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This study evaluated bond strength of glass fiber posts to root dentin using push‐out (PO) and diametral compression (DC), testing glycolic acid as a conditioner and varying dentin moisture. An additional aim was to test whether DC can be an alternative test to PO for bond strength assessment. Eighty bovine teeth were divided into eight groups (n = 10) defined by the use of either 37% glycolic acid or 37% phosphoric acid (PA) on moist or wet dentin before bonding with either Adapter SingleBond/RelyX ARC or One Step Plus/Duo‐Link Bisco. Each tooth provided discs with an internal diameter of 2 mm, external diameter of 5 mm, and height of 2 mm, which underwent PO and DC. Finite element analysis (FEA) was carried out on 3D models. When analyzing PO results through linear regression, the highest values of bond strength were observed using glycolic acid on wet dentin in the cervical and middle thirds of the teeth. Analyzing DC results, the only statistical influence on values was the dental thirds. The scatterplot of the DC results and the PO bond strength values indicated no relationship between the results of the two tests (r = 0.03; p = 0.64). PO test detected more sensitive changes in bond strength values than DC. [ABSTRACT FROM AUTHOR]

Objective: Sodium hypochlorite solution (NaOCl) is an effective canal irrigant but interferes with the mechanical features of dentin and the bonding capability of adhesives when restoring endodontically treated teeth. This study evaluated whether access cavity resin sealing before using canal irrigant would augment the resistance of endodontically treated anterior teeth against fracture. Methods: Sixty maxillary incisors underwent endodontic treatment in five groups (n = 12). Irrigation with 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) was performed in all groups except for Group 5. After root canal obturation, in Group 1, the access cavity was kept unrestored. In Group 2, immediate restoration after obturation was achieved. For Group 3, delayed restoration after 1 week was provided. In Group 4 (pre‐sealed), before canal irrigation, the dentin surface of access cavities was sealed using self‐adhesive composite resin (Vertise Flow) and then restored after obturation. In Group 5, which was saline irrigated, immediate restoration was performed. After storage and thermal cycling for 5000 cycles at 5°C–55°C with a dwell time of 15 s and a transfer time of 5 s, teeth were statically loaded by a universal testing machine until a fracture occurred. Data were collected as the fracture resistance (FR) and analyzed using the one‐way analysis of variance and Tukey's tests. Results: FR significantly differed between all groups (p < 0.001). The lowest FR was recorded in the unrestored group (284 ± 86 N), which was not statistically different from the immediately restored group (p = 0.065). The pre‐sealed group exhibited the highest FR value (810 ± 127 N, p ≤ 0.02 vs. other groups). The FR of the saline‐irrigated and delayed restored groups was almost similar (p = 0.13). Conclusions: NaOCl/EDTA irrigation resulted in an adverse effect on FR. Delayed restoration could reduce this adverse effect. Access cavity pre‐sealing with flowable composites led to a higher FR than conventional methods and may be considered an effective step during treatment procedures. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusions Clinical Significance To assess the clinical performance of two composite materials with two universal adhesives and a two‐step self‐etch adhesive on class II restorations for 18 months.Two hundred and fifty‐two class II cavities were bonded with G‐Premio Bond, Single Bond Universal, and Clearfil SE Bond 2. A nanohybrid composite (Filtek Z550 Universal) or a microhybrid composite (G‐aenial Posterior) was used to fill the bonded cavities. World Dental Federation criteria were used to evaluate the restorations at 1 week, 6, and 18 months. Statistical analysis was performed using Friedman and Fisher's exact tests (α = 0.05).Retention loss and fracture were not observed in any restorations during the 18 months. The adhesives used showed no significant differences for all criteria examined (p > 0.05) regardless of composite material. After an 18‐month follow‐up, seven G‐aenial Posterior and three Filtek Z550 Universal restorations presented slight marginal discrepancies, with no significant differences (p = 0.246). At 1 week, Filtek Z550 Universal (9.5%) led to significantly higher postoperative sensitivity compared with G‐aenial Posterior (0.8%) (p = 0.001).Universal adhesives showed similar clinical performance to Clearfil SE Bond 2. The restorations with Filtek Z550 Universal had a relatively higher risk of postoperative sensitivity.Universal adhesives were clinically successful for 18 months. At 1 week, the type of composite material used significantly affected the occurrence of postoperative sensitivity. [ABSTRACT FROM AUTHOR]

