Post-cure depth of cure of bulk fill dental resin-composites

OBJECTIVES

To determine the post-cure depth of cure of bulk fill resin composites through using Vickers hardness profiles (VHN).

METHODS

Five bulk fill composite materials were examined: Tetric EvoCeram(®) Bulk Fill, X-tra base, Venus(®) Bulk Fill, Filtek™ Bulk Fill, SonicFill™. Three specimens of each material type were prepared in stainless steel molds which contained a slot of dimensions (15 mm × 4 mm × 2 mm), and a top plate. The molds were irradiated from one end. All specimens were stored at 37°C for 24h, before measurement. The Vickers hardness was measured as a function of depth of material, at 0.3mm intervals. Data were analysed by one-way ANOVA using Tukey post hoc tests (α=0.05).

RESULTS

The maximum VHN ranged from 37.8 to 77.4, whilst the VHN at 80% of max.VHN ranged from 30.4 to 61.9. The depth corresponding to 80% of max.VHN, ranged from 4.14 to 5.03 mm. One-way ANOVA showed statistically significant differences between materials for all parameters tested. SonicFill exhibited the highest VHN (p<0.001) while Venus Bulk Fill the lowest (p≤0.001). SonicFill and Tetric EvoCeram Bulk Fill had the greatest depth of cure (5.03 and 4.47 mm, respectively) and was significant's different from X-tra base, Venus Bulk Fill and Filtek Bulk Fill (p≤0.016). Linear regression confirmed a positive regression between max.VHN and filler loading (r(2)=0.94).

SIGNIFICANCE

Bulk fill resin composites can be cured to an acceptable post-cure depth, according to the manufacturers' claims. SonicFill and Tetric EvoCeram Bulk Fill had the greatest depth of cure among the composites examined.

Proinflammatory cytokine levels and peri-implant parameters among cigarette smokers, individuals vaping electronic cigarettes, and non-smokers

BACKGROUND

Tobacco smoking compromises the prognosis of dental implant treatment and is associated with increased risk of peri-implant bone loss and increased implant failure rate. There is a dearth of studies that have compared clinical, radiographic, and immunological peri-implant parameters among cigarette smokers (CS), individuals vaping e-cigarettes (e-cigs), and non-smokers (NS). This study aimed to compare clinical and radiographic peri-implant parameters and levels of matrix metalloproteinase (MMP)-9 and interleukin (IL)-1β levels among CS, individuals' vaping e-cigs, and NS.

METHODS

Thirty-two CS (group 1), 31 individuals vaping e-cigs (group 2), and 32 NS (group 3) were included. Demographic- and implant-related data were collected using a structured baseline questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded and marginal bone loss (MBL) were assessed using standardized digital radiographs. Enzyme-linked immunosorbent assay was used to assess levels of MMP-9 and IL-1β in peri-implant sulcular fluid. Pearson correlation coefficient was used to analyze for correlations of MMP-9 and IL-1β levels with peri-implant parameters.

RESULTS

BOP showed significantly higher values in group 3 as compared with groups 1 and 2 (P < 0.01). PI (P < 0.01), PD ≥ 4 mm (P < 0.01), and mean concentrations of MMP-9 (P < 0.001) and IL-1β (P < 0.01) were significantly higher in groups 1 and 2 than group 3. MBL was significantly higher in group 1 as compared with group 2 and group 3 (P < 0.01). Significant positive correlations were found between MMP-9 (P = 0.0198) and IL-1β (P = 0.0047) levels and MBL in group 1; and a significant positive correlation between IL-1β and MBL in group 2 (P = 0.0031).

CONCLUSIONS

Peri-implant health was compromised among CS than vaping individuals and NS. Increased levels of proinflammatory cytokines in CS and vaping individuals may suggest greater peri-implant inflammatory response.

Diametral Tensile Strength, Flexural Strength, and Surface Microhardness of Bioactive Bulk Fill Restorative

AIM

The aim was to perform comparative analysis of bioactive, contemporary bulk-fill resin-based composites (RBCs) and conventional glass-ionomer materials for flexural strength (FS), diametral tensile strength (DTS), and Vickers hardness number (VHN) in the presence of thermocycling.

