Is the adhesive or mechanical behavior of glass ceramics influenced by the adhesive layer application after etching and silanization? A literature review

Aim: This review investigated the effect of applying an adhesive after surface treatment of glass-ceramics on the bonding, mechanical or clinical behavior. Methods: Studies comparing the adhesive, mechanical or clinical behavior of glass-ceramics, with or without adhesive application after surface treatment, were included. Searches were performed in PubMed, Scopus, and Web of Sciences databases (January 2022), resulting in 15 included studies. Results: Regarding the evaluated outcomes, 13 studies assessed bond strength, 2 studies assessed biaxial flexural strength and 1 study assessed fatigue failure load, while no study evaluating clinical outcomes was included. It was possible to observe that the adhesive application after ceramic surface treatment was unfavorable or did not influence the evaluated outcomes. Conclusion: Most of the evidence available in the literature shows that the adhesive application after surface treatment does not improve the adhesive and mechanical behavior of glass-ceramics

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial

Abstract Objectives This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. Methodology A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. Results After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). Conclusion Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

Uso efectivo de los adhesivos de octava generación / Effective use of eighth generation adhesives

Introducción: se realizó una revisión bibliográfica con el objetivo de conocer, analizar y comparar los diferentes tipos de adhesivos de octava generación que se encuentran en el mercado y la diferencia que existe entre cada uno. Los adhesivos universales han demostrado mejoras en su resistencia, sobre todo en las técnicas de aplicación y en las propiedades de estos materiales, al mejorar la fuerza adhesiva para que el odontólogo pueda brindar tratamientos restaurativos exitosos. Objetivo: conocer, analizar y comparar los diferentes tipos de adhe- sivos de la octava generación empleados en odontología. Material y métodos: se realizó una búsqueda en las bases de datos electrónicas PubMed, BVS, Redalyc y ScienceDirect. Se utilizaron 32 artículos que cumplieron con los criterios predeterminados y la especificidad reque- rida para la pregunta de investigación. Conclusiones: se demostró que la tecnología cada día avanza, sobre todo en el área de los adhesivos, ya que éstos son de mucha utilidad en el día a día del odontólogo; es importante conocer cada uno de éstos, puesto que es un poco complejo seleccionar el correcto, mas no el uso. En la actualidad, existen diversas opciones por las que el odontólogo puede optar, es por ello que el pro- fesional debe estar capacitado sobre cada una de las diferentes marcas existentes y, de acuerdo al tratamiento, debe elegir cuál es mejor utilizar en una rehabilitación. Es importante para el odontólogo conocer estos materiales, ya que esto lo beneficiará al momento de llevar un plan de tratamiento restaurador (AU)

Introduction: a bibliographic review was carried out to learn about, analyze, and compare the different types of eighth-generation adhesives on the market and the difference between each one. Universal adhesives have demonstrated improvements in their resistance, especially in the application techniques and properties of these materials, improving the adhesive strength so that the dentist can provide successful restorative treatments. Objective: to know, analyze and compare the different types of eighth-generation adhesives used in dentistry. Material and methods: a search was made of the following electronic databases: PubMed, BVS, Redalyc, ScienceDirect. Finally, 32 articles that met the predetermined criteria and the specificity required for the research question were used. Conclusions: it was demonstrated that technology is advancing every day, especially in the area of adhesives since these are very useful in the daily life of the dentist. It is important to know each one of these since it is a little complex at the moment of selecting the correct one, but not the use. Currently, there are several options that the dentist can choose, which is why the professional must be trained on each of the various existing brands and according to the treatment which is the best to use at the time of rehabilitation. The dentist needs to know these materials since they will benefit him/her when carrying out a restorative treatment plan (AU)

Ellagic acid on the quality of the adhesive interface of class I composite resin restorations after aging

To evaluate the effect of ellagic acid on the inhibition of matrix metalloproteinase by analyzing the quality of the adhesive interface with bond strength measures in periods of 24 hours and six months of storage. Method: 40 healthy human third molars were prepared with class I cavities (5x4x3mm). The teeth were divided into four experimental groups: Group 1- without application of ellagic acid and storage time of 24 hours; Group 2- with ellagic acid/24 hours; G3- without ellagic acid/six months; Group 4- with ellagic acid/six months. Then, the cavities were restored with Single Bond Universal adhesive and Z350 composite resin, with and without the previous application of ellagic acid. Subsequently, hourglass-shaped specimens were obtained and subjected to the bond strength (BS) test (n = 10) in a universal testing machine. The bond test was performed after 24 hours and six months of storage. For the standard evaluation (n = 3) the samples were infiltrated with silver nitrate and placed in a developing solution for analysis in a Scanning Electron Microscope (SEM). The data obtained were analyzed with the Kruskal-Wallis non-parametric test, showing a statistically significant difference. Results: The highest bond strength values were found for the 24-hour groups followed by the groups with six months of storage. For nano-infiltration, groups G1 and G2 showed lower infiltration than groups G3 and G4. Conclusion: The previous application of ellagic acid did not affect the BS of the adhesive interface of the adhesive system analyzed, regardless of storage time.

