Influence of fiber insertion and different material type on stress distribution in endocrown restorations: a 3D-FEA study.

The study aimed to evaluate the effects of fibers insertion and restorative material type on the stress distribution in endocrowns with finite element analysis. Five 3D models of first mandibular molars were created and restored as follows: (1) IN: intact tooth, (2) IPS-E: tooth restored with lithium disilicat ceramic endocrowns, (3) C-E: tooth restored with composite endocrowns, (4) IPS-E + F: lithium disilicate ceramic endocrowns + fiber, (5) C-E + F: composite endocrowns + fiber. Vertical masticatory load was imitated with finite element analysis. The equivalent stress of von Mises failure criterion (mvM) was calculated. The maximum mvM stress, enamel/crown, dentin and cement were compared among models and strength of the materials. Endocrowns presented a lower mvM stress level than intact tooth. In IPS-E, the mvM stress values in the crown and dentin were higher than C-E, while the mvM stress values in cement were higher in C-E group. Fibers insertion did not affect the stress level of IPS-E and C-E groups. In IPS model, fiber showed more stress absorption than C-E. The restorative material type changed the stress distribution of endocrown restorations. The fiber application did not affect the stress distribution in either endocrown group. But, more stress absorption was observed in fiber under IPS-E than C-E.

The effect of immediate dentin sealing with chlorhexidine pretreatment on the shear bond strength of dual-cure adhesive cement.

The purpose of this in vitro study was to evaluate the effect of immediate dentin sealing (IDS) with and without chlorhexidine (CHX) pretreatment on the shear bond strength (SBS) of dual-cure adhesive resin cement. Mid-coronal dentin surfaces were obtained from 75 human molars. They were randomly allocated into five groups in accordance to type of IDS [etch&rinse/ER (Adper Single Bond2) and universal/U adhesive systems (Single Bond Universal)] and presence of CHX application (n = 15): Group ER; Group ER + CHX; Group U; Group U + CHX; and Group C (no IDS). Dual-cure adhesive resin cements were bonded with a cylinder-shaped Teflon mold. The SBS was measured using a universal test machine. Fracture type was evaluated with stereomicroscope. The resin/dentin interfaces were examined with an environmental scanning electron microscope. Data were statistically analyzed with two-way analysis of variance and Bonferroni tests (p < .05). Regarding the IDS treatment groups with/without CHX, there were no significant differences in SBS (p > .05). Group U + CHX showed significantly higher SBS than Group C (p < .05). Regarding the presence of CHX, no significant differences in SBS were found (p > .05). The prevalent failure mode was the mixed type for most of the groups. Group C exhibited an intact and regular hybrid layer with no resin tag, whereas longer and clear resin-tag formation was visible for Group U + CHX. CHX pretreatment improved the bond strength between adhesive resin cement and dentin when IDS treatment was performed with a universal adhesive system.

The use of a liner under different bulk-fill resin composites: 3D GAP formation analysis by x-ray microcomputed tomography.

