Repair strength of dimethacrylate-based composites resins: Effect of sandblasting, adhesive bonding, and thermocycling.

Background: The goal of this study is to determine the effect of different sandblasting particles and dental adhesive systems on the repair strength of dimethacrylate-based composite resins. Materials and Methods: In this in-vitro study, 96 specimens of X-trafil composite blocks were prepared and divided into eight groups (n = 12). Four groups were sandblasted with Aluminum Oxide (AL) and four other groups with Bio-Active Glass particles (BAG). A two-component silane was applied on the surface of all the samples after phosphoric acid etching and rinsing. Two groups of the sandblasted specimens were treated with Clearfil SE Bond (CSB) and the other two groups were treated with Single Bond Universal (SBU) and new composite was bonded to the prepared surfaces. Half of the specimens in each group were thermocycled. Shear force was applied to the bonded composite using a universal testing machine with a crosshead speed of 0.5 mm/min and mean shear bond strength (MSBS) was calculated (MPa). The data was analyzed using Kruskal-Wallis and Man-Whitney U-tests with the significance level of 0.05. Results: Significant differences were observed between different groups (P < 0.001). The highest and the lowest MSBS of the thermocycled samples were reported 18.88 MPa with application of AL and SBU and 11.46 MPa with the application of AL and CSB, respectively. No significant difference was observed with application of BAG particles after thermocycling. Conclusion: Effect of AL on repair shear bond strength of composite resins is affected by bonding type. Bonding type did not affect repair shear bond strength of BAG. Thermocycling reduced bond strength in all groups.

Dentin extracellular matrix loaded bioactive glass/GelMA support rapid bone mineralization for potential pulp regeneration.

The study aims to develop a novel dentin extracellular matrix (dECM) loaded gelatin methacrylate (GelMA)-5 wt% bioactive glass (BG) (Gel-BG) hydrogel for dental pulp regeneration. We investigate the role of dECM content (2.5, 5, and 10 wt%) on the physicochemical characteristics and biological responses of Gel-BG hydrogel in contact with stem cells isolated from human exfoliated deciduous teeth (SHED). Results showed that the compressive strength of Gel-BG/dECM hydrogel significantly enhanced from 18.9 ± 0.5 kPa (at Gel-BG) to 79.8 ± 3.0 kPa after incorporation of 10 wt% dECM. Moreover, we found that in vitro bioactivity of Gel-BG improved and the degradation rate and swelling ratio reduced with increasing dECM content. The hybrid hydrogels also revealed effectual biocompatibility, >138 % cell viability after 7 days of culture; where Gel-BG/5%dECM was most suitable. In addition, the incorporation of 5 wt% dECM within Gel-BG considerably improved alkaline phosphatase (ALP) activity and osteogenic differentiation of SHED cells. Taken together, the novel bioengineered Gel-BG/dECM hydrogels having appropriate bioactivity, degradation rate, osteoconductive and mechanical properties represent the potential applications for clinical practice in the future.

Effect of Calcium Hypochlorite and Sodium Hypochlorite as Root Canal Irrigants on Push-out Bond Strength of Fiber Post Cemented with Etch-and-Rinse Resin Cement: An in Vitro Study.

Objectives: Calcium hypochlorite (CH) has been recently used as a root canal irrigant. The aim of the present study was to compare the effect of CH and sodium hypochlorite (SH), as root canal irrigants, on the push-out bond strength of fiber posts cemented with an etch-and-rinse resin cement. Materials and Methods: In this experimental in-vitro study, 40 human anterior teeth with similar root lengths were randomly divided into five groups (N=8) according to the protocol of root canal irrigation as follows: group 1: saline (control); group 2: 2.5% SH; group 3: 5.25% SH; group 4: 2.5% CH; group 5: 5% CH. Before post placement, the post space was irrigated using the same irrigation protocol, and after that, they were irrigated by distilled water. Fiber posts were cemented with All-Bond 3 bonding and Dou-Link Universal cement. After thermocycling (1000 cycles, 5-55°C), a push-out test was performed, and data were analyzed using one-way analysis of variance and Tukey's post-hoc test with SPSS version 23 (α=0.05). Results: The highest and lowest mean bond strengths were detected in groups 2 and 5, respectively. There was no significant difference between group 1 and the SH groups (P>0.05), but the difference between group 1 and the CH groups was significant (P<0.001). There was a significant difference between SH groups and CH groups (P<0.001). Conclusion: Compared to SH, as a root canal irrigant, CH decreased the push-out bond strength of fiber posts cemented with an etch-and-rinse resin cement.