Influence of customization and light-curing device on the bond strength of glass fiber posts - in vitro study / Influência da reanatomização e do aparelho fotopolimerizador na resistência de união de pinos de fibra de vidro - estudo in vitro

Introduction: Endodontically treated teeth are usually affected by extensive structure loss requiring the use of intraradicular posts to provide retention and restoration. Objective: An in vitro assessment was performed on the bonding of glass fiber posts to the root dentin. Material and method: Ninety (n = 10) single bovine roots were used in a 3 x 3 x 3 factorial study with subdivided plots: post customization varying the presence and type of resin (without customization, conventional resin, and Bulk Fill resin), light-curing device (Valo, Radii-Cal, Rainbow), and root third (cervical, middle, and apical). Result: For the customization factor, Tukey's test (5%) showed the superiority of the Bulk Fill (8.16 MPa) and Z350 (7.40 MPa) groups compared to the control group (4.92 MPa), without differing from each other. All light-curing devices differed, showing the superiority of Valo (9.36 MPa), Radii (6.96 MPa) as an intermediate, and the inferiority of Rainbow (4.17 MPa). The cervical root third (7.81 MPa) was superior, the apical third was inferior (5.80 MPa), and the middle third (6.88 MPa) was an intermediate without differing from the others. Conclusion: The customization of glass fiber posts increases the bond strength to the root dentin, regardless of the resin used. There was a compromise in the apical third and when using light-curing devices with lower light intensity.

Introdução: Dentes com extensa perda de estrutura podem comprometer a retenção das restaurações ao remanescente dental, onde pinos intraradiculares são indicados. Objetivo: Avaliou-se in vitro a união de pinos de fibra de vidro à dentina radicular em função de diferentes modos de reanatomização, fotopolimerizadores e regionalização radicular. Material e método: Noventa (n=10) raízes bovinas uniradiculares foram usadas num estudo fatorial 3 x 3 x 3 com parcelas subdivididas: Reanatomização do pino, variando a presença e tipo de resina (Sem reanatomização, Resina Convencional e Resina Bulkfill); Fotopolimerizador (Valo, Radii-cal, Rainbow); e Terço radicular (cervical, médio e apical). Resultado: O teste de Tukey (5%) evidenciou para o Fator Reanatomização superioridade dos grupos BulkFill (8.16MPa) e Z350 (7.40MPa) ao grupo Controle (4.92MPa), sem diferirem entre si. Todos os fotopolimerizadores diferiram entre si, com superioridade de Valo (9.36MPa), Radii (6.96MPa) intermediário, e inferioridade de Raiwbow (4.17MPa). O terço radicular cervical (7.81MPa) foi superior e o apical inferior (5.80MPa), com o terço médio (6.88MPa) intermediário e sem diferir dos demais. Conclusão: Conclui-se que a reanatomização de pinos de fibra de vidro aumenta a resistência de união à dentina radicular, independentemente da resina utilizada, havendo prejuízo no terço apical e quando são empregados fotopolimerizadores com menor intensidade luminosa.

Effect of ceramic thicknesses and opacities on water sorption and solubility of a light-curing resin cement by different units

Aim: This study evaluated the water sorption and solubility of a light-cured resin cement, under four thicknesses and four opacities of a lithium disilicate ceramic, also considering three light-emitting diode (LED) units. Methods: A total of 288 specimens of a resin cement (AllCem Veneer Trans ­ FGM) were prepared, 96 samples were light-cured by each of the three light curing units (Valo ­ Ultradent / Radii-Cal ­ SDI / Bluephase II ­ Ivoclar Vivadent), divided into 16 experimental conditions, according to the opacities of the ceramic: High Opacity (HO), Medium Opacity (MO), Low Translucency (LT), High Translucency (HT), and thicknesses (0.3, 0.8, 1.5, and 2.0 mm) (n = 6). The specimens were weighed at three different times: Mass M1 (after making the specimens), M2 (after 7 days of storage in water), and M3 (after dissection cycle), for calculating water sorption and solubility. Results: The higher thickness of the ceramic (2.0 mm) significantly increased the values of water sorption (44.0± 4.0) and solubility (7.8±0.6), compared to lower thicknesses. Also, the ceramic of higher opacity (HO) generated the highest values of sorption and solubility when compared to the other opacities, regardless of the thickness tested (ANOVA-3 factors / Tukey's test, α = 0.05). There was no influence of light curing units. Conclusion: Higher thicknesses and opacities of the ceramic increased the water sorption and solubility of the tested light-cured resin cement