MATERIALS AND METHODS

Five restorative materials [Tetric N-Ceram Bulk Fill; smart dentin replacement (SDR) Flowable Material; Bioactive restorative material (ACTIVA Bulk Fill); Ketac Universal Aplicap; and GC Fuji II] were evaluated for DTS, FS, and VHN. Half the samples in each material group were ther-mocycled. The DTS was performed under compressive load at a cross-head speed of 1.0 mm/min. The FS was assessed by three-point bending test at a cross-head speed of 0.5 mm/min. The VHN was determined using a Vickers diamond indenter at 50 gf load for 15 seconds. Differences in FS, DTS, and VHN were analyzed using analysis of variance (ANOVA) and Tukey post hoc tests at a = 0.05 level of significance.

RESULTS

N-Ceram, ACTIVA, and SDR demonstrated the highest and comparable (p > 0.05) FS. The SDR had the highest DTS value (141.28 ± 0.94), followed by N-Ceram (136.61 ± 1.56) and ACTIVA (129.05 ± 1.78). Ketac had the highest VHN value before and after thermocycling.

CONCLUSION

ACTIVA showed mechanical properties (FS and DTS) comparable with bulk-fill resin composite materials. ACTIVA showed potential for durability, as VHN was comparable post-thermocycling.

CLINICAL SIGNIFICANCE

Bioactive materials showed acceptable DTS and FS values. However, hardness was compromised compared with included materials. ACTIVA Bulk Fill shows potential for dentin replacement but it needs to be covered with a surface-resistant restorative material. Further studies to improve surface characteristics of ACTIVA Bulk Fill are recommended.

How effective the problem-based learning (PBL) in dental education. A critical review

The purpose of this critical review is to explore the research supporting the effectiveness of problem-based learning (PBL) as a teaching method in dental education. PBL was developed more than 40 years ago in reaction to the problems and limitations of traditional teaching approaches. Here, aspects of the PBL teaching approach are reviewed, and the reasons for the substantial effect of this approach on dental education are discussed. Evidence shows that students in PBL-based courses exhibit superior professional skills and effective learning compared with those instructed using traditional approaches.

Evaluation of Synergic Potential of rGO/SiO2 as Hybrid Filler for BisGMA/TEGDMA Dental Composites

Graphene and graphene oxide based nanomaterials have attained immense significance in research because of their matchless physiochemical characteristics. Although potential biomedical applications of graphene have been extensively studied, however, dentistry related applications were rarely explored. This study aimed to investigate the effect of various percentages of surface modified reduce graphene oxide (S-rGO) in combination with SiO₂ nanoparticles (bulk filler) on numerous physio-mechanical characteristics of acrylate-based (BisGMA/TEGDMA: 1:1 by wt.) composites. BisGMA/TEGDMA reinforced with 30 wt.% surface modified fumed-silica (S-A200) was considered as control group (base composite). Various concentrations (0, 0.5, 1, 2, 4 wt.%) of S-rGO were incorporated into the base composite via solution casting and high-speed mixing. The obtained composites were characterized for rheological properties before curing by using Rheometer (Anton Paar, USA) in the oscillatory mode under a frequency sweep over a range of angular frequency of 0.1–100 rad/s at 25 °C. The degree of conversion (DC) was measured by using Fourier transform infrared spectroscopy (FTIR). A Nano-indentation test was carried out to obtain nano-hardness and elastic modulus. The surface roughness was measured by optical microscope (Bruker^®), 3D non-contact surface profilometer. The structural and morphological properties were studied by using Scanning Electron Microscopy (SEM). The mean and standard deviation were calculated and a simple mean comparisons test was performed for comparison using SPSS. The results revealed that the addition of a tiny proportion of S-rGO considerably increased the nano-indentation hardness, elastic modulus and DC. Conversely, a gradual reduction in viscosity was observed with increasing S-rGO concentration. The study demonstrates that a small fraction of S-rGO in combination with SiO₂ could enhance physical, mechanical and rheological properties of acrylate based composites. Thus S-rGO/SiO₂ combination could be used as a potential hybrid filler for dental nanocomposites.

Clinical and radiographic peri-implant health status around narrow diameter implant-supported single and splinted crowns

BACKGROUND

Studies assessing and comparing clinical and radiographic peri-implant status around narrow diameter implant-supported single crowns (NDISCs) and splinted crowns (NDISPs) are scarce.