Effects of Calcium Hypochlorite and Sodium Hypochlorite, as Root Canal Irrigants, on the Bond Strength of Glass Fiber Posts Cemented with Self-Adhesive Resin Cement.

OBJECTIVES: Calcium hypochlorite (Ca(OCl)2) is currently used as a root canal irrigant. The aim of this study was to compare the effects of calcium hypochlorite and sodium hypochlorite (NaOCl), as root canal irrigants, on the bond strength of posts cemented with a self-adhesive resin cement. MATERIALS AND METHODS: In this in-vitro study, 40 maxillary central incisors with similar root lengths were decoronated. The teeth were randomly divided into five groups based on the irrigant used: Group 1: normal saline (control), Group 2: 2.5% sodium hypochlorite, Group 3: 5.25% sodium hypochlorite, Group 4: 2.5% calcium hypochlorite, and Group 5: 5% calcium hypochlorite. Root canal treatments were performed with Gates-Glidden drills and the irrigant corresponding to each group was used upon changing the file and for irrigating the post space. Then, glass fiber posts were cemented by BisCem self-adhesive cement. After applying 1,000 thermocycles at 5-55°C, three samples of the mid-section of each root were prepared: one for scanning electron microscopy (SEM), and the rest for push-out testing. Data were analyzed with SPSS 23 software using one-way analysis of variance and post-hoc Tukey's test. RESULTS: The highest and lowest mean bond strengths were recorded in groups 5 and 1, respectively. There was a significant difference between the 5% calcium hypochlorite group and the other groups (P<0.001). The difference between the other groups was not significant. CONCLUSION: The use of 5% calcium hypochlorite with self-adhesive cements increases the push-out bond strength of fiber posts to radicular dentin.

Bond strength of composite resin to white mineral trioxide aggregate: Effect of different surface treatments.

BACKGROUND: The main aim of restorative dentistry is to restore and preserve dental health with the use of appropriate restorative modalities to protect the pulp and restore its function. This study compared the effect of different surface treatments of mineral trioxide aggregate (MTA) on the bond strength of composite resin to MTA. MATERIALS AND METHODS: Forty cylindrical acrylic blocks with a hole were prepared and filled by ProRoot MTA. The samples were assigned to four groups: Group 1 - no surface treatment; Group 2 - phosphoric acid etching; Group 3 - sandblasting; and Group 4 - hydrofluoric acid (HF) etching, rinsing, and silane application. OptiBond Solo Plus adhesive was utilized in all the groups. Then, composite resin cylinders were bonded to sample surfaces. The samples were thermocycled and tested for microshear bond strength using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests. Scanning electron microscopy images were prepared for each study group after surface treatments. RESULTS: Means and standard deviations of bond strength values in study groups 1-4 were 14.83 ± 7.76, 21.85 ±7.99, 6.48 ± 3.89, and 26.01 ± 11.09 Mpa, respectively. CONCLUSIONS: Within the limitations of this study, phosphoric acid etching or HF etching plus silanization was preferred to surface treatment of MTA before composite resin bonding.

Interfacial fracture toughness of universal adhesive systems treated with an antioxidant.

BACKGROUND: Secondary caries, degradation of the dentin-resin interface and fracture of the restoration are the most common forms of failure. The aim of this study was to assess the interfacial fracture toughness of three different adhesive approaches and to compare their fracture toughness after surface treatment with antioxidant. MATERIAL AND METHODS: Seventy two dentin blocks with 3×4mm dimension and 3mm thickness were prepared and attached to precured 3×4×12mm composite blocks from both sides. Six adhesive groups (N=12), All-bond universal, Scotchbond universal and Clearfil SE bond with or without antioxidant treatment (Sodium Ascorbate 10% )were applied to dentin surfaces, a 160µ polyethylene paper formed the chevron in adhesive-dentin interfaces. Chevron-notched beam fracture toughness was measured following a modified ISO 24370 standard. The uniform composite-dentin-composite block was subjected to a 4-point test in universal machine. Data were analyzed by Kruskal-Wallis, Wilcoxon signed-rank and Mann-Whitney tests (α =0.05). RESULTS: Different adhesive approaches yielded different significant in fracture toughness rates. A significant increase of fracture toughness was observed between adhesive groups after antioxidant surface treatment. The difference in fracture toughness between Scotchbond universal and All-bond universal were significant. CONCLUSIONS: The highest value of fracture toughness was reported for Clearfil SE bond and the lowest value was found for All-bond universal. Sodium ascorbate as antioxidant surface treatment had a significant effect in increasing the fracture toughness. Key words:Chevron-notched beam fracture toughness, fracture toughness, dentin, adhesive, antioxidant.