Aim Methodology Results Conclusions To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors.Twenty recently extracted and intact mandibular incisors were initially scanned using a micro‐CT device. The specimens were anatomically matched to create two groups (n = 10). A wedge‐shaped non‐carious cervical lesion (NCCL) was created on the buccal aspect of all teeth using a double‐faced segmented diamond disc. In group 1, a TradAC was prepared, whilst in group 2, access was created through the simulated NCCL using a round diamond bur 1012. After root canal preparation with Rotate instruments sizes 15/0.04, 20/0.04, and 25/0.04, the teeth were scanned again and evaluated for root canal volume and surface area, static voxels, volume of removed dental tissue, and dentine thickness. After that, the root canals were filled using the single‐cone technique, teeth were restored with composite resin, and subsequently rescanned to calculate the volume of filling materials and voids. Then, the restored teeth were subjected to fracture resistance tests using a universal testing machine. Statistical comparisons between groups were performed with the Mann–Whitney test or the Student's t‐test, with a statistical significance level of 5%.Statistical comparisons indicated no significant differences between groups in terms of root canal volume, surface area, static voxels, removed root dentine, root canal filling volume, percentage of voids, or fracture resistance load (p > .05). Conversely, teeth prepared with TradAC showed a significantly higher percentage of dental tissue removed from the crown (p = .001) and a greater volume of filling material remnants in the pulp chamber (p < .001) compared to the CervAC group. A significantly lower percentage reduction in dentine thickness was observed only on the mesial aspect of root at Level 1 in TradAC group (p = .008).CervAC can be considered a viable alternative approach in the presence of NCCL in mandibular incisors. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effects of different surface treatments on the repair bond strength between a fiber‐reinforced dentin composite and a posterior composite. Methods: Forty fiber‐reinforced dentin composite resin blocks (4 mm × 4 mm × 4 mm) were separated into eight groups (n = 5) according to the surface preparation methods: (G1) negative control group, (G2) adhesive application, (G3) 50% dimethylsulfoxide (DMSO) application, (G4) 50% DMSO + adhesive application, (G5) 37% phosphoric acid etch + adhesive application, (G6) air abrasion + adhesive application, (G7) 37% phosphoric acid etch + 50% DMSO application + adhesive application, and (G8) air abrasion +50% DMSO application + adhesive application group. The composite surfaces were repaired in two layers with a posterior composite. Composite sticks were subjected to a micro tensile bond strength (μTBS) test. Fractured surfaces were evaluated using a stereomicroscope (×25). Short fiber‐reinforced composite samples' surfaces were investigated by scanning electron microscope (SEM). Shapiro Wilk, one‐way ANOVA, and Tukey HSD tests were used for statistical evaluation. Results: The highest average (μTBS) values were observed in G8, whereas the lowest mean μTBS values were evident in the G1 group. Statistically significant μTBS values were found in all adhesive‐applied groups when compared with the negative control group. Notably, the application of 50% DMSO without adhesive did not lead to a statistically significant increase in μTBS values. SEM images demonstrated that acid etching partially eliminated residues on the composite surface, while air abrasion had a detrimental effect on the integrity of fiber structures. Conclusion: In the repair of fiber‐reinforced dentin composite with a posterior composite, adhesive application is an effective approach. The treatment of 50% DMSO without adhesive did not confer a statistically significant advantage, and the supplemental use of acid etch or air abrasion did not show an additional benefit compared to adhesive‐only repairs. Clinical Significance: Adhesive application emerges as a potent and effective strategy for the repair of bur‐roughened fiber‐reinforced dentin composites. With its limitations, the study highlights the efficacy of adhesive‐only repairs without the necessity for additional surface treatments. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of different hydrofluoric acid concentrations and etching times on the surface, chemical composition and microstructure of lithium disilicate. Material and Methods: Ninety specimens of pressed lithium disilicate (LDS) were obtained (IPS e.max Press, Rosetta SP and LiSi Press). The specimens of each material were divided in two groups according to the hydrofluoric acid concentration: 5% and 10% (n = 15/group), and subdivided according to the etching time: 20, 40 and 60 s (n = 5/group). Crystalline evaluations and chemical composition were performed through x‐ray diffraction (XRD) and energy‐dispersive x‐ray spectroscopy (EDS), respectively. Microstructural analyses were performed by scanning electron microscope (SEM), surface roughness (Ra), and material thickness removal evaluation. Thickness removal and Ra data were analyzed by ANOVA and Tukey test (p < 0.05). Results: XRD demonstrated characteristic peaks of lithium disilicate crystals, lithium phosphate and of a vitreous phase for all materials. EDS identified different compositions and SEM confirmed different surface responses to acid etching protocols. Material and etching time influenced Ra and material thickness removal (p < 0.05). Conclusion: Hydrofluoric acid concentration and etching time affect the surface characteristics of LDS differently. LiSi Press presented higher resistance to hydrofluoric acid etching compared to e.max Press and Rosetta SP. Clinical Significance: Applying the appropriate etching protocol is pivotal to avoid excessive material removal and to prevent jeopardize the mechanical and optical properties of the material. [ABSTRACT FROM AUTHOR]

Introduction: In a suitable condition, it is important to perform any dental restorative procedure using an operatory field isolated. Then, the aim of this study was to compare the bond strength of composite restorations to dentin affected by any contamination agent through a systematic review. Methods: This systematic review was performed following the PRISMA 2020 guidelines. The literature search was conducted until September 2022 by scanning the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts evaluated the bond strength of resin‐based materials to permanent human dentin contaminated with blood or saliva were selected for full‐text review. The risk of bias was assessed by the RoBDEMAT tool. Results: A total of 3750 papers resulted from the search from all databases. After the full‐text reading, a total of 62 articles remained for the qualitative analysis. The contamination agents used were blood, saliva, and hemostatic agents. A great variety of protocols were used to contaminate the dentin surface, and the contamination process occurred in several steps of the bonding process, including before and after the etching process, after the primer application and after the adhesive application. Also, several decontamination procedures were tested, including reapplication of the etching material, rinsing with water, chlorhexidine or sodium hypochlorite and reapplication of the adhesive system. Conclusion: Any contamination with blood or saliva impaired the bond strength of resin‐based materials to dentin. Decontamination procedures including water‐spray and reapplication of the bonding system could revert the impairment produced by the saliva or blood contamination. The use of hemostatic agents as a method of blood decontamination is not recommended. Clinical Significance: Clinicians should avoid contamination during a bonding procedure, otherwise, a reduction in the bond quality is expected. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of etch‐and‐rinse (ER) versus self‐etch (SE) strategies of a universal adhesive applied with a manual brush (MB) or rotary brush (RB) on the bonding interface of fiber post cementation. Methods: Forty bovine incisor roots were prepared and divided into four groups according to the methods of application and strategy of universal adhesive use (MB‐ER, RB‐ER, MB‐SE and RB‐SE). After 6 months, specimens from different thirds of the post space were evaluated of push‐out strength, analysis of adhesive failure patterns, and extent of tags. Results: The RB‐ER and RB‐SE groups showed the highest bond strength values in the cervical and middle thirds of the post space. Cohesive adhesive failure had the highest incidence in the different thirds of the post space in the ER strategy, regardless of the adhesive application method. The RB‐ER group showed the highest tag extensions. Conclusions: The protocols of universal adhesive application with RB provided the greater bond strength, but only the ER strategy favored the formation of a greater extension of tags at the adhesive interface. Clinical Significance: The application of universal adhesive with RB into the post space increases the strength of the post‐cemented fiber bond. [ABSTRACT FROM AUTHOR]

Background: This study introduced the root plastique technique (RPT), the aim of which is to modify the gingival phenotype of sites with gingival recessions (GRs) associated with Non-Carious Cervical Lesions (NCCLs) prior to surgical treatment.Methods: RPT was performed in 22 subjects with 53 RT1 A/B + GRs. Changes in keratinized tissue thickness (KTT), keratinized tissue width (KTW), relative gingival recession (RGR), relative clinical attachment level (RCAL) and probing pocket depth (PPD) were measured at baseline (T0) and 2 months (T1) after the procedure was performed. All analyses were performed by means of hierarchical models.Results: The study revealed statistically significant changes (p<0.01) in KTT (0.45 ± 0.04 mm), RGR (0.80 ± 0.13mm), KTW (0.67 ± 0.07mm), RCAL (-0.72 ± 0.16mm) and KTW (0.67 ± 0.07). No changes in PPD (p>0.05) were observed. Regression analyses of KTT increase and RGR reduction at T0 showed statistically significant correlation between the 2 variables (p<0.05). All the teeth with a KTT of <0.8mm at T0 (N = 14) reached or surpassed this threshold at T1.Conclusion: RPT increases KTT and KTW. In most of the sites, a reduction in GR was also achieved. This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]