OBJECTIVE

The aim of this retrospective study was to estimate and compare complication rates, patient satisfaction, peri-implant status and peri-implant bone loss (PBL) of NDISCs and NDISPs.

MATERIALS AND METHODS

Patients receiving narrow diameter implants (NDIs) in the posterior mandible were assessed. Technical complication and patient satisfaction were recorded. Clinical peri-implant plaque index (PI), bleeding on probing (BoP), probing depth (PD) and PBL were assessed. Technical complications and patient satisfaction were recorded. Log-rank test was computed to evaluate the influence of prostheses type and NDIs location on technical complications. P-value less than 0.05 was regarded as significant.

RESULTS

Seventy-eight patients (43 male and 35 females) agreed to follow up. The mean follow-up duration of the patients was 3.6 years. A total of 102 (43 NDISCs and 59 NDISPs) NDIs with moderately rough surfaces were included. No significant differences in PI, BoP, or PD were observed between NDISCs and NDISPs. The average PBL score was 1.17 (range: 0.03-4.15) at implant level and 1.14 (range: 0.03-4.14) at patient level. Seven implants and three patients showed peri-implantitis. The rates of technical complication of single crowns were significantly higher than those of splinted crowns (P = 0.036). PBL was significantly higher in molar sites than those in premolar sites (P = 0.041). A total of 67 patients (85.9%) were satisfied with the esthetics of the crowns, while a total of 59 patients (75.6%) were satisfied with the function of the crowns.

CONCLUSION

NDISCs and NDISPs offer high patient satisfaction and tolerable complication rates. Peri-implant conditions and peri-implant bone levels were comparable around NDISCs and NDISPs. However, bone loss of implants was higher in molar sites than those implants in premolar sites.

New Monomer Based on Eugenol Methacrylate, Synthesis, Polymerization and Copolymerization with Methyl Methacrylate-Characterization and Thermal Properties

Poly(eugenyl-2-hydroxypropyl methacrylate) (PEUGMA), poly(methyl methacrylate) (PMMA) and poly(eugenyl-2-hydroxypropyl methacrylate-co-methyl methacrylate) (PEUGMA-co-MMA) were synthesized by a free radical polymerization route in the presence of azobisisobutyronitrile. EUGMA was synthesized by etherification of the eugenol phenolic hydroxyl group with glycidyl methacrylate. Polymers and copolymers were characterized using size exclusion chromatography, Fourier transform infrared, and nuclear magnetic resonance. The effects of the encumbering substituent on the thermal behavior of the polymers and copolymers were studied by differential scanning calorimetry, thermogravimetry (TG) and direct analysis, using real-time, time-of-flight mass spectroscopy (DART-ToF-MS) methods. The results obtained revealed that for PEUGMA, the average molecular weight was 1.08 × 10⁵, and increased slowly with the decrease in the EUGMA content in the copolymer. The order of the distribution of dyads comonomer units in the copolymer chains estimated by the Igarashi method based on the reactivity ratio does reveal a random distribution with a tendency toward alternation. The glass transition temperature of PEUGMA (46 °C) increased with the MMA content in the copolymer, and those of the copolymer fit well with the Johnston’s linearized expression. The TG analysis of pure PEUGMA revealed a significantly high thermal stability compared to that of PMMA. During its degradation, the preliminary decomposition was at 340 °C, and decreased as the MMA units increased in the copolymer. The DART-ToF-MS analysis revealed that the isothermal decomposition of PEUGMA led to a regeneration of raw materials such as EUGMA, GMA and EUG, in which the maximum amount was achieved at 450 °C.

Influence of experimental staining on the color stability of indirect computer-aided design/computer-aided manufacturing dental provisional materials

Objective:

This study presents a comparative analysis of the color stability of computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated provisional restorations with those of conventional restorations.

Materials and Methods:

Three different provisional restorative materials (Systemp C&B, 3M Protemp 4, and Telio CAD) were inspected for their color stability using four solutions (Pepsi, coffee, tea, and distilled water). All samples used were fabricated using A1 shade by following the manufacturer's instructions. Color assessment was performed using CIELAB system and a colorimeter. After baseline color measurement, color assessments were done weekly after immersion in specified solutions. Triplicate readings were taken for every sample and the mean value of the color coordinates (L*), (a*), and (b*) were recorded at baseline, week 1, week 2, week 3, and week 4. The data within different groups were compared statistically using analysis of variance (α = 0.05).

