Ecological Momentary Assessment of Awake Bruxism Frequency in Patients with Different Temporomandibular Disorders.

Self-reported awake bruxism (AB) has been associated with temporomandibular disorders (TMD). However, the daily amount of AB behavior has not been quantified in pain patients. Therefore, this study aimed to assess AB frequency in patients with myofascial pain and temporomandibular joint (TMJ) pain and compare it to a group of pain-free individuals. Eighty-four individuals belonging to either a TMD group (n = 54) or a healthy control group (n = 30) were selected. AB frequency was obtained by ecological momentary assessment with a dedicated smartphone application that sent sound alerts at random intervals during the day for one week. Upon receiving the alert, the volunteer reported the current muscular condition and/or the teeth position, i.e., relaxed jaw muscle, jaw bracing, teeth contact, teeth clenching, or teeth grinding. Data were evaluated by independent t-test (α = 0.05). During the seven days, AB frequency was 62.1% ± 26.8% for TMD patients and 36.2% ± 27.3% for pain-free subjects (p < 0.001). Mandible bracing was most common in the TMD group (p < 0.001), while teeth contact, clenching, and grinding did not differ between groups. Moreover, no differences were found in AB frequency between myofascial pain and TMJ pain patients. Therefore, TMD patients have higher AB frequency characterized by jaw bracing, irrespective of pain location.

Six-month color change and water sorption of 9 new-generation flowable composites in 6 staining solutions.

Color match and water sorption are two factors that affect restorative materials. Discoloration is essential in the lifespan of restorations. The aim of this study was to evaluate color change and water sorption of nine flowable composites at multiple time points over 6 months. 60 samples of each composite were divided into two groups (Color Change and Water Sorption/Solubility). Each Color Change group was divided into six subgroups, which were immersed in distilled water (DW), coffee (CF), Coca-Cola (CC), red wine (RW), tea (TE) and orange juice (OJ). The color was measured at the baseline, 1, 2, 3 and 4 weeks, and 3 and 6 months and color change values (ΔE) were calculated. Each Water Sorption [WS]/Solubility [WL] group was tested according to ISO 4049:2009. The data were evaluated using two-way ANOVA, Fisher's post-hoc test and Pearson's correlation test. The composite with the lowest ΔE differed for each solution: Filtek™ Bulk Fill in DW (∆E = 0.73 (0.17-1.759)); Vertise Flow in CF (∆E = 14.75 (7.91-27.41)), in TE (∆E = 7.27 (2.81-24.81)) and OJ (∆E = 3.17 (0.87-9.92)); Tetric EvoFlow® in CC (∆E = 1.27 (0.45-4.02)); and Filtek™ Supreme XTE in RW (∆E = 8.88 (5.23-19.59)). RW caused the most discoloration (∆E = 23.62 (4.93-51.36)). Vertise Flow showed the highest water sorption (WS = 69.10 ± 7.19). The Pearson test showed statistically significant positive correlations between water sorption and solubility and between water sorption and ∆E; the positive solubility-∆E correlation was not statistically significant. The findings suggest that water sorption is one factor associated with the ability of composites to discolor; however, discoloration is a multifactorial problem.

Six-month color change and water sorption of 9 new-generation flowable composites in 6 staining solutions