Objective: The objectives of the study were to evaluate the survival rates for lower lingual retainers (LLRs) and to establish a correlation between patients' treatment‐related factors (age, sex, malocclusion, appliance used for treatment, teeth bonded, retention protocols) to the survival of LLRs. Materials and Methods: A total of 765 subjects [474 females and 291 males: mean age = 24.29 ± 10.67 years] between 2013 and 2022 were included. A customized data collection form was utilized to gather the data from the electronic health record (EHR) of subjects. Patient‐related factors, crowding or spacing, deep bite or open bite and duration of treatment were extracted from patients' files. Kaplan–Meier estimator was used for the survival function, whereas Cox proportional hazards regression models were used to associate risk factors with retainer survival. Results: 328 (42.9%) subjects had their LLRs failed, and the survival period was on average 17.37 ± 22.85 months. On the other hand, the follow‐up period for the retainers that did not fail was on average 47.19 ± 23.66 months. 192 (28.3%) subjects had segment failure (retainer detached from 3 teeth or less), while 51 (7.5%) subjects had failures in more than 3 teeth (complete). None of the evaluated clinical variables were significantly associated with LLRs failure except for the bite category (P =.013) and the appliance used for treatment (P <.001). Conclusion: Success rate for LLRs was 57.1% over 47.19 months, failure rate was 42.9% over 17.37 months. The presence of deep bite and treatment with aligners were significantly associated with increased failure rate. [ABSTRACT FROM AUTHOR]

Objectives: Our previous studies showed that strontium (Sr)‐modified sand‐blasted, large grit, acid etched titanium surface (Sr‐SLA) is beneficial for osseointegration; however, the supporting mechanisms have not been explored in detail. Materials and Methods: Whole‐transcriptome RNA sequencing of peri‐implant bone tissue was performed, and CDH2 was selected as a key mediator of Sr‐SLA‐mediated osseointegration. To test this hypothesis, a lentivirus‐mediated vector targeting the silencing of the CDH2 gene was used in mesenchymal stem cells (MSCs) prior to seeding on Ti substrates. The effects of CDH2 interference on MSCs vitality, differentiation, and β‐catenin signaling activity were evaluated. In vivo, a recombinant adeno‐associated virus 9 vector carrying an artificial siRNA that target CDH2 (AAV9‐CDH2i) was intravenously injected in mice, followed by tibial surgery with implant placement. Osseointegration were monitored using micro‐CT analysis. Results: CDH2 expression in MSCs on Sr‐SLA was higher than the control group, which was in parallel with the enhanced cell migration, adhesion, and upregulation of early osteogenic markers. Knocking down CDH2 in MSCs resulted in decreased cell viability and osteogenic differentiation, and the elevated biocompatibility and osteoinductive effect of Sr‐SLA were greatly diminished. Surprisingly, Sr‐SLA‐induced upregulation of CDH2 was not followed by restriction of β‐catenin signaling because Sr‐SLA also promoted the expression and nuclear translocation of β‐catenin. Systemic administration of AAV9‐CDH2i effectively knocked down CDH2 expression in bone marrow cells, and in turn, inhibited bone formation induced by Sr‐SLA. Conclusions: The results indicated that CDH2 is required for Sr‐SLA‐mediated bone regeneration, which reveals a new mechanism to explain the osteoinductive effect of Sr‐SLA. Thus, biomaterial modifications targeting CDH2 may help improve early osseointegration and bone healing. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of non‐thermal atmospheric pressure plasma on the bond strength of a universal adhesive used in etch‐and‐rinse mode. Dentin surfaces were etched with phosphoric acid and samples were divided into groups exposed to either dry bonding, plasma‐dried bonding, plasma‐dried and rewetted bonding, or wet bonding (n = 10). Dentin surfaces of the plasma‐dried specimens were treated with a plasma jet before the adhesive procedure. After application, composite blocks were built, and specimens were subjected to micro‐tensile bond strength testing after 24 h and after 10,000 thermal cycles. The hybrid layer formation was evaluated by micro‐Raman spectral analysis; the resin–dentin interface was analyzed by scanning electron microscopy. One‐way ANOVA and Tukey's post hoc multiple comparison tests were used to statistically analyze the data. The bond strength values of the plasma‐dried bonding groups were statistically higher than the non‐plasma‐treated groups both before and after aging. After the thermal cycles, bond strength values decreased significantly only in the wet bonding group. Micro‐Raman spectral analysis revealed that plasma‐drying increased adhesive penetration, especially hydrophobic monomer infiltration. This may increase the mechanical properties and durability of the resin–dentin interface, provide long‐term stability, and improve the polymerization rate of the adhesive layer. [ABSTRACT FROM AUTHOR]

Objectives: Debridement methods may damage implant surfaces. This in vitro study investigated eight debridement protocols across three implant surfaces to assess both biofilm removal and surface alterations. Material and Methods: One hundred sixty commercially pure titanium discs were treated to simulate commercially available titanium implant surfaces—smooth, abraded and abraded and etched. Following inoculation with whole human saliva to create a mixed species biofilm, the surfaces were treated with eight debridement methods currently used for clinical peri‐implantitis (n = 10). This included air abrasion using powders of glycine, sodium bicarbonate and calcium carbonate; conventional mechanical methods—piezoelectric scaler, carbon and stainless steel scalers; and a chemical protocol using 40% citric acid. Following treatment, remaining biofilm was analysed using scanning electron microscopy and crystal violet assays. For statistical analysis, ANOVA was applied (p < 0.05). Results: All debridement techniques resulted in greater than 80% reduction in biofilm compared with baseline, irrespective of the surface type. Glycine powder delivered through an air polishing system eliminated the most biofilm. Mechanical instruments were the least effective at eliminating biofilm across all surfaces and caused the greatest surface alterations. Citric acid was comparable with mechanical debridement instruments in terms of biofilm removal efficacy. Titanium surfaces were least affected by air abrasion protocols and most affected by mechanical methods. Conclusions: Mechanical protocols for non‐surgical debridement should be approached with caution. Glycine powder in an air polisher and 40% citric acid application both gave minimal alterations across all implant surfaces, with glycine the superior method in terms of biofilm removal. [ABSTRACT FROM AUTHOR]

