Clinical Evaluation of Composite Restorations with and without Polyethylene Fiber in First Permanent Molars: A 24-Month Randomized Clinical Trial

ABSTRACT Objective: To evaluate the 24-month clinical performance of composite resin restorations with and without polyethylene fiber in the first permanent molars of pediatric patients with extensive caries. Material and Methods: In total, 75 Class II restorations were placed in the permanent molar teeth of 75 children (mean age 11.3 years) with (FC; n=38) or without (C; n=37) fiber. One operator placed all the restorations. The restorations were evaluated using the modified USPHS criteria in terms of retention, color match, marginal discoloration, anatomic form, marginal adaptation, secondary caries, and postoperative sensitivity. Statistical data were analyzed using chi-square and Cochran tests (p<0.05). Results: At the end of two years, 65 restorations (FC:31; C:34) were followed up. No changes were observed during the first six months. After 24 months of follow-up, there were minor changes in marginal adaptation and marginal color in both groups; however, no statistically significant difference was observed between the clinical performances for all criteria (p>0.05). Conclusion: Extensive composite restorations with or without fibers displayed good clinical performance in high load-bearing areas after 24 months.

Oral health-related quality of life of preschool-aged Turkish children with congenital heart disease.

BACKGROUND: Dental caries and poor oral hygiene can affect the quality of life (QoL) of patients with congenital heart disease (CHD). Information about the oral health-related quality of life (OHRQoL) of Turkish preschool children with CHD is scarce. OBJECTIVES: The aim of the present study was to assess the OHRQoL, and the presence of caries, plaque and gingivitis in Turkish preschool children with CHD as compared to children without CHD (control group). MATERIAL AND METHODS: Children aged 3-6 years with CHD (n = 75) and a control group (n = 75) were included in the study. Examinations were conducted using the plaque index (PI), the gingival index (GI) and the World Health Organization (WHO) caries diagnostic criteria. The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was completed by the children's families. RESULTS: The amount of caries and plaque, as well as the number of missing teeth were higher in children with CHD. The OHRQoL was lower in children with CHD. However, the differences between the 2 groups were not statistically significant (p > 0.05). The number of filled teeth was significantly higher in the control group (p < 0.05). CONCLUSIONS: According to the findings of the present study, the high amount of caries and plaque in both groups demonstrates that caries continues to be a major public health problem. Although there was no significant difference in terms of QoL scale scores between the 2 groups, the study showed that OHRQoL was lower in children with CHD.

Inhibition Effects of Different Toothpastes on Demineralisation of Incipient Enamel Lesions.

PURPOSE: To evaluate the inhibitory effects of different toothpastes on demineralisation of incipient enamel lesions using a toothbrush simulator. MATERIALS AND METHODS: Fifty enamel specimens were prepared from extracted human molars. The specimens were randomly assigned to the following groups (n = 10/group): 1. no treatment (control); 2. toothpaste containing arginine (ProRelief, Colgate;); 3. fluoride toothpaste (Pronamel, Sensodyne GlaxoSmithKlein); 4. tooth mousse containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (Recaldent, GC); 5. toothpaste (Restore, Dr. Collins) containing bioactive glass (NovaMin, GlaxoSmithKlein). All specimens were exposed to pH cycling. The remineralising agents were applied to the samples with a toothbrush simulator for 2 min twice a day for five days. The weight percentage of mineral changes for the elements calcium (Ca), phosphorus (P), sodium (Na) and silica (Si) were measured by SEM energy-dispersive x-ray spectroscopy (SEM-EDX). SEM revealed properties of treated enamel surfaces. The data were analysed using one-way ANOVA. RESULTS: Statistically significantly higher levels of Ca and P were found in all groups compared to the control (p < 0.05). CONCLUSIONS: The toothpastes' efficacy of inhibiting demineralisation depended on the active ingredients in the respective toothpaste. The demineralisation inhibition efficacy of the tested toothpastes depended on the active ingredients in the toothpaste.

Effects of Er:YAG Laser Treatment on the Mineral Content and Morphology of Primary Tooth Enamel.