Results:

Overall, the highest color stability was found in CAD/CAM material, followed by Protemp and SystempC&B. It was also observed that the maximum color variation was observed in case of coffee, followed by tea and Pepsi.

Conclusions:

CAD/CAM provisional material (Telio CAD) showed better color stability compared to conventional materials (Protemp 3M ESPE and SystempC&B Ivoclar Vivadent). CAD/CAM provisional materials are recommended for long-term temporization procedures. This is attributed to the prepolymerization, higher monomer conversion, and minimal preparation errors in CAD/CAM materials.

Effect of Malachite green, Ocimum Sanctum, and Er, Cr: YSGG laser on antimicrobial activity against S.mutans and CAD disinfection bonded to resin restoration

AIMS

Evaluation of survival of S.mutans and shear bond strength (SBS) of adhesive restorative material bonded to carious affected dentin (CAD) after using cavity disinfectant i.e., Er, Cr: YSGG (ECYL), (Nd: YAG) (NYL), Malachite green (MG), Ocimum sanctum (OS) in comparison to the conventional control chlorhexidine gluconate (CHX).

MATERIALS AND METHODS

Seventy-five caries-affected mandibular third molars having ICDAS scores 4 and 5 were included. Carious infected dentin was eliminated and CAD surface was obtained. On twenty-five samples, an uncontaminated suspension of S. mutans strain ATCC 35668 in Brain-Heart Infusion broth (BHI) was obtained after 12 hours of incubation at 37°C. Based on the disinfection regime used to sterilize the CAD surface, all the specimens were allocated into five different groups. (n=15) Group 1: CAD disinfected with CHX, Group 2: CAD disinfected with ECYL, Group 3: CAD disinfected with NYL, Group 4: CAD disinfected with MG, and Group 5: CAD disinfected with OS. An assessment of the survival rate of S. mutans was performed. Fifty specimens were smeared with single-step adhesive bond followed by restoring the CAD surface using packable composite. SBS and failure mode were determined using a universal testing machine and stereomicroscope at 40x magnification. ANOVA and post-hoc Tukey-Kramer test was used for data analysis p=0.05 RESULTS: Group 1: CHX-treated specimens displayed the lowest bacterial viability (0.11±0.03 CFU/mL). However, group 4: MG exhibited the highest bacterial survival (0.15 ±0.09 CFU/mL). The highest and lowest SBS of resin adhesive bonded to disinfected CAD surface were exhibited by (group 5: OS) (21.48±1.39 MPa) and (group 3: NYL) (16.41±0.90 MPa) respectively (p>0.05).

CONCLUSION

Ocimum sanctum seems to be promising in terms of its antibacterial efficacy against S.mutans and positive impact on SBS of resin adhesive to CAD surface.

Effect of universal adhesives on microtensile bond strength to hybrid ceramic

Background

The aim of this study was to evaluate the effect of universal adhesives (UA) and silane on the microtensile bond strength (μTBS) of resin cement to a hybrid ceramic Vita Enamic (VE).

Methods

VE specimens were acid etched using hydrofluoric acid (HF) and were assigned to three groups (n = 10) based on the applied bonding technique. In group 1 (S), a silane-based primer was used as a surface treatment prior to the application of a resin cement (Variolink Esthetic DC). In group 2, a silane-containing UA, Clearfil Universal Bond (CUB) was used for the surface treatment, and in group 3, A silane-free UA, Tetric N-Bond Universal (TNU) was used for surface treatment. Resin cement build-ups were prepared. The bonded specimens were sectioned into resin-ceramic beams. Half of the beams of each group were stored for 24 h at 37 °C and the other half were subjected to a thermo-cycling aging. The microtensile bond strength (μTBS) was measured at a crosshead speed of 0.5 mm/min. Failure modes were assessed accordingly. Data were analyzed using a) two-way analysis of variance ANOVA followed by one-way ANOVA and Tukey tests between groups and b) independent t-test to detect differences (α = 0.05) for each group. The surface topographies of the ceramic surface were evaluated using scanning electron microscopy.