Effect of Polyhydroxybutyrate/Chitosan/Bioglass nanofiber scaffold on proliferation and differentiation of stem cells from human exfoliated deciduous teeth into odontoblast-like cells.

Scaffolds and their characteristics play a central role in tissue engineering. The purpose of this study was to determine the effects of Polyhydroxybutyrate (PHB)/Chitosan/nano-bioglass (nBG) nanofiber scaffold made using the electrospinning method, on the proliferation and differentiation of stem cells obtained from human exfoliated deciduous teeth into odontoblast-like cells. In this experimental study, the pulps of the molten deciduous teeth were isolated, thereafter, the stem cells from human exfoliated deciduous teeth (SHED) were extracted and then the 3-(4,5-dimethylthiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to determine the cell viability percentage. The expression of some stem cell genes was studied by flowcytometry. These cells were then subjected to odontoblast by using the bone morphogenetic proteins-2 (BMP2) growth factor in the differentiation medium and for the expression of their specific genes. Primers of collagen type-I, dentin sialophosphoprotein (DSPP) and alkaline phosphatase (ALP) were used and the percentage of differentiation to odontoblast cells in induction scaffolds was investigated using real-time PCR and immunohistochemistry methods. The results revealed a 6-fold increase in the expression of DSPP genes and collagen type-I, and a 2-fold increase in the expression of ALP in scaffold with BMP2 group compared to the scaffold as control group which according to the immunohistochemical test results, showed the extracted SHED to have been differentiated into dentin odontoblast-like cells. As a result, this scaffold can be used as a suitable substrate to apply in dentin tissue engineering.

Cytotoxicity assessment of polyhydroxybutyrate/chitosan/nano- bioglass nanofiber scaffolds by stem cells from human exfoliated deciduous teeth stem cells from dental pulp of exfoliated deciduous tooth.

BACKGROUND: The aim of this study was to compare the cytotoxicity and the biocompatibility of three different nanofibers scaffolds after seeding of stem cells harvested from human deciduous dental pulp. Given the importance of scaffold and its features in tissue engineering, this study demonstrated the construction of polyhydroxybutyrate (PHB)/chitosan/nano-bioglass (nBG) nanocomposite scaffold using electrospinning method. MATERIALS AND METHODS: This experimental study was conducted on normal exfoliated deciduous incisors obtained from 6-year-old to 11-year-old healthy children. The dental pulp was extracted from primary incisor teeth which are falling aseptically. After digesting the tissue with 4 mg/ml of type I collagenase, the cells were cultured in medium solution. Identification of stem cells from human exfoliated deciduous teeth was performed by flowcytometry using CD19, CD14, CD146, and CD90 markers. Then, 1 × 104 stem cells were seeded on the scaffold with a diameter of 10 mm × 0.3 mm. Cell viability was evaluated on days 3, 5, and 7 through methyl thiazol tetrazolium techniques (P < 0.05) on different groups that they are groups included (1) PHB scaffold (G1), (2) PHB/chitosan scaffold (G2), (3) the optimal PHB/chitosan/nBG scaffold (G3), (4) mineral trioxide aggregate (MTA), and (5) the G3 + MTA scaffold (G3 + MTA). Data were analyzed with two-way ANOVA at significance level of P < 0.05. RESULTS: The results indicated that the PHB/chitosan/nBG scaffold and PHB/chitosan/nBG scaffold + MTA groups showed significant difference compared with the PHB/chitosan scaffold and PHB scaffold groups on the 7th day (P < 0.05). CONCLUSION: Thus, it can be concluded that the scaffold with nBG nanoparticles is more biocompatible than the other scaffolds and can be considered as a suitable scaffold for growth and proliferation of stem cells.