Objective: The aim of this study was to evaluate the mineral content and morphology of primary tooth enamel prepared using an Er:YAG laser at different power settings. Materials and methods: The buccal surfaces of 45 noncarious primary molars were assessed in this study. The surfaces were cleaned and the teeth were randomly divided into nine groups (n = 5 each) to evaluate the effects of Er:YAG laser treatment at different energy levels: 200 mJ, 2 Hz; 200 mJ, 3 Hz; 200 mJ, 10 Hz; 250 mJ, 2 Hz; 250 mJ, 3 Hz; 250 mJ, 10 Hz; 300 mJ, 2 Hz; 300 mJ, 3 Hz; and 300 mJ, 10 Hz. The mean percentage weight (wt%) of calcium (Ca), phosphorous (P), fluoride (F), magnesium (Mg), potassium (K), and sodium (Na) in the primary tooth enamel was calculated for each group using scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy before and after laser application. The enamel morphology was also evaluated using SEM. The obtained data were statistically analyzed by one-way analysis of variance and Tukey's honest significant difference test. Results: The mean wt% of Ca, P, and F in the enamel exhibited a significant change after laser treatment (p < 0.05); the wt% of Mg, K, and Na remained unchanged (p > 0.05). There was no association between the power setting of the laser and changes in the wt% of minerals in the enamel (p > 0.05). SEM showed that enamel irradiated at different energy levels exhibited a characteristic lava flow appearance, and more surface irregularities were observed with the 250-mJ setting than with the 200-mJ setting. Conclusions: Our findings suggest that the mineral content and morphology of the enamel of primary teeth are affected by Er:YAG laser irradiation.

Comparative evaluation of apical sealing ability of different root canal sealers.

PURPOSE: The aim of this study was to compare the short and long term apical sealing ability of different root canal sealers. MATERIALS AND METHODS: Fifty-five extracted human anterior single-root teeth were used. The coronal part of each tooth was removed and the root canals were prepared with NiTi rotary instruments. Teeth were divided into 5 study groups; Group I: MTA Fillapex (Angelus, Brazil); Group II: Sealapex (Sybron-Kerr, Romulus, MI, USA) and Group III: AH Plus (Dentsply, Konstanz, Germany) (n=15) and negative and positive control groups (n=5). The quality of root canal sealing was assessed by a fluid filtration method performed at 24 h and 180-day time intervals. Kruskal Wallis and Mann Whitney U tests were used to compare the groups. RESULTS: At 24 h evaluation, MTA Fillapex presented significantly less microleakage than the Sealapex and AH Plus (p<0.05). At long term interval (180-day), Sealapex and AH Plus presented significantly less microleakage than the MTA Fillapex (p<0.05). CONCLUSION: Sealapex and AH Plus showed significantly better sealing abilities than MTA Fillapex in the long term.

Effect of endodontic sealers on bond strength of restorative systems to primary tooth pulp chamber.

BACKGROUND/PURPOSE: Although current literature suggests that root canal sealers affect the bonding ability of restorative systems to pulp chamber dentin of permanent teeth, primary teeth have not been investigated. This study intended to evaluate the microtensile bond strength (µTBS) of three restorative systems to pulp chamber dentin in primary teeth and to determine the effect of two different root canal sealers on the µTBS. MATERIALS AND METHODS: Ninety primary molars were used in this study. The teeth were randomly divided into three main groups according to canal sealers: (1) control (without sealer); (2) Metapex; and (3) zinc-oxide eugenol. The main groups were further divided into three subgroups depending on the coronal restorative system: (1) compomer (Prime Bond NT + Dyract EXTRA); (2) composite (Clearfil Tri-S Bond + Clearfil Photo Posterior); and (3) resin-modified glass ionomer (Fuji II LC). After restoration, the buccal wall of the pulp chamber was sectioned to obtain sticks (1 mm × 1 mm). The µTBS was then measured. Data were analyzed with two-way analysis of variance, followed by a posthoc test. The interfacial morphology of the bonded space was evaluated using scanning electron microscopy. RESULTS: In the control group, a significant difference was observed only for the µTBS of the composite (P < 0.05). Compared with the control groups, Metapex and zinc-oxide eugenol significantly reduced the µTBS of restorative systems (P < 0.05). CONCLUSION: Composite materials seemed to bond to pulp chamber dentin in primary teeth with a higher strength than compomer and resin-modified glass ionomer. Metapex and zinc-oxide eugenol canal filling materials reduced the bond strength of all three restorative systems.

