The level of knowledge and acceptance towards the COVID-19 vaccine among the community in Johor Bahru, Johor

INTRODUCTION

Several necessary initiatives have been made to create a readily available vaccine against the Coronavirus Disease 2019 (COVID-19) worldwide pandemic. However, the vaccination program's success is dependent on the population's willingness as well as their knowledge of vaccination. Hence, the present study aimed to assess the level of knowledge and acceptance towards the COVID-19 vaccine among the community in Johor Bahru, Johor.

MATERIALS AND METHODS

A cross-sectional study was conducted using an online survey between February and May 2022, with 423 respondents. The questionnaire consisted of socio-demographic, assessment of knowledge level and acceptance level towards COVID-19 vaccine. The descriptive analysis and non-parametric tests were employed to investigate the study outline objectives.

RESULTS

Of all 423 participants, 293 (69.3%) of the participants had a high level of knowledge about the COVID- 19 vaccine (median knowledge score 6; IQR = 3), and 239 (56.5%) were reported to have a low level of vaccine acceptance (median acceptance scores 4; IQR=2). The knowledge level towards the COVID-19 vaccine was significantly associated with the vaccine acceptance level (p<0.001).

CONCLUSION

The community's level of knowledge towards COVID-19 vaccine was high; however, the vaccine acceptance was low.

Effect of at-home and in-office bleaching on microleakage of class V composite resin restorations using different types of universal adhesives: An in vitro study

Background

When bleaching agents contact dental structures, they act on restorative materials and adhesive interfaces. This study investigated the effect of "at-home" and "in-office" bleaching on the microleakage of composite resin restorations performed with different universal adhesives in self-etch and etch-and-rinse modes.

Methods

Class V cavities were prepared in 132 premolars. The samples were divided into four groups (n=33). All Bond Universal adhesive was used in the first and second groups, and G-Premio Bond adhesive was used in the third and fourth groups. The total-etch mode was used in the first and third groups, and the self-etch mode was used in the second and fourth groups. The samples were divided into three subgroups (n=11). In the first subgroup, home bleaching was used, and in the second subgroup, office bleaching was used. In the third subgroup, bleaching was not performed. The specimens were examined under a stereomicroscope for microleakage. Ordinal regression analysis was applied (P<0.05).

Results

The adhesive type, application method, and margin type significantly affected microleakage (P<0.05). The amount of microleakage in All Bond Universal adhesive was significantly higher than in G-Premio Bond adhesive. The chance of microleakage in the self-etch mode was almost twice as high as in the etch-and-rinse mode. The bleaching method did not significantly affect microleakage (P>0.05).

Conclusion

Based on the results of the microleakage test, bleaching after composite resin restorations did not significantly affect the microleakage of Class V restorations.

Effect of Incorporating Titanium Dioxide Nanoparticles into White Portland Cement, White Mineral Trioxide Aggregate, and Calcium Enriched Mixture Cement on the Push-out Bond Strength to Furcal Area Dentin

Statement of the Problem

Bond strength of furcation repair materials is an essential factor in clinical success. Studies on the effect of adding titanium dioxide (TiO2) nanoparticles on the push-out bond strength of commonly used endodontic cements for furcation perforation repair is limited.

Purpose

This study aimed to evaluate the effect of adding TiO2 nanoparticles to white Portland cement (PC), white mineral trioxide aggregate (MTA), and calcium enriched mixture cement (CEM) on their push-out bond strengths.

Materials and Method

In this in vitro study, 120 endodontically treated molars were assigned to six groups (n=20) based on the material used to repair the perforation. In three groups, the cements (white PC, white MTA, and CEM) were placed in pure form, and in the three remaining groups, 1 weight % of TiO2 was added. The push-out bond strength was measured using a universal testing machine at a strain rate of 0.5 mm/min. Data were analyzed using one-way ANOVA and post hoc Games-Howell test (p< 0.05).

Results

One-way ANOVA showed significant differences in the mean bond strength values between the six groups (p= 0.002). The post hoc Games-Howell test showed that the bond strengths in MTA+TiO2 and PC+TiO2 groups were significantly higher than those in MTA and PC groups, respectively. However, there was no significant difference in the bond strength between CEM and CEM+ TiO2 groups.

Conclusion

The incorporation of TiO2 into MTA and PC increased their push-out bond strength. However, it did not affect the push-out bond strength of CEM cement.

Comparison of the effect of preheating on the flexural strength of giomer and nanohybrid composite resin

Background. Considering the increased use of preheating and novel resin-based materials to restore teeth, the present study investigated the impact of preheating on the flexural strength of a giomer and compared it with a nanohybrid composite resin. Methods. Two restorative materials (Beautifil II giomer and Alpha III nanohybrid composite resin) were used. Thirty rod-shaped samples (adding up to 60 samples) were prepared from the materials above and divided into two subgroups: with and without preheating (n=15). Before sample preparation, the giomer and nanohybrid composite resin tubes were preheated at 68ºC for 15 minutes in the preheating subgroups. In the subgroups without preheating, the tubes were kept in a room at 25ºC. Then the flexural strength was compared between the two groups with two-way ANOVA at a significance level of P<0.05. Results. The results showed significantly higher flexural strength in the preheated subgroups than in the non-preheated subgroups (P<0.001). In addition, the mean flexural strength values were significantly higher in the giomer groups than in the nanohybrid composite resin groups (P<0.001). Conclusion. Preheating increased the studied materials' flexural strengths significantly. The flexural strength of the giomer restorative material was higher than that of the nanohybrid composite resin, irrespective of preheating.

Effect of intraradicular reinforcement strategies on the fracture strength of endodontically treated anterior teeth with overflared canals

Background

This study is done to evaluate the effect of different reinforcement techniques of overflared root canals with fiber posts on the fracture resistance of endodontically treated anterior teeth. It also introduces a new technique for simultaneous reinforcement and cementation of fiber posts using dual-cured core build-up composite resin.

Material and Methods

The crowns of 48 single-rooted maxillary anterior teeth were cut and randomly divided into 4 groups (n=12) based on root reinforcement techniques after root canal treatment and post space preparation: Group 1: self-adhesive resin cement (SARC), Group2: dual-cure composite resin (DCC), Group3: Composite resin reinforcement (CRR), Group 4: Direct anatomical post (DAP). Then a core was made for the roots. The periodontal ligament was simulated using a thin layer of PVC impression material. A universal testing machine applied a compressive force to the lingual surface at an angle of 135 ° and 1 mm/min speed. Data were analyzed using One-Way ANOVA and a post-hoc Tukey test. Fracture patterns were analyzed using the Chi-square test (p<0.05).

Results

The difference between the control and DAP group was statistically significant (p=0.01), but there were no significant differences between other groups (p>0.05). Regarding fracture patterns, there were no significant differences between groups.

Conclusions

All reinforcement techniques increased the fracture strength compared to the control group. However, DAP was the only group that had a statistically significant difference. CRR and DCC presented intermediate values without significant differences.

Key words:Fiber post, endodontically treated teeth, root canals, reinforcement, fracture strength.

Effect of RaCe, ProTaper, and V-Taper rotary systems on dentinal crack formation during endodontic treatment: An in vitro study

Background. Prevention of dentinal crack formation is of utmost importance in endodontic treatment. This study aimed to evaluate the effect of RaCe, ProTaper, and V-Taper rotary systems on dentinal crack formation in three root regions during endodontic treatment.

Methods. Seventy human mandibular first molars were selected randomly, and their distal roots were used. Ten samples were assigned to the control group, and sixty samples were assigned to three groups (n=20). Each group was prepared with RaCe, ProTaper, or V-Taper rotary files according to the manufacturers’ instructions. A stereomicroscope was used to view cracks at ×40 magnification. Friedman’s, chi-squared, and Kruskal-Wallis tests were used for statistical analysis of data (P < 0.05).

Results. A comparison of the three rotary systems did not reveal any significant differences in the number of cracks between the three root thirds evaluated (P > 0.05). A comparison of the number of cracks in the coronal, middle, and apical thirds in each rotary system showed that the number of cracks in the middle third was fewer than that in the two other thirds only in the V-Taper group (P < 0.05), with no significant differences in the ProTaper and RaCe groups between the different root regions (P > 0.05).

Conclusion. The application of RaCe, ProTaper, and V-Taper rotary files resulted in a similar rate of crack formation in endodontic treatment. V-Taper files created the minimum number of cracks in the middle third.

