nm laser diode irradiation prior to bonding procedure on postoperative sensitivity following class II composite restorations: a split-mouth randomized clinical trial

The aim of this study was to evaluate the effect of 940 nm laser diode on class II composite cavities prior to bonding and restoration process on the postoperative sensitivity (POS). Thirty patients with two bilateral premolars with mesio or disto-occlusal carious lesions were evaluated. In each patient, the teeth were randomly divided into the control and laser groups. After cavity preparation and isolation and before the bonding process, the laser group was subjected to 940 nm irradiation (Epic 10, Biolase, USA) by 400 μ tip continuously at 100 mW with 398 J/cm² energy density of tip, which was applied for 5 s at a distance of 2 mm on the axial wall of the cavity. In the control group, irradiation was performed by using the aiming beam. Access cavity was then restored with a composite resin. Cold sensitivity was measured using a cold spray application on the middle third of teeth buccal surface at baseline (before the intervention), 1, 14, and 30 days after the restoration by visual analog scale (VAS) criteria. The mean Friedman and Wilcoxon signed-rank tests were used for data analysis. It was shown that in both laser and control groups, the VAS was significantly decreased at all times compared to the baseline (p ≤ 0.05). There was no statistically significant difference between the mean VAS of two groups at baseline and first day (p ≤ 0.05), but at 14 and 30 days after the intervention, it was significantly lower in the laser group (p ≤ 0.05). The results of this study demonstrated that the cavity pretreatment with laser diode (940 nm) effectively reduces the postoperative sensitivity in class II composite restorations.

Effect of different cement systems and aging on the bond strength of chairside CAD-CAM ceramics

STATEMENT OF PROBLEM

The bond strength of different chairside computer-aided design and computer-aided manufacturing (CAD-CAM) restorative materials to dentin with different resin cements needs to be evaluated.

PURPOSE

The purpose of this in vitro study was to investigate the effect of 3 different cementation systems after thermal aging on the shear bond strength of different CAD-CAM materials.

MATERIAL AND METHODS

The occlusal surfaces of 63 molar teeth of similar size were removed, and 21 zirconia-reinforced lithium disilicate (Vita Suprinity-VS), 21 polymer infiltrated ceramic (Vita Enamic-VE), and 21 resin nanoceramic (GC Cerasmart-GC) rectangular specimens of 2.5 mm in thickness were obtained. The ceramics were cemented using total etch (TE), self-etch (SE), and self-adhesive (SA) cement systems. Half of the specimens were subjected to thermal aging with 5000 cycles. The shear bond strength test of all the specimens was measured. Fractured ceramic surfaces were examined by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDX) analysis. The Shapiro-Wilk test, 3-way analysis of variance (ANOVA), and Fisher Least Significant Difference (LSD) tests were used to analyze the shear bond strength test data (α=.05).

RESULTS

The highest bond strength value was found in the nonthermal aged VS-TE and the lowest in the thermal aged VE-TE. Significant interaction was found between TE and SE cemented ceramics (P<.001). For specimens cemented with the SA system, significant interaction was found among ceramics with thermal aged specimens (P<.001). Thermal aging significantly decreased the mean bond strength (P<.05).

CONCLUSIONS

Differences in bond strength were observed in chairside CAD-CAM ceramics when cemented with TE, SE, and SA systems. Additionally, thermal aging significantly reduced the bond strength values of all the ceramic materials, regardless of the cementation procedure. Clinicians should consider these variables and choose the most suitable cementation systems for the material used.

Comparison of physical properties of three commercial composite core build-up materials

Various materials have been used for core build-up when restoring the coronal portion of the tooth. Currently, bulk-fill resin composites have been produced to restore a large posterior cavity in single increment. This study aimed to evaluate the compressive strength, flexural strength, and microhardness of three commercial composite core build-up materials. All data were analyzed by oneway ANOVA and Tukey test methods (α=0.05). Flexural strength data were subjected to Weibull statistics analysis. All three groups presented significant differences in the compressive strength, flexural strength, and Knoop hardness. Filtek^TM Z350 XT had the greatest compressive strength (MPa) and Knoop hardness while Filtek^TM bulk fill had the highest flexural strength. MultiCore^®Flow had the lowest properties; however, it revealed the highest Weibull modulus (m) value. With regard to the properties tested in this study, bulk-fill resin composite can be used as an alternative to conventional resin composite for core build-up material.