Intrapulpal Thermal Changes during Setting Reaction of Glass Carbomer® Using Thermocure Lamp.

Objectives. To measure the temperature increase induced during thermocure lamp setting reaction of glass carbomer and to compare it with those induced by visible light curing of a resin-modified glass ionomer and a polyacid-modified composite resin in primary and permanent teeth. Materials and Methods. Nonretentive class I cavities were prepared in extracted primary and permanent molars. Glass carbomer (GC) was placed in the cavity and set at 60°C for 60 sn using a special thermocure lamp. Resin-modified glass ionomer (RMGIC) and polyacid-modified composite resin (PMCR) were placed in the cavities and polymerized with an LED curing unit. Temperature increases during setting reactions were measured with a J-type thermocouple wire connected to a data logger. Data were examined using two-way analysis of variance and Tukey's honestly significant difference tests. Results. The use of GC resulted in temperature changes of 5.17 ± 0.92°C and 5.32 ± 0.90°C in primary and permanent teeth, respectively (p > 0.05). Temperature increases were greatest in the GC group, differing significantly from those in the PMCR group (p < 0.05). Conclusion. Temperature increases during polymerization and setting reactions of the materials were below the critical value in all groups. No difference was observed between primary and permanent teeth, regardless of the material used.

The setting mechanism of mineral trioxide aggregate.

Mineral trioxide aggregate (MTA) is a powder containing calcium silicate composed of hydrophilic particles which harden at the presence of moisture. MTA was initially introduced as a root end filling material. Due its practical advantages that include superior biocompatility, effective sealing capability, and the ability to improve regeneration of the pulp and peripheral root tissues, it is used in different clinical applications such as pulp capping, apexification, pulpotomy and perforation. Despite being a promising material in endodontic treatment, MTA is not commonly used. Long setting time is the main clinical disadvantage of MTA. The aim of this review is to provide an overview of the current literature concerning the setting mechanism of MTA, accelerators and devices used to evaluate various steps of the hardening process.

Idiopathic Juvenile Osteoporosis: A Case Report.

Idiopathic Juvenile Osteoporosis (IJO) is a very rare disease, self restrictive and shows marked, spontaneous improvement during adolescence. The major clinical features were pain with difficulty walking, growth retardation, oral and dental abnormalities with radiographically porous bone structure. A 13-year-old male referred to paediatric dentistry clinic for toothache. The observations made with extra-intraoral clinic examination that one revealed short and skinny stature, diffuse caries in deciduous teeth, abraded lower incisor, deep bite and dysmorphic appearance in permanent incisor. This report emphasizes the recognized features of IJO as well as describes facio-dental findings that could aid in the diagnosis and management of these patients.

Periostitis ossificans managed with endodontic treatment.

Periostitis ossificans (PO) is a specific type of chronic osteomyelitis. Radiographically, it is characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic appearance of "onion skin." The most common cause of PO is periapical infection of the mandibular permanent first molar, which occurs primarily in children and young adults. Treatment in these cases is directed toward eliminating the source of the infection, either by extraction of the offending tooth or endodontic therapy. The purpose of this paper is to present a case of PO involving a permanent mandibular first molar managed with endodontic treatment.

Antimicrobial effect of ozonated water, sodium hypochlorite and chlorhexidine gluconate in primary molar root canals.

OBJECTIVE: The aim was to determine the antimicrobial effect of ozonated water, ozonated water with ultrasonication, sodium hypochloride and chlorhexidine (CHX) in human primary root canals contaminated by Enterococcus faecalis (E. faecalis). MATERIALS AND METHODS: Fifty-eight extracted human primary molar teeth were used. Crowns were cut off using a diamond saw under water-cooling. One hundred roots were obtained and mechanically prepared. The roots were then sterilized by autoclaving in water for 15 min at 121°C. All samples were contaminated with E. faecalis for 24 h and the root canals were randomly divided into five groups (n = 20). Group I: 25 mg/L of Ozonated water (O3aq), Group II: 25 mg/L of O3aq with ultrasonication, Group III: 2.5% Sodium hypochloride (NaOCl), Group IV: 2% CHX and Group V: Positive control. The canal of each specimen was irrigated for 4 min and positive control was untreated. All root canals were agitated with sterile saline solution. The saline solution was collected from canals with sterile paper points. For each specimen, the paper points were transposed to eppendorf vials containing 2 ml of brain heart infusion. According to bacterial proliferation, the mean values of optical density were achieved by ELISA (Biotek EL ×800, Absorbance Microplate Reader, ABD) and the data were analyzed. RESULTS: NaOCI, CHX and two types of O3aq were found statistically different than positive control group. NaOCI irrigation was found significantly most effective. CONCLUSIONS: NaOCl, CHX and O3aq applications provide antibacterial effect in vitro conditions in primary root canals.

