Effect of Polywave and Monowave Light Curing Units on the Microtensile Bond Strength and Failure Types of Different Bulk-Fill Resin Composites: An in vitro Study.

Aim: This study aimed to evaluate the effects of polywave and monowave light-emitting diode curing units on the microtensile bond strength and failure types of three bulk-fill resin composites. Materials and Methods: This in vitro experimental study was performed on 180 microbars obtained from human third molars and were distributed into 12 groups according to the type of bulk-fill resin composite and the light-curing unit. Third molars were restored using Filtek One Bulk Fill Restorative, Tetric® N-Ceram Bulk Fill, and Opus Bulk Fill resin composites was light-cured with Elipar Deep Cure L and Valo in three modes: standard, high power, and extra power. Subsequently, microtensile analysis was carried out with a universal testing machine and the type of failure with an optical stereomicroscope. For statistical analysis, the Kruskal-Wallis H-test was used, with the Bonferroni post hoc test and Fisher's exact test, considering a significance of p<0.05. Results: There were significant differences in the microtensile bond strength between the Filtek One Bulk Fill restorative and Opus Bulk-Fill (p = 0.042) when light was cured with the polywave unit at standard power. On the other hand, the Filtek One Bulk Fill Restorative and Opus Bulk Fill resins showed significant differences in microtensile bond strength when light was cured with the monowave unit compared with the polywave unit (p<0.05). Conclusion: The presence of alternative photoinitiator systems that are more reactive than camphorquinone produced higher microtensile bond strength in Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins when light-cured with a high and standard polywave unit, respectively, compared to Filtek One Bulk Fill resins. Finally, Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins had the highest percentage of mixed failures, while Filtek One Bulk Fill resin had adhesive failures, which was related to its lower microtensile bond strength.

Comparative Evaluation of Microtensile Bond Strength in Three Different Dentin Luting Agents: An In vitro Study.

Aim: Long-term clinical success on indirect restorations is largely determined by bonding efficiency of the luting agent, with adhesion to dentin being the main challenge. Therefore, aim of this study was to assess the microtensile bond strength when using flowable resin composite, preheated resin composite and dual self-adhesive resin cement as dentin luting agents. Materials and Methods: Occlusal thirds of molar teeth were cut and randomly divided into 3 groups to be cemented: RelyX™U200, Filtek™ Z250 XT- preheated to 70° and Filtek Flow™ Z350XT. They were then thermocycled 5000 times between 5+/-2°C and 55+/-2°C. Subsequently, 10 microbars per group were prepared. The 30 samples were placed in saline solution for 24 hours at room temperature prior to microtensile test. This was performed with a digital universal testing machine at a crosshead speed of 0.5 mm/min. The bond strength values obtained were analyzed in Megapascals (MPa). Measures of central tendency such mean and measures of dispersion such standard deviation were used. In addition, the Kruskall Wallis non-parametric test with Bonferroni post hoc test was applied, considering a significance value of 5% (P < 0.05), with type I error. Results: The dentin microtensile bond strengths of preheated resin composite, flowable resin composite and dual self-adhesive cement were 6.08 ± 0.66 Mpa, 5.25 ± 2.60Mpa and 2.82 ± 1.26Mpa, respectively. In addition, the preheated resin composite exhibited significantly higher microtensile bond strength compared to the dual self-adhesive cement (P < 0.001). While the flowable resin composite showed no significant difference with the dual self-adhesive cement (P = 0.054) and the preheated resin composite (P = 0.329). Conclusions: The microtensile bond strength in dentin was significantly higher when using a preheated resin composite at 70°C as a luting agent compared to dual self-adhesive cement. However, the preheated resin composite showed similar microtensile bond strength compared to the flowable resin composite.

Shear bond strength of three different metal bracket base designs on human premolars: An in vitro comparative study.

Background: Adequate bracket-enamel bonding is critical to prevent detachment during orthodontic treatment and minimize any potential delay in results. The aim was to compare the shear bond strength of three metal bracket base designs: laser-structured base, mesh base, and retention grooves base. Material and Methods: In this experimental in vitro study, 54 human premolars were immersed for one week in 0.1% thymol solution, then placed in distilled water with weekly replacement until the start of the study. The premolars were cemented with brackets of varying base designs: A. Discovery® Smart (laser structured), B. Mini Master® Series (base with mesh), and C. Roth Max (base with retention grooves). All brackets were cemented using TransbondTM XT. A universal testing machine was used to evaluate the shear bond strength at a crosshead speed of 0.75 mm/min. Welch's one-factor ANOVA with robust variance and Tukey's post hoc test were used to compare means, with a significance level of p<0.05. Results: The average shear bond strength values were for the bracket with laser-structured base (14.78 ± 5.79 MPa), the bracket with mesh base (9.64 MPa ± 2.54 MPa) and the bracket with retention groove base (15.38 MPa ± 2.67 MPa). It was found that brackets with mesh bases had significantly lower shear bond strength than brackets with laser-structured bases (p=0.001) and brackets with retention grooves bases (p<0.001). No significant differences were observed between the latter two types of brackets (p = 0.893). Conclusions: The bracket base design influenced in vitro shear bond strength with significantly higher values observed for Roth Max and Discovery® Smart brackets compared to Mini Master® Series brackets. Key words:Shear strength, laser-structured bracket, bracket with mesh base, bracket with retention groove base.