Physicochemical properties and biological effects of quaternary ammonium methacrylates in an experimental adhesive resin for bonding orthodontic brackets

Abstract Fixed orthodontic appliances may lead to biofilm accumulation around them that may increase caries risk. This study aimed to evaluate the influence of quaternary ammonium methacrylates (QAMs) on the physicochemical properties, cytotoxicity, and antibacterial activity of adhesive resins for orthodontic purposes. Methodology: A base resin was prepared with a comonomer blend and photoinitiator/co-initiator system. Two different QAMs were added to the base adhesive: dimethylaminododecyl methacrylate at 5 wt.% (DMADDM) or dimethylaminohexadecyl methacrylate (DMAHDM) at 10 wt.%. The base adhesive, without QAMs, (GC) and the commercial Transbond™ XT Primer 3M (GT) were used as control. The resins were tested immediately and after six months of aging in the water regarding the antibacterial activity and shear bond strength (SBS). The antibacterial activity was tested against Streptococcus mutans via metabolic activity assay (MTT test). The groups were also tested for the degree of conversion (DC) and cytotoxicity against keratinocytes. Results: The resins containing QAM showed antibacterial activity compared to the commercial material by immediately reducing the metabolic activity by about 60%. However, the antibacterial activity decreased after aging (p<0.05). None of the groups presented any differences for SBS (p>0.05) and DC (p>0.05). The incorporation of DMADDM and DMAHDM significantly reduced the keratinocyte viability compared to the GT and GC groups (p<0.05). Conclusion: Both adhesives with QAMs showed a significant reduction in bacterial metabolic activity, but this effect decreased after water aging. Lower cell viability was observed for the group with the longer alkyl chain-QAM, without significant differences for the bonding ability and degree of conversion. The addition of QAMs in adhesives may affect the keratinocytes viability, and the aging effects maybe decrease the bacterial activity of QAM-doped materials.

Polywave And Monowave Light-Curing Units Effects On Polymerization Efficiency Of Different Photoinitiators / Efeito Da Unidade De Cura Por Luz Polywave E Monowave Na Eficiência De Polimerização De Diferentes Fotoiniciadores

Objective: The objective of this study was to characterize and correlate the absorption spectra of three photoinitiators [camphorquinone (CQ), diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) and phenylbis (2,4,6-trimethylbenzoyl)-phosphine oxide (BAPO)], using second or third-generation light curing units (LCU), and to evaluate the degree of conversion and the physical properties of an experimental resin adhesive. Material and methods: Second-generation (Radii-cal® and Emitter D®) and third-generation (Valo® Cordless and Bluephase N®) LCU were assessed regarding spectrum and irradiance rate of emitted light. Also, the photoinitiators (CQ, TPO and BAPO) were characterized by a light absorption spectrum assessed by UV-Vis spectroscopy, degree of conversion and yellowing effect. Statistical analyzes considered two-way ANOVA and post-hoc Tukey test. Results: BAPO presented higher reactivity compared to TPO. Regarding degree of conversion of the photoinitiators activated by different light-curing units, the Emitter D® device promoted a high degree of conversion. BAPO presented the highest yellowing effect values. Conclusions: The emission and absorption characteristics of the photoinitiators were different. The polymerization reaction activated by the second-generation light-curing unit was reduced when using an experimental resin with photoinitiator TPO, and the third-generation light-curing unit showed a higher polymerization potential regardless of the photoinitiator. (AU)

Objetivo: Caracterizar e correlacionar os espectros de absorção de três fotoiniciadores [canforoquinona (CQ), difenil 2,4,6-trimetilbenzil óxido de fosfina (TPO) e óxido de di (2,4,6-trimetilbenzil) difenil fosfina (BAPO)], com unidades de fotoativação (LCU) de segunda ou terceira geração, e avaliar o grau de conversão e as propriedades físicas de um adesivo experimental. Material e métodos: LCU de segunda geração (Radii-cal® e Emitter D®) e terceira geração (Valo® Cordless e Bluephase N®) foram avaliadas quanto ao espectro e taxa de irradiância da luz emitida. Além disso, os fotoiniciadores (CQ, TPO e BAPO) foram caracterizados por um espectro de absorção de luz avaliado por espectroscopia UV-Vis, avaliado o grau de conversão dos adesivos e efeito de amarelamento. A análise estatística empregada foi ANOVA duas vias e teste post-hoc de Tukey. Resultados: BAPO apresentou maior reatividade comparado ao TPO. Em relação ao grau de conversão dos fotoiniciadores ativados por diferentes aparelhos fotopolimerizadores, o dispositivo Emitter D® promoveu um alto grau de conversão. BAPO apresentou os maiores valores de efeito de amarelamento. Conclusões: As características de emissão e absorção dos fotoiniciadores foram diferentes. A reação de polimerização ativada pelas unidades de fotopolimerização de segunda geração foi reduzida com o uso de uma resina experimental com fotoiniciador TPO. As unidades de fotopolimerização de terceira geração apresentaram maior potencial de polimerização independentemente do fotoiniciador. (AU)