This study compared different methods for cleaning the sealer‐contaminated access cavity of upper incisors. After standard endodontic access, the canals of 50 extracted maxillary incisors were chemomechanically prepared and obturated with gutta‐percha and epoxy resin sealer. Teeth were randomly assigned to one of five different pulp chamber cleaning protocols (n = 10): air/water spray, ethanol‐saturated cotton pellet (CP), ethanol‐saturated microbrush reaching the root filling (MB), MB + air polishing (PROPHYflex; KaVo), or MB + etching with 37% phosphoric acid. Each tooth was split and the sealer‐covered area of the pulp chamber was determined on images taken before and after cleaning using image analysis software. The sealer‐covered area was compared across groups using one‐way ANOVA. Greatest mean sealer‐covered area reduction was observed for MB + etching (98.0%), MB + air polishing (95.2%), and MB alone (92.8%), yielding a significantly higher sealer‐covered area reduction than after air/water spray (8.3%) and ethanol‐saturated cotton pellet (53.4%). The upper incisor access cavity is best cleaned with an ethanol‐saturated microbrush reaching up to the root filling, followed by air/water spraying and etching. The use of cotton pellets should be discouraged. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this clinical study was to evaluate the performance of two different adhesive resin cement systems in the cementation of inlay/onlay restorations produced from resin nanoceramic blocks using the CAD/CAM system. Materials and Methods: A total of 70 inlay/onlay restorations made from Cerasmart (GC, Tokyo, Japan) resin nanoceramic blocks using CEREC Omnicam (Sirona Dental, Bensheim, Germany) were placed in 53 patients. The restorations were cemented with RelyX U200 Automix (3M ESPE, Seefeld, Germany) self‐adhesive resin cement (RXU) after selective enamel etching or with G‐CEM LinkForce (GC, Tokyo, Japan) adhesive resin cement (GCL) in combination with a universal adhesive (G‐Premio Bond) in selective etch mode. At baseline and after 6, 12, and 18 months, restorations were examined by two calibrated clinicians according to modified USPHS criteria. The data were analyzed using Chi‐square (χ2) test and Friedman test (p < 0.05). Results: After 18 months, two teeth at RXU group were endodontically treated due to hypersensitivities. At GCL group, three restorations were lost due to debondings (2) and ceramic fracture (1). The survival rates of RXU (94.3%) and GCL group (91.4%) exhibited no statistically significant difference (p = 0.661). No significant differences were detected for surface texture, secondary caries, anatomic form, color match, marginal discoloration, marginal integrity, interproximal contacts, and patient satisfaction (p > 0.05). Conclusions: The two resin cement systems showed acceptable clinical performance for the cementation of resin nanoceramic CEREC Omnicam inlay/onlay restorations. Clinical Significance: Resin nanoceramic restorations fabricated using CEREC Omnicam and cemented with either a self‐adhesive or a universal adhesive/resin cement system demonstrated clinically acceptable results for posterior teeth in a single visit. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical performance of a 1‐step self‐etch dentin adhesive that was applied according to the manufacturers' recommendations, doubling the adhesive application time and layer in Class I cavities with a composite resin. Materials and Methods: A total of 39 patients aged between 14 and 43 (mean age: 19.1) years were enrolled in the study. Each patient received three restorations. In these three restorations, a 1‐step self‐etch adhesive was applied according to the manufacturer's recommendations (control group), by doubling the adhesive application time, and with double layers. The restorations were evaluated according to modified USPHS criteria at baseline, and 1, 2, 3, and 4‐year recalls. Results: After 4 years, the success rate was 100% for restorations with the adhesive applied according to the manufacturers' recommendations, 96.9% for restorations applied by doubling the adhesive application time, and 93.8% for restorations applied with double adhesive layers. There was no significant difference between the three application methods among all the evaluation periods regarding the evaluation criteria. Conclusions: The 4‐year success rates of a 1‐step self‐etch dentin adhesive that was applied according to the manufacturers' recommendation, by doubling the adhesive application time, and with double layers were excellent. Clinical Significance: It is not recommended to double the adhesive application time nor apply a double layer of a 1‐step self‐etch adhesive because it does not improve the clinical performance of Class I composite restorations. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of zoledronic acid (ZA) on human umbilical vein endothelial cells (HUVECs) attached to different surfaces. Materials and Methods: A total of three groups were evaluated in this study: sandblasting and acid etching (SLA) + HUVECs; mechanically polished (MP) + HUVECs; and plastic cell culture plates + HUVECs. Scanning electron microscopy, energy‐dispersive X‐ray spectroscopy, surface roughness and water contact angle were tested for titanium surface characterisation. ZA was added at different concentrations (0, 1, 10, 50 and 100 μM). Cell adhesion, proliferation, viability, apoptosis and gene expression were evaluated. Results: Mechanically polished and SLA surfaces showed negative effects on cell adhesion and proliferation and promoted cell apoptosis with 100 μM ZA (p <.05). The highest expression of intercellular adhesion molecule‐1 (ICAM‐1) and angiopoietin‐1 was found on SLA surfaces (p <.01). The lowest expression of platelet‐endothelial cell adhesion molecule‐1 and ICAM‐1 was found on MP surfaces (p <.05). A significant decrease in von Willebrand factor was detected on MP and SLA surfaces (p <.001). Conclusions: Zoledronic acid has an anti‐angiogenic effect on HUVECs attached to titanium implants, while the SLA surface might stimulate HUVECs to express angiogenic and adhesive factor genes despite ZA treatment. [ABSTRACT FROM AUTHOR]