Evaluation of formocresol, calcium hydroxide, ferric sulfate, and MTA primary molar pulpotomies.

OBJECTIVE: The aim of this study is to evaluate four different pulpotomy medicaments in primary molars. MATERIALS AND METHODS: A total of 147 primary molars with deep caries were treated with four different pulpotomy medicaments (FC: formocresol, FS: ferric sulfate, CH: calcium hydroxide, and MTA: mineral trioxide aggregate) in this study. The criteria for tooth selection for inclusion were no clinical and radiographic evidence of pulp pathology. During 30 months of follow-up at 6-month intervals, clinical and radiographic success and failures were recorded. The differences between the groups were statistically analyzed using the Chi-square test and Kaplan-Meier analysis. RESULTS: At 30 months, clinical success rates were 100%, 95.2%, 96.4%, and 85% in the FC, FS, MTA, and CH groups, respectively. In radiographic analysis, the MTA group had the highest (96.4%), and the CH group had the lowest success rate (85%). There were no clinical and radiographic differences between materials (P > 0.05). CONCLUSIONS: Although there were no differences between materials, only in the CH group did three teeth require extraction due to further clinical symptoms of radiographic failures during the 30-month follow-up period. None of the failed teeth in the other groups required extraction during the 30-month follow-up period.

Effects of Er:YAG laser on bond strength of self-etching adhesives to caries-affected dentin.

The erbium:yttrium-aluminum-garnet (Er:YAG) laser may be effective the bond strength of adhesive systems on dentine surfaces, the chemical composition and aggressiveness of adhesive systems in clinical practice. The purpose of this study was to evaluate the effects of the Er:YAG laser system with the bonding ability of two different self-etching adhesives to caries-affected dentine in primary molars. Ninety mid-coronal flat dentine surfaces obtained from sound and caries-affected human primary dentine were treated with an Er:YAG laser or a bur. The prepared surfaces were restored with an adhesive system (Xeno V; Clearfil S³) and a compomer (Dyract Extra). The restored teeth were sectioned with a low-speed saw and 162 samples were obtained. The bond strength of the adhesive systems was tested using the micro-tensile test method. The data were statistically analyzed. A restored tooth in each group was processed for scanning electron microscopy evaluation. The values of the highest bond strength were obtained from the Clearfil S³-Er:YAG laser-sound dentine group in all groups. (24.57 ± 7.27 MPa) (P > 0.05). The values of the lowest bond strength were obtained from the Xeno V-Er:YAG laser-sound dentine group in all groups (11.01 ± 3.89 MPa). It was determined that the Clearfil S³ increased the bond strength on the surface applied with Er:YAG laser according to the Xeno V.

Eruption of impacted permanent teeth after treatment of a dentigerous cyst: a case report.

Dentigerous cysts are the most common developmental odontogenic cysts. It is a benign and asymptomatic intraosseous lesion that affects the bones of the maxillofacial complex, interfering with tooth eruption. Although enucleation is the treatment of choice, marsupialization is the better option for large cysts involving unerupted permanent teeth. The purpose of this article is to report the eruption of impacted permanent mandibular right canine and first and second premolars after marsupialization of an infected dentigerous cyst. Two years after marsupialization and orthodontic treatment, the cyst disappeared and the canine and premolars erupted uneventfully.

Reattachment of fractured maxillary incisors using fiber-reinforced post: Two case reports.