Ultimate tensile strength of total and self-etch adhesives: effect of light irradiation distance

Objective: To evaluate the ultimate tensile strength (UTS) of total and self- etch adhesives irradiated at different distances. Materials and Methods: Sixty cylindrical specimens of 0.78mm diameter and 10 mm length were prepared of two types of adhesive systems total etch Excite DSC (EX ­ Ivoclar Vivadent, Schaan, Liechtenstein) and one-step self-etch Clearfil S3 Bond (S3, Kuraray Medical Inc., Tokyo, Japan). Specimens of each adhesive were divided into three groups according to the light irradiation distance (0, 2, 4mm) (n=10). Each specimen was attached to universal testing machine (Digital Force Gauge, IMADA CO., LTD, Japan) and loaded at cross head speed of 1mm/min until failure. Data were analyzed using two-way ANOVA and Independent Student t-test at p< 0.05. Results: Mean UTS for total etch (24.63, 18.19, 17.26 Mpa) and for self-etch (12.68, 8.53, 7.58Mpa) at (0, 2, 4mm) distances. Specimens irradiated directly show significantly the highest UTS while those irradiated at 4mm show the lowest values (p<0.05). Excite DSC total etch adhesive have higher UTS than Clearfil S3 self-etch adhesive regardless of irradiation distance (p<0.05).Conclusions: The UTS of the evaluated adhesives was light irradiation distance and adhesive system dependant.

Influence of pre-curing different adhesives on the color stability of cemented thin ceramic veneers

Abstract The objective was to evaluate the color stability of thin ceramic veneers as a function of the curing mode (with and without pre-cure) of different adhesive systems applied to the internal surface of ceramics. Five adhesive systems (Scotchbond Multi-Purpose, Single Bond Universal, Gluma 2 Bond, Ambar, and Ambar APS) and photo-cured resin cement (Allcem Veneer) were used for cementing 0.6 mm-thick feldspathic veneers (Mark II) on composite resin substrates (Charisma Diamond). The groups, according to adhesive system, were divided into two subgroups (n=10): i) adhesive and resin cement were polymerized separately (pre-cure of the adhesive), ii) adhesive and resin cement were polymerized simultaneously. The CIELab color parameters were determined with a spectrophotometer at 24h (baseline), 7 days, 30 days and 12 months. Data were analyzed by two-way ANOVA and Tukey's test (α=0.05). The results indicated statistically significant differences for adhesive systems and time. The mode of curing of the adhesive system was not statistically significant: pre-cured adhesives (2.6±1.3) and not pre-cured adhesives (2.8±1.4). For the adhesives, ΔE values varied in the following order: Ambar-APS (1.6±0.5) < Scotchbond Multi-Purpose (2.6±1.2) = Gluma 2 Bond (2.7±1.2) = Ambar (2.9±1.2) < Single Bond Universal (3.5±1.5). For time, ΔE values were: 7 days (1.7±0.7), 30 days (3.5±1.2) and 12 months (2.9±1.3). It can be concluded that the different adhesive systems used for cementing thin ceramic veneers influenced the final color of the indirect restorations. The adhesives curing mode did not present a significant effect in the color stability of thin ceramic veneers.

Resumo O objetivo deste estudo foi avaliar a estabilidade de cor de laminados cerâmicos de espessura fina em função do momento de ativação de diferentes sistemas adesivos na superfície interna das cerâmicas. Foram utilizados 5 sistemas adesivos (Scotchbond Multiuso, Single Bond Universal, Gluma 2 Bond, Ambar and Ambar APS) e o cimento resinoso fotoativado (Allcem Veneer) para cimentação de lâminas de cerâmica feldspática (Mark II) com 0,6 mm de espessura, sobre substratos de resina composta (Charisma Diamond). Os grupos, de acordo com o sistema adesivo utilizado, foram divididos em dois subgrupos (n=10): i) adesivo e cimento resinoso foram polimerizados separadamente (polimerização isolada do adesivo), ii) adesivo e cimento resinoso foram polimerizados ao mesmo tempo (polimerização simultânea). Os parâmetros de cor do sistema CIELab foram determinados com um espectrofotômetro nos tempos de 24 h (baseline), 7 dias, 30 dias e 12 meses. Os dados foram analisados por ANOVA a dois fatores e teste de Tukey (α=0,05). Os resultados indicaram diferenças estatísticas significantes para os sistemas adesivos e tempo. O momento da fotoativação do sistema adesivo não foi estatisticamente significante: polimerização prévia (2,6±1,3) e polimerização simultânea (2,8±1,4). Para o sistema adesivo, os valores médios de ΔE variaram na seguinte ordem: Ambar APS (1,6±0,5)<Scotchbond Multi-Purpose (2,6±1,2)=Gluma 2 Bond (2,7±1,2)=Ambar (2,9±1,2)<Single Bond Universal (3,5±1,5). Para o fator tempo o ΔE foi: 7 dias (1,7±0,7), 30 dias (3,5±1,2) e 12 meses (2,9±1,3). Pode-se concluir que os diferentes sistemas adesivos utilizados na cimentação de laminados cerâmicos de espessura fina influenciaram na cor final das restaurações. O momento da fotoativação, isolada ou simultânea ao cimento resinoso, não apresentou efeito significativo na estabilidade de cor dos laminados cerâmicos de espessura fina.