Background: The immediate microtensile bond strength (µTBS) of self‐etch (SE) adhesives to primary dentine is promising, but evidence about the durability is scarce. Aim: To assess the long‐term µTBS of SE adhesives to primary dentine and to examine the effect of 7‐s etching on µTBS of a 3‐step etch‐and‐rinse (ER) adhesive. Design: The enamel of 115 caries‐free human primary teeth was ground flat, and bonding was performed according to group assignment: G‐aenial™ Bond/GC [GB], Clearfil™ SE Bond/Kuraray [CS], OptiBond™ XTR/Kerr [OX], Scotchbond™ Universal/3M™ [SU], Prime&Bond® NT™/Dentsply [PB], and OptiBond™ FL/Kerr [OF]. After storage (24 h, 6 mos., 12 mos.), 1,762 beams were cut for µTBS testing. Fracture analysis was performed using light/fluorescence microscopy. Resin‐dentine interfaces were exemplarily analyzed using SEM. Results: After 24 h, OX and SU showed significantly higher estimated mean µTBS than GB, which exhibited the lowest µTBS at all stages (p <.05). μTBS within each adhesive group showed slight variations over time (p >.05). OF_SE produced acceptable µTBS. Etching increased the mean immediate µTBS for OF (p >.05) and the percentage of cohesive fractures. Conclusions: SE adhesives achieved durable μTBS to primary dentine. 7‐s etching may improve the immediate µTBS of a 3‐step ER adhesive. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this in vitro study was to evaluate the effects of different durations of silane coupling agent application compared to a universal adhesive system regarding the shear bond strength of two ceramic materials. Materials and Methods: A total of 120 human molars were ground to the dentinal coronal third and then fixed into an acrylic resin holder. Lithium disilicate specimens were divided into two main groups according to the ceramic type: computer‐aided design/computer‐aided manufacturing IPS e.max CAD and heat‐pressed Initial LiSi Press GC (dimensions of 4 × 3× 3 mm). Each main group was subdivided into 6 subgroups (n = 10) according to the duration of the silane and universal adhesive system application (20, 60, or 120 seconds) on the ceramic surface before cementation; then, the cementation procedures were performed. All specimens were subjected to 5000 thermal cycles at 5 and 55°C before testing. The shear bond strength was measured using a universal testing machine. ANOVA and Scheffe post hoc test multiple comparisons tests were conducted (α = 0.05). Results: The shear bond strength increased as the duration of the silane and universal adhesive system application increased. The highest bond value for each material was found for the silane application at 120 seconds, with a significant difference between 120 and 60, and 20 seconds for both e. max CAD and Initial LiSi materials (p = 0.029 and p ˂ 0.001, respectively). No significant difference was found between 60 and 20 seconds when silane and universal adhesive system were applied for both e. max CAD and Initial LiSi materials (p = 0.169 and p = 0.120, respectively). All groups treated with the silane primer showed significantly higher values than the universal adhesive system for each application time (p ˂ 0.001). Conclusion: Increasing the duration of the silane coupling agent and universal adhesive system application to 120 seconds on the ceramic surface before cementation improved the shear bond strength of the ceramic‐cement interface. Ceramic pretreatment with silane could be an essential step for bonding ceramic to dentin regardless of silane presence in the universal adhesive system. [ABSTRACT FROM AUTHOR]

This study investigated the effect of the bonding agent application method on the dentin bond durability of a two‐step adhesive utilizing a universal‐adhesive‐derived primer. The bonding durability of a universal adhesive was compared with those of two conventional two‐step adhesives by shear bond strength testing after thermal cycling. The primer was applied (with or without phosphoric acid pre‐etching), and the specimens were divided into three groups based on the bonding agent application method used as follows: (i) strong air‐flow application, (ii) gentle air‐flow application, and (iii) gentle air‐flow + second bonding application. The shear bond strength was determined after thermal cycling. All the factors (bonding agent application method, adhesive system, and storage condition) significantly influenced the dentin shear bond strength both with and without phosphoric acid pre‐etching. The specimens exposed to gentle air‐flow showed a higher shear bond strength than did those exposed to strong air‐flow and gentle air‐flow + second bonding. The bond durability of the tested adhesive systems was influenced by the bonding agent application method, and this trend was material dependent. The G2‐Bond Universal exhibited the same or greater dentin bond durability to the other two‐step adhesive systems. [ABSTRACT FROM AUTHOR]

Objective: This study examined the influence of surface contamination during repair procedures with hydrofluoric acid, silane, or ammonium polyfluoride on the bond strength of universal adhesives to dentin using different etching modes before and after thermocycling. Materials and Methods: Dentin surfaces of human molars were contaminated in different ways (silane, hydrofluoric acid, ammonium polyfluoride, and no pretreatment as control) followed by application of a universal adhesive (etch & rinse or self‐etch mode). After a composite build‐up was placed onto each tooth, sticks for the microtensile bond strength (MTBS) test were sectioned. Half of the sticks were tested after water storage for 24 h, the other half after thermocycling (15,000 cycles, 5/55°C). The MTBS data were analyzed statistically by using the Kolmogorov–Smirnov test, one‐way analysis of variance, and Tukey HSD test (p < 0.05). The fracture patterns of all specimens were evaluated and analyzed using a χ2 test. Results: Dentin contamination with a multifunctional silane does not influence microtensile bond strength irrespective of aging. Contamination with hydrofluoric acid or an ammonium polyfluoride primer leads to a significantly lower bond strength after aging, irrespective of the etch mode. Conclusion: Dentin contamination with hydrofluoric acid or ammonium polyfluorides during repair procedures should be avoided, as they appear to decrease the bond strength of universal adhesives. [ABSTRACT FROM AUTHOR]

Endogenous dentin proteases contribute to the degradation of collagen fibrils in the hybrid layer. Recently, inhibition of host‐derived proteases by curcuminoids has shown promising results. The aim of this study was to evaluate the effect of curcuminoid treatment on the microtensile bond strength (μTBS) after 24 h or 12 months of storage. Fifty‐four extracted sound human molars were flattened to mid‐coronal dentin and divided into nine groups. After phosphoric acid‐etching for 15 s, the dentin was experimentally treated for 60 s using 100 μM or 200 μM of curcumin, diflourobenzocurcumin, or demethoxycurcumin dissolved in 1% and 2% dimethyl sulfoxide (DMSO)/water solutions. Untreated and DMSO‐treated groups served as controls. After bonding agent application, each tooth was restored with dental composite. The molars were sectioned into 0.9 × 0.9 × 6 mm beams. The μTBS testing was performed after 24 h and 12 months of storage in artificial saliva. Data were analyzed using regression analyses. Failure patterns were evaluated using scanning electron microscopy. Dentin treatment with curcuminoids did not adversely affect 24‐h μTBS compared to controls. After 12 months, the μTBS of curcuminoid groups was statistically significantly higher than the controls. This study indicates the feasibility of using curcuminoids as protease inhibitors. [ABSTRACT FROM AUTHOR]