Effect of Intracanal Irrigants on Coronal Fracture Resistance of Endodontically Treated Teeth Undergoing Combined Bleaching Protocol: An In Vitro Study.

OBJECTIVES: Irrigation plays a critical role in endodontic treatment. Various single and combined irrigants and irrigation protocols are available. The aim of this study was to evaluate the effect of some common irrigation protocols on the coronal fracture resistance of endodontically treated teeth undergoing bleaching. MATERIALS AND METHODS: After preparation of access cavities in 120 maxillary premolars, the teeth were divided into five groups (n=24) based on the irrigation protocol; G1:2.5% sodium hypochlorite (NaOCl), G2: 2% chlorhexidine (CHX), G3: NaOCl+CHX, G4: NaOCl+ethylenediaminetetraacetic acid (EDTA), G5: NaOCl+EDTA+CHX. Each group was subdivided into 2 subgroups of A: non-bleached (NB) and B: bleached (B). In subgroup B, the teeth underwent in-office and at-home bleaching techniques using 38% hydrogen peroxide and 20% carbamide peroxide gels for 3 weeks. The teeth were restored with composite resin, thermocycled, incubated for 24 hours, and underwent fracture resistance tests. Data were analyzed with one-way analysis of variance (ANOVA) and t-test (α=0.05). RESULTS: T-test showed significant differences between every two corresponding groups (P<0.0001). In subgroup A, the minimum fracture resistance was recorded in G1. Also, G2 specimens exhibited a significantly higher fracture resistance compared to G1, G4, and G5. In subgroup B, G2 specimens exhibited a significantly higher fracture resistance compared to G1 and G4 that were irrigated using NaOCl and NaOCl+EDTA. CONCLUSIONS: It can be concluded that irrigation protocols can affect the coronal fracture resistance of bleached endodontically treated teeth, and specific irrigation protocols can be recommended for teeth undergoing bleaching.

Effect of Delayed Light-Curing Through a Zirconia Disc on Microhardness and Fracture Toughness of Two Types of Dual-Cure Cement.

OBJECTIVES: Photopolymerization immediately sets dual-cure cements and prevents the continuation of chemical polymerization. Delayed light-curing allows the chemical process to continue up to the point before starting irradiation; however, there is a controversy in this respect. The present study evaluates the effect of delayed light-curing through a zirconia disc on the microhardness and fracture toughness (KIC) of two types of dual-cure cement. MATERIALS AND METHODS: Samples measuring 25×5×3 mm3 were prepared for fracture toughness test, and discs measuring 5 mm in diameter and 3 mm in thickness were prepared for microhardness test using Bifix and BisCem cements. Light-curing protocols were as follows: immediate light-curing (group A), a 2-minute delay (group B), a 5-minute delay (group C), direct irradiation (group D), and no irradiation (group E). In groups A to C, light-curing was carried out through a zirconia disc. Data were analyzed by two-way and one-way analysis of variance (ANOVA), post-hoc Tukey's test, and Kruskal-Wallis test at 95% confidence interval. RESULTS: There was a significant difference in the microhardness of the cements (P=0.00). Delayed light-curing had no effect on microhardness (P=0.080). The microhardness of BisCem in group E was significantly lower than that in group D (P=0.015). The fracture toughness of Bifix in groups B and C was significantly different than that in group E and BisCem groups. CONCLUSIONS: Under the limitations of our study, delayed light-curing had different effects on microhardness and fracture toughness. Differences in light-curing protocols resulted in different effects based on the cement type. Light-curing is recommended to achieve optimal mechanical properties.

Tissue engineering: Dentin - pulp complex regeneration approaches (A review).

