A randomized five-year clinical study of a two-step self-etch adhesive with or without selective enamel etching.

The purpose of this study was to evaluate the five-year clinical performance of a two-step self-etch adhesive in non-carious cervical sclerotic lesions with or without selective acid-etching of enamel margins. A total of 104 cervical restorations in 22 patients (46-64 years) were bonded following either self-etch approach (AdheSE non-etch) or a similar application, including selective acid-etching of enamel margins (AdheSE etch), and were restored with resin composite. The restorations were evaluated at baseline and after one, two, three and five-years (84 restorations in 19 patients) according to the USPHS criteria. Data were analyzed using McNemar's test. Cumulative retention rates for the non-etch and etch groups were 82.6% and 86.1% respectively. No significant differences were detected in the retention rates, marginal adaptations at dentin side and secondary caries between the groups. After five-years, the clinical performance of the two-step self-etch adhesive with or without selective acid-etching of enamel margins, was acceptable.

The effect of prophylactic polishing pastes on surface roughness of indirect restorative materials.

The purpose of this study was to evaluate the influence of prophylactic polishing pastes (PPP; Detartrine (DT), Topex (TP)) on surface roughness (R(a)) of indirect composites (IRC; Tescera (TES), Gradia (GRD), and Estenia C&B (EST)), a glass ceramic (Empress 2 layering (E2)), and a leucite reinforced glass ceramic (Empress Esthetic (EE)) with two different (glazed (G); polished (P)) surface preparations. A total of 90 IRC and 120 ceramic discs, 8 mm in diameter and 2 mm thick, were prepared. E2 and EE specimens were randomly divided into two groups (n = 30). One group was glazed (GE2; GEE), while the other group was polished (PE2; PEE) the same as the IRCs. The specimens in each group were subsequently divided into three subgroups: control (C), DT, and TP. R(a) (µm) was evaluated with a profilometer. Data were analyzed by Kruskal Wallis, followed by the Dunn's multiple comparison tests (P < 0.05). DT and TP resulted in significant surface roughening for TES, GRD, and EST, while no significant differences were detected between DT and TP (P > 0.05). PE2 and PEE were not affected by DT or TP (P > 0.05), while GE2 and GEE exhibited significant roughening after TP (P < 0.05). Surface roughness of IRCs and glazed ceramics can be affected by PPP applications.

Surface roughness and morphology of resin composites polished with two-step polishing systems.

The purpose of this study was to investigate surface roughness (Ra) and morphology of supra-nanofilled [Estelite Omega (EO), Estelite ∑ Quick (EQ)], micro-hybrid [Esthet.X HD (EHD), G-aenial (GAE)] and nano-hybrid [Clearfil Majesty Posterior (CMP), Charisma Diamond (CD), Beautifil II (BII)] composites polished with two-step polishing systems [Enhance/PoGo (EP); Venus Supra (VS)]. Composite discs, 30 of each type, were prepared. Each composite group was divided into three subgroups: Mylar (control), EP and VS. Ra was evaluated with profilometer. In each composite group, the control had the lowest Ra. With both polishing systems, EO and EQ had significantly the lowest Ra, whereas CMP and BII had the highest. Except for GAE, CD and BII, the differences in Ra between EP and VS in each composite group were significant, showing smoother surfaces for EP. Supra-nanofilled composites created smoother surfaces than nano-hybrids, and their performance was similar or slightly better than that of micro-hybrids.

Three-year clinical evaluation of a two-step self-etch adhesive with or without selective enamel etching in non-carious cervical sclerotic lesions.

OBJECTIVE: The purpose of this prospective, controlled, randomized study was to evaluate the 3-year clinical performance of a two-step self-etch adhesive (AdheSE, Ivoclar Vivadent; Schaan, Liechtenstein) in non-carious cervical sclerotic lesions with or without selective acid-etching of the enamel margins. MATERIAL AND METHODS: Twenty-two patients (mean age 51.5) having at least two pairs of non-carious cervical sclerotic erosion/attrition/abfraction lesions with incisal or occlusal margins in the enamel and gingival margins in the dentin were included in the study. The two-step self-etch adhesive was applied following either the self-etch approach (AdheSE non-etch, n = 52) or a similar application approach, including prior selective acid-etching of the enamel margins (AdheSE etch, n = 52). Composite resin Point 4 (Kerr Corp; Orange, CA, USA) was used as the restorative material for all 104 restorations. The restorations were evaluated at baseline and after 1, 2, and 3 years, according to the modified USPHS criteria. Data were analyzed using McNemar's test (p < 0.05). RESULTS: The retention rates for AdheSE non-etch were 100 %, 98 %, and 91.5 %; whereas, 100 %, 100 %, and 97.9 % retention rates were recorded for AdheSE etch after 1, 2, and 3 years, respectively. No significant differences were detected between the retention rates, marginal adaptation at the dentin side, secondary caries, and postoperative sensitivity (p > 0.05). A significantly higher number of restorations in AdheSE non-etch group showed clinically acceptable slight marginal discoloration (p = 0.0001) and clinically acceptable small marginal defects at the enamel side (p = 0.008) than in the AdheSE etch group. CONCLUSIONS: After 3 years, the two-step self-etch adhesive exhibited acceptable clinical performance with or without selective enamel etching in non-carious cervical sclerotic lesions. CLINICAL RELEVANCE: Selective acid-etching of the enamel margins enhanced the performance of the two-step self-etch adhesive in terms of marginal discoloration and marginal adaptation at the enamel side.