Background: Melasma is a common hyperpigmentation disorder. This study aimed to compare the efficacy of Nd‐Yag fractional 1064 plus microinjection of tranexamic acid versus Nd‐Yag fractional 1064 plus oral tranexamic acid in patients with melasma. Materials and methods: This is a prospective, randomized study with a sample size of 40 patients, 20 in each treatment arm, which was done six times with 2‐week intervals. Twenty patients were administered localized microinjections (4 mg/ml) of tranexamic acid and Q‐switched 1064 laser every 2 weeks in one arm, while in the other arm, 20 were given oral tranexamic acid 250 mg three times a day and Q‐switched 1064 laser every 2 weeks per visit. Results: Twenty‐one patients with mean SD 40.52+‐4.95 y/o were treated with oral tranexamic acid, and 20 patients with 43.3+‐5.87 y/o treated with microinjection of tranexamic acid were analyzed. There was no statistically significant difference between the two groups in terms of demographic and clinical characteristics at the baseline (p > 0.05). The patients MASI score and ∆E decrease over the study period in both treatments significantly (p < 0.001). However, patient's MASI score (p = 0.99) and ∆E (p = 0.53) did not differ significant between the two group over the time. Satisfaction (p = 0.41) and complication during the study period (p = 0.09) were not significantly different between the two group. Conclusion: The combination treatment method can be a viable option for Middle Eastern patients having melasma disorder, and tranexamic acid appears to be an effective and safe treatment for melasma, irrespective of its route of administration. Tranexamic acid can increase the permeability locally by non‐invasive methods such as microneedling which is less painful than microinjection and can also increase patient satisfaction. Although the oral method is more tolerable for the patient, it may have systemic side effects, and its combination with Q‐switch laser increases its effect regardless of the type of prescription. Therefore, it is recommended to use of this drug topically (cream or lotion) by non‐invasive methods like microneedling to reduce pain and laser treatment in future studies. [ABSTRACT FROM AUTHOR]

Objectives: To assess the osseointegration of calcium-coated (CS) and chemically modified, sandblasted, large-grit, acid-etched (MS) dental implants with a lack of primary mechanical stability. Materials and Methods: Eighteen implants in CS and MS groups each were loosely placed in the mandible of six mongrel dogs and allowed to heal for 2, 4 and 8 weeks. Implant stability quotient (ISQ) and implant stability test (IST) values recorded periodically and bone-to-implant contact (BIC) and the number of Haversian canals per 1 mm2 measured histologically were statistically analysed (p < .05). Results: All CS and MS implants placed survived. Compared with immediately after installation, ISQ and IST values in both groups increased significantly to over 76 at 2 weeks (p < .0083) and remained stable thereafter. BIC was significantly greater at 8 weeks (61.3 ± 13.6% in CS group; 57.6 ± 5.9% in MS group) compared to 2 and 4 weeks in both groups (p < .017). There were no significant intergroup differences in ISQ, IST or BIC at different time points. Significantly more Haversian canals were observed in group CS (6.2 ± 1.0/mm2) compared with group MS at 4 weeks (3.7 ± 1.8/mm2; p < .05), while intergroup difference was not significant at 8 weeks. Conclusion: Both CS and MS implants inserted without primary stability obtained osseointegration within 2 weeks, and lamellar bone adjacent to the implants was first observed at 8 weeks. The formation of primary osteons was more active at 4 weeks in group CS than in group MS. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the shear‐bond strength (SBS) of resin‐luting cement to experimental short fiber‐reinforced CAD/CAM composite (SFRC) compared to conventional CAD/CAM (Cerasmart 270), 3D printed (GC TEMP PRINT, Pro3dure GR‐17), and laboratory (Gradia Plus) composites. Moreover, translucency parameter values and light transmission were evaluated. For each of the five types of composites, discs were prepared (n = 16/group) and divided into subgroups (n = 8/group) according to surface treatment protocol (hydrofluoric acid or air‐particle abrasion). SBS test was performed using universal testing machine until failure, and failure modes were visually analyzed. Translucency parameter and curing‐light transmission values through 1, 2, and 3 mm thickness were quantified using spectrophotometry and the MARC resin calibrator, respectively. Scanning electron microscopy (SEM) was used to examine the CAD/CAM composites after surface treatment. Composite type and surface treatment had a significant effect on SBS. Laboratory composite showed the highest SBS value (22.4 MPa). Cerasmart 270 exhibited higher translucency parameter values (19.8, 11.0, 5.0) than SFRC (14.5, 5.2, 1.6) at the three composite thicknesses tested. Air‐particle abrasion was more effective in enhancing SBS than acid etching. Experimental SFRC CAD/CAM composite showed higher SBS values than Cerasmart 270. For all composites, translucency parameter values and light transmission decreased as thickness increased. [ABSTRACT FROM AUTHOR]

Objective: Different root modifiers have been proposed in the literature with an attempt to improve the healing process and the success rate of root coverage procedures. The aim of the present retrospective study was to evaluate the effect of three different types of root surface conditioning, namely, tetracycline (TTC), ethylene‐di‐amino‐tetra‐acetic acid (EDTA) and saline, on the outcome of root coverage procedures applying the same surgical technique. Materials and methods: Twenty‐nine patients with 60 Classes I, II, or III recession defects were treated using connective tissue with a partial‐thickness double‐pedicle graft. In 21 recession defects root surface was treated with TTC and, in other 21, with EDTA, while in the remaining, saline solution was applied. Statistical analysis consisted of descriptive statistics and Kruskal‐Wallis, Mann–Whitney, and chi‐square tests. Results: Differences between pre‐ and postoperative values were statistically significant only within but not between groups. Mean root coverage was 73.25%, 69.19%, and 82.17% in the TTC, the EDTA, and the saline groups, respectively. The study revealed no statistically significant differences for all evaluated parameters between groups. Conclusion: Within the limits of this study, root conditioning, prior to root coverage procedures, does not significantly affect their outcome. Clinical significance: Clinical outcome of root coverage procedures is not related to the type of root surface conditioning. [ABSTRACT FROM AUTHOR]

This study aimed at determining the enamel bond durability of universal adhesives to intact enamel (IE) and ground enamel (GE) in different etching modes under thermal cycling (TC) and fatigue stresses. Two universal adhesives and a two‐step self‐etch adhesive were used. Enamel specimens were divided into four groups by treatment: (i) GE in etch‐and‐rinse, (ii) IE in etch‐and‐rinse, (iii) GE in self‐etch, and (iv) IE in self‐etch. Bonded specimens were subjected to TC, and then shear bond strengths (SBS) were conducted. SBS tests were also conducted after storage in 37°C water for 24 h (baseline). For shear fatigue strength (SFS) testing, bonded specimens were subjected to fatigue stress at a frequency of 10 Hz for 50,000 cycles. At baseline, all adhesives showed significantly higher SBS values with GE than IE in self‐etch mode in contrast to in etch‐and‐rinse mode. After TC, the universal adhesives with IE showed lower SBS values than the baseline, regardless of the etching mode. Universal adhesives showed significantly lower SFS values with IE in etch‐and‐rinse, but not in self‐etch mode. Phosphoric acid pre‐etching or grinding of the aprismatic enamel may be helpful in establishing reliable initial and long‐term bonds to enamel when using universal adhesives in self‐etch mode. [ABSTRACT FROM AUTHOR]