Results

The results showed that silane-based primer (S) application resulted in significantly higher (p < 0.05) μTBS values after 24 h and after thermocycling compared to both silane-containing UA (CUB) and silane-free UA (TNU). The μTBS values of all groups were significantly reduced after thermocycling. No statistically significant difference was observed between the μTBS of CUB and TNU after 24 h. However, TNU showed significantly higher μTBS after thermocycling. Different failure modes were observed, and adhesive failure was the most common in all groups. Marked surface topographic changes were observed following HF etching.

Conclusion

It is concluded that, the UAs tested cannot be recommended as substitutes to the silanization of Hybrid ceramic.

A Low-Viscosity BisGMA Derivative for Resin Composites: Synthesis, Characterization, and Evaluation of Its Rheological Properties

This study aimed to synthesize new bisphenol A-glycidyl methacrylate (BisGMA) derivatives, targeting a reduction in its viscosity by substituting one of its OH groups, the leading cause of its high viscosity, with a chlorine atom. Hence, this monochloro-BisGMA (mCl-BisGMA) monomer was synthesized by Appel reaction procedure, and its structure was confirmed using Fourier transform infrared spectroscopy, ¹H and ¹³C-nuclear magnetic resonance spectroscopy, and mass spectroscopy. The viscosity of mCl-BisGMA (8.3 Pa·s) was measured under rheometry conditions, and it was found to be more than 65-fold lower than that of BisGMA (566.1 Pa·s) at 25 °C. For the assessment of the viscosity changes of model resins in the presence of mCl-BisGMA, a series of resin matrices, in which, besides BisGMA, 50 wt % was triethylene glycol dimethacrylate, were prepared and evaluated at 20, 25, and 35 °C. Thus, BisGMA was incrementally replaced by 25% mCl-BisGMA to obtain TBC0, TBC25, TBC50, TBC75, and TBC100 blends. The viscosity decreased with temperature, and the mCl-BisGMA content in the resin mixture increased. The substantial reduction in the viscosity value of mCl-BisGMA compared with that of BisGMA may imply its potential use as a dental resin matrix, either alone or in combination with traditional monomers. However, the various properties of mCl-BisGMA-containing matrices should be evaluated.

Longitudinal evaluation of clinical, spectral and tissue degradation biomarkers in progression of periodontitis among cigarette and electronic cigarette smokers

OBJECTIVES

To longitudinally evaluate the periodontal parameters and MMP-8 and CTX (C-terminal crosslinked telopeptide of type I collagen) levels from diseased and healthy sites from cigarette and electronic cigarette (e-cig) smokers and characterize the gingival crevicular fluid (GCF) samples using Raman spectroscopy In addition, to longitudinally determine if MMP-8 and CTX are predictive factors for attachment loss in periodontitis sites.

METHODS

Sixty periodontally healthy and 60 periodontitis/diseased sites from 30 e-cig and 30 cigarette smokers were monitored at baseline, 3 months, and 6-months. GCF was sampled to study the MMP-8 and CTX concentrations using enzyme-linked immunosorbent assay. Infra-red absorption spectra of GCF were acquired at all time points and processed to identify key functional groups.

RESULTS

A significantly increased attachment loss was observed at 6 months for both smokers when compared with baseline (p < 0.01). This difference was significantly high for cigarette smokers compared with e-cig users (p < 0.01). MMP-8, CTX, smoking pack-years were significantly correlated with probing depth and clinical attachment loss among both e-cig and cigarette smokers. For MMP-8 and CTX, the periodontitis sites showed a statistically significant difference between e-cig and cigarette smokers at both 3- and 6 months follow-up. From baseline to 6 months follow-up, periodontitis sites from both groups showed higher spectral band intensities with deconvulations and Raman shifts for Amide I and Amide II peaks.

CONCLUSION

Cigarette smokers showed higher periodontal worsening than e-cig smokers. Smoking, MMP-8, CTX are prognostic factors for clinical attachment loss in cigarette and e-cig smokers.

CLINICAL SIGNIFICANCE

Data for Raman scattering and spectral information identifying collagen degradation among e-cig and cigarette smokers have been analyzed. This type of analysis proves a robust diagnostic and prognostic tool for periodontal diseases. Smoking, MMP-8, and CTX are prognostic factors for clinical attachment loss in cigarette and e-cig smokers.

Effects of different antibacterial disinfectants on microleakage of bulk-fill composite bonded to different tooth structures

Background

This in-vitro study aimed to investigate the effect of two different antibacterial disinfectants on the microleakage performance of newly developed bulk-fill composite, bonded to different tooth structures.