Abstract Color match and water sorption are two factors that affect restorative materials. Discoloration is essential in the lifespan of restorations. The aim of this study was to evaluate color change and water sorption of nine flowable composites at multiple time points over 6 months. 60 samples of each composite were divided into two groups (Color Change and Water Sorption/Solubility). Each Color Change group was divided into six subgroups, which were immersed in distilled water (DW), coffee (CF), Coca-Cola (CC), red wine (RW), tea (TE) and orange juice (OJ). The color was measured at the baseline, 1, 2, 3 and 4 weeks, and 3 and 6 months and color change values (ΔE) were calculated. Each Water Sorption [WS]/Solubility [WL] group was tested according to ISO 4049:2009. The data were evaluated using two-way ANOVA, Fisher's post-hoc test and Pearson's correlation test. The composite with the lowest ΔE differed for each solution: Filtek™ Bulk Fill in DW (∆E = 0.73 (0.17-1.759)); Vertise Flow in CF (∆E = 14.75 (7.91-27.41)), in TE (∆E = 7.27 (2.81-24.81)) and OJ (∆E = 3.17 (0.87-9.92)); Tetric EvoFlow® in CC (∆E = 1.27 (0.45-4.02)); and Filtek™ Supreme XTE in RW (∆E = 8.88 (5.23-19.59)). RW caused the most discoloration (∆E = 23.62 (4.93-51.36)). Vertise Flow showed the highest water sorption (WS = 69.10 ± 7.19). The Pearson test showed statistically significant positive correlations between water sorption and solubility and between water sorption and ∆E; the positive solubility-∆E correlation was not statistically significant. The findings suggest that water sorption is one factor associated with the ability of composites to discolor; however, discoloration is a multifactorial problem.

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal

OBJECTIVE: This study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure. MATERIAL AND METHODS: One luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: Group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blotdried. A trial adhesive (base to catalyst on a 1:1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TeGDMA, 0.5% eDMAB, 0.13% CQ); Group 2: A trial adhesive (base to catalyst on a 1:2 ratio) was luted as in Group 1; Group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in Group 1; Group 4: OSP strictly following the manufacturer's instructions using the luting agent as in Group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy. RESULTS: Push-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as Group 1 (exp 1 - ethanol-wet bonding technique)=Group 2 (exp 2 - ethanol-wet bonding technique)=Group 3 (OSP - ethanol-wet bonding technique)=Group 4 (control, OSP - water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface. CONCLUSIONS: The results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal.

OBJECTIVE: This study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure. MATERIAL AND METHODS: One luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blotdried. A trial adhesive (base to catalyst on a 1:1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TeGDMA, 0.5% eDMAB, 0.13% CQ); group 2: A trial adhesive (base to catalyst on a 1:2 ratio) was luted as in group 1; group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in group 1; group 4: OSP strictly following the manufacturer's instructions using the luting agent as in group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy. RESULTS: Push-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as group 1 (exp 1--ethanol-wet bonding technique)=group 2 (exp 2--ethanol-wet bonding technique)=Group 3 (OSP--ethanol-wet bonding technique)=group 4 (control, OSP--water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface. CONCLUSIONS: The results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

Push-out bond strength of fiber posts luted with unfilled resin cement.

PURPOSE: The study evaluates the behavior of different adhesive systems and resin cements in fiber post placement, with the intent to clarify the possible role of unfilled resin as a luting material for fiber posts. MATERIALS AND METHODS: Two luting agents (Dual-Link and Unfilled Resin) for cementing fiber posts into root canals were applied either with All-Bond 2 or One-Step Plus, or without an adhesive system, and challenged with the push-out test. Slices of roots restored with posts were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under SEM. RESULTS: Push-out strength was significantly influenced by the luting agent (p < 0.05), but not by the bonding strategy (p > 0.05). The best results were obtained in combination with Unfilled Resin with One-Step Plus. Dual-Link groups failed mainly cohesively within the cement, while Unfilled Resin demonstrated more adhesive fracture at the post interface. CONCLUSION: The results of this study support the hypothesis that adhesive unfilled resin application is essential for achieving high bond strength to radicular dentin.

Early and 24-hour bond strength and degree of conversion of etch-and-rinse and self-etch adhesives.

PURPOSE: To evaluate early and 24-hour microtensile bond strength (microTBS) and the degree of conversion (DC) of one representative adhesive system from each of the four current bonding approaches. METHODS: 40 human molars were sectioned occluso-gingivally into two halves. Resin composite was bonded incrementally to flat, mid-coronal dentin, using the adhesives Adper Scotchbond MP (MP); Adper Scotchbond 2 (SB); Clearfil SE Bond (SE); and Adper Prompt L-Pop (LP) according to the respective manufacturer's instructions (n = 10). One half was immediately sectioned into sticks and subjected to muTBS test. As the sectioning process took approximately 1 hour, the results were designated as 1-hour bond strengths. The other half was stored in distilled water at 37 degrees C for 24 hours before being sectioned and tested. The DC of these systems was measured using Fourier Transform-Raman spectroscopy in three periods: immediately, 1 and 24 hours after polymerization. Data were analyzed with ANOVA and Tukey's tests. RESULTS: There were no significant differences between the 1-hour and 24-hour bond strengths (P > 0.05), or among the DC measured immediately, 1 hour and 24 hours after polymerization (P > 0.05). However, significant differences were observed among adhesives (P < 0.05). microTBS values obtained, in MPa (1 hour/24 hour), were: SB (48.6 + 1.3/48.4 + 3.5) = SE (51.9 + 4.7/53.3 +/- 2.9) > MP (35.3 +/- 10.9/38.6 + 6.7) > LP (25.5 + 1.1/26.0 + 1.5). The DC, in percentage (immediately/1 hour/24 hour), were: SE (81/82/87) > MP (79/77/81) > SB (60/63/65) > LP (39/37/42).

A novel method to obtain microtensile specimens minimizing cut flaws.

Cutting procedures conventionally used for microtensile specimens' preparation induce mechanical stress and attrition, leading to cracks in dental structure. Enamel is mainly affected due to its high module of elasticity and brittleness. As an alternative to the conventional diamond saw, a diamond wire was used for cutting. The two techniques were compared in efficacy in the preparation of two different sample shapes. Forty human molars, flattened in dentin or enamel, were used for sample preparation. After bonding procedures, resin block was built incrementally. Half of the teeth were cut using a diamond disc and the other half using a diamond wire, obtaining slabs and stick-shaped specimens. Slabs were then shaped to obtain hourglass samples. Five samples from each subgroup were randomly selected for Scanning electron microscopy (SEM) analysis. Remaining samples underwent microtensile test and the results were analyzed, including/excluding premature failures (pf), with three-way ANOVA and Tukey test, performed separately, by substrate. On dentin, only the exclusion of pf showed a significant higher bond strength values than when pf were included (p < 0.05); however, on enamel, all factors (equipment, shape and including/excluding pf) had a significant effect on bond strength (p<0.05). The most remarkable finding from SEM was the incidence of specimens' cracks and defects when diamond blade was used. Scratches and cracks in the hourglass-shaped specimens were also detected. In both cases, enamel was more affected than dentin.

Resistência à microtração e avaliação por microscopia eletrônica de varredura da interface entre um adesivo com "primer" autocondicionante e esmalte ou dentina / Microtensile strength and SEM evaluation of the interface between an adhesive with self-eatching primer and enamel or dentin

O objetivo do presente estudo foi avaliar, por teste de microtração, a resitência de união do adesivo com "primer" autocondicionante Clearfil SE Bond (Kuraray Medical Inc.) ao substrato (esmalte ou dentina); e verificar, através de MEV, a integridade da interface entre adesivo e substrato antes do teste de microtração. Quatorze molares humanos hígidos foram aleatoriamente divididos em dois grupos (n=7) de acordo com o substrato a ser usado: dentina ou esmalte. Após a aplicação do sistema adesivo, um bloco de resina composta (Tetric Ceran - Ivoclar Vivadent, Schaan, Liechtenstein) de aproximadamente 5 x 5 x 5 mm foi construído sobre o dente, sendo cada incremento fotoativado por 40 segundos com 60mW/cm² (Optilux 401 - Demetron Research Corporation). Após 24 horas, os blocos dente/adesivo/resina foram seccionados, obtendo-se corpos de prova em forma de palito, com área de união de aproximadamente 0,8mm². Foram obtidos 156 corpos-de-prova, sendo que 120 palitos foram usados para o teste de microtração e 36 foram preparados para análise em microscopia eletrônica de varredura. A média de resistência de união (MPa) em dentina foi de 44,5 (+/-7,7) e em esmalte, 38,9 (+/-4,8), sendo estatisticamente semelhantes entre si. A análise em MEV mostrou presença de bolhas e/ou microtrincas na interface adesiva e no substrato, principalmente em esmalte

Microtensile bond strength of current dentin adhesives measured immediately and 24 hours after application.

PURPOSE: To evaluate the immediate microtensile bond strengths achieved with representative adhesive systems from each of the four current bonding approaches. MATERIALS AND METHODS: Resin composite was bonded incrementally to flat, midcoronal dentin from 33 human molars, using the adhesives (Adper Scotchbond MP; Adper Scotchbond 1; Optibond Solo Plus; Clearfil SE Bond; AdheSE; Tyrian SPE + One Step Plus; Optibond Solo Plus self-etching; One-Up Bond F; iBond; Adper Prompt L-Pop; Xeno III) according to the respective manufacturer's instructions. The bonded specimens were immediately sectioned into sticks and underwent microtensile bond testing either immediately or after 24 h. Data were analyzed with two-way ANOVA and LSD tests. RESULTS: No significant differences were found between immediate and 24-h bond strengths (p > 0.05). However, significant differences were observed among adhesives (p = 0.001). The all-in-one adhesive iBond showed statistically lower values when compared to all the other adhesives. Adper Prompt L-Pop, Xeno III, Tyrian SPE + One Step Plus and One-Up Bond F, all self-etching adhesives, were significantly weaker than AdheSE, Optibond Solo Plus, Adper Scotchbond 1, Optibond Solo Plus self-etching, Clearfil SE Bond, and Adper Scotchbond MP, which did not differ statistically from each other. CONCLUSION: Microtensile bond strengths of representative adhesive systems from the four categories of bonding agents were not equivalent, with the lowest values recorded for the one-step self-etching adhesives. There were no differences in the bond strengths when measured immediately and after 24 h.

Influência da geometria dos espécimes em dentina e esmalte no teste de microtração: análise da resistência de união e microscopia eletrônica de varredura / Influence of specimens' characteristics on dentin and enamel on microtensile bond test: microtensile bond strenght and scanning electron microscopy analysis

Este estudo teve como objetivo verificar a influência da geometria dos espécimes em dentina e esmalte no teste de microtração. 32 molares íntegros foram divididos em dois grupos: dentina [D] ou esmalte [E]. Para o grupo [D], o terço oclusal da coroa foi removido e para o grupo [E], a superfície vestibular foi asperizada, expondo, em ambos os casos, superfícies planas. Após a criação de camada smear padrão, foi aplicado o sistema adesivo experimental ABF (Kuraray Medical Inc.) e um bloco de resina composta (Clearfil APX - Kuraray Medical Inc.) foi construído sobre o dente. Após 24 horas, os dentes foram aleatoriamente divididos em quatro subgrupos (n=4), de acordo com o formato (ampulheta ou palito) e a área de união (0,5x0,5mm ou 1x1mm) dos espécimes. Com um disco diamantado, os conjuntos foram seccionados paralelamente ao longo do eixo do dente, obtendo-se fatias com as espessuras determinadas. Para obtenção das ampulhetas, entalhes foram realizados com uma broca diamantada FF. Para obtenção dos palitos, foram feitos cortes perpendiculares aos primeiros. Três corpos-de-prova (cps) de cada condição experimental foram aleatoriamente selecionados e preparados para microscopia eletrônica de varredura (MEV); os demais foram submetidos ao teste de microtração. Tanto o substrato quanto as dimensões e os formatos dos cps influenciaram estatisticamente os resultados de resistência adesiva (p<0,001). Em MEV, foram freqüentemente observadas linhas de fraturas nas ampulhetas na interface adesiva. Essa ocorrência foi mais comum nos cps em esmalte do que em dentina. O entalhamento, principalmente em esmalte, é bastante crítico e influencia os resultados de adesão

Microtensile dentin bond strength of self-etching and single-bottle adhesive systems in different cavity configurations.

PURPOSE: To evaluate the bond strength of a self-etching (Clearfil SE Bond) and a single-bottle (Excite) adhesive system using two cavity configurations (C-factors 5 and 1). MATERIALS AND METHODS: Class I cavities (3 x 4 x 2.5 mm) were prepared in 28 extracted human molars using diamond burs under water cooling. Teeth were divided into 4 groups: G1: Excite, C-factor 5; G2: Excite, C-factor 1; G3: Clearfil, C-factor 5; G4: Clearfil, C-factor 1. To determine C-factor 5, systems were applied to all cavity walls according to the manufacturers' instructions (5 bonded, 1 unbonded). For C-factor 1, lateral walls were isolated using nail varnish, and adhesive systems were only applied to the pulpal floor (5 unbonded, 1 bonded). Cavities were restored using Tetric Ceram composite resin (Ivoclar/Vivadent), and bulk light cured for 40 s (500 mW/cm2). Teeth were stored in distilled water for 24 h at 37 degrees C, and then sectioned using a diamond disk, yielding stick-shaped specimens with a bonded area of approximately 0.8 mm2. Specimens were submitted to the microtensile bond test at a rate of 1 mm/min speed in a universal testing machine. RESULTS: Resin-dentin bond strengths (MPa) were submitted to ANOVA and Tukey's tests (p < 0.05) [number of specimens]: G1 = 35.8b [43]; G2 = 48.9a [55]; G3 = 45.9a [60]; G4 = 49.0a [53]. There was no statistically significant difference between adhesive systems for C-factor 1. For C-factor 5, Clearfil SE Bond produced higher values when compared to the other group. CONCLUSION: Changes in C-factor only affected the total-etch adhesive system tested. This may be a result of the different filler volume in the self-etching system, and not of the bonding technique itself.

Microleakeage and resin cement film thickness of luted all-ceramic and gold electroformed porcelain-fused-to-metal crowns.

PURPOSE: The purpose of this study was to evaluate the sealing ability of single-unit all-ceramic and gold-electroformed crowns luted with a resin cement under laboratory conditions. MATERIALS AND METHODS: Thirty extracted maxillary premolars were selected. Standardized abutments were prepared for full-crown restorations with cervical margins located 1 mm below the cementoenamel junction. Samples were divided into two groups (n = 15) based on type of restorative system: Group 1: a heat-pressed all-ceramic system (IPS Empress 2, Ivoclar-Vivadent); Group 2: a gold-electroformed porcelain-fused-to-metal system (Gramm Technik). Crowns were luted with Excite DSC bonding system (Ivoclar-Vivadent) and Variolink II resin cement (Ivoclar-Vivadent) following manufacturer's instructions. After luting procedures and 700 thermal cycles (5 degrees C and 55 degrees C, 1 min dwell time), 20 specimens (n = 10 per group) were randomly selected and processed for microleakage evaluation at cervical sites. The remaining specimens (n = 5 per group) were prepared for SEM investigation on film thickness. Microleakage and film thickness data were statistically evaluated using the Mann-Whitney U-test (p < 0.05). RESULTS: Fifty percent of group 1 and 60% of group 2 samples showed leakage. For group 1, dye penetration was mostly observed between metal and resin material, while group 2 specimens showed leakage mainly between ceramic margins and resin cement. Samples from group 1 showed a cement thickness of 82 microm, while 71 microm was found for group 2. Statistically significant differences were not found between samples from the two groups. CONCLUSION: Regarding microleakage and film thickness, both restorative systems evaluated in this study performed similarly.