OBJECTIVE: The reattachment of the crown fragment to a fractured tooth is a conservative treatment that should be considered for young patients with crown-root fractures to the maxillary incisors if the subgingival fracture can be exposed to provide isolation. Gingivectomy, the surgical or orthodontic extrusion of the apical fragment is necessary to expose the subgingival fracture. This report demonstrates the treatment of two cases with the combination of gingivectomy or resective osseous surgery, reattachment of coronal fracture and fiber-reinforced polymer posts and shows three years long term follow-up. Subgingivally extended crown-root fractures of maxillary incisors were restored with a combination of chemically cured resin material, light cured resin material and polyethylene fiber. CONCLUSION: Within the limitations of this case report, it was demonstrated that reattachment of tooth fragments can successfully benefit periodontal health, aesthetic needs and normal functioning after three years.

Rapp-Hodgkin syndrome: clinical and dental findings.

Rapp-Hodgkin syndrome is a rare form of ectodermal dysplasia involving the hair, eyes, sweat glands, nails, teeth and palate. This syndrome is characterized by stiff sparse hair with the appearance of steel wool, sparse eyebrows and lashes, cleft palate, absence of lacrimal punctae, epiphora, a decreased number of sweat glands, and dystrophic nails. Cleft palate, hypodontia, abnormal tooth shape, multiple caries, delayed eruption of teeth are the main oral manifestations. In this paper we describe the clinical and dental findings of this syndrome in a 7 year old girl referred to the dental clinic because of severe tooth ache. The dental treatment included root canal treatment, composite restorations, extractions and removable prostheses. This paper highlights features of Rapp-Hodgkin Syndrome and its dental rehabilitation.

Effect of light curing units and storage time on the degree of conversion of fissure sealants / Efeito das unidades fotopolimerizadoras e do tempo de armazenamento no grau de conversão dos selantes de fissuras

OBJECTIVE: To investigate the effect of light curing units and storage time on the degree of conversion of fissure sealants. MATERIAL AND METHOD: Three different fissure sealants were used: a resin-based pit and fissure sealant (Clinpro SealantTM), a polyacid modified resin composite (Dyract SealTM), and a resin modified glass ionomer cement (VitremerTM). Each fissure sealant was polymerized with a halogen, high intensity quartz tungsten halogen, LED. Half of the specimens were tested to assess the degree of conversion immediately after polymerization and the others after one month’s storage in artificial saliva. The degree of conversion was measured by FTIR. The data were analyzed using two way ANOVA. RESULTS: Statistical analysis of Dyract SealTM showed significant differences between the DC values of samples tested immediately and again after one month’s storage (p < 0.05). The DC values of ClinproTM increased after the storage period (p < 0.05). The DC of VitremerTM showed no change after storage (p > 0.05). Results of the curing units testing showed no significant differences among the DC of samples polymerized with LED, HQTH, OTH tested immediately and again after one month for Dyract SealTM, VitremerTM and Clinpro SealantTM (p > 0.05). CONCLUSION: Light curing units had no effect on the degree of conversion of the fissure sealants. But storage after initial light activation and polymerization for one month in artificial saliva can affects on DC of fissure sealants.

OBJETIVO: Investigar o efeito de unidades de polimerização por luz no grau de conversão dos selantes de fissuras. MATERIAL E MÉTODO: Três diferentes selantes foram utilizados: um selante resinoso de fissuras (Clinpro SealantTM, uma resina composta poliácida modificada (DyractSealTM) cimento de ionômero de vidro modificado (VitremerTM). Cada selante de fissura foi polimerizado por LED halógeno de quartzo/tungstênio. Metade dos espécimes foi testada para assegurar o grau de conversão imediatamente após polimerização e outros após um mês de armazenamento em saliva artificial. O grau de conversão foi medido por FTIR. Os resultados foram analisados por meio do ANOVA. RESULTADOS: A análise estatística do Dyract SealTMdemonstrou diferenças estatisticamente significantes entre os valores DC dos espécimes testados imediatamente e novamente após um mês de armazenamento (p < 0,05). Os valores do ClimproTM aumentaram após o período de armazenamento (p < 0.05). O DC do VitremerTM não demonstraram alterações após o armazenamento (p > 0.05). Os resultados das unidades de fotopolimerização não mostraram diferenças significantes ente DC de amostras polimerizadas com LED, HQTH, O TH testados imediatamente e novamente após um mês para o Diract SealTM, VitremerTM e Climpro SealantTM. CONCLUSÃO: Unidades de fotopolimerização não tiveram efeito no grau de conversão dos selantes de fissuras. Porém, armazenamento após ativação inicial e polimerização por um mês em saliva artificial pode afetar o DC dos selantes de fissuras.

