Sonic Activation of a Desensitizing Gel Prior to In-Office Bleaching.

This double-blind, randomized, and controlled clinical trial evaluated the effect of sonic activation during the application of a desensitizing agent (DA) containing 5% potassium nitrate and 2% sodium fluoride on the occurrence of tooth sensitivity (TS) associated with in-office dental bleaching. Treatment with or without sonic activation of the DA was randomly assigned to one-half of the maxillary teeth of 34 patients in a split-mouth design. On the side without sonic activation (noSA), the DA was applied and maintained in contact with the teeth for 10 minutes. On the sonic activation side (SA), the DA was activated 30 seconds per tooth. The DA application was followed by application of 35% hydrogen peroxide in two bleaching sessions separated by a one-week interval. The primary outcome was the absolute risk of TS, recorded using a numeric rating scale and a visual analog scale. Color was evaluated with a digital spectrophotometer and a value-oriented shade guide. No significant difference between treatments was observed in the absolute risk of TS, which occurred in 93% (p=1.00) of both noSA and SA groups. The TS intensity was higher in the 24-hour interval after sessions, for both treatments, without differences between them. There was no difference in the color change for the treatments, with the average change in number of shade guide units of the Vita Classical scale of 6.35 for both (p=0.87). Sonic activation of DA containing 5% potassium nitrate and 2% sodium fluoride did not reduce the absolute risk and intensity of TS associated with in-office bleaching.

Effect of the Photo-initiator System Contained in Universal Adhesives on Radicular Dentin Bonding.

CLINICAL RELEVANCE: The photo-initiator system based on an advanced polymerization system may be an alternative that can be used to overcome the disadvantages of radicular dentin, especially for the apical third. SUMMARY: Objectives: The purpose of this study was to evaluate the effects of universal adhesives with different photo-initiator systems applied in etch-and-rinse (ER) and self-etch (SE) modes on dentin interaction (push-out bond strength [PBS], nanoleakage [NL], and degree of conversion [DC] within the hybrid layer) in the different root thirds after fiber post cementation.Methods and Materials: Roots of endodontically prepared human premolars were randomly divided into six groups according to one of three adhesive systems (Scotchbond Universal [SBU], Ambar Universal [AMB], and Ambar Universal APS [AMB-APS]) and two adhesive strategies (ER and SE) for each system. Posts were cemented, and PBS was tested at 0.5 mm/min. The NL was evaluated by scanning electron microscopy. DC was measured using micro-Raman spectroscopy. The data were analyzed by three-way analysis of variance and Tukey tests (α=0.05).Results: AMB-APS showed similar performance in all root thirds (p>0.05) and higher values of DC, especially in the apical third (p<0.0001). AMB and SBU showed the lowest values in the apical third (p<0.0001).Conclusions: The APS photo-initiator system contained in universal adhesives is a feasible alternative for improving radicular bonding procedure.

Randomized 36-month follow-up of posterior bulk-filled resin composite restorations.

OBJECTIVE: The aim of this double blind, randomized controlled trial was to evaluate the 36-month clinical performance of the layering technique (incremental [IF] vs. bulk-fill [BF]) in posterior composite resin restorations bonded with self-etch (SE) and etch-and-rinse (ER) strategies. METHODS: Posterior dental cavities of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. The restorations were bonded using either the Tetric N-Bond ER or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either IF or using BF. Two experienced and calibrated examiners evaluated the restorations using FDI criteria in the baseline and after 12, 24 and 36-month. The statistical analyses were performed using the Wilcoxon Signed rank test (α = 0.05) RESULTS: After 36-month, 14, 21 and 33 restorations showed minor fractures, marginal desadaptation and color mismatch, respectively (p > 0.05). Thirty-three restorations showed some marginal discoloration after 36-month with significant difference between ER (3 for ER-IF; 3 for ER-BF) and SE (14 for SE-IF; 12 for SE-BF; p < 0.05). CONCLUSION: The BF technique showed excellent clinical performance, which was comparable during the 36-month of clinical evaluation with the 2-mm IF and it was not affected by the adhesive strategy. However, using the ER strategy reduces the risk of some marginal discoloration, irrespectively of the filling technique. CLINICAL RELEVANCE: The bulk-fill material showed excellent clinical behavior when compared to its use in an incremental filling technique, mainly when associated to etch-and-rinse adhesive material after 3 years of clinical evaluation.

Effect of different enamel treatments on bond strength using resin dental adhesives.

OBJECTIVE: The aim of this investigation was to evaluate the effect different cleaning techniques used on enamel surfaces have on the bond strength of a composite resin to the dental enamel. METHOD AND MATERIALS: Eighty-eight bovine enamel fragments were mounted in acrylic resin bases. The enamel surfaces were sanded using 200-, 400-, and 600-grit sandpapers, thus creating a smear layer. These surfaces were then randomly divided in 2 groups: 1 of them received salivary contact for 10 minutes, and the other received it for 60 minutes. Then all surfaces were cleaned with a pumice and water paste applied with a rubber cup, followed by the application of biological detergent, sodium bicarbonate jet, or air/water spray. After cleansing, the enamel surfaces received the application of the Scotchbond Multi-Purpose adhesive system and Z100 composite resin, following the manufacturer's instructions, using an appropriate matrix. After storage at 37 degrees C for 8 days, traction tests were carried out using an Instron machine operating at 0.5 mm/minute. Some fractured specimens (randomly chosen) were analyzed under scanning electron microscopy. RESULTS: The statistical analysis using descriptive and inferential methods did not show significant differences between the different periods of time of salivary contact. The technique of pumice and water paste cleaning followed by the application of biological detergent was significantly more efficient than the others. Scanning electron micrographs of the fragments after traction tests confirmed these results. CONCLUSION: The technique of pumice and water paste cleaning followed by the application of biological detergent was the treatment that allowed the best results in terms of resin bonding to bovine enamel covered with acquired pellicle, and the sodium bicarbonate jet technique presented the lowest bond strength values and seemed to disturb the acid conditioning of enamel surfaces.