Effect of curing method and thermocycling on flexural strength and microhardness of a new composite resin with alkaline filler

BACKGROUND

Cention N has been introduced as an alternative material for amalgam. The purpose was to investigate the flexural strength and microhardness of this material in self-cure and dual-cure modes before and after thermocycling.

MATERIALS AND METHODS

In this experimental study, 40 samples of Cention N were prepared in order to determine and compare the microhardness. Half of the samples were set by self-cure method and the other half with dual-cure method. The Vickers microhardness test was performed once after 24 h and again after 10000 thermocyclings. Three-point flexural test was used to determine and compare the flexural strength of 52 rod-shaped samples. Half of the samples were set by self-cure method and the other half with dual-cure method. Among 26 samples in each group, 13 samples were randomly selected and three-point flexural test was performed after 24 h and for another 13 samples after 10,000 thermocyclings. Data were analyzed using two-way ANOVA and paired samples t-test (P < 0.05).

RESULTS

There was a statistically significant difference between the mean of microhardness values in two curing methods (P < 0.001) and in two storage conditions (P < 0.001). The mean of dual-cure microhardness (100.99 ± 7.22) was higher than that of self-cure (64.61 ± 12.51) and the mean value associated with pre-thermocycling (89.75 ± 15.84) was higher than that of the post-thermocycling (76.44 ± 23.56). There was no statistically significant difference between the mean flexural strength in the two curing methods (self-cure [72.85 ± 16.26], dual cure [79.87 ± 23.07]; [P > 0.05]). However, the mean flexural strength without thermocycling (85.98 ± 21.74) was higher than that of the thermocycled group (64.24 ± 6.40) (P < 0.001).

CONCLUSION

The microhardness of Cention N in dual-cure mode was higher than that of self-cure mode, but the flexural strength of dual-cure was not significantly different from that of self-cure. Thermocycling had a significant effect on the microhardness and flexural strength.

Influence of Varying Dentin and Enamel Layer Thicknesses of Nano-composite Resins on Color Match between Lithium Disilicate Dental Ceramic and Composite Resins

Objectives: The aim of this study was to evaluate the influence of varying dentin and enamel layer thicknesses of two nano-composite resins on color match of composite resins and lithium disilicate dental ceramic. Materials and Methods: Twenty-six specimens of two types of nano-composite resins, Opallis and Vittra, were fabricated using the two-layered technique with different thickness ratios of enamel and dentin composites (A2 shade) with a total thickness of 1.2mm. Thirteen discs of the same shade and thickness of IPS e.max Press LT (low translucency) lithium disilicate dental ceramic were also fabricated. Specimen color was measured with a spectrophotometer. The difference in color (ΔE00) of composite and ceramic specimens, and the translucency parameter (TP) of all specimens were calculated. Data were analyzed using multi-factor ANOVA (P<0.05). Results: The color difference (ΔE00) values of composites and ceramic were not clinically acceptable in any areas of either of the two composites (ΔE00>2.25). But ΔE00 between the two composite resins was in the clinically acceptable range (ΔE00<2.25). The mean TP value of IPS e.max Press was greater than that of Vittra and lower than that of Opallis. Conclusion: In similar thicknesses, composite resins with any enamel/dentin thickness ratio could not successfully simulate the color and translucency of IPS e.max Press LT ceramic.

The effects of different surface contaminators on the shear bond strength of a universal adhesive system to dentin: an experimental study

Background. Contamination of dentin surface is one of the common problems in restorative dentistry. The aim was to investigate the effects of different surface contaminators on the dentin shear bond strength (SBS) of universal adhesive system (UAS) applied in etch-and-rinse (ER) and self-etch (SE) strategies.

Methods. One hundred forty-four maxillary anterior sound human teeth were divided into six groups based on the types of surface contaminators: no surface contaminator (control) and experimental groups contaminated with blood, saliva, aluminium chloride (ALC), ferric sulphate (FS), and caries disclosing agent (CDA). Then, each group was further subdivided into two, based on the application strategy of UAS (ER and SE). After applying the adhesive according to the manufacturer’s instructions, and bonding cylindrical composite samples, the SBS was measured. The data were analysed using two-way ANOVA, Tukey’s HSD test and t test (P < 0.05).

Results. The SBS in all contaminated groups, except for CDA, was significantly lower in both ER and SE strategies compared to control group (P < 0.05). A comparison between the application strategies revealed that ER and SE were only significantly different in the FS contaminated group (P < 0.05).

Conclusion. All tested contaminators, except CDA, significantly decreased SBS of UAS in both ER and SE strategies.

Effect of accelerated aging and double application on the dentin bond strength of universal adhesive system

BACKGROUND

Despite the many advantages of simplified adhesive systems, there are concerns about the durability of the adhesive layer over time. The aim was to investigate the effects of various aging methods and double application of an adhesive layer on the bond strength of the universal adhesive system using etch-and-rinse (ER) and self-etch (SE) strategies.

MATERIALS AND METHODS

In this in vitro study, the occlusal enamel of 120 extracted, intact human third molars was removed to expose the dentin. Then, the samples were randomly divided into four groups of thirty according to All-Bond Universal (ABU) adhesive application strategy (ER and SE) and the number of adhesive layers (1 or 2). Then, each group was subdivided into three subgroups of ten according to aging method (control, thermal cycling, and 10% sodium hypochlorite [NaOCl]). The shear bond strength was measured at the strain rate of 0.5 mm/min. Data were analyzed using three-way ANOVA and Tukey's post hoc tests (P < 0.05).

RESULTS

The effect of adhesive application strategy (P < 0.001) and aging method (P < 0.001) on the bond strength was statistically significant, but the effect of the double application was not statistically significant (P > 0.05). In addition, the interactive effect of adhesive application strategy-aging method was significant (P = 0.005).

CONCLUSION

Using ABU with ER strategy leads to higher dentin bond strength compared to the SE method in the control and thermal cycling groups. However, no significant differences were observed between ER and SE strategies after aging with the NaOCl. Furthermore, the double application might not have any effect on the bond strength and durability.

Effect of Cavity Disinfection with Chlorhexidine on Marginal Gap of Class V Composite Restorations Bonded with a Universal Adhesive Using Self-Etch and Etch-and-Rinse Bonding Strategy

Objectives:

This in-vitro study aimed to evaluate the effect of cavity disinfection with chlorhexidine (CHX) on marginal gaps of Class V composite resin restorations bonded with a universal adhesive using self-etch and etch-and-rinse bonding strategy.

Materials and Methods:

Sixty sound human premolars were randomly assigned to two groups (n=30): group 1 (CHX) and group 2 (no CHX). Each group was divided into two subgroups (n=15) according to the bonding strategy of the universal adhesive (self-etch or etch-and-rinse). Class V cavities were prepared on the buccal surfaces of the teeth. The occlusal and gingival margins of the cavities were placed in enamel and dentin, respectively. In the first and second subgroups of both groups, the All-Bond Universal adhesive was applied with self-etch and etch-and-rinse bonding strategy, respectively. After restoration and thermocycling, the samples were sectioned, and marginal gaps at the gingival margins were measured in micrometer (μm) under a stereomicroscope. Two-way analysis of variance (ANOVA) was used to compare marginal gaps between the groups and the subgroups.

Results:

The mean marginal gap size was significantly affected by cavity disinfection (P=0.001) and bonding strategy (P=0.002). However, the interaction effect of these two factors on the mean marginal gap size was not significant (P=0.79).

Conclusion:

The use of CHX resulted in larger marginal gaps at the gingival margins of Class V composite resin restorations. Irrespective of disinfection, the self-etch bonding strategy resulted in larger marginal gaps compared to the etch-and-rinse bonding strategy.

Correction to: Comparison of the effect of bleaching with 15% carbamide peroxide and 35% hydrogen peroxide on flexural strength of Cention N in self-cured and dual-cured polymerization modes

[This corrects the article DOI: 10.34172/joddd.2020.023.].