Dental pulp is a highly specialized tissue that preserves teeth. It is important to maintain the capabilities of dental pulp before a pulpectomy by creating a local restoration of the dentin-pulp complex from residual dental pulp. The articles identified were selected by two reviewers based on entry and exit criteria. All relevant articles indexed in PubMed, Springer, Science Direct, and Scopus with no limitations from 1961 to 2016 were searched. Factors investigated in the selected articles included the following key words: Dentin-Pulp Complex, Regeneration, Tissue Engineering, Scaffold, Stem Cell, and Growth Factors. Of the 233 abstracts retrieved, the papers which were selected had evaluated the clinical aspects of the application of dentin-pulp regeneration. Generally, this study has introduced a new approach to provoke the regeneration of the dentin-pulp complex after a pulpectomy, so that exogenous growth factors and the scaffold are able to induce cells and blood vessels from the residual dental pulp in the tooth root canal. This study further presents a new strategy for local regeneration therapy of the dentin-pulp complex. This review summarizes the current knowledge of the potential beneficial effects derived from the interaction of dental materials with the dentin-pulp complex as well as potential future developments in this exciting field.

Prevention and Treatment of White Spot Lesions in Orthodontic Patients.

Decalcification of enamel, appearing as white spot lesions (WSLs), around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence.

Comparison of the Dentin Bond Strength of Two Self-Etch Adhesives After Prolonged Air-Drying and Additional Light-Curing.

OBJECTIVES: It has been reported that the water, solvents, or the primer incorporated into adhesive resins decrease the polymerization, compromise the mechanical properties, reduce the bond strength, and lead to a poor bonding performance of self-etch adhesives. This article evaluated the effect of air-drying and light-curing duration of self-etch adhesives on the micro-shear bond strength between composite resin and dentin. MATERIALS AND METHODS: A total of 120 extracted sound human third molars were randomly divided into twelve groups (n=10). The occlusal dentin in each tooth was exposed. Clearfil SE Bond (CSEB) and Clearfil S3 Bond (CS3B) were used according to the manufacturer's instructions, followed by air-drying for 3 and 10 seconds in different groups. The adhesives were light-cured for 10, 20 and 40 seconds in different subgroups. Next, the composite resin (Clearfil AP-X) was placed on the dentin surface and was polymerized for 40 seconds. The micro-shear bond strength values were determined using a universal testing machine, and the results were statistically analyzed by three-way ANOVA and Tukey's post-hoc test (α=0.05). RESULTS: CSEB exhibited a significantly higher dentin bond strength than CS3B. Increasing the curing time of CSEB resulted in an increase in the bond strength, whereas an increase in the air-drying time did not affect the bond strength of the two adhesives. CONCLUSIONS: Within the limitations of this study, an increase in the curing time improved the bond strength of CSEB, whereas the air-drying time did not affect the bond strength of the evaluated adhesives.

Influence of Intracanal Irrigants on Coronal Fracture Resistance of Endodontically Treated and Bleached Teeth: An In vitro Study.

BACKGROUND: Irrigation has a key role in the success of endodontic treatment. Intracanal irrigant solutions have adverse effects on the physical properties of dentin. AIM: The present study aimed to evaluate the effect of different irrigation protocols on coronal fracture resistance of endodontically treated teeth undergoing bleaching treatment. DESIGN AND MATERIALS AND METHODS: Access cavities were prepared in 120 maxillary premolars which were divided into two groups (n = 60) - Group A: nonbleached, Group B: bleached (B). Each group was subdivided into five subgroups based on irrigation protocol (n = 12); G1: normal saline (NS), G2: 2.5% sodium hypochlorite (NaOCl), G3: 10% citric acid (CA), G4: 17% ethylene diamine tetra acetic acid, and G5: NaOCl plus CA. In Group B, the teeth were bleached using 38% hydrogen peroxide and 20% carbamide peroxide gels as in-office and at-home bleaching techniques for 3 weeks. All the teeth were restored with composite resin, thermocycled, and incubated for 24 h. The specimens underwent fracture resistance tests. Data were analyzed with ANOVA, Tukey honestly significant difference test, t-test, and Chi-squared test (α =0.05). RESULTS: T-test showed significant differences between each two corresponding subgroups (P < 0.0001). In Group A, NS demonstrated significantly higher fracture resistance compared to others; however, minimum fracture resistance recorded in G2. In Group B, the maximum fracture resistance was recorded in G1, with the minimum being recorded in G5. Samples irrigated with NaOCl and NaOCl plus CA exhibited significantly lower fracture resistance compared to NS subgroup (P < 0.05). CONCLUSIONS: Within the limitations of this study, it can be concluded that the irrigation protocol used during endodontic treatment with/without bleaching can affect the coronal fracture resistance.