Shear bond strength of resin cement to an acid etched and a laser irradiated ceramic surface.

PURPOSE: To evaluate the effects of hydrofluoric acid etching and Er,Cr:YSGG laser irradiation on the shear bond strength of resin cement to lithium disilicate ceramic. MATERIALS AND METHODS: Fifty-five ceramic blocks (5 mm × 5 mm × 2 mm) were fabricated and embedded in acrylic resin. Their surfaces were finished with 1000-grit silicon carbide paper. The blocks were assigned to five groups: 1) 9.5% hydrofluoric-acid etching for 60 s; 2-4), 1.5-, 2.5-, and 6-W Er,Cr:YSGG laser applications for 60 seconds, respectively; and 5) no treatment (control). One specimen from each group was examined using scanning electron microscopy. Ceramic primer (Rely X ceramic primer) and adhesive (Adper Single Bond) were applied to the ceramic surfaces, followed by resin cement to bond the composite cylinders, and light curing. Bonded specimens were stored in distilled water at 37℃ for 24 hours. Shear bond strengths were determined by a universal testing machine at 1 mm/min crosshead speed. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests (α=0.05). RESULTS: Adhesion was significantly stronger in Group 2 (3.88 ± 1.94 MPa) and Group 3 (3.65 ± 1.87 MPa) than in Control group (1.95 ± 1.06 MPa), in which bonding values were lowest (P<.01). No significant difference was observed between Group 4 (3.59 ± 1.19 MPa) and Control group. Shear bond strength was highest in Group 1 (8.42 ± 1.86 MPa; P<.01). CONCLUSION: Er,Cr:YSGG laser irradiation at 1.5 and 2.5 W increased shear bond strengths between ceramic and resin cement compared with untreated ceramic surfaces. Irradiation at 6 W may not be an efficient ceramic surface treatment technique.

Influence of a prophylaxis paste on surface roughness of different composites, porcelain, enamel and dentin surfaces.

OBJECTIVE: To investigate the effect of a prophylaxis paste on surface roughness of different composites, enamel, dentin and porcelain surfaces. METHODS: Three different composites (FiltekZ250/Group1, Filtek Supreme XT/Group2, Premise/Group3), enamel/Group4, dentin/Group5 and porcelain/Group6 samples were used in this study. All specimens were prepared flat by SiC discs and polished with a diamond polishing paste. The surface roughness measurements were determined with a profilometer after polishing (initial surface roughness). Prophylaxis paste was applied to the samples for 12 seconds, renewing every 6 seconds. After cleaning the samples, roughness values were measured again. Data were analyzed by Kruskal Wallis and Dunn's multiple comparison test. Wilcoxon test was performed for the comparison of the initial and final surface roughness values (P<.05). The results were evaluated within the P<.05 confidence level. RESULTS: The initial and final surface roughness values (µm) were determined as follows: Group1: 0.039±0.009 and 0.157±0.018, Group2: 0.023±0.005 and 0.145±0.027, Group3: 0.028±0.008 and 0.109±0.012, Group4: 0.024±0.006 and 0.071±0.015, Group5: 0.030±0.007 and 0.143±0.029, Group6: 0.024±0.006 and 0.064±0.014. Significant difference was determined between the initial and final values for all groups. CONCLUSIONS: Composite and dentin surfaces were more affected by the application of prophylaxis paste than enamel and porcelain surfaces. The prophylaxis paste increased the surface roughness of all groups, but did not reach the bacterial retention roughness rate of 0.2µm.

Effect of bleaching on microhardness of esthetic restorative materials.