Effect of Bleaching Method and Curing Time on the Surface Microhardness of Microhybrid Composite Resin

Objectives: The present study aimed to evaluate the effect of curing time and bleaching agents on microhybrid composite resin surface microhardness. Material and method: A total of 180 microhybrid composite resin disks were divided into two groups in terms of curing time: 40 s, 60 s. Then, each group was divided into three subgroups: control (distilled water), home bleaching (15% carbamide peroxide) and office bleaching (40% hydrogen peroxide). Surface microhardness of the samples was determined by using Vickers hardness test both at baseline and after the completion of the tests. Two-way ANOVA and Tukey HSD tests were used to analyze and compare microhardness changes between groups. Statistical significance was defined at P<0.05. Results: Based on the two-way ANOVA, curing time, bleaching method, and cumulative effect of these two variables significantly affected composite resin microhardness (P<0.001). Tukey HSD tests showed that microhardness had significantly decreased in the bleaching groups, with the highest decrease when the office bleaching method was used (P<0.001). The samples cured for 40 s exhibited lower microhardness than those cured for 60 s and had an increased reduction in microhardness after bleaching (P<0.001). Conclusions: Application of both bleaching methods decreased the surface hardness of microhybrid composite resin. An increase in the curing time was associated with a decrease in adverse effects of bleaching agents on microhardness.

The effect of pre-heating on monomer elution from bulk-fill resin composites

Background

The present study was aimed to evaluate the effect of pre-heating of bulk -fill resin composites on monomer elution from them.

Material and Methods

Three different types of resin composites were used including Tetric N-Ceram Bulk Fill, X-tra Fill and X-tra Base. 10 cylindrical samples were prepared from each resin composites. Before light curing, 5 samples were pre-heated until reaching 68˚C, then 5 other samples were polymerized at room temperature. After 24 hours, release of UDMA, TEGDMA and BIS-GMA monomers were measured by High-Performance Liquid Chromatography analysis. Data analysis was performed by two-way ANOVA test, Games-Howell and Sidak post hoc tests.

Results

Pre-heating did not have any statistically significant effect on the mean values of UDMA, TEGDMA and Bis-GMA elution (p>0.05). The greatest amount of released Bis-GMA and UDMA was obtained from Tetric N-Ceram Bulk-fill composite. The greatest amount of released TEGDMA was obtained from X-tra Fill composite. X-tra Base composite showed the lowest amount of monomer release (P<0.001).

Conclusions

Pre-heating did not have any effect on monomer release from bulk-fill resin composites. Moreover, the amount and the type of monomers released from various bulk-fill resin composites were not similar.

Key words:Bulk fill composite resin, elution, HPLC, residual monomer, temperature.

Comparison of the effect of bleaching with 15% carbamide peroxide and 35% hydrogen peroxide on flexural strength of Cention N in selfcured and dual-cured polymerization modes

Background. The use of bleaching agents might result in microstructural changes in tooth structure and in restorative materials. This study compared the effects of bleaching with %15 carbamide peroxide and %35 hydrogen peroxide on the flexural strength of Cention N restorative material using the self-cured and dual-cured polymerization modes. Methods. Sixty bar-shaped samples of Cention N restorative material were included in this in vitro study and assigned to three groups (n=20) randomly: control, bleaching with %15 carbamide peroxide and bleaching with %35 hydrogen peroxide. Each group was divided into two subgroups: samples polymerized in the self-cured mode and samples polymerized in the dual-cured mode. Then the flexurals trengths of the samples were determined. Two-way ANOVA was used to compare flexural strengths between the three groups in two polymerization modes, followed by post hoc Tukey test. Statisticals ignificance was defined at P<0.05. Results. The difference in the mean flexural strength was significant in terms of the bleaching regimen (P<0.001), with significantly lower flexural strength in the two bleaching groups compared to the control group. However, the mean flexural strengths were not significantly different in terms of the polymerization mode applied (P=0.14). Conclusion. The application of %15 carbamide peroxide and %35 hydrogen peroxide bleaching agents decreased the flexural strength of Cention N restorative material. Irrespective of the bleaching regimen, there was no significant difference in the flexural strength of Cention N between the self-curing and dual-curing polymerization modes.

Effect of preheating on the cytotoxicity of bulk-fill composite resins

Background. Due to the effect of pre-heating on the degree of conversion of composite resins and the possible effect on cytotoxicity, the effect of pre-heating of bulk-fill composite resins was investigated on cytotoxicity in this study. Methods. In this study, three different types of composite resin were used, including Tetric N-Ceram Bulk-Fil, Xtrafil, and Xtrabase. From each composite resin, 10 cylindrical samples (5 mm in diameter and 4 mm in height) were prepared, with five samples preheated to 68°C, and the other five samples polymerized at room temperature (25°C). Twenty-four hours after polymerization, cytotoxicity was assessed by MTT assay on human fibroblasts. Statistical analysis of data was carried out with two-way ANOVA and Sidak Post-Hoc. The significance level of the test was determined at 0.05. Results. There was no statistically significant difference between the mean percentage of cytotoxicity in terms of pre-heating (P>0.05), but the cytotoxicity of the studied composite resins was significantly different (P<0.001). The cytotoxicity of Tetric N-Ceram Bulk-fil composite resin was higher than that of the two other composite resins. Conclusion. Pre-heating of bulk-fill composite resin did not affect their cytotoxicity. In addition, the cytotoxicity of different bulk-fill composite resins was not the same.

Effect of different application strategies of universal adhesive used for immediate and delayed dentin sealing on the microtensile bond strength of self-adhesive resin cement to dentin with and without aging

Background

Bond strength of indirect restorations is a very important issue that should be given special attention. Immediate dentin sealing (IDS) technique has been suggested in recent years. The aim of the present study was to investigate the effect of different strategies of universal adhesive application for immediate and delayed dentin sealing (DDS) on the microtensile bond strength (μTBS) of self-adhesive resin cement with and without aging.

Material and Methods

In this experimental study, 24 healthy human third molars were selected. After exposing the occlusal dentin, the teeth were randomly divided into two groups of 12 based on the All-Bond Universal adhesive application strategy (etch-and-rinse or self-etch). Each group was further subdivided into two (n=6) based on IDS or DDS technique. Then composite blocks were cemented on the occlusal surface with self-adhesive resin cement. After cutting the samples into 1 mm2 cross-sections, half of the samples of each subgroup were subjected to µTBS test after one week, and the other half were tested under μTBS after 10,000 thermal cycles. Data were analyzed using three-way ANOVA (P<0.05).

Results

μTBS was significantly affected by all three factors of bond strategy, sealing technique and aging. There was also a significant interaction between the three factors.

Conclusions

Immediate dentin sealing improved μTBS. The etch-and-rinse strategy resulted in higher μTBS, while aging led to a decrease in μTBS. Key words:Adhesives, dental bonding, dentin, universal, sealing.

Surface Roughness of Different Composite Resins after Application of 15% Carbamide Peroxide and Brushing with Toothpaste: An In-Vitro Study

Objectives:

This study aimed to evaluate the effect of toothbrushing after application of 15% carbamide peroxide (CP) on the surface roughness of three types of composite resins.

Materials and Methods:

Twenty samples, measuring 4 mm in height and diameter, were fabricated of three composite resins namely microfilled (MF) Heliomolar HB, nanohybrid (NH) IPS Empress Direct and microhybrid (MH) Tetric Ceram HB. After polishing, the initial surface roughness was measured with a profilometer. The tray technique was used to apply 15% CP gel for 6 hours. Then, cleaning was carried out with an Oral-B electric toothbrush for 3 minutes in a tank containing a freshly mixed toothpaste. These procedures were repeated for 21 days. Then, the surface roughness was measured again and compared with the initial values. A mixed-design ANOVA model was used for the analysis of data (P<0.05).

Results:

The baseline roughness was significantly lower in MF compared to the NH and MH composites (P<0.001). Roughness increased in all study groups during the intervention period; however, this increase was not significant in the MH group (P=0.17). Furthermore, the increase in roughness in MF was smaller than that in NH (P<0.001) and MH (P=0.02) groups.

Conclusion:

The effect of intervention was more pronounced on NH and MH groups. Surface roughness changes were minor in MF composite resin.

Antibacterial activity of self-adhesive resin cements against Streptococcus mutans at different time intervals

BACKGROUND AND OBJECTIVES

Self-adhesive resin cements release fluoride and have cytotoxic and preventive monomers against the bacteria in their composition. They have acidic property before their complete setting too. The antibacterial activity of three different self-adhesive resin cements against Streptococcus mutans at different time intervals was investigated in this study.

MATERIALS AND METHODS

The modified direct contact test was used to evaluate the antibacterial effect of Max-Cem, G-Cem and Bis-Cem on S. mutans after aging the samples in phosphate-buffered saline solution for one hour, 24 hours and 1 week. Data were analyzed using one-way ANOVA, repeated measurement ANOVA and Tukey HSD tests (P<0.05).