Comparison of immediate and delayed light-curing on nano-indentation creep and contraction stress of dual-cured resin cements.

STATEMENT OF PROBLEM: Polymerization protocol of dual-cured resin cements plays a great role in the success of restorations. Knowledge about the effect of light-curing protocol on the contraction stress value and the mechanical properties would assist in the development, selection and handling of the resin cement material. PURPOSE: This study was undertaken to assess the effects of two different light-curing protocols on the polymerization shrinkage stress and nano-creep of two current dual-cured resin cements. MATERIALS AND METHODS: Twenty-four soda-lime glass disks, measuring 1mm in thickness, with a perforation in their center that measured 3mm in diameter, received four Vickers indentations at a distance of 500µ from the margin. The indent cracks were measured before and at 15-, 30- and 60-min intervals after restoration of the cavity with either CLEARFIL™ SA or RelyX™ Ultimate cement. Twelve specimens were prepared from each resin cement and divided into two groups according to the curing protocol used: immediate and delayed light-curing. Stresses at the indent impression were calculated by considering glass fracture toughness and the increase in crack length. Stress at the bonded interface was calculated using the Lame equation for thick-walled cylinder under an internal pressure. Nano-indentation hardness, modulus of elasticity and creep of each cement were measured under a 10-mN load for 20s holding time. The specimens were stored in distilled water at 37°C for 24h before the nano-indentation tests. Data were analyzed with two-way and repeated-measures ANOVA (α≤0.05). RESULTS: Curing protocol had a significant effect on both resin cements; higher stress values were recorded with the immediate curing mode (P=0.033). Curing mode did not exert a significant effect on the modulus of elasticity (P=0.595) and hardness (P=0.454) of resin cements. However, in relation to creep, it exhibited significant effects (P<0.0001). CONCLUSIONS: Immediate light-curing resulted in higher polymerization stress and lower nano-creep values compared to the delayed protocol with the resin cements assessed.

Effect of three nanobiomaterials on microhardness of bleached enamel.

OBJECTIVES: The aim of this in vitro study was to evaluate the effect of incorporating three different nanobiomaterials into bleaching material on microhardness of bleached enamel. MATERIALS AND METHODS: The crowns of 24 extracted sound human molars were sectioned. Sixty enamel specimens (2 × 3 × 4 mm) were selected and divided into five groups (n = 12): Group 1 received no bleaching procedure (control); Group 2 underwent bleaching with a 40% hydrogen peroxide (HP) gel; Groups 3, 4, and 5 were bleached with a 40% HP gel modified by incorporation of bioactive glass (BAG), amorphous calcium phosphate (ACP) and hydroxyapatite (HA), respectively. The enamel microhardness was evaluated. The differences in Knoop microhardness data of each group were analyzed by one-way ANOVA, followed by post hoc Tukey tests. RESULTS: Significant differences were observed between the study groups. The enamel microhardness changes in Groups 1, 3, 4, and 5 were significantly lower than that of Group 2 (p < 0.001). CONCLUSIONS: Within the limitations of this study, it can be concluded that incorporation of each one of the three tested biomaterials as remineralizing agents might be effective in decreasing enamel microhardness changes subsequent to in-office bleaching.

Composite resin bond strength to caries-affected dentin contaminated with 3 different hemostatic agents.

Bonding of composite resins to sound and caries-affected dentin in cervical areas may necessitate the use of hemostatic agents to control sulcular fluid and hemorrhage. The aim of this in vitro study was to evaluate the bond strengths of a self-etching adhesive system to sound and caries-affected dentin after the use of 3 different hemostatic agents. Composite resin cylinders were bonded to 48 caries-affected and 48 sound dentin surfaces in 8 groups. Groups 1-4 utilized caries-affected dentin: group 1, uncontaminated control; 2, ViscoStat; 3, ViscoStat Clear; and 4, trichloroacetic acid (TCA). Groups 5-8 utilized sound dentin: group 5, uncontaminated control; 6, ViscoStat; 7, ViscoStat Clear; and 8, TCA. The hemostatic agents were applied for 2 minutes and rinsed. After 500 rounds of thermocycling, shear bond strength tests were carried out. Data were analyzed with 1- and 2-way analyses of variance, t test, and post hoc Tukey tests at a significance level of P < 0.05. Bond strength was significantly influenced by dentin type (F = 38.23; P = 0.0001) and hemostatic agent (F = 6.32; P = 0.001). Furthermore, groups 2 and 6 (ViscoStat) showed significantly lower bond strength values than the control groups (groups 1 and 5) in both affected and sound dentin (P = 0.043 and P = 0.009, respectively). Within the limitations of this study, the bond strength of composite resin to caries-affected dentin was significantly reduced compared to that with sound dentin. Among the studied hemostatic agents, ViscoStat resulted in a greater decrease in dentin bond strength. Contamination of both sound and caries-affected dentin with hemostatic agents decreased composite resin bond strength. Of the 3 hemostatic agents used, ViscoStat Clear appeared to have the least detrimental effect on bond strength.