This study evaluated the cytotoxicity of methacrylate‐based resins containing dimethyl sulfoxide (DMSO). DMSO was incorporated into hydrophobic (R2) and hydrophilic (R5) resins at weight concentrations of 0, 0.01, 0.1, 1, 5, or 10 w/w %. Resin discs (n = 10/group) were prepared. Human gingival fibroblasts (HGF‐1) were exposed to resin eluates for 24 h. Furthermore, dentin barrier test was performed using 3‐D cultures of odontoblast‐like cells (SV40 transfected pulp derived cells) with dentin slices of 400 µm thickness (n = 8). After acid etching of dentin, DMSO‐modified resins were applied into the cavity part of the device and light‐cured for 20 s. Cell viability (%) was assessed by MTT and analyzed spectrometrically. Data were analyzed by ANOVA and Tukey test (α = 0.05). Resin eluates showed statistically significantly lower % cell viability for all neat and DMSO‐modified resins than seen for the negative control. Moreover, DMSO‐R5 eluates resulted in significantly lower % cell viability than DMSO‐R2 emulates. The dentin barrier test showed that DMSO‐R2 did not result in significantly lower % cell viability, whereas incorporation of 1‐10 w/w % DMSO into R5 resulted in significantly lower % of cell viability. Incorporating DMSO into hydrophilic self‐etching resins may increase cytotoxicity. The biocompatibility is not influenced by the addition of DMSO into hydrophobic resin. [ABSTRACT FROM AUTHOR]

Background: Due to the chemical and morphological differences between primary vs. permanent teeth, the time reduction of the acid etching or acidic primer can result in higher values of bond strength. Aim: To assess through a systematic review and meta‐analysis the influence of the reducing etching (acid etching or acidic primer) time on the bond strength of adhesive systems to primary dentin. Design: A systematic search was carried out in 3 databases: PubMed, Web of Science and Scopus. Studies that evaluated the effect of reducing the etching time on the bond strength of adhesive systems to primary dentin were included. Meta‐analyses were performed using a random‐effects model, with subgroups for etch‐and‐rinse and self‐etching adhesives, with a significance level of P <.05. The risk of bias and heterogeneity between studies (Cochrane and I2 tests) were assessed. Results: Eight studies were included in the systematic review and seven in the meta‐analyses. The shortening etching time did not influence the immediate dentin bond strength for etch‐and‐rinse (Z = 0.07, P =.95) and self‐etching adhesives (Z = 0.41, P =.69). After ageing, however, the shorting etching time improved the bond strength for etch‐and‐rinse adhesives (Z = 2.01, P =.04). All studies presented high bias risk. Conclusions: Reducing the acid‐etching time to primary dentin improves the long‐term bond strength to this substrate. [ABSTRACT FROM AUTHOR]

This in vitro study aimed to assess the influence of different concentrations and durations of hydrofluoric acid (HF) and Monobond Etch & Prime (MEP) etching on the surface roughness (Ra) of different CAD/CAM materials and on the shear bond strength (SBS) of a self‐adhesive resin bonded to the materials. Seventy specimens of hybrid ceramic, leucite‐based glass‐ceramic, lithium disilicate glass‐ceramic, and zirconia‐reinforced lithium silicate glass‐ceramic were prepared and divided into seven groups according to the surface treatments: Control (C); MEP etching for 60 (MEP60) and 120 (MEP120) s; 5% HF etching for 60 (HF‐5%60) and 120 (HF‐5%120) s; 9.5% HF etching for 60 (HF‐9.5%60) and 120 (HF‐9.5%120) s. The Ra was measured using a 3D profilometer. All groups were treated with a universal primer except for the C, MEP60, and MEP120 groups. A self‐adhesive resin cement was bonded to all specimens, and the bond strengths were measured using a universal testing machine. All surface treatments increased both Ra and SBS values compared to the control in each material. Neither the duration of surface treatments nor the HF acid concentrations had a statistically significant effect on SBS. Within the limitations of this experimental study, it can be concluded that Monobond Etch & Prime may be a preferable method to achieve high bond strength values. [ABSTRACT FROM AUTHOR]

Background: There are different etching gels available, which have different composition, different pH, and different viscosity, and there is little information in the literature comparing all these products. Objective: To evaluate the mean microshear bond strength and morphological characteristics of tooth enamel by evaluating different phosphoric acids combined with a universal adhesive system. Materials and Methods: Eighty‐four enamel samples were used, which were divided according to the acid conditioning: G1: Scotchbond Etchant (3M Oral Care), G2: Ultra‐Etch (Ultradent), G3: Eco‐Etch (IvoclarVivadent), G4: ETCH‐37 with BAC (Bisco), G5: Etching gel (Densell), G6: Condac 37 (FGM), and G7: Scotchbond Universal Adhesive (3M Oral Care) in self‐etch mode. For the adhesive procedure, Scotchbond Universal Adhesive was the one used as indicated the manufacturer's instructions, 0.9‐mm‐diameter resin cylinders were placed. The microshear bond strength test was performed after being stored for 24 hours in water. The morphological characteristics of tooth enamel were analyzed using the Raman confocal microscope alpha300RA. The analysis of variance (ANOVA) test and Tukey post‐test were used to analyze the differences between the groups. Results: The mean microshear bond strength values obtained for groups 1, 4, 5 were significantly greater than groups 2, 3, 6 and 7 (p <.05). All groups presented demineralization after the application of the etching acid, and few signs of demineralization were evident in group 7. Conclusions: Acid‐etching with ETCH‐37 with BAC, Etching gel, and Scotchbond Etchant improved the adhesive strength in the enamel using an universal adhesive, and acid‐etching with Condac 37, Ultra‐Etch, and Eco‐Etch provides similar adhesive strength values to self‐etch mode of universal adhesive. Clinical Significance: All acid etchants should be considered as different. The test confirms that enamel etching prior to the application of a universal adhesive system depends on the selected acid etchand product. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the microtensile bond strength of four dental computer‐aided design/computer‐aided manufactured (CAD/CAM) ceramics after application of four different surface treatments. Materials and methods: Four dental CAD/CAM ceramics were tested: feldspathic ceramic (VITABLOCKS‐Mark II), polymer‐infiltrated ceramic network (VITA ENAMIC), zirconia‐reinforced lithium silicate (VITA SUPRINITY), and yttria‐stabilized zirconia (VITA YZ T). Four surface treatments were applied: no treatment, 5% hydrofluoric acid‐etching, airborne particle abrasion, and tribochemical silica coating. The ceramic blocks were repaired with nanohybrid composite (Tetric N‐Collection). Sixteen test groups of 12 specimens were prepared. After thermocycling, microtensile bond testing was performed. The microtensile strengths values were statistically analyzed using two‐way analysis of variance and Tukey's post‐hoc test. Results: Repaired feldspathic and resin polymer‐infiltrated ceramic network ceramics demonstrated superior microtensile bond strengths compared to zirconia‐reinforced lithium silicate and yttria‐stabilized zirconia. Etched feldspathic and polymer‐infiltrated ceramic network ceramics had higher bond strength than the untreated groups. Surface treatments did not affect the bond strength of zirconia‐reinforced lithium silicate and yttria‐stabilized zirconia with the exception of etching, which reduced the bond strength of yttria‐stabilized zirconia. Conclusion: Feldspathic ceramic and polymer‐infiltrated ceramic network were repaired with dental composite after surface etching with hydrofluoric acid. Repair of zirconia‐reinforced lithium silicate and yttria‐stabilized zirconia did not demonstrate promising results. Clinical significance: Repair of feldspathic ceramic and polymer‐infiltrated ceramic network restorations may be a cost‐effective means to promote the longevity of dental restorations. However, zirconia and zirconia‐reinforced lithium disilicate restorations do not offer such an option. [ABSTRACT FROM AUTHOR]