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial

Abstract Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

Bond strength and marginal microleakage in restorations photopolymerized with LED and halogen light associated with three application modes of a universal adhesive system: in vitro study / Resistência de união e da microinfiltração marginal em restaurações fotopolimerizadas com LED e luz halógena associadas a três modos de aplicação de um sistema adesivo universal: estudo in vitro

ABSTRACT Objective: This study aimed to assess the bond strength and marginal microleakage in composite resin restorations, using the Single Bond Universal adhesive system associated with Ultralux (halogen) and Bluephase (LED) light curing units. Methods: For bond strength, 80 healthy human third molars were divided into halogen light (n=40) and LED (n=40), and subdivided according to the following application techniques for the adhesive system: etch-and-rinse (enamel), self-etching (enamel), etch-and-rinse (dentin), and self-etching (dentin). The teeth were subjected to the microtensile test and the fracture pattern was observed under an optical microscope at 40X magnification; they were analyzed by ANOVA, and Fisher and Tukey's tests (5%). For the marginal microleakage test, 120 class II cavities were prepared in 60 healthy human third molars that were randomly divided into halogen light (n=30) and LED (n=30), and subdivided according to the following application techniques for the adhesive system: etch-and-rinse, selective etching, and self-etching. The teeth were thermocycled 2000 times (±5/55°C), stained in 5% basic fuchsin and sectioned for qualitative and quantitative assessments; they were analyzed by Kruskall-Wallis and Dunn tests (5%). Results: For the bond strength of enamel and dentin, the adhesive application with prior acid etching was better than self-etching (p<0.0001), regardless of the type of light curing unit (p<0.05). Etch-and-rinse showed the lowest microleakage values (p<0.0001). Conclusion: Etch-and-rinse obtained the best results relative to the other application techniques for the adhesive system in both tests, regardless of the type of light curing unit.

RESUMO Objetivo: Avaliar a resistência de união e microinfiltração marginal em restaurações de resina composta, utilizando sistema adesivo Single Bond Universal associado com fotoativadores Ultralux (halógeno) e Bluephase (LED). Métodos: Para resistência de união, oitenta terceiros molares humanos hígidos foram divididos: Halógena (n=40); LED (n=40), sendo subdivididos de acordo com a técnica de aplicação do sistema adesivo: condicionamento total-esmalte; autocondicionante-esmalte; condicionamento total-dentina; autocondicionante-dentina. Os dentes foram submetidos ao teste de microtração e o padrão de fratura foi observado em microscópio ótico - 40X de aumento, analisadas pelos testes ANOVA, Tukey e Fisher (5%). Para o ensaio de microinfiltração marginal, 120 cavidades classe II foram preparadas em sessenta terceiros molares humanos hígidos, aleatoriamente divididos: Halógena (n=30); LED (n=30) e subdivididos de acordo com a técnica de aplicação do sistema adesivo: condicionamento total; condicionamento seletivo; autocondicionante. Os dentes foram termociclados 2000 vezes (±5/55ºC), corados em fucsina básica 5% e seccionados para avaliações qualitativa e quantitativa, analisados pelos testes Kruskall-Wallis e Dunn (5%). Resultados: Para resistência de união em esmalte e dentina, a aplicação do adesivo com condicionamento ácido prévio, foi melhor que o autocondicionante (p<0.0001), independentemente do tipo de fotoativador utilizado (p<0.05). O condicionamento total mostrou os menores valores de microinfiltração, (p<0.0001). Conclusão: O condicionamento total, obteve os melhores resultados em relação às outras técnicas de aplicação do sistema adesivo em ambos os testes, independentemente do tipo de aparelho fotoativador.

Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial

Abstract The objectives of this double-blind randomized clinical trial were to compare (a) the clinical times and (b) the occurrence and severity of postoperative sensitivity, of posterior restoration that used a universal adhesive, in a self-etch or selective enamel-etching technique, along with incremental or bulk-fill composites (presented in syringes or capsules). A total of 295 posterior restorations were placed according to the following groups: SETB - self-etch/bulk-fill in syringe; SETC - self-etch/bulk-fill in capsules; SETI - self-etch/incremental; SEEB - selective enamel-etching/bulk-fill in syringe; SEEC - selective enamel-etching/bulk-fill in capsules; and SEEI - selective enamel-etching/incremental. Clinical time was assessed by a reason (s/mm3) between the total volume of resin inserted and the total time required to perform the restorations. Postoperative sensitivity was evaluated using two scales (Numeric Rating Scale and Visual Analogue Scale). Mean clinical time results, analyzed by Wald's Chi-square, showed significant statistical differences among all groups (p<0.001), indicating that the restorative strategy affected the time required for the restoration. A generalized estimating equation model statistical analysis, performed to compare postoperative sensitivity, showed that neither the restorative technique, the adhesive strategy nor the presentation mode of the bulk-fill composite affected the overall risk of postoperative sensitivity (4.06 [2.22-6.81]). The use of bulk-fill composite, presented in capsules or syringes, is less time consuming and does not increase the risk or intensity of postoperative sensitivity relative to the traditional incremental technique.

Mechanical-physicochemical properties and biocompatibility of catechin-incorporated adhesive resins

Abstract Several anti-proteolytic dentin therapies are being exhaustively studied in an attempt to reduce dentin bond degradation and improve clinical performance and longevity of adhesive restorations. Objectives This study assessed the effect of epigallocatechin-3-gallate (EGCG) on long-term bond strength when incorporated into adhesives. Material and Methods Adhesive systems were formulated with EGCG concentrations of 0 wt%: (no EGCG; control); 0.5 wt% EGCG; 1.0 wt% EGCG, and 1.5 wt% EGCG. Flexural strength (FS), modulus of elasticity (ME), modulus of resilience (MR), compressive strength (CS), degree of conversion (DC), polymerization shrinkage (PS), percentage of water sorption (%WS), percentage of water solubility (%WL) and cytotoxicity properties were tested. Dentin microtensile bond strength (µTBS) was evaluated after 24 h and again after 6 months of water storage. The adhesive interface was analyzed using scanning electron microscopy (SEM). Results No significant differences were found among the groups in terms of FS, ME, MR, CS and PS. EGCG-doped adhesives increased the DC relative to the control group. EGCG concentrations of 1.0 wt% and 0.5 wt% decreased the WS of adhesives. WL decreased in all cases in which EGCG was added to adhesives, regardless of the concentration. EGCG concentrations of 1.0 wt% and 0.5 wt% reduced cytotoxicity. EGCG concentrations of 1.0 wt% and 0.5 wt% preserved µTBS after 6 months of storage, while 1.5 wt% EGCG significantly decreased µTBS. SEM: the integrity of the hybrid layer was maintained in the 0.5 wt% and 1.0 wt% EGCG groups. Conclusion EGCG concentrations of 1.0 wt% and 0.5 wt% showed better biological and mechanical performance, preserved bond strength and adhesive interface, and reduced cytotoxicity.

Minimization of polymerization shrinkage effects on composite resins by the control of irradiance during the photoactivation process

Abstract High levels of shrinkage stress caused by volumetric variations during the activation process are one of the main problems in the practical application of composite resins. Objective The aim of this study is to reduce the shrinkage stress and minimize the effects caused by composite resin volumetric variation due to the photopolymerization. In this way, this work proposes a systematic study to determine the optimal dimming function to be applied to light curing processes. Material and Methods The study was performed by applying mathematical techniques to the optimization of nonlinear objective functions. The effectiveness of the dimming function was evaluated by monitoring the polymerization shrinkage stress during the curing process of five brands/models of composites. This monitoring was performed on a universal testing machine using two steel bases coupled in the arms of the machine where the resin was inserted and polymerized. The quality of the composites cured by the proposed method was analyzed and compared with the conventional photoactivation method by experiments to determine their degree of conversion (DC). Absorbance measurements were performed using Fourier-transform infrared spectroscopy (FT-IR). A T-test was performed on DC results to compare the photoactivation techniques. We also used scanning electron microscopy (SEM) to analyze in-vitro the adhesion interface of the resin in human teeth. Results Our results showed that the use of the optimal dimming function, named as exponential, resulted in the significant reduction of the shrinkage stress (~36.88% ±6.56 when compared with the conventional method) without affecting the DC (t=0.86, p-value=0.44). The SEM analyses show that the proposed process can minimize or even eliminate adhesion failures between the tooth and the resin in dental restorations. Conclusion The results from this study can promote the improvement of the composite resin light curing process by the minimization of polymerization shrinkage effects, given an operational standardization of the photoactivation process.