This study evaluated the effect of a high-concentration carbamide peroxide­containing home bleaching system (Opalescence PF) and a hydrogen peroxide­containing over-the-counter bleaching system (Treswhite Supreme) on the microhardness of two nanocomposites (Filtek Supreme XT and Premise) and leucite-reinforced glass ceramic (Empress Esthetic), glass ceramic (Empress 2 layering), and feldspathic porcelain (Matchmaker MC). A total of 100 specimens, 20 of each kind of the restorative materials, 2 mm in thickness and 10 mm in diameter, were fabricated. Then the specimens were polished with SiC paper and 1 µm alumina polishing paste. After polishing, porcelain specimens were glazed in accordance with the manufacturer's instructions. Each type of restorative material was then randomly divided into two groups (n=10), and the specimens were treated with either Opalescence PF or Treswhite Supreme. The microhardness of the specimens before bleaching (baseline) and after bleaching was determined using a digital microhardness tester. Data were analyzed using the Mann-Whitney U-test and the Wilcoxon test. Opalescence PF significantly influenced the hardness of all the restorative materials. Statistically significant decreases with respect to before bleaching were found for Premise (p=0.005), Empress Esthetic (p=0.003), Empress 2 layering (p=0.005), and Matchmaker-MC (p=0.003), whereas a statistically significant increase was observed in Filtek Supreme XT (p=0.028). The difference in the microhardness values between before and after bleaching using Treswhite Supreme was statistically significant only for Premise (p=0.022). High-concentration carbamide peroxide­containing home bleaching may affect the microhardness of restorative materials.

Long-term provisional anterior tooth replacement using fiber-reinforced composite and avulsed tooth crowns as pontics.

The loss of anterior teeth due to trauma requires immediate attention for function and esthetics. While implant- supported or conventional fixed prostheses may be the treatments of choice for adults, relatively noninvasive and reversible provisional procedures for tooth replacement are necessary for adolescents. In recent years, developments in fiber and composite technology offer a conservative treatment approach to restore the anterior edentulous space as a fixed provisional tooth replacement. This case report presents the chairside procedures of anterior tooth replacement in an adolescent using the avulsed tooth crowns as pontics which were bonded to teeth on either side of the edentulous space and reinforced with a preimpregnated fiber.

The effect of endodontic irrigants on the microtensile bond strength of dentin adhesives.

INTRODUCTION: The purpose of this study was to evaluate the microtensile bond strength of a total etch (XP-Bond) and a self-etch (Clearfil SE Bond) adhesive system to dentine surfaces treated using endodontic irrigants. METHODS: Twenty-four freshly extracted third molars were used. After creating a smear layer on the coronal midthird portion of the crowns, the teeth were divided into three groups and surfaces were irrigated with distilled water, 5.25% NaOCl + 17% EDTA, and 1.3% NaOCl + BioPure MTAD, respectively. Each group was divided into two subgroups, and a self-etching adhesive and an etch-and-rinse adhesive were applied respectively. The teeth were restored with a composite material and sectioned to produce sticks for microtensile bond testing. RESULTS: The microtensile bond strength of the MTAD + Clearfil SE group was found to be significantly lower than the microtensile bond strength of the distilled water + Clearfil SE Bond group and the NaOCl, EDTA, + Clearfil SE Bond group (p = 0.0001, p = 0.009). CONCLUSIONS: Because of the significant reduction of Clearfil SE Bond to coronal dentine after MTAD application, an etch-and rinse adhesive such as XP-Bond may be preferred if this irrigant has been chosen during endodontic treatment.

Endodontic and surgical management of a maxillary lateral incisor with type III dens invaginatus: a 12-month follow-up.

This article reports the endodontic and surgical management and 12-month follow-up of a maxillary lateral incisor diagnosed as type III dens invaginatus. A 21-year-old male patient presented to our clinics with complaints of pain and swelling in the right maxillary region. Intraoral and radiographical examination disclosed the presence of a peg-shaped maxillary right lateral incisor diagnosed as type III dens invaginatus. Root canal treatment combined with periapical surgery was initiated. After the completion of root canal treatment for both maxillary right central and lateral incisors, periapical surgery was scheduled. During the surgery, periapical granulation tissue was curreted and bovine-derived hydroxil apatite (Unilab-Surgibone, Mississauga, Ontario, Canada) covered with collagen membrane (Unilab-Surgibone) was placed in the resorptive areas. ProRoot MTA (Dentsply, Tulsa, OK) was placed as a root end filling material. Postoperative 12-month follow-up revaled a satisfactory healing process.