Objectives: To compare the clinical performance of a universal adhesive in class V non‐carious cervical lesions (NCCLs) using two surface treatment protocols (self‐etch [SfE] vs selective‐enamel‐etch [SelE]). Material and methods: Thirty‐three adults, each with ≥2 NCCLs, received one resin composite restoration utilizing a SfE universal adhesive and another utilizing the adhesive and SelE with 37% phosphoric acid. Restorations were evaluated for sensitivity, retention, marginal discoloration, marginal adaptation, and clinical acceptability through 24 months using Cochran‐Mantel‐Haenszel tests for stratified, ordered categorical outcomes. Results: Sixty‐six restorations (35 SfE, 31 SelE; 27 volunteers) were evaluated at 24 months. There were no significant differences between SfE and SelE for sensitivity, retention, marginal adaptation, or clinical acceptability. One SfE restoration was lost. Marginal adaptation was significantly worse at 24 months than baseline for SelE (P = 0.01), but not for SfE. Marginal discoloration was significantly worse for SfE (P = 0.02), but not for SelE. Sensitivity improved from baseline to 24 months for both groups (SelE P = 0.004, SfE P = 0.002). Conclusions: Twenty‐four‐month data indicated significantly reduced sensitivity for both groups, worse marginal discoloration for SfE, and worse marginal adaptation for SelE. No changes in retention or clinical acceptability were observed in either group. All retained restorations were clinically acceptable at 24 months. Clinical Significance: Both self‐etch and selective enamel etch techniques with a universal adhesive produced clinically acceptable results in resin composite restorations for NCCLs over 2 years. [ABSTRACT FROM AUTHOR]

The effect of smear layer‐deproteinizing pretreatment using hypochlorous acid (HOCl) on the micro‐shear bond strengths (μSBS) of conventional and resin‐modified glass‐ionomer cements (GIC) to dentin was investigated and compared with demineralizing pretreatment with polyacrylic acid (PAA). Three GICs: Fuji IX GP Extra (restorative conventional GIC), GC Fuji II LC EM (restorative resin‐modified GIC), and GC Fuji Luting EX (luting resin‐modified GIC), were used. One hundred fifty human molars were divided into groups (n = 10) according to the cements and dentin pretreatments; no pretreatment (control), 10 s PAA pretreatment, and HOCl pretreatment for 5, 15, or 30 s. After 24 h, μSBS was tested and the data were statistically analyzed using a two‐way ANOVA, followed by Tukey's post‐hoc test. HOCl pretreatment significantly increased μSBS of conventional GIC compared to the control group. For resin‐modified restorative GIC, 5 s HOCl deproteinization significantly increased μSBS, while longer application times did not. There was no significant difference between HOCl‐pretreated and control groups of resin‐modified luting GIC. PAA pretreatment increased the μSBS of all cements significantly. In conclusion, smear layer deproteinization with HOCl can enhance the dentin bonding of conventional GIC. However, the residual radicals may adversely affect the polymerization of resin‐modified GICs. [ABSTRACT FROM AUTHOR]

Objectives: It is well known that surface treatments of dental implants have a great impact on their rate of osseointegration. The aim of this study was to compare the biocompatibility and the bone–implant contact (BIC) of titanium dental implants with different surface treatments. Material and methods: Test implants (Biotech Dental) had a nanostructured surface and control implants (Anthogyr) were grit‐blasted with biphasic calcium phosphate and acid‐etched surface. Both titanium implants were inserted in mandible and maxillary bones of 6 Yucatan minipigs for 4 and 12 weeks (n = 10 implants/group). Biocompatibility and osseointegration were evaluated by non‐decalcified histology and back‐scattered electron microscopy images. Results: The reading of histology sections by an antomo‐pathologist indicated that the test implants were considered non‐irritating to the surrounding tissues and thus biocompatible compared with control implants. The BIC values were higher for test than for control dental implants at both 4 and 12 weeks. Conclusions: In summary, the new nanostructured titanium dental implant is considered biocompatible and showed a better osseointegration than the control implant at both 4 and 12 weeks. [ABSTRACT FROM AUTHOR]

Background and Purpose: Poorly controlled diabetes mellitus has been related to higher risk of implant treatment complications due to increased susceptibility to infection and delayed wound healing. Lipopolysaccharides (LPS) stimulate cytokine production leading to chronic inflammation and immunological host response that accentuates the destruction of periodontal tissues. This study aimed to evaluate the effect of different glycemic conditions on secretion and mineralization of bone matrix under sterile inflammation induced by LPS on osteoblasts seeded over sandblasted/acid‐etched (SLA) titanium surface. Materials and Methods: Osteoblast cell viability was performed to determine the influence of different glucose concentrations (5.5, 8, 12, and 24 mM), which were chosen to reflect normal, postprandial, and high glucose values, similar to those typically seen