Methods

Class V cavities were prepared in 30 sound premolar teeth, with enamel occlusal margins (OM) and dentin cervical margins (CM). Two disinfectants, 2% chlorhexidine gluconate (CHX) and Listerine Miswak (ListM), were used. Teeth were divided into three groups (n = 10): G1, Control; G2, CHX; and G3, ListM. Disinfectants were applied to the cavity preparation walls after they were etched with 35% phosphoric acid. The Single Bond Universal adhesive system was then used, and teeth were restored with Filtek One Bulk Fill composite. Samples were examined, after thermocycling aging, by stereomicroscopy for the evaluation of marginal dye penetration.

Results

The highest mean microleakage score was reported in the CM of G1 (2.60 ± 1.174), which was significant compared with that of G2 only (p = 0.02). OM in G1 showed no microleakage, with no significant differences found among groups (χ² = 1.39, p = 0.50). No significant differences were reported between G2 and G3 (p = 0.45 OM; p = 0.17 CM).

Conclusions

Cavity pretreatment with CHX is not significantly different to pretreatment with CHX. In contrast, CHX improved the cervical marginal seal as compare to the control group (G1).

Influence of the Physical Inclusion of ZrO2/TiO2 Nanoparticles on Physical, Mechanical, and Morphological Characteristics of PMMA-Based Interim Restorative Material

Polymethyl methacrylate (PMMA) is often used in restorative dentistry for its easy fabrication, aesthetics, and low cost for interim restorations. However, poor mechanical properties to withstand complex masticatory forces are a concern for clinicians. Therefore, this study aimed to modify a commercially available PMMA-based temporary restorative material by adding TiO2 and ZrO2 nanoparticles in different percentages as fillers and to investigate its physio-mechanical properties. Different percentages (0, 0.5, 1.5, and 3.0 wt%) of TiO2 and ZrO2 nanoparticles were mixed with the pristine PMMA resin (powder to liquid ratio: 1 : 1) and homogenized using high-speed mixer. The composites obtained were analyzed for their flexural strength (F.S.), elastic modulus (E.M.), Vickers hardness (H.V.), surface roughness Ra, morphology and water contact angle (WCA). The mean average was determined with standard deviation (SD) to analyze the results, and a basic comparison test was conducted. The results inferred that adding a small amount (0.5 wt%) of TiO2 and ZrO2 nanoparticles (NPs) could significantly enhance the physio-mechanical and morphological characteristics of PMMA interim restorations. EM and surface hardness increased with increasing filler content, with 3.0 wt.% ZrO2 exhibiting the highest EM (3851.28 MPa), followed by 3.0 wt.% TiO2 (3632.34 MPa). The WCA was significantly reduced from 91.32 ± 4.21° (control) to 66.30 ± 4.23° for 3.0 wt.% ZrO2 and 69.88 ± 3.55° for 3.0 wt.% TiO2. Therefore, TiO2 and ZrO2 NPs could potentially be used as fillers to improve the performance of PMMA and similar interim restorations.

Effectiveness of final cavity disinfectant Terminalia chebula, Malachite, and Indocyanine green, against E. faecalis and on the bond interface of fiber post to radicular dentin

AIMS

Evaluation of antimicrobial efficacy of contemporary disinfection Malachite green (MG), Terminalia chebula (T. chebula), and Indocyanine green (ICG)) against E. faecalis and their effect on push-out bond strength (PBS) of glass fiber post (GFP) bonded to root dentin in comparison to conventional irrigation used (Sodium hypochlorite (NaOCl) + Ethylene diamine tetraacetic acid (17% EDTA).

MATERIALS AND METHODS

Root canal treatment was initiated on sixty human single-rooted premolars and working length was established. The canals were enlarged using ProTaper universal system till F3. The prepared canals were obturated with Gutta-percha (GP) and AH Plus sealer followed by post-space preparation. Twenty canals contained a standard strain of E. faecalis (n=5 in each group) cultured overnight at 37 °C in BHI broth. All the samples were randomly allocated into four groups based on post-space irrigation. (n = 10) Group 1: 5.25% NaOCl+17% EDTA (Control), Group 2: 5.25% NaOCl + ICG, Group 3: 5.25% NaOCl + MG and Group 4: 5.25% NaOCl + T. chebula. Survival rates of E. faecalis were evaluated on the twenty specimens. GFP was placed on the remaining samples using self-etch dual-cure pastes and sectioning was performed in 1 mm thick slices. PBS and failure mode were analyzed using a universal testing machine and stereomicroscope. One-way analysis of variance (ANOVA) and Tukey multiple comparison t-tests were used for data analysis. (p = 0.05).