RESULTS

The differences in the mean bacterial counts between all the study groups and between the study groups and the corresponding control groups were significant at 1-hour and 24-hour intervals (P<0.001). At 1-week, only the differences between Bis-Cem and G-Cem, between Max-Cem and Bis-Cem, and between Bis-Cem and the corresponding control group were significant (P<0.001). There were significant differences between G-Cem and Max-Cem at all the time intervals (P<0.001). In addition, with the use of Bis-Cem there were significant differences between 1-hour and 1-week (P=0.01) and 24-hour and 1-week (P<0.001).

CONCLUSION

All the cements exhibited antibacterial activity after 1 hour and 24 hours. However, after 1 week, only Bis-Cem retained its antibacterial activity.

Color agreement between try-in paste and resin cement: Effect of thickness and regions of ultra-translucent multilayered zirconia veneers

Background. The current study aimed at identifying the color agreement between try-in pastes and the respective resin cements and investigated the effect of thickness and regions of Ultra-Translucent Multilayered Zirconia Veneers.

Methods. A total of 90 cubic zirconia discs were prepared at two different thicknesses (0.5 mm and 0.7 mm) (n=45) in five groups in terms of the shade of the try-in paste and resin cement as follows: Universal, Clear, Brown, White and Opaque. Try-in paste and the respective resin cement were applied between the specimens and composite substrate, respectively, and colorimetric evaluation was carried out using CIE-Lab system. For each specimen, ΔE between the try-in paste and cement was calculated. Data were analyzed with SPSS 17 using Multifactor ANOVA (P<0.05).

Results. Multifactor ANOVA results showed that ΔE values were significantly affected by the resin cement shade and the thickness of ceramic veneer (P<0.05). The results showed better shade agreement between the try-in paste and the respective resin cement with thicker ceramic veneers. The results of Tukey HSD revealed that ΔE values for the Clear, Universal and Brown shades were less than those of the White and Opaque shades. Lighter shades exhibited better agreement between the try-in paste and the respective resin cement.

Conclusion. Perceptible color difference was found between the try-in pastes and the respective resin cement in most colors investigated. Although, the agreement of the try-in pastes and the respective resin cement was affected by the thickness of zirconia veneers, the different regions of multilayered ultra-translucent zirconia ceramic showed no significant effect.

Effect of Relining with Different Composite Resins on the Push-out Bond Strength of Anatomical Fiber Posts to Root Canal Dentin

Introduction

Relining fiber posts using composite resins helps the posts adapt to the anatomical space of the root canals. The aim of this study was to evaluate the effect of composite resin type on the push-out bond strength of anatomical fiber posts to intra canal dentin.

Methods and Materials

Forty-eight bovine upper incisors were prepared for post space after root canal therapy and randomly divided in to six groups. Five different types of composite resin (GrandioSO, GrandioSO Heavy Flow, X-tra Fil, X-tra base and everX Posterior) were used for relining the prepared fiber posts. In the control group, the prepared post was cemented into the post space without relining. Cervical, middle and apical cross-sections were achieved from each root and push-out test was conducted at a crosshead speed of 0.5 mm/min. One sample from each group was scanned using a micro-CT scanner which provided views from the apical, middle and coronal thirds. Data were analyzed using Kolmogorov-Smirnov test, repeated measures ANOVA and post hoc tests using SPSS 17 (P<0.05).

Results

Statistical analysis showed significant differences in terms of mean push-out bond strengths between different composite resin types and cross-sections (P<0.001). The mean push-out bond strength of the samples relined with Grandio SO composite resin (15.48±2.32) and X-tra Fil Bulk-fill composite resin (14.09±1.98) were significantly higher than that of other groups (P<0.05). The unrelined group had a mean push-out bond strength (5.94±1.45) which was significantly lower than that in other groups (P<0.05). In addition, there was a relationship between cross-sections and composite resin types (P<0.05).

Conclusion

This in vitro study showed that the composite resins used for relining can affect the push-out bond strength to intra canal dentin based on their physical and mechanical properties.

Effect of bleaching protocols on surface roughness and biofilm formation on silorane-based composite resin

BACKGROUND

Knowledge about the effect of bleaching on behavior of composite resins is important to find a suitable composite resin for restoration of teeth undergoing bleaching. This study aimed to assess the effect of different bleaching protocols on surface roughness and biofilm formation on a silorane-based composite resin.

MATERIALS AND METHODS

In this in vitro experimental study, 60 silorane-based composite resin samples measuring 3 mm in thickness and 6 mm in diameter were fabricated and polished. They were then randomly divided into four groups (n = 15). In Group 1, samples were stored in distilled water as control. Samples in Groups 2, 3, and 4 were subjected to bleaching with 15% carbamide peroxide, 35% hydrogen peroxide, and 35% hydrogen peroxide activated by light, respectively. Surface roughness was measured using a profilometer. Streptococcus mutans cultured in brain-heart infusion broth was used for the assessment of biofilm formation on the samples. The bacterial colonies were counted using the pure-plate technique. Data were analyzed using one-way ANOVA and post hoc Tukey's tests. Regression model was used to assess the association between surface roughness and biofilm formation (P < 0.05).

RESULTS

The mean surface roughness of the four groups was not significantly different (P = 0.11); however, a significant difference was noted in the mean biofilm formation among the groups (P = 0.00).

CONCLUSION

Bleaching decreased biofilm formation. The lowest biofilm formation was noted in the group subjected to light-activated 35% hydrogen peroxide. Increased surface roughness enhanced biofilm formation to a certain level; excessive roughness did not increase biofilm formation.

Effects of different etching strategies on the microtensile repair bond strength of beautifil II giomer material

Background

Considering the differences in the filler particles between giomer and conventional composite resins and the importance of these fillers in the repair bond strength, the aim was to evaluate the effects of different etching strategies with phosphoric acid (PA) and hydrofluoric acid (HF) on the microtensile repair bond strength (µTRBS) of giomer.

Material and Methods

Ten giomer blocks were randomly assigned into 10: 1) control; 2) 37%PA-20s; 3) 3%HF-20s; 4) 3%HF-120s; 5) 9.6%HF-20s; 6) 9.6%HF-120s; 7) 37%PA-20s + 3%HF-120s; 8) 37%PA-20s + 9.6%HF-120s; 9) 3%HF-120s + 37%PA-20s; 10) 9.6%HF-120s + 37%PA-20s. In all groups, the One-Step Plus bonding system was applied and the new giomer block was bonded to the existing giomer. After cross-sectional cutting, 18 samples were prepared from each block and the µTRBS of the samples was measured at a strain rate of 0.5 mm/min. Data were analyzed with one-way ANOVA and post hoc Tukey tests (P<0.05).

Results

The µTRBS in groups 4, 5, 6, 7, 8 and 10 were significantly higher than that in the control group (P<0.05). The µTRBS in group 2 was even less than that in the control group (P<0.001). The highest µTRBS was recorded in group 10, which was significantly different from those in groups 3, 4 and 9 (P<0.05). In addition, the differences between group 9 and groups 6, 7 and 8 were significantly different (P<0.05).

Conclusions

Etching with PA resulted in a decrease in µTRBS. Etching with HF, except for 3%HF-20s and HF after etching with PA, resulted in a significant increase in giomer`s µTRBS. An increase in the application time of 3%HF resulted in a significant increase in the µTRBS.

Key words:Dental restoration repair, Hydrofluoric acid, Phosphoric acid, etching.

Effect of Different Intraorifice Barriers and Bleaching Agents on the Fracture Resistance of Endodontically Treated Anterior Teeth

INTRODUCTION

Intraorifice barriers (IOBs) are usually used before internal bleaching for coronal sealing and the prevention of cervical resorption. The aim of this study was to investigate the effect of different IOBs on the fracture resistance (FR) of endodontically treated anterior teeth bleached with various bleaching agents (BAs).

METHODS

After performing root canal treatment for 72 extracted bovine upper incisors, the coronal 3 mm of gutta-percha was removed, and samples were classified into 3 based on the type of IOB: calcium-enriched mixture, mineral trioxide aggregate, and resin-modified glass ionomer. After applying IOBs, samples of each group were subdivided into 4 based on the BA: carbamide peroxide 45% (CP), hydrogen peroxide 35% (HP), sodium perborate (PB), and distilled water as the control. At the end of bleaching, the access cavities were restored with composite resin. The FR was measured with a universal testing machine at a crosshead speed of 5 mm/min. The data were analyzed using 2-way analysis of variance and least significant difference post hoc tests (P < .05).