Temperature rise under normal and caries-affected primary tooth dentin disks during polymerization of adhesives and resin-containing dental materials.

The purpose of this study was to compare the temperature rise under normal and caries-affected primary tooth dentin during photopolymerization of two adhesives and resin-containing restorative materials. Caries-affected and normal dentin disks were prepared from extracted primary molars with only mesial or distal approximal caries (4 mm in diameter, 1 mm in height). Temperature rise during photopolymerization of adhesive materials was measured with a J-type thermocouple wire that was connected to a data logger. Data were analyzed with two-way ANOVA and independent samples t-test. Temperature rise under caries-affected primary tooth dentin disks was higher than that of normal primary tooth dentin disks during polymerization of both adhesive systems and resin-containing dental materials (p < 0.05). It was found that adhesive systems induced a higher temperature rise during polymerization as compared to the resin-containing restorative materials (p < 0.05). In particular, temperature rise during polymerization of adhesive materials exceeded 5.5 degrees C under caries-affected primary tooth dentin.

Bond strength of two total-etching bonding systems on caries-affected and sound primary teeth dentin.

AIM: As bond strength of currently available adhesive systems in caries-affected teeth dentin on primary tooth dentin was not well known, the bond strength of two bonding systems (PQI and OptiBond Solo Plus) was evaluated on caries-affected and sound primary molar tooth dentin and observed the micromorphology of the adhesive-dentin interfaces. METHODS: By grinding both the sound (n = 30) and caries-affected (n = 30) approximal surfaces of teeth, flat dentin surfaces were obtained. The prepared surfaces were bonded with one of the each adhesive systems and a composite resin. After storing the bonded specimens in water at 37 degrees C for 24 h, the samples were sectioned and the bond strength of the adhesive systems was tested by the microshear test method. The data were statistically analysed. RESULTS: Microshear bond strengths of PQI group for caries-affected and sound primary tooth dentin were 9.43 +/- 2.44 (MPa) and 9.32 +/- 2.95 (MPa) (P > 0.05), respectively, and the bond strengths of OptiBond Solo Plus group for caries-affected and sound primary tooth dentin were 15.33 +/- 3.59 (MPa) and 11.96 +/- 2.30 (MPa) (P < 0.05), respectively. Micromorphological features between sound and caries-affected dentin were similar in both PQI and OptiBond Solo Plus groups. CONCLUSION: Both the adhesives showed significantly different bond strengths in caries-affected dentin but showed similar bond strengths in sound dentin.

Microtensile and microshear bond strength of an antibacterial self-etching system to primary tooth dentin.

OBJECTIVES: The aim of this study was to test the hypothesis that the bonding ability of antibacterial bonding system to primary dentin was not different from the parental material which did not contain any antibacterial component. METHODS: Extracted human non-carious primary molars were ground to expose the coronal dentin, and then randomly divided into two experimental groups: treatment with Clearfil Protect Bond or with Clearfil SE Bond (Kuraray Medical Inc.). Composite-dentin sticks with a cross-sectional area of approximately 0.90 mm(2) were prepared and subsequently subjected to microtensile bond strength (muTBS) and microshear bond strength (muSBS) tests. For the muTBS tests, specimens were attached to an Instron testing machine with a cyanoacrylate adhesive. For muSBS testing, the sticks were mechanically fixed to the muSBS testing apparatus. The bonds were stressed in shear or tension at a crosshead speed of 1mm/min until failure occurred. Resin-dentin interfaces produced by each system were examined using SEM. The data were analyzed with Mann-Whitney's U test. RESULTS: The muTBS and muSBS of Clearfil Protect Bond were 30.69+/-9.71 and 9.94+/-3.78 MPa, respectively. Clearfil SE Bond showed significantly greater values of 37.31+/-9.57 and 12.83+/-3.15 MPa, respectively. SEM analysis demonstrated similar micro-morphological features including the thickness of the hybrid layer for both materials. CONCLUSIONS: It was showed that antibacterial self-etching system Clearfil Protect Bond showed lower bond strength values compared to primary dentin than that of to Clearfil SE Bond on primary dentin. (Eur J Dent 2008;2:11-17).