Chitosan in different concentrations added to a two-step etch-and-rinse adhesive system: influence on bond strength to dentin / Quitosana em diferentes concentrações adicionada a um sistema adesivo convencional de dois passos: influência na resistência de união à dentina

Objectives: the aim of the present study was to evaluate the influence of adding different concentrations of chitosan to an experimental two-step etch-and-rinse adhesive system on the bond strength and failure mode to dentin. Material and Methods: thirty-two flat dentin surfaces were obtained from extracted human third molars and divided into four groups (n=8) for application of the adhesive systems: AD - conventional two-step adhesive system (Adper Single Bond 2); EXP ­ experimental two-step etch-and-rinse adhesive system; Chi0.2% - EXP with addition of 0.2% Chitosan; Chi0.5% - EXP with addition of 0.5% Chitosan. Resin composite build-ups were made and the composite/ dentin specimens were sectioned to obtain rectangular beams with a bond area of approximately 1mm2 . After 24 hours, the sticks were submitted to microtensile bond strength tests in a universal test machine. The fracture pattern was evaluated under a stereoscopic loupe at 40X magnification. Results: one-way analysis of variance showed that the type of adhesive system had no significant effect on the bond strength values (p = 0.142), showing the mean bond strength values (standard deviation), in MPa, for the groups as follows: AD=20.1 (5.4); EXP=16.6 (2.3); Chi0.2%=16.1 (2.8); Chi0.5%=16.9 (2.3). In all the groups there was predominance of cohesive fractures in dentin, representing 68 to 82% of the failure modes. Conclusion: the addition of 0.2 or 0.5% of chitosan had no influence on the bond strength and failure mode of an experimental two-step etch-andrinse adhesive system to dentin. (AU)

Objetivo: o objetivo deste estudo foi avaliar a influência da incorporação de diferentes concentrações de quitosana em um sistema adesivo experimental convencional de dois passos na resistência de união à dentina e modo de falha. Material e Métodos: trinta e duas superfícies de dentina planificadas foram obtidas de terceiros molares e separadas em quatro grupos (n=8) para aplicação dos sistemas adesivos: AD - sistema adesivo convencional de dois passos (Adper Single Bond 2); EXP ­ sistema adesivo convencional de dois passos experimental; Chi0,2% - EXP com incorporação de quitosana a 0,2%; Chi0,5% - EXP com incorporação de quitosana a 0,5%. Blocos de resina composta foram confeccionados e os espécimes de resina composte/ dentina foram seccionados para se obter palitos retangulares com interface adesiva foi seccionada para obtenção de palitos com área de união de aproximadamente 1mm2 . Após 24 horas, os palitos foram submetidos aos testes de resistência de união por microtração em máquina universal de ensaios. O modo de falha foi avaliada em lupa estereoscópica com aumento de 40 vezes. Resultados: análise de variância a um critério mostrou que o tipo de sistema adesivo não apresentou efeito significativo nos valores de resistência de união (p = 0,142), observando-se os respectivos valores de média (desvio-padrão), em MPa, para os grupos: AD=20,1 (5,4); EXP=16,6 (2,3); Chi0,2%=16,1 (2,8); Chi0,5%=16,9 (2,3). Para todos os grupos houve predominância de fraturas coesivas em dentina, representando 68 a 82% dos modos de falhas. Conclusão: a incorporação de quitosana a 0,2 ou 0,5% na influenciou a resistência de união à dentina e o modo de falha de um sistema adesivo convencional de dois passos experimental à dentina. (AU)

Optimizing light-cured composite through variations in camphorquinone and butylhydroxytoluene concentrations

Abstract The use of a free-radical polymerization inhibitor, butylhydroxytoluene (BHT), and a common photo-initiator, camphorquinone (CQ), to reduce polymerization stress in dental composite was investigated in this study. Samples were prepared by mixing Bis-GMA, UDMA, and TEGDMA at a 1:1:1 ratio (wt%), and silanized borosilicate glass fillers at 70 wt% were added to form the composite. Sixteen groups of resin composite were prepared using combinations of four CQ (0.1%, 0.5%, 1.0%, and 1.5%) and four BHT (0.0%, 0.5%, 1.0%, and 1.5%) concentrations. For each group, six properties were tested, including flexural strength (FS), flexural modulus (FM), degree of conversion (DC), contraction stress (CS), stress rate, and gel point (GP). The effects of CQ and BHT combinations on each of these properties were evaluated using two-way analysis of variance (ANOVA) and Fisher's Protected Least Significant Differences test at the 5% significance level. Groups with low CQ and BHT showed moderate values for FS, FM, and CS with a 70% DC. Increasing the BHT concentration caused a decrease in CS and DC with an increase in GP values. Increasing the CQ content led to a steady increase in values for FS and FM. High CQ and BHT combinations showed the most promising values for mechanical properties with low stress values.

Evaluation of three different agents for in‑office treatment of dentinal hypersensitivity: A controlled clinical study.