RESULTS

The effect of BAs on the FR was significant (P < .05); however, the effect of the IOB and the interactive effect of these variables were not significant (P > .05). The FR in the HP and PB groups was significantly different from the control (P < .05) but that of CP was not significantly different from the control (P > .05).

CONCLUSIONS

Mineral trioxide aggregate and calcium-enriched mixture act similarly to resin-modified glass ionomer as an IOB. CP, unlike HP and PB, did not significantly decrease the FR.

Shear bond strengths of composite resin and giomer to mineral trioxide aggregate at different time intervals

Background

The efficacy of the bond between the restorative materials and the pulp capping materials has an important role in the success of vital pulp therapy. Therefore, the aim of this study was to evaluate the shear bond strength of composite resin and giomer to MTA at different time intervals after mixing of MTA.

Material and Methods

Ninety cylindrical MTA samples were prepared and assigned to two groups (n=45) based on the restorative materials used (composite resin or giomer). Each group was subdivided into 3 subgroups (n=15) based on the evaluation intervals (immediately, 2.45 hours and 3 days after mixing MTA). After the bonding procedures, the shear bond strengths of the samples were measured in MPa at a strain rate of 0.5 mm/min. Data were analyzed with repeated-measures ANOVA, post hoc tests and t-test (P<0.05).

Results

Bond strength of composite resin was minimum at baseline but it increased significantly 2.45 hours after mixing MTA (P=0.002), with no significant changes in bond strength up to three days (P=0.08). Bond strength of giomer did not exhibit any significant changes from baseline to 2.45 hours after mixing MTA (P=078); however, at 3 days it reached a minimum (P=0.000). In addition, the means of bond strength of composite resin 2.45 hours and 3 days after mixing were significantly higher than those of giomer (P=0.001 and P=0.000, respectively).

Conclusions

Bond strengths of composite resin 2.45 hours and also 3 days after mixing were significantly higher than those of giomer. In addition, the shear bond strength of giomer decreased over time; however, the shear bond strength of composite resin increased.

Key words:Composite resin, Giomer, Shear bond strength, Vital pulp therapy.

Factors affecting marginal integrity of class II bulk-fill composite resin restorations

Background. Bulk-fill composite resins are a new type of resin-based composite resins, claimed to have the capacity to be placed in thick layers, up to 4 mm. This study was carried out to evaluate factors affecting gap formation in Cl II cavities restored using the bulk-fill technique.

Methods. A total of 60 third molars were used in this study. Two Cl II cavities were prepared in each tooth, one on the mesial aspect 1 mm coronal to the CEJ and one on the distal aspect 1 mm apical to the CEJ. The teeth were divided into 4 groups: A: The cavities were restored using the bulk-fill technique with Filtek P90 composite resin and its adhesive system and light-cured with quartz tungsten halogen (QTH) light-curing unit. B: The cavities were restored similar to that in group A but light-cured with an LED light-curing unit. C: The cavities were restored using the bulk-fill technique with X-tra Fil composite resin and Clearfil SE Bond adhesive system and light-cured with a QTH curing unit. D: The cavities were restored similar to that in group C but light-cured with an LED light-curing unit. The gaps were examined under a stereomicroscope at ×60. Data were analyzed with General Linear Model test. In cases of statistical significance (P<0.05), post hoc Bonferroni test was used for further analyses.

Results. The light-curing unit type had no effect on gap formation. However, the results were significant in relation to the composite resin type and margin location (P<0.001). The cumulative effects of light-curing unit*gingival margin and light-curing unit*composite resin type were not significant; however, the cumulative effect of composite rein type*gingival margin was significant (P=0.04)

Conclusion. X-tra Fil composite exhibited smaller gaps compared with Filtek P90 composite with both light-curing units. Both composite resins exhibited smaller gaps at enamel margins.

Scanning Electron Microscopy and Energy-Dispersive X-Ray Microanalysis of Set CEM Cement after Application of Different Bleaching Agents

INTRODUCTION

The present study evaluated the element distribution in completely set calcium-enriched mixture (CEM) cement after application of 35% carbamide peroxide, 40% hydrogen peroxide and sodium perborate as commercial bleaching agents using an energy-dispersive x-ray microanalysis (EDX) system. The surface structure was also observed using the scanning electron microscope (SEM).

METHODS AND MATERIALS

Twenty completely set CEM cement samples, measuring 4×4 mm², were prepared in the present in vitro study and randomly divided into 4 groups based on the preparation technique as follows: the control group; 35% carbamide peroxide group in contact for 30-60 min for 4 times; 40% hydrogen peroxide group with contact time of 15-20 min for 3 times; and sodium perborate group, where the powder and liquid were mixed and placed on CEM cement surface 4 times. Data were analyzed at a significance level of 0.05 through the one Way ANOVA and Tukey's post hoc tests.

RESULTS

EDX showed similar element distribution of oxygen, sodium, calcium and carbon in CEM cement with the use of carbamide peroxide and hydroxide peroxide; however, the distribution of silicon was different (P<0.05). In addition, these bleaching agents resulted in significantly higher levels of oxygen and carbon (P<0.05) and a lower level of calcium (P<0.05) compared to the control group. SEM of the control group showed plate-like and globular structure. Sodium perborate was similar to control group due to its weak oxidizing properties. Globular structures and numerous woodpecker holes were observed on the even surface on the carbamide peroxide group.

CONCLUSION

The mean elemental distribution of completely set CEM cement was different when exposed to sodium perborate, carbamide peroxide and hydrogen peroxide.

Reparability of giomer using different mechanical surface treatments

Background

In the repair process achieving high bond strength between the new and old resin based materials is necessary for clinical longevity. This study compared the effect of three different mechanical surface treatments (air abrasion, Nd:YAG laser and diamond bur) on the repair bond strength of giomer.

Material and Methods

In this in vitrostudy, 125 cylindrical giomer samples were used. The giomer samples were randomly assigned to 5 groups (n=25). In group 1, the samples did not undergo any surface treatment. In groups 2 to 4, the samples underwent surface treatments with air abrasion, Nd:YAG laser and a diamond bur. The samples in group 5 were prepared to measure giomer cohesive strength. Subsequently, the new giomer was bonded to the existing giomer in groups 1 to 4. Then the repair bond strength of the samples was measured. One-way ANOVA and post hoc Tukey test were used to compare the bond strength.

Results

There were significant differences between the different surface treatments (P<0.001); the repair bond strength in the air abrasion group was significantly higher than that in the Nd:YAG laser group, in which it was significantly higher than that in the diamond bur group, which was in turn higher than that in group 1 (no surface treatment) (P<0.001). In addition, the cohesive strength of giomer was significantly higher than the repair bond strength in the 4 other study groups (P<0.001).

Conclusions

Of all the surface treatments, air abrasion and Nd:YAG laser, in descending order, yielded the highest repair bond strength values, with the repair bond strength values of 60‒70% of the giomer cohesive strength.

Key words:Air abrasion, bond strength, giomer, Nd:YAG laser, repair, surface treatment.

Effect of different concentrations of specific inhibitor of matrix metalloproteinases on the shear bond strength of self-adhesive resin cements to dentin

Background

Considering the probability of chemical and enzymatic reactions between matrix metalloproteinases (MMPs) in the dentin structure and their specific inhibitors, the aim of the present study was to evaluate the effect of different concentrations of specific inhibitor of MMPs (galardin) on the shear bond strength of self-adhesive resin cements to dentin.

Material and Methods

Forty-eight sound human premolars were mounted in self-cured acrylic resin after removal of the enamel on the buccal and lingual surfaces. The dentin surfaces achieved were polished and prepared with 600-grit silicon carbide paper. The samples were divided into 3 groups (n=16) based on the concentration of galardin used (with no galardin, galardin at a high concentration and galardin at a low concentration). In addition, 96 composite resin blocks, measuring 3 mm in height and diameter, were prepared. The composite resin blocks were bonded to the buccal and lingual surface dentin with Rely-X Unicem (RXC) and Speed CEM (SPC) self-adhesive resin cements, respectively, according to manufacturers’ instructions. After 24 hours of storage in distilled water at 37°C, the shear bond strength values were determined in MPa and fracture modes were evaluated under a stereomicroscope. Data were analyzed with two-way ANOVA and post-hoc Bonferroni test (α=0.05).