Effect of root canal rinsing protocol on dentin bond strength of two resin cements using three different method of test.

BACKGROUND: Different studies have used different tests to evaluate bond strength of resin cements to root dentin. In this in vitrostudy, three different tests were used to evaluate the bond strength of two resin cements to root dentin using two root dentin irrigation protocols. MATERIAL AND METHODS: Ninety-six intact single-rooted teeth were selected for this study. Forty-eight teeth, with a root length of 15mm, were randomly divided into two groups and irrigated with normal saline or 2.5% sodium hypochlorite solutions during root canal preparation, respectively. For each 12 specimens from each group, fiber post #1 was bonded using an etch-and-rinse (Duo-Link) and a self-adhesive (BisCem) resin cement, respectively. After incubation, two specimens were prepared for the push-out test from the middle thirds of the roots. In another 24 teeth, after two 1.5-mm sections were prepared from the middle thirds of the prepared roots, sections of the post were bonded in two subgroups with each of the cements mentioned above and the samples were prepared for the pull-out test. For shear test, the crowns of 48 teeth were cut away, the dentin surfaces were prepared, the two irrigation solutions were used, and the resin cements were bonded. Data collected from the three tests were evaluated by ANOVA, post-hoc Tukey and Weibull tests (α=0.05). RESULTS: There were significant differences in the mean bond strength values between the three bond strength tests (P<0.001). Rinsing protocol and cement type resulted in similar variations in the mean bond strength in all tests (P>0.05). CONCLUSIONS: Under the limitations of the present study, the method of the test used had an effect on the recorded bond strength between the resin cement and root dentin. Cement type and irrigation protocol resulted in similar variations with all the tests. Push-out and shear tests exhibited more coherent results. KEY WORDS: Bond strength, endodontically treated tooth, fiber post, resin cement, sodium hypochlorite.

Fracture toughness of bleached enamel: Effect of applying three different nanobiomaterials by nanoindentation test.

BACKGROUND: Despite the absence of dispute about the efficacy of bleaching agents, a prime concern is about their compromising effect on the enamel structure. This in vitro study investigated whether the addition of three different biomaterials, including nano-bioactive glass (n-BG)/nano-hydroxy apetite (n-HA)/nano-amorphous calcium phosphate (n-ACP), to bleaching agents can affect the fracture toughness (FT) and vickers hardness number (VHN) of bovine enamel. MATERIALS AND METHODS: The crowns of the newly extracted permanent bovine incisors teeth were separated from the root and sectioned along their central line; one half serving as the control specimen and the other half as the test specimen. After mounting and polishing procedure, all the control specimens (C) were subjected to nano-indentation test to obtain the baseline values of FT. Then, the control specimens were exposed to a 38% hydrogen peroxide for four times, each time for 10 min. The test specimens were divided into three groups and treated as follows, with the same protocol used for the control specimens: Group 1; ACP + hydrogen peroxide (HP) mixed gel; Group 2 BG + HP mixed gel; and Group 3 HA + HP mixed gel. FT measurements with nano-indentation were carried out subsequent to bleaching experiments. Data were analyzed using SPSS and Kruskal-Wallis test (α = 0.05). RESULTS: A significant difference in young's modulus (YM), VHN, and FT at baseline and subsequent to bleaching in control group was observed. However, no significant differences were found in YM, VHN, and FT between the test groups, compared to the respective baseline values. CONCLUSION: Under the limitations of the current study, it can be concluded that the n-HA, n-ACP, and n-BG could be potential biomaterials used to reduce the adverse effects of tooth bleaching.