INTRODUCTION: Gap formation of composite resin restorations is a serious shortcoming in clinical practice. Polymerization shrinkage stress exceeds the tooth-restoration bond strength, and it causes bacterial infiltration within gaps between cavity walls and the restorative material. Thus, an intermediate liner application with a low elastic modulus has been advised to minimize polymerization shrinkage as well as gap formation. OBJECTIVE: The purpose of this in vitro study was to assess gap formation volume in premolars restored with different bulk-fill composites, with and without a resin-modified glass-ionomer cement (RMGIC) liner, using x-ray micro-computed tomography (micro-CT). METHODOLOGY: Sixty extracted human maxillary premolars were divided into six groups according to bucco-palatal dimensions (n=10). Standardized Class II mesio-occluso-distal cavities were prepared. G-Premio Bond (GC Corp., Japan) was applied in the selective-etch mode. Teeth were restored with high-viscosity (Filtek Bulk Fill, 3M ESPE, USA)-FB, sonic-activated (SonicFill 2, Kerr, USA)-SF and low viscosity (Estelite Bulk Fill Flow, Tokuyama, Japan)-EB bulk-fill composites, with and without a liner (Ionoseal, Voco GmbH, Germany)-L. The specimens were subjected to 10,000 thermocycles (5-55°C) and 50,000 simulated chewing cycles (100 N). Gap formation based on the volume of black spaces at the tooth-restoration interface was quantified in mm3 using micro-computed tomography (SkyScan, Belgium), and analyses were performed. Data were analyzed using repeated-measures ANOVA and the Bonferroni correction test (p < 0.05). RESULTS: The gap volume of all tested bulk-fill composites demonstrated that Group SF (1.581±0.773) had significantly higher values than Group EB (0.717±0.679). Regarding the use of a liner, a significant reduction in gap formation volume was observed only in Group SFL (0.927±0.630) compared with Group SF (1.581±0.773). CONCLUSION: It can be concluded that different types of bulk-fill composite resins affected gap formation volume. Low-viscosity bulk-fill composites exhibited better adaptation to cavity walls and less gap formation than did sonic-activated bulk-fill composites. The use of an RMGIC liner produced a significant reduction in gap formation volume for sonic-activated bulk-fill composites.

The use of a liner under different bulk-fill resin composites: 3D GAP formation analysis by x-ray microcomputed tomography

Abstract Gap formation of composite resin restorations is a serious shortcoming in clinical practice. Polymerization shrinkage stress exceeds the tooth-restoration bond strength, and it causes bacterial infiltration within gaps between cavity walls and the restorative material. Thus, an intermediate liner application with a low elastic modulus has been advised to minimize polymerization shrinkage as well as gap formation. Objective: The purpose of this in vitro study was to assess gap formation volume in premolars restored with different bulk-fill composites, with and without a resin-modified glass-ionomer cement (RMGIC) liner, using x-ray micro-computed tomography (micro-CT). Methodology: Sixty extracted human maxillary premolars were divided into six groups according to bucco-palatal dimensions (n=10). Standardized Class II mesio-occluso-distal cavities were prepared. G-Premio Bond (GC Corp., Japan) was applied in the selective-etch mode. Teeth were restored with high-viscosity (Filtek Bulk Fill, 3M ESPE, USA)-FB, sonic-activated (SonicFill 2, Kerr, USA)-SF and low viscosity (Estelite Bulk Fill Flow, Tokuyama, Japan)-EB bulk-fill composites, with and without a liner (Ionoseal, Voco GmbH, Germany)-L. The specimens were subjected to 10,000 thermocycles (5-55°C) and 50,000 simulated chewing cycles (100 N). Gap formation based on the volume of black spaces at the tooth-restoration interface was quantified in mm3 using micro-computed tomography (SkyScan, Belgium), and analyses were performed. Data were analyzed using repeated-measures ANOVA and the Bonferroni correction test (p < 0.05). Results: The gap volume of all tested bulk-fill composites demonstrated that Group SF (1.581±0.773) had significantly higher values than Group EB (0.717±0.679). Regarding the use of a liner, a significant reduction in gap formation volume was observed only in Group SFL (0.927±0.630) compared with Group SF (1.581±0.773). Conclusion: It can be concluded that different types of bulk-fill composite resins affected gap formation volume. Low-viscosity bulk-fill composites exhibited better adaptation to cavity walls and less gap formation than did sonic-activated bulk-fill composites. The use of an RMGIC liner produced a significant reduction in gap formation volume for sonic-activated bulk-fill composites.

Investigation of eluted monomers from resin-based root canal sealer by high-performance liquid chromatography analysis.