Results

The shear bond strength of galardin at high concentration was significantly higher than that in the control group and galardin at a low concentrations (P<0.001). In addition, galardin at a low concentration exhibited higher shear bond strength compared to the control group (P=0.005). Furthermore, higher shear bond strength values were reported with the use of RXC compared to SPC (P<0.001).

Conclusions

Irrigation with galardin increased the shear bond strength of self-adhesive resin cements to dentin and this increase had a direct relationship with the concentration of galardin in the solution.

Key words:N-(2(R)-2-(hydroxamidocarbonylmethyl)-4-methylpentanoyl)-L-tryptophan methylamide, Matrix metalloproteinase inhibitors, Dentin, Extracellular matrix, Luting agents, Dental Bonding.

Effect of two different tooth bleaching techniques on microhardness of giomer

BACKGROUND

Tooth bleaching is a safe and conservative treatment modality to improve the esthetic appearance of discolored teeth. One of the problems with the use of bleaching agents is their possible effect on surface microhardness of resin-based materials. The present study was carried out to evaluate the effect of in-office and at-home bleaching on surface microhardness of giomer.

MATERIAL AND METHODS

Seventy-five disk-shaped giomer samples (Beautifil II) were prepared and cured with a light-curing unit. The samples were randomly assigned to three groups (n=25). In group 1 (control), the samples were stored in distilled water for 14 days. The samples in groups 2 and 3 underwent a bleaching procedure with 15% carbamide peroxide (CP) (8 hours daily) and 45% CP (30 minutes daily), respectively, for 14 days. Finally, the microhardness of samples was measured with Vickers hardness tester using a 100-g force for 20 seconds. One-way ANOVA was used to compare the mean microhardness values among the study groups, followed by post hoc Tukey test for two-by-two comparison of the groups. Statistical significance was set at P<0.05.

RESULTS

One-way ANOVA showed significant differences in the mean microhardness values among the study groups (P<0.001). Based on the results of Tukey test, microhardness in the bleached groups was significantly less than that in the control group (P<0.0005). In addition, microhardness in the 45% CP group was significantly less than that in the 15% CP group (P<0.0005).

CONCLUSIONS

Use of both bleaching agents during in-office and at-home bleaching techniques resulted in a decrease in surface microhardness of giomer. The unfavorable effect of in-office bleaching (45% CP) was greater than that of at-home bleaching (15% CP). Key words:Dental restorations, hardness, tooth bleaching.

Effect of different bleaching strategies on microhardness of a silorane-based composite resin

Background. Dentists’ awareness of the effects of bleaching agents on the surface and mechanical properties of restorative materials is of utmost importance. Therefore, this in vitro study was undertaken to investigate the effects of different bleaching strategies on the microhardness of a silorane-based composite resin.

Methods. Eighty samples of a silorane-based composite resin (measuring 4 mm in diameter and 2 mm in thickness) were prepared within acrylic molds. The samples were polished and randomly assigned to 4 groups (n=20). Group 1 (controls) were stored in distilled water for 2 weeks. The samples in group 2 underwent a bleaching procedure with 15% carbamide peroxide for two weeks two hours daily. The samples in group 3 were bleached with 35% hydrogen peroxide twice 5 days apart for 30 minutes each time. The samples in group 4 underwent a bleaching procedure with light-activated 35% hydrogen peroxide under LED light once for 40 minutes. Then the microhardness of the samples was determined using Vickers method. Data were analyzed with one-way ANOVA and post hoc Tukey tests (P < 0.05).

Results. All the bleaching agents significantly decreased microhardness compared to the control group (P < 0.05). In addition, there were significant differences in microhardness between groups 2 and 4 (P = 0.001) and between groups 3 and 4 (P<0.001). However, no significant differences were detected in microhardness between groups 2 and 3 (P > 0.05).

Conclusion. Bleaching agents decreased microhardness of silorane-based composite resin restorations, the magnitude of which depending on the bleaching strategy used.

Effect of pre-heating on the mechanical properties of silorane-based and methacrylate-based composites

BACKGROUND

The use of composites in dental restoration has been commonly criticized, due to their underwhelming mechanical properties. This problem may be solved partially by preheating. The present research aims to determine the effect of preheating on the mechanical properties of two different classes of composites.

MATERIAL AND METHODS

A Silorane-based (Silorane) and a Methacrylate-based (Z250) composite were preheated to different temperatures (25, 37, and 68 °C) and afterwards were tested with the appropriate devices for each testing protocol. The material's flexural strength, elastic modulus, and Vickers microhardness were evaluated. Two-way ANOVA, and Tukey's post hoc were used to analyze the data.

RESULTS

Microhardness and elastic modulus increased with preheating, while flexural strength values did not increase significantly with preheating. Furthermore the methacrylate-based composite (Z250) showed higher values compared to the Silorane-based composite (Silorane) in all the tested properties.

CONCLUSIONS

Preheating Silorane enhances the composite's microhardness and elastic modulus but does not affect its flexural strength. On the other hand, preheating Z250 increases its microhardness but does not change its flexural strength or elastic modulus. In addition, the Z250 composite shows higher microhardness and flexural strength than Silorane, but the elastic modulus values with preheating are similar. Therefore Z250 seems to have better mechanical properties making it the better choice in a clinical situation. Key words:Composite, elastic modulus, flexural strength, microhardness, preheating.

Effect of an extra layer of hydrophobic resin on the microleakage of Cl V composite resin restorations with a universal adhesive system

AIM

The aim of the present study was to evaluate the effect of the application of a hydrophobic resin on the microleakage of Cl V composite resin restorations using a universal adhesive system applied in the self-etch (SE) and etch-and-rinse (ER) modes.

METHOD

Cl V cavities were prepared on the buccal surfaces of 64 human premolar teeth and divided into four groups (n = 16): ER, ER with hydrophobic resin (ERH), SE, and SE with hydrophobic resin (SEH). Microleakage at occlusal and gingival margins was evaluated using 0.5% methylene blue dye penetration technique under stereomicroscope at 40 × magnification. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests (P < 0.05).

RESULTS

At the enamel margins, the ER group had significantly less microleakage than the SE and SEH groups (P < 0.001), but had no significant difference compared with the ERH group (P > 0.05). There was also no statistically-significant difference between the SE and SEH groups (P > 0.05). At the dentinal margins, the SE group had significantly less microleakage compared with the ER (P < 0.001) and ERH groups (P = 0.005). Furthermore, microleakage of the SEH group was significantly less than the SE group (P < 0.001).

CONCLUSION

Applying an extra layer of hydrophobic resin significantly decreased microleakage in the SE mode at the dentinal margin, but had no significant effect in the ER mode.

Mercury release of amalgams with various silver contents after exposure to bleaching agent

Background. Since it is possible for carbamide peroxide (CP) bleaching agent to contact old amalgam restorations, the present in vitro study evaluated the amount of dissolved mercury released from amalgam restorations with various percent-ages of silver content subsequent to the use of 15% CP.

Methods. Thirty ANA 2000 amalgam disks with 43.1% silver content and thirty ANA 70 amalgam disks with 69.3% silver content were prepared. In each group, 15 samples were randomly placed in glass tubes containing 15% CP (as experimental groups) and the remaining 15 samples were placed in buffered phosphate solution (as control groups) with the same 3-mL volume for 48 hours. Subsequently, the amount of mercury dissolved in each test tube was measured using Mercury Analyzing System (Cold Vapor Atomic Absorption, MASLO, Shimadzu, Japan). Data was analyzed with two-way ANOVA and a post hoc Tukey test. (α = 0.05).

Results. The amount of mercury released after exposure to CP was significantly higher than that released after exposure to buffered phosphate (P < 0.001). In addition, the amount of mercury released from dental amalgam with a silver content of 43% was significantly higher than that released from dental amalgam with a silver content of 69% (P < 0.001).

Conclusion. The amount of mercury release is inversely proportional to the silver content of dental amalgam.

Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial

This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques regarding their rates of success and complications in patients with kidney stones. Patients were randomly assigned to two groups. Forty-four patients (24 men; mean age: 50.40±2.02 years) received totally tubeless percutaneous nephrolithotomy (PCNL; no nephrostomy catheter or ureteral catheter after PCNL) and 40 patients (18 men; mean age: 49.95±13.38 years) underwent standard PCNL (a nephrostomy catheter and ureteral catheter were used after PCNL). All surgeries were performed by one surgeon. Postoperative changes in hemoglobin, the blood transfusion rate, changes in creatinine levels, operation time, analgesic need, hospitalization time, and complication rate were compared between the groups. No significant differences were observed in age, gender, stone size, and surgery side between the groups (P<0.05). The operation time was significantly lower in the totally tubeless PCNL group than in the standard PCNL group (P=0.005). Pethidine requirements were significantly higher in the standard PCNL group than the totally tubeless PCNL group (P=0.007). Hospitalization time was significantly higher in the standard PCNL group than in the totally tubeless PCNL group (P<0.0001). The complication rate was 15% in the standard PCNL group and 9.1% in the totally tubeless PCNL group (P=0.73). The totally tubeless PCNL technique is safe and effective, even for patients with staghorn stones. This technique is associated with decreased pain, analgesic needs, and operative and hospitalization time. We believe that a normal peristaltic ureter is the best drainage tube.

Effect of sodium ascorbate on the bond strength of all-in-one adhesive systems to NaOCl-treated dentin

BACKGROUND

Ascorbic acid and its salts are low-toxicity products, which are routinely used in food industries as antioxidants. The aim of the present study was to evaluate the effect of 10% sodium ascorbate on the bond strength of two all-in-one adhesive systems to NaOCl-treated dentin.

MATERIAL AND METHODS

After exposing the dentin on the facial surface of 90 sound human premolars and mounting in an acrylic resin mold, the exposed dentin surfaces were polished with 600-grit SiC paper under running water. Then the samples were randomly divided into 6 groups of 15. Groups 1 and 4 were the controls, in which no surface preparation was carried out. In groups 2 and 5 the dentin surfaces were treated with 5.25% NaOCl alone for 10 minutes and in groups 3 and 6 with 5.25% NaOCl for 10 minutes followed by 10% sodium ascorbate for 10 minutes. Then composite resin cylinders, measuring 2 mm in diameter and 2 mm in height, were bonded on the dentin surfaces in groups 1, 2 and 3 with Clearfil S3 Bond and in groups 4, 5 and 6 with Adper Easy One adhesive systems according to manufacturers' instructions. The samples were stored in distilled water for 24 hours at 37°C and then thermocycled. Finally, the samples underwent shear bond strength test in a universal testing machine at a strain rate of 1 mm/min. Data were analyzed with two-way ANOVA and post hoc Tukey tests at α=0.05.

RESULTS

The differences between groups 1 and 2 (P=0.01), 1 and 5 (P=0.003). 1 and 6 (P=0.03) and 4 and 5 (P=0.03) were statistically significant. Two-by-two comparisons did not reveal any significant difference between other groups (P>0.05).

CONCLUSIONS

Use of 10% sodium ascorbate for 10 minutes restored the decreased bond strength of the adhesive systems to that of the control groups.

KEY WORDS

Sodium ascorbate, adhesive systems, all-in-one, bond strength, sodium hypochlorite.

Effect of an Extra Hydrophobic Resin Layer on Repair Shear Bond Strength of a Silorane-Based Composite Resin

OBJECTIVES

Composite repair is a minimally invasive and conservative approach. This study aimed to evaluate the effect of an additional hydrophobic resin layer on the repair shear bond strength of a silorane-based composite repaired with silorane or methacrylate-based composite.

MATERIALS AND METHODS

Sixty bar-shaped composite blocks were fabricated and stored in saline for 72 hours. The surface of the samples were roughened by diamond burs and etched with phosphoric acid; then, they were randomly divided into three groups according to the repairing process: Group 1: Silorane composite-silorane bonding agent-silorane composite; group 2: Silorane composite-silorane bonding agent-hydrophobic resin-silorane composite, and group 3: Silorane composite-silorane bonding agent-hydrophobic resin methacrylate-based composite. Repairing composite blocks measured 2.5×2.5×5mm. After repairing, the samples were stored in saline for 24 hours and thermocycled for 1500 cycles. The repair bond strength was measured at a strain rate of 1mm/min. Twenty additional cylindrical composite blocks (diameter: 2.5mm, height: 6mm) were also fabricated for measuring the cohesive strength of silorane-based composite. The data were analyzed using One-way ANOVA and the post hoc Tukey's test (α=0.05).

RESULTS

Cohesive bond strength of silorane composite was significantly higher than the repair bond strengths in other groups (P<0.001). The repair bond strength of group 3 was significantly higher than that of group 1 (P=0.001).

CONCLUSION

Application of an additional hydrophobic resin layer for repair of silorane-based composite with a methacrylate-based composite enhanced the repair shear bond strength.

The Effect of Thickness on the Sealing Ability of CEM Cement as a Root-end Filling Material

Background and aims. Different materials have been used for root-end filling during surgical endodontic treatment. The aim of this in vitro study was to evaluate the dye penetration in different thicknesses of calcium enriched mixture (CEM) cement as root-end filling material. Materials and methods. Following root canal filling in 70 extracted human single-rooted premolar teeth, the apical 3 mm of their root-ends was resected; the root-end cavities with depths of 1, 2 and 3 mm were prepared by ultrasonic retrotips and filled with CEM cement. After setting of cement, the roots were immersed in 2% Rhodamine B and the dye leakage was measured under stereomicroscope (×16) using Image J software. The data were analyzed by one-way ANOVA and Bonferroni post hoc tests at 5% significance level. Results. The means and standard deviations of dye penetration in the 1, 2, and 3 mm groups were 3395.5±1893.4, 3410.4±1440.5, and 2581.6±1852.9 μm, respectively. The one-way ANOVA analysis indicated significant differences (P < 0.001); however, the Bonferroni post hoc test revealed that only the positive control group differed significantly from the experimental groups (P < 0.001). Conclusion. The findings demonstrated CEM cement to have an adequate root-end sealing ability in 3-mm thickness.

Shear bond strength of calcium enriched mixture cement and mineral trioxide aggregate to composite resin with two different adhesive systems

OBJECTIVE

Immediate restoration after vital pulp therapy is essential in order to create and maintain effective coronal seal.

PURPOSE OF STUDY

The aim of this study was to evaluate the shear bond strength of recently used pulp capping materials: white mineral trioxide aggregate (MTA), and calcium enriched mixture cement (CEM) to composite resin with the use of etch-and-rinse and self-etch adhesive systems and compare them with the bond strength of commonly used resin modified glass ionomer (RMGI) cement.

MATERIALS AND METHODS

Forty specimens from each test material were fabricated, measuring 4 mm in diameter and 2 mm in depth. The specimens of each material were divided into 2 groups of 20 specimens according to the adhesive system (Single Bond vs. Clearfil SE Bond) used for bonding of resin composite. The shear bond strength values were measured at a crosshead speed of 1.0 mm/min and fractured surfaces were examined. Data were analyzed using two-way ANOVA and a post hoc Tukey's test (P<0.05).

RESULTS

Analysis of data showed a significantly higher bond strength for RMGI compared to MTA and CEM (P<0.001); however, no significant differences were observed in the bond strength values of MTA and CEM (P=0.9). Furthermore, there were no significant differences in relation to the type of the adhesive system irrespective of the type of the material used (P=0.95) All the failures were of cohesive type in RMGI, MTA and CEM.

CONCLUSION

Bond strength of RMGI cement to composite resin was higher than that of MTA or CEM cement irrespective of the type of the adhesive system.

Effect of Casein Phosphopeptide-amorphous Calcium Phosphate Treatment on Microtensile Bond Strength to Carious Affected Dentin Using Two Adhesive Strategies

Background and aims. The aim was to evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on microtensile bond strength (μTBS) to carious affected dentin (CAD) using etch-and-rinse and self-etch adhesive systems.

Materials and methods. The occlusal surface of 32 human molars with moderate occlusal caries was removed. Infected dentin was removed until reaching CAD and the teeth were randomly divided into two groups based on the Single Bond (SB) and Clearfil SE Bond (CSE) adhesive systems. Before composite resin bonding, each group was subdivided into three subgroups of ND, CAD and CPP-ACP-treated CAD (CAD-CPP) based on the dentin substrate. After dissecting samples to l-mm-thick cross-sections (each subgroup: n = 13), μTBS was measured at a strain rate of 0.5 mm/min. Data was analyzed using two-way ANOVA, independent samples t-test and post-hoc Tukey tests (α=0.05).