An Overview of Dental Adhesive Systems and the Dynamic Tooth-Adhesive Interface

From the conception of resin-enamel adhesion to today's contemporary dental adhesive systems, clinicians are no longer afraid of exploring the many advantages brought by adhesive restorative concepts. To maximize the performance of adhesive-based restorative procedures, practitioners must be familiar with the mechanism of adhesion, clinical indications, proper handling, the inherent limitations of the materials and the biological challenges. This review provides an overview of the current status of restorative dental adhesives, their mechanism of adhesion, mechanisms of degradation of dental adhesive interfaces, how to maximize performance, and future trends in adhesive dentistry.

Comparison of two test designs for evaluating the shear bond strength of resin composite cements

OBJECTIVE

To compare a shear bond strength test for resin composite cements developed in order to better consider the shrinkage stress (here termed "Swiss shear test") with the shear test design according to ISO 29022.

METHOD

Four restorative materials (VITA Enamic (VE), VITA Suprinity (VS), Vitablocs Mark II (VM) and VITA YZ T (YZ)) served as substrate. VE, VS and VM were polished or etched. YZ was polished, sandblasted or etched. Specimens were either bonded according to the Swiss or the ISO shear test. RelyX Unicem 2 Automix, Maxcem Elite and PermaFlo DC were used as cements. Shear bond strength (SBS) was measured. Failure modes (adhesive, cohesive or mixed) were evaluated by means of SEM.

RESULTS

Mean SBS values obtained with the Swiss shear test were significantly lower than those obtained with the ISO shear test. VE and VM exhibited similar SBS, values of VS were significantly higher. On etched surfaces VM and VE exhibited primarily cohesive failures, VS primarily adhesive failures. On polished substrates significantly lower bond strength values and exclusively adhesive failures were observed. YZ exhibited solely adhesive failures. Compared to polished YZ, SBS significantly increased after sandblasting and even more after etching. Only for adhesively failed specimens mean SBS values of Swiss and ISO shear test were strongly correlated.

SIGNIFICANCE

Both test designs showed the same ranking of test results. When adhesive failure occurred test results were strongly correlated. When cohesive failure was involved, both test designs did not provide reliable results.

Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?: A systematic review and meta-analysis

OBJECTIVES

A systematic review and meta-analysis were performed on the risk and intensity of postoperative sensitivity (POS) in posterior resin composite restorations bonded with self-etch (SE) and etch-and-rinse (ER) adhesives.

SOURCE

A comprehensive search was performed in the MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The abstracts of the annual conference of the IADR (1990-2014), unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and Periodicos Capes Theses databases.

STUDY SELECTION

We included randomized clinical trials that compared the clinical effectiveness of SE and ER used for direct resin composite restorations in permanent dentition of adult patients. The risk/intensity of POS was the primary outcome. The risk of bias tool of the Cochrane Collaboration was used. The meta-analysis was performed on the studies considered 'low' risk of bias.

DATA

After duplicates removal, 2600 articles were identified but only 29 remained in the qualitative synthesis. Five were considered to be 'high' risk of bias and eleven were considered to be 'unclear' in the key domains, yielding 13 studies for meta-analysis. The overall relative risk of the spontaneous POS was 0.63 (95% CI 0.35 to 1.15), while the stimuli-induced POS was 0.99 (95% CI 0.63 to 1.56). The overall standardized mean difference was 0.08 (95%CI -0.19 to 0.35). No overall effect was revealed in the meta-analyses, meaning that no influence of the ER or SE strategy on POS.

SIGNIFICANCE

The type of adhesive strategy (ER or SE) for posterior resin composite restorations does not influence the risk and intensity of POS. CRD42014006617.

Influence of air abrasion and sonic technique on microtensile bond strength of one-step self-etch adhesive on human dentin

The purpose of this in vitro study was to evaluate the microtensile bond strength of one-step self-etch adhesive to human dentin surface modified with air abrasion and sonic technique and to assess the morphological characteristics of the pretreated dentin surface. The occlusal enamel was removed to obtain a flat dentin surface for thirty-six human molar teeth. The teeth were randomly divided into three experimental groups (n = 12 per group), according to the pretreatment of the dentin: (1) control group, (2) air abrasion group, and (3) sonic preparation group. Microtensile bond strength test was performed on a universal testing machine. Two specimens from each experimental group were subjected to SEM examination. There was no statistically significant difference in bond strength between the three experimental groups (P > 0.05). Mean microtensile bond strength (MPa) values were 35.3 ± 12.8 for control group, 35.8 ± 13.5 for air abrasion group, and 37.7 ± 12.0 for sonic preparation group. The use of air abrasion and sonic preparation with one-step self-etch adhesive does not appear to enhance or impair microtensile bond strength in dentin.