In Vitro Color Stability Evaluation of Three Polished and Unpolished Nanohybrid Resin Composites Immersed in a 0.12% Chlorhexidine-Based Mouthwash at Different Times.

The use of chlorhexidine-based mouthwashes on resin composites with rough surfaces can cause discoloration which compromises the esthetic of patients. The present study aimed to evaluate the in vitro color stability of Forma (Ultradent Products, Inc., South Jordan), Tetric N-Ceram (Ivoclar Vivadent, Schaan, Liechtenstein) and Filtek Z350XT (3M, ESPE, St. Paul, MN, USA) resin composites, with and without polishing, after being immersed in a 0.12% chlorhexidine (CHX)-based mouthwash at different times. The present in vitro experimental and longitudinal study used 96 nanohybrid resin composite blocks (Forma, Tetric N-Ceram and Filtek Z350XT) 8 mm in diameter and 2 mm thick, evenly distributed. Each resin composite group was divided into two subgroups (n = 16) with and without polishing and then immersed in a 0.12% CHX-based mouthwash for 7, 14, 21 and 28 days. Color measurements were performed with a calibrated digital spectrophotometer. Nonparametric tests were used to compare independent (Mann-Whitney U and Kruskal-Wallis) and related (Friedman) measures. In addition, the Bonferroni post hoc correction was used considering a significance level of p < 0.05. All polished and unpolished resin composites presented color variation < 3.3 when immersed for up to 14 days in 0.12% CHX-based mouthwash. The polished resin composite with the lowest color variation (ΔE) values over time was Forma, and the one with the highest values was Tetric N-Ceram. When comparing the color variation (ΔE) over time, it was observed that the three resin composites, with and without polishing, presented a significant change (p < 0.001), although these changes in color variation (ΔE) were evident from 14 days between each color acquisition (p < 0.05). The unpolished Forma and Filtek Z350XT resin composites showed significantly more color variation than the same polished ones at all times when immersed in a 0.12% CHX-based mouthwash for 30 s daily. In addition, every 14 days, all three resin composites with and without polishing showed a significant color change, while, every 7 days, color stability was maintained. All the resin composites showed clinically acceptable color stability when exposed for up to 14 days to the above-mentioned mouthwash.

The Microhardness and Surface Roughness Assessment of Bulk-Fill Resin Composites Treated with and without the Application of an Oxygen-Inhibited Layer and a Polishing System: An In Vitro Study.

The aim of this study was to assess the microhardness and surface roughness of bulk-fill resin composites treated with and without the application of an oxygen-inhibited layer (OIL) and a polishing system. This in vitro experimental study consisted of 72 resin composite blocks divided into three groups: Tetric N-Ceram Bulk Fill, Opus Bulk Fill APS, and Filtek Bulk Fill. Each resin composite group was further divided into two subgroups: with and without OIL control. Subsequently, surface roughness and microhardness were measured before and after polishing. A t-test was used to compare independent and related measures. For the intergroup comparison of variation before and after polishing, the Kruskal−Wallis test with Bonferroni post hoc was used considering a significance level of p < 0.05. When comparing surface roughness, significant differences were observed between Opus Bulk Fill resin composite with and without OIL control (p = 0.003) before polishing. The same occurred when comparing Tetric N-Ceram resin composite with and without OIL control (p = 0.039) after polishing. In addition, the surface roughness of Filtek Bulk Fill, Opus Bulk Fill, and Tetric N-Ceram Bulk Fill resin composites, with and without OIL control, decreased significantly after polishing (p < 0.001), while surface microhardness significantly increased (p < 0.05), with the exception of Opus Bulk Fill resin with OIL control (p = 0.413). In conclusion, OIL control and polishing significantly improved the surface roughness and surface microhardness of Filtek Bulk Fill and Tetric N-Ceram Bulk Fill resin composites. However, in the case of Opus Bulk Fill resin composite, only its surface roughness was significantly improved.

Surface roughness and oxygen inhibited layer control in bulk-fill and conventional nanohybrid resin composites with and without polishing: in vitro study.