Results. Bond strength of both adhesive systems to ND was significantly higher than that to CAD (P <0.001) and CAD/CPP (P < 0.001). There were no significant differences between the μTBS of SB to CAD and CAD-CPP (P > 0.05).μTBS of CSE to CAD-CPP was higher than that to CAD; however, the difference was not significant (P > 0.05). Significant differences were found between SB and CSE systems only with CAD substrate (P < 0.001).

Conclusion. Regardless of the adhesive system used, surface treatment of CAD with CPP-ACP did not have a significant effect on bond strength. However, bond strength to CAD was higher with SB rather than with CSE.

Effect of Light Intensity on the Degree of Conversion of Dual-cured Resin Cement at Different Depths with the use of Translucent Fiber Posts

OBJECTIVES

To evaluate the effect of different light intensities on the degree of conversion (DC) of dual-cured resin cement at different depths of translucent fiber posts.

MATERIALS AND METHODS

Thirty translucent fiber posts were randomly assigned into three (n=10) groups. They were cemented in the simulated canal spaces using Duo-Link dual-cured resin cement. The cement was light-cured under 600, 800 and 1100 mW/cm(2) light intensities for 40 seconds. DC of the resin cement was calculated at cervical, middle and apical thirds using the spectra of FT-Raman spectrometer. Data were analyzed by repeated measurement ANOVA and Tukey's post hoc tests (α=0.05).

RESULTS

In all the groups, the least DC was obtained at the apical region. There were no significant differences in the DC with different light intensities between the cervical and middle regions (p>0.05). However, in the apical region, the DC in both 800 and 1100 mw/cm(2) was similar (p>0.05), but greater with 600 mW/cm(2) light intensity (p=0.02 and p<0.001, respectively).

CONCLUSION

In comparison with the light intensity of 600 mW/cm(2), the light intensity of 800 mW/cm(2) significantly increased the DC of dual-cured resin cement in the apical region. However, DC was not significantly different between 800 and 1100 mw/cm(2) light intensities. If the resin cement, especially in the apical areas is not sufficiently cured, microleakage might increase and post retention might be jeopardized. In comparison with 600 mW/cm(2) light intensity, 800 mW/cm(2) significantly increases DC at the apical third that might be clinically beneficial.

Effect of Nd:YAG laser pulse energy on mercury vapor release from the dental amalgam

OBJECTIVE

The aim of this study was to evaluate the effect of different pulse energies of Nd:YAG laser on the amalgam ablation, and its effect on the amount of mercury vapor release from amalgam.

BACKGROUND DATA

Toxic vapor release from amalgam restorations at the laser focus site is possible.

MATERIALS AND METHODS

Forty-five amalgam samples (4 mm in diameter and 5 mm in height) were placed in sealed containers and underwent Nd:YAG laser irradiation with pulse energies of 50, 150, and 250 mJ at a distance of 1 mm from the amalgam surface for 4 sec. Subsequently, 150 mL of air was collected from the inside of the container using an Apex Pump to analyze the amount of mercury vapor in the air samples using a mercury vapor analyzer. Data were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p<0.05).

RESULTS

The amount of mercury vapor release significantly increased with an increase in the pulse energy of Nd:YAG laser (p<0.001). In addition, the amount of mercury vapor release with 250 mJ pulse energy was significantly higher compared with the standard mercury vapor concentration (50 μg/m(3)) (p<0.001). Nd:YAG laser produced cavities on the amalgam surface, which increased in size with an increase in the energy of the laser beam.

CONCLUSIONS

The amount of mercury vapor significantly increased with an increase in the pulse energy of the laser beam, and was significantly higher than the standard mercury vapor concentration with 250 mJ pulse energy.

Fracture Resistance of Endodontically-treated Maxillary Premolars Restored with Composite Resin along with Glass Fiber Insertion in Different Positions

Background and aims

The aim was to evaluate the effect of three methods of fiber insertion on fracture resistance of root-filled maxillary premolars in vitro.

Materials and methods

Sixty extracted human maxillary premolars received endodontic treatment followed by preparation of mesioocclusodistal (MOD) cavities, with gingival cavosurface margin 1.5 mm coronal to the cementoenamel junction (CEJ). Subsequently, the samples were randomly divided into four groups: no-fiber group; occlusal fiber group (fiber was placed in the occlusal third); circumferential fiber group (fiber was placed circumferentially in the cervical third); and dual-fiber group (occlusal and circumferential fibers). Subsequent to restoring with composite resin and thermocycling, a compressive force was applied until fracture. Data was analyzed using one-way ANOVA and Tukey test at significance levels of P < 0.05 and P < 0.02, respectively.

Results

Fiber placement significantly increased fracture resistance. Fracture resistance in the dual-fiber group was significantly higher than that in the circumferential fiber group (P < 0.007); however, there were no significant differences between the dual-fiber and occlusal fiber groups (P = 0.706). The highest favorable fracture rate was observed in the circumferential fiber group (60%).

Conclusion

Composite resin restoration along with glass fiber in the occlusal and gingival thirds can be an acceptable treatment option for restoring root-filled upper premolars.

Effect of three different contamination removal methods on bond strength of a self-etching adhesive to dentin contaminated with an aluminum chloride hemostatic agent

AIM

This study evaluated the effect of three different contamination removal methods on bond strength of one-step self-etching adhesive to dentin contaminated with an aluminum chloride hemostatic agent.

MATERIALS AND METHODS

One hundred noncarious adult molars were used in this study; 2-mm-thick dentin disks were prepared and randomly assigned to 5 groups (n = 20). Group I: control; group II: hemostatic agent-contaminated; group III: hemostatic agent-contaminated and rinsing with water; group IV: hemostatic agent-contaminated and ethylene diamine tetraacetic acid (EDTA) application; and group V: hemostatic agent-contaminated and phosphoric acid application. Clearfil S3 Bond was used to bond composite to dentin surfaces. Subsequent to adding composite cylinders the shear bond strength test was performed. Data were analyzed by one-way ANOVA and Tukey test. Two additional specimens from each group were prepared and evaluated under scanning electron microscope (SEM).

RESULTS

There were statistically significant differences in bond strength among the groups (p < 0.001). In two-by-two comparisons statistically significant differences were observed in bond strength values between all the groups (p < 0.001) except for groups I and IV (p = 0.933).

CONCLUSION

Aluminum chloride hemostatic agent adversely affected the bond strength of self-etch adhesive to dentin. However, application of EDTA increased the bond strength to the level of normal dentin.

CLINICAL SIGNIFICANCE

EDTA and phosphoric acid removed aluminum chloride hemostatic agent contamination of dentin surfaces. However, unlike EDTA phosphoric acid failed to increase the bond strength of self-etch adhesive to dentin to the level of the control group.

Effect of Different Surface Treatments on Repair Micro-shear Bond Strength of Silica- and Zirconia-filled Composite Resins

Background and aims

Effect of surface treatments on repair bond strength of aged composite resins might be different due to their dissimilar fillers. The aim was to evaluate the effect of different surface treatments on repair micro-shear bond strength (µSBS) of silica- (Spectrum TPH) and zirconia-filled (Filtek Z250) composite resins.

Materials and methods

Twenty-seven composite resin blocks were made from each type of composite resin: Z250 and Spectrum TPH. After aging, blocks of each type were randomly divided into three groups according to surface treatments: alloy primer, silane, and only surface roughening. Subsequently, each group was further subdivided into 3 subgroups based on the adhesive system used: Single Bond, Clearfil SE Bond, and Margin Bond. Four composite resin columns were added on each block. After thermocycling, µSBStest were done at cross head speed of 0.5 mm/min. Data was analysed using multifactor ANOVA, one-way ANOVA and a post-hoc Bonferroni tests (α = 0.05).

Results

Analysis of data showed that the effect of composite resin type was not significant (p > 0.05), but the effects of the type of surface treatment (p = 0.01) and the type of adhesive system (p = 0.01) were significant on repair µSBS. In addition, the cumulative effect of the composite type-surface treatment and the composite type with the type of adhesive system were not statistically significant (p > 0.05). However, the cumulative effects of the adhesive system-surface treatment (p = 0.03) and the composite type-the adhesive system-surface treatments (p = 0.002) were significant.

Conclusion

Although repair µSBS values of both silica- and zirconia-filled composite resins were similar, use of different combinations of surface treatments and adhesive systems affected their repair µSBS differently.