Context: Dentin desensitizers are used for in‑office treatment of dentinal hypersensitivity. They block the open tubules and bring about a reduction in hypersensitivity. Aim: The aim was to evaluate and compare the clinical effectiveness of a dentin desensitizer, a combination of a dentin desensitizer + adhesive and one‑bottle self‑etching adhesive for in‑office treatment of dentin hypersensitivity. Settings and Design: Institutional, prospective double-blind parallel clinical design. Subjects and Methods: A total of 54 teeth in 20 patients were randomly allocated to one of the three study groups, with 18 teeth in each group as follows: Group A‑Gluma Desensitizer (GD), Group B‑Gluma Comfort Bond + Desensitizer (GCBD), Group C‑Single Bond Universal (SBU). The patients’ dentinal hypersensitivity scores for tactile (hand‑held scratch device), thermal (cold), and evaporative (dental unit air syringe) stimuli were recorded on a visual analog scale. The parameters were recorded at baseline, immediately after application of the agent, 3‑ and 6‑week posttreatment. Statistical Analysis Used: The data were analyzed with Friedman’s test, Wilcoxon signed ranks test, Kruskal–Wallis test, and Mann–Whitney‑U‑test (P < 0.05). Results: All three groups showed a significant reduction in dentinal hypersensitivity (P < 0.05) compared to baseline at all time intervals. Statistically, significant differences were noted between GD and SBU; between GCBD and SBU in all testing parameters. Between GD and GCBD no significant difference was noted. Conclusions: GD and GCBD showed a greater reduction in dentin hypersensitivity than SBU.

Physicochemical Properties of a Methacrylate-Based Dental Adhesive Incorporated with Epigallocatechin-3-gallate

This study aimed to evaluate the influence of epigallocatechin-3-gallate (EGCG) incorporation on the physicochemical properties of a methacrylate-based dental adhesive. EGCG was added to Adper Easy One (3M-ESPE) except in control group, to obtain concentrations of 0.01% w/w and 0.1% w/w of EGCG-doped adhesives. For water sorption (WS) and solubility (SL) surveys, resin discs were assayed following ISO recommendations (n=10). The degree of conversion (DC) was analyzed by FTIR whereas flexural strength (FS) was tested by three-point bending with bar specimens (n=10). Data were subjected to one-way ANOVA and Tukey's test (p<0.05). No significant difference in the DC, WS and FS were found between the different concentrations of EGCG (p>0.05). Adhesives containing 0.1% or 0.01% of EGCC demonstrated similar values of SL (p>0.05) and higher than those found for adhesive without EGCC (p<0.05). In conclusion, the addition of EGCC to adhesive reduced the solubility without affecting the other evaluated properties.

Esse estudo teve como objetivo avaliar a influência da incorporação de epigalocatequina-3-galato (EGCG) nas propriedades físico-químicas de um sistema adesivo à base de metacrilato. O EGCG foi adicionado ao Adper Easy One (3M-ESPE), exceto para o grupo controle, para a obtenção das concentrações de 0,01% e 0,1% p/p. No ensaio de sorção (S) e solubilidade (SL), foram confeccionados discos de resina de acordo com as recomendações da ISO (n=10). O grau de conversão (GC) foi analisado através de FTIR, enquanto a resistência flexural (RF) foi avaliada em teste de flexão de três pontos com espécimes em forma de barra (n=10). Os dados foram submetidos à Análise de Variância a um critério e teste de Tukey (p<0,05). Não houve diferença significativa entre as concentrações de EGCG testadas no GC, SL e RF (p>0,05). Adesivos contendo EGCG a 0,1% ou 0,01% apresentaram valores similares de SL (p>0,05) e maiores do que os valores obtidos pelo adesivo não incorporado por EGCG. Conclui-se que a adição de EGCG ao adesivo reduziu a solubilidade sem afetar as outras propriedades avaliadas.

Long-term bond strength, degree of conversion and resistance to degradation of a HEMA-free model adhesive

Aim: To evaluate the long-term bond strength, degree of conversion and resistance to degradation in ethanol of HEMA-containing and HEMA-free model adhesive resins of a three-step etch-and-rinse adhesive system. Methods: The superficial dentin of 16 bovine incisor teeth was exposed, and the teeth were divided in two groups according to the HEMA concentration in the experimental adhesive (0% and 15%). In each tooth were made 6 cylindrical composite restorations. Half of the tooth restorations were submitted to microshear bond strength test after 24 h and the other half after 6 months. Degree of conversion of experimental resins was determined by Fourier transform infrared spectroscopy. Crosslink density was indirectly determined by the Knoop hardness of five specimens per group before and after immersion in ethanol for 6 h. Results: The group with 0% HEMA showed no difference in bond strength as compared to the group with 15% HEMA after 24 h or 6 months. There was no difference in degree of conversion and crosslink density between groups. Conclusions: HEMA content of the adhesive resin did not influence the bond strength to dentin, degree of conversion or resistance to degradation in ethanol.