Biological and physical properties of calcium hydroxide-based pulp-capping materials and their modifications.

PURPOSE: To evaluate the biological and physical properties of calcium hydroxide-containing pulp-capping materials and their modifications with different solutions and antioxidant Resveratrol (RES) addition. METHODS: Calcium hydroxide+distilled-water:C, calcium hydroxide+saline:S, calcium hydroxide+synthetic tissue fluid:STF, Dycal:D, calcium hydroxide+distilled-water+RES:C+RES, calcium hydroxide+saline+RES:S+RES, calcium hydroxide+synthetic tissue fluid+RES:STF+RES, Dycal+RES:D+RES were tested. Cytotoxicity was determined by WST-1. Antibacterial-activity was evaluated by agar-diffusion. The water-absorption and solubility were examined for ISO-6876 and ISO-3107. The color-change was evaluated by spectrophotometer. Radiopacity was evaluated for ISO-6876 and ISO-9917. The normal distribution and homogeneity were determined and comparisons were made with appropriate analysis and post hoc tests (P < 0.05). RESULTS: The highest cell-viability was determined in the C+RES and the lowest was in D and D+RES after 24 h (P < 0.0001). RES-addition increased cell-viability and the highest rate was detected in C+RES, S+RES and STF+RES after 48 h (P < 0.0001). A limited inhibition-zone against Streptococcus mutans was detected in D and D+RES. RES-addition did not change the water-absorption in S and STF or the solubility in S group. CONCLUSION: RES-addition may be used to increase the biocompatibility of calcium hydroxide without any adverse effect on physical properties. Saline may be the first choice as a mixing solution.

Comparative evaluation of resin infiltration and fluoride varnish treatment for moderate to high caries risk adults: A randomized controlled trial.

PURPOSE: To evaluate the arresting effect of micro-invasive (resin infiltration) and non-invasive (fluoride varnish) treatment options on non-cavitated proximal lesions in individuals with moderate to high risk of caries. In addition, the study evaluated the effect of repeated dental examinations and oral hygiene motivation on daily flossing, brushing frequency, dietary habits, and gingival status. METHODS: The study was a randomized, controlled, prospective, and parallel-designed clinical trial. 60 adults were enrolled and randomly allocated in a 1:1 ratio to the treatment groups. Cariogram was used to assess the caries risk. The advising instruction for daily habits and oral hygiene by individual risk illustration was given to all participants. Two experienced examiners visually evaluated the severity and activity of the lesions by using the International Caries Detection and Assessment System and Nyvad Activity Assessment respectively. Radiographic scoring of the lesions was performed on bite-wing radiographs by the same examiners. The gingival index was used to check the gingival status of the patients at the initial and control sessions. After examination, resin infiltration (Icon) was applied to 30 subjects, while the other 30 received fluoride varnish (Clinpro White Varnish). The follow-up time was 18 months with 6-month intervals. RESULTS: According to the Pearson Chi-Square test, there was no difference in the arresting effect of resin infiltration and fluoride varnish (P= 0.491). Both treatment groups exhibited a notable arresting effect on non-cavitated lesions, achieving a success rate of 98% (55 out of 56) during the 18-month evaluation period. However, one lesion of a subject who received resin infiltration was observed to progress from an E2 score to cavitation. Furthermore, at the end of 18 months, the subjects' motivation for oral hygiene had increased, and gingival index score decreased from 2 to 1 in 15% of the subjects. CLINICAL SIGNIFICANCE: Both resin infiltration and fluoride varnish yielded satisfactory results in the treatment of non-cavitated proximal lesions in individuals with moderate to high risk of caries. Repeated motivational instructions were beneficial for patients in maintaining their daily oral hygiene habits and gingival health.

The effects of extended polymerization time for different resin composites on reactive oxygen species production and cell viability.

PURPOSE: The present study was conducted to determine oxidative stress and cell viability after contact with resin composites polymerized for different times. METHODS: Disk-shaped specimens of Admira Fusion, Ceram X One Universal, Solare x and Filtek Z550 (n = 12) were prepared, and two subgroups with polymerization times of 20 and 40 s were employed. The specimens were incubated with mouse fibroblast cells for 48 and 72 h, and changes in reactive oxygen species (ROS) production and cellular viability were determined by an assay with a cell-permeable fluorescent dye, 2',7'-dichlorodihydrofluorescein diacetate (H2DCF-DA), and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, respectively. RESULTS: At 72 h, ROS production in the presence of Admira Fusion polymerized for 40 s was reduced relative to that in the presence of Admira Fusion polymerized for 20 s (P < 0.05). Cell viability was maximal in the Admira Fusion and Solare x groups and there was no difference relative to the control group at 48 h. Cell viability was higher in the Admira Fusion and Solare x groups polymerized for 40 s than for the same materials polymerized for 20 s at 72 h (P < 0.05). CONCLUSION: Extension of the polymerizaton time has a material-specific effect and may be used as a strategy to increase the biocompability of resin composites.

Follow-up of flowable resin composites performed with a universal adhesive system in non-carious cervical lesions: A randomized, controlled 24-month clinical trial.

PURPOSE: This randomized, controlled study evaluated the 2-year clinical performance of two flowable resin composites performed with a universal adhesive in two etching modes for restoring non-carious cervical lesions (NCCLs). METHODS: One hundred NCCLs were restored with two flowable composites ( Charisma Opal Flow and G-aenial Universal Flo) and a universal adhesive (Single Bond Universal) with two etching modes (self-etch and etch&rinse) in a random order. The restorations were evaluated for retention, marginal adaptation, anatomic form, marginal discoloration, surface texture and secondary caries (modified USPHS criteria) at baseline, and after 6, 12 and 24 months. RESULTS: The clinical success for retention, surface texture and secondary caries parameters was scored as 100% for each group after 6, 12 and 24 months. The first acceptable changes (Bravo score) in marginal adaptation, anatomical form and marginal discoloration started to show up after 12 months for all test groups, except for etch&rinse+Charisma Opal Flow. Self-etch+Charisma Opal Flow and self-etch+G-aenial Universal Flo showed progressive marginal discoloration that remained in the clinical acceptability level after 2 years. After 24 months, each resin composite restored with either the etch&rinse mode or the self-etch mode of the universal adhesive showed similar clinical performance. Marginal discoloration was higher in the restorations performed with the self-etch system. Selective-etching can be favorable. CLINICAL SIGNIFICANCE: The clinical performance of flowable composites performed with a universal adhesive in two etching modes was clinically acceptable after 24 months.