BACKGROUND: It has been demonstrated that dental restorations with rough surfaces can have several disadvantages such as pigment retention or plaque accumulation, which can facilitate caries formation, color variation, loss of brightness, degradation of restoration, among others. The present study aimed to assess surface roughness in bulk fill and conventional nanohybrid resins with and without polishing, controlling the oxygen inhibited layer. METHODS: This in vitro and longitudinal experimental study consisted of 120 resin blocks of 6 mm diameter and 4 mm depth, divided into two groups: Bulk Fill (Tetric® N-Ceram Bulk-fill, Opus Bulk Fill APS, Filtek™ Bulk Fill) and conventional nanohybrid (Tetric® N-Ceram, Opallis EA2, Filtek™ Z250 XT). Each resin group was divided into two equal parts, placing glycerin only on one of them, in order to control the oxygen inhibited layer. Subsequently, the surface roughness was measured before and after the polishing procedure with Sof-Lex discs. The data were analyzed with the T-test for related measures, and for comparison between groups before and after polishing, the non-parametric Kruskal Wallis test with the Bonferroni post hoc was used, considering a significance level of p < 0.05. RESULTS: Before polishing, the resin composites with the lowest surface roughness were Opus Bulk Fill APS (0.383 ± 0.186 µm) and Opallis EA2 (0.430 ± 0. 177 µm) with and without oxygen inhibited layer control, respectively; while after polishing, those with the lowest surface roughness were Opus Bulk Fill APS (0.213 ± 0.214 µm) and Tetric N-Ceram (0.097 ± 0.099 µm), with and without oxygen inhibited layer control, respectively. Furthermore, before and after polishing, all resins significantly decreased their surface roughness (p < 0.05) except Opus Bulk Fill APS resin with oxygen inhibited layer control (p = 0.125). However, when comparing this decrease among all groups, no significant differences were observed (p < 0.05). CONCLUSION: The Opus Bulk Fill APS resin with oxygen inhibited layer control presented lower surface roughness both before and after polishing, being these values similar at both times. However, after polishing the other bulk fill and conventional nanohybrid resins with and without oxygen inhibited layer control, the surface roughness decreased significantly in all groups, being this decrease similar in all of them.

El nivel de conocimiento como factor de riesgo para el ingreso hospitalario de personas con diabetes tipo 2 / Level of knowledge as risk factor for hospital readmition in type 2 diabetes patients

Resumen

Summary

Introduction: the existence of health education remotes to the begining of human origin, when men jointed against the natural fenomenon for obtaining from their fights and experiences the knowledge to substain and conquer a better way of life.

Objective: to determine if the low health educational level is a risk factor to hospital admition in type 2 diabetic patients.

Methodology: we study 80 cases and 80 controls defining as cases patients with type 2 diabetes mellitus reaquiring hospitalization with more than a year of illness and as controls the diabetic patients who did not had need for hospitalization. We use a cuestionary for evaluating health education.

Results: sixty two cases had low health education level and 18 high level, in the control group 41 had high level and 39 low level stablishing an estadistical significative asociation with a alpha of 0.05. OR 3.6 IC 95 % 2.1 to 5.4.

Conclusions: low health educational level in diabetic patients is a risk factor for admition and re-admition to hospital.

Introducción: el desconocimiento del autocuidado de la salud puede ser un factor de riesgo en el ingreso hospitalario del paciente diabético. Se ha observado que pacientes con enfermedades cronico-degenerativas tienen un bajo nivel de conocimiento sobre el autocuidado.

Objetivo: determinar el nivel de conocimiento como factor de riesgo en el ingreso hospitalario en los pacientes diabéticos tipo 2, en el Hospital General Regional 1 de Culiacán, Sinaloa.

Metodología: se realizó un estudio de casos y controles en pacientes con diabetes mellitus tipo 2. Se consideraron como casos aquellos que requirieron hospitalización (n = 80) y como controles los que no ameritaron hospitalización (n = 80) durante los meses de agosto a septiembre del 2007. Se utilizó un cuestionario que evaluó el nivel de conocimiento sobre educación para la salud. Para el análisis estadístico se utilizó la χ2 y RM con IC del 95 %.

Resultados: se encontró que 62 casos (77.5 %) tuvieron nivel bajo y 18 (22.5 %) nivel alto de conocimiento para la salud, en los controles 41 (51.2 %) tuvieron un nivel alto y 39 (48.8 %) nivel bajo encontrando asociación estadísticamente significativa con una alfa de 0.05 y RM 3.6 IC 95 % 2.1 a 5.4.

Conclusiones: el bajo nivel de conocimiento para la salud en pacientes diabéticos es un factor de riesgo para el ingreso hospitalario.