RESULTS

5.25% NaOCl+17% EDTA demonstrated (0.11±0.01 CFU/mL) the lowest survival rate of E. faecalis. However, Group 2 (5.25% NaOCl + ICG) exhibited the highest survival rate (0.52 ± 0.10). Furthermore, the coronal third of group 4 (5.25% NaOCl + T. chebula) (8.71±0.25 MPa) specimens demonstrated the highest PBS of GFP. However, an apical section of group 2 samples (5.25% NaOCl + ICG) (1.21±0.71 MPa) displayed the lowest outcome of bond integrity.

CONCLUSION

Terminalia chebula when used as a final canal disinfectant seems to be promising in improving canal sterility and the bond strength of GFP to the root dentin.

Simultaneous Evaluation of Creep Deformation and Recovery of Bulk-Fill Dental Composites Immersed in Food-Simulating Liquids

The aim of this study is to compare the creep/recovery behavior of bulk-fill dental composites after storage in various food simulating organic solvents. For this purpose, five different resin-composites (four bulk-fills and one conventional) were used. A total of 20 rectangular specimens (14 mm &times; 3 mm &times; 0.7 mm) were prepared by filling the resin-composites in Teflon mold. All of the specimens for each material (n = 5) were divided into four groups namely dry (control), distilled water (DW), artificial saliva, and absolute ethanol. The specimens were subjected to three-point bending creep test during immersion directly. A constant load of 2 N was used for each specimen with loading and unloading time 2 h each.

RESULTS

SF2 and XF showed a lower creep strain % after immersion, ranging from 0.44 (dry) to 0.75 (saliva) and 0.43 (dry) to 0.80 (ethanol), respectively. TNC BF depicts the maximum creep strain % ranging from 1.24% (dry) to 2.87% (ethanol) followed by FBF ranging from 1.17 (dry) to 2.59 (ethanol). However, the conventional material (GR) showed lower creep strain after immersion ranging from 0.28 to 0.54. Moreover, SF2 resulted in the highest creep recovery in all of the composites groups, as well as conventional material. The other composite groups showed lower creep recovery as compared to the conventional material (GR). The creep strain % for all the bulk-fill composites materials were increased during immersion in the liquids. However, for the conventional material, the creep deformation is decreased after immersion. SF2 showed the highest percentage of creep recovery among the bulk-fill composites, followed by XF.

Adhesive Bonding to Computer-aided Design/ Computer-aided Manufacturing Esthetic Dental Materials: An Overview

AIM

To review the adhesive bonding to different computer-aided design/computer-aided manufacturing (CAD/CAM) esthetic restorative materials.

BACKGROUND

The use of CAD/CAM esthetic restorative materials has gained popularity in recent years. Several CAD/ CAM esthetic restorative materials are commercially available. Adhesive bonding is a major determinant of success of CAD/ CAM restorations. Review result: An account of the currently available bonding strategies are discussed with their rationale in various CAD/ CAM materials.

CONCLUSION

Different surface treatment methods as well as adhesion promoters can be used to achieve reliable bonding of CAD/CAM restorative materials. Selection of bonding strategy to such material is determined based on its composition. Further evidence is required to evaluate the effect of new surface treatment methods, such as nonthermal atmospheric plasma and self-etching ceramic primer on bonding to different dental ceramics.

CLINICAL SIGNIFICANCE

An understanding of the currently available bonding strategies to CA/CAM materials can help the clinician to select the most indicated system for each category of materials.

Preparation and Characterization of Poly(ethylene-co-vinyl alcohol)/poly(ε-caprolactone) Blend for Bioscaffolding Applications

In order to improve the cell adhesion on poly(ε-caprolactone) (PCL) scaffolds, poly(ethylene-co-vinyl alcohol) (E-VAL) which has hydroxyl groups capable of developing hydrogen bonds with celling was blended with this polymer. To reach this goal, a series of E-VAL/PCL blends with different compositions were prepared by the solvent casting method. The miscibility of the polymer blend was proved by differential scanning calorimetry and Fourier-transform infrared spectroscopy spectrometry. Furthermore, the mechanical properties of the polymer blends were assessed in their wet state by dynamic mechanical analysis. The surfaces wettability of blends and their components were examined through static contact angle measurements. The pore interconnections in the resulted scaffolds were achieved by the incorporation of naphthalene microparticles which were used as porogen and then removed in its gas state by sublimation under reduced pressure. The presence of pores interconnected inside the polymeric materials and their surface morphologies was examined by scanning electron microscopy. The in-vitro cytotoxicity and cell adhesion on the prepared materials were examined by an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay.

Efficiency of the new reciprocating and rotary systems with or without ultrasonics in removing root-canals filling with calcium silicate-based sealer (MTA)

BACKGROUND

To compare the efficiency of endodontic rotary and reciprocating systems in removing calcium silicate-sealer based fillings and to investigate the impact of passive ultrasonic irrigation (PUI) on their efficiency.

MATERIALS AND METHODS

160 root-canals were instrumented, filled with gutta-percha and calcium silicate based-sealer and divided into 10 equal groups. Five groups in which the reciprocating systems (WaveOne-Gold, Reciproc-Blue and R-Motion) and rotary systems (Fanta-AF-One and Tango-Endo) were used to remove root-canals' fillings. In the other five groups the fillings were removed by the same systems then additionally with PUI. The times to complete retreatments procedures were recorded. Micro-computed tomography's analysis of the root-canals fillings' volume before and after retreatments was used to determine the remaining filling materials (RFMs) volumes.

RESULTS

The RFMs after using rotary systems (10.1%) was greater than after using reciprocating systems (3.8%) (P < 0.001). The RFMs after using WOG (2%) and RB systems (2.6%) were less than those in the RM (6.8%), TE (9.5%) and FAFO (10.7%) systems [P < 0.05]. The times required to remove the filling materials using the TE (3.7 min), FAFO (4.1 min) and RM (4.1 min) systems were shorter than those required by the RB (5.4 min) and WOG (4.9 min) systems [P < 0.05]. Using PUI resulted in less RFMs (1.44%) when compared to using only rotary or reciprocating systems (6.27%) [P < 0.001].

CONCLUSIONS

Endodontic reciprocation systems were more effective, but needed longer times than rotary systems in removing calcium silicate based- sealers fillings. The PUI significantly improved removal of the root-canals' filling materials.

CLINICAL RELEVANCE

Reciprocating systems and PUI are recommended whenever root-canals retreatment is considered regardless of using calcium silicate-based sealers.

Poly(δ-valerolactone)/Poly(ethylene-co-vinylalcohol)/β-Tri-calcium Phosphate Composite as Scaffolds: Preparation, Properties, and In Vitro Amoxicillin Release

Two poly(δ-valerolactone)/poly(ethylene-co-vinylalcohol)/beta-tricalcium phosphate (PEVAL/PDVAL/β-TCP) composites containing an equal ratio of polymer and filled with 50 and 70 wt% of β-TCP microparticles were prepared by the solvent casting method. Interconnected pores were realized using the salt leached technique, and the porosity of the resulted composites was evaluated by the scanning electron microscopy (SEM) method. The homogeneity of the hybrid materials was investigated by differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analysis. The prepared materials' SEM images showed interconnected micropores that respond to the conditions required to allow their uses as scaffolds. The porosity of each scaffold was determined from micro computed tomography (micro-CT) data, and the analysis of the mechanical properties of the prepared materials was studied through the stress-strain compressive test. The proliferation test results used human mesenchymal stem cells (MSCs) to grow and proliferate on the different types of prepared materials, reflecting that the hybrid materials were non-toxic and could be biologically acceptable scaffolds. The antibacterial activity test revealed that incorporation of amoxicillin in the specimens could inhibit the bacterial growth of S. aureus. The in vitro study of the release of amoxicillin from the PEVAL/PDVAL/amoxicillin and PEVAL/PDVAL/β-TCP/amoxicillin drug carrier systems in pH media 7.4, during eight days, gave promising results, and the antibiotic diffusion in these scaffolds obeys the Fickian model.