OBJECTIVE: The purpose of the current study was to determine the amount of urethane dimethacrylate (UDMA), bisphenol A-glycidyl methacrylate (Bis-GMA), poly (ethylene glycol) dimethacrylate (PEGDMA), bisphenol A ethoxylated dimethacrylate (Bis-EMA), and 2-hydroxyethyl methacrylate (HEMA) eluted from resin-based root canal sealer, epiphany, using high-performance liquid chromatography (HPLC). MATERIALS AND METHODS: Epiphany was placed into the plastic molds and light-cured with a light emitting diode. After the curing process, each specimen in the first group (n = 12) was immersed in Eppendorf tubes containing a phosphate-buffered saline solution (PBS) and incubated for 45 s. In the second group, each specimen (n = 12) was immersed in Eppendorf tubes containing PBS and incubated for 24 h. Of the specimen extracts, 100 µL were subjected to HPLC. Analysis of data was accomplished with one-way analysis of variance (P < 0.05). RESULTS: All of the samples eluted HEMA, UDMA, Bis-GMA, PEGDMA, and Bis-EMA. A significant difference was determined between the time periods of HEMA, UDMA, PEGDMA, and Bis-EMA (P < 0.05). CONCLUSION: The results of the current study showed that Epiphany releases HEMA, UDMA, Bis-GMA, PEGDMA, and Bis-EMA in both time periods.

Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

OBJECTIVES: Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems. MATERIAL AND METHODS: 158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE) combined with Single Bond (3M/ESPE, group SI), Clearfil SE (Kuraray Medical Inc., group CL) and Xeno III (De Trey Dentsply, group XE). In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria. RESULTS: After 2 years, no significant difference was found between the retention rates of the groups (p >0.05). Although groups CL and SI showed significantly better marginal adaptation than group XE (p<0.05) at 2 years, no significant difference was found between the marginal adaptation of the groups SI-B, CL-B and XE-B (p>0.05). After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05). CONCLUSION: Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up.

Effect of different disinfectant methods on the initial microtensile bond strength of a self-etch adhesive to dentin.

The aim of this in vitro study was to evaluate the effect of different disinfection methods on the initial microtensile bond strength of a two-step, self-etch adhesive to dentin. Twenty mandibular molars were sectioned parallel to the occlusal plane to expose the mid-coronal dentin. All of the teeth were divided into four groups (n = 5 per group): (1) in group OZ, the dentin surfaces were exposed to ozone gas from the Ozonytron X delivery system (OzonyTron X-Bioozonix, Munich, Germany), (2) in group ND, the dentin surfaces were irradiated with an Nd:YAG laser (Pulsmaster 600 IQ, American Dental Technologies, U.S.), (3) in group CHX, the dentin surfaces were treated with a 2% chlorhexidine solution, and (4) in the control group, no treatment was applied. In all of the groups, the teeth were restored with Clearfil SE Bond (Kuraray, Tokyo, Japan) and Clearfil Majesty Posterior (Kuraray, Tokyo, Japan), according to the manufacturer's instructions. The teeth were sectioned perpendicular to the bonded surface (surface area of approximately 1 mm(2)). Thus, six to seven specimens were obtained from each tooth, and a total of 34 specimens were analyzed in each group. The specimens were attached to the microtensile test machine (Micro Tensile Tester, T-61010 K, Bisco, U.S.). The data was analyzed using the one-way analysis of variance (ANOVA) and Tukey test (p < 0.05). Fracture modes of each specimen were determined using a stereomicroscope (SZ-PT Olympus, Tokyo, Japan) and a scanning electron microscope (SEM). The lowest bond strength occurred in the OZ group. Significant differences were determined only between group OZ and the other groups (group ND, group CHX, and control group) (p < 0.05). In conclusion, although ozone decreased the microtensile bond strength of the self-etch adhesive system to dentin, the Nd:YAG laser and 2% chlorhexidine did not change the microtensile bond strength so in context of the present study it would appear that the Nd:YAG laser and 2% chlorhexidine may be used as pre-restorative sterilization procedures on the dentin prior to the application of a two-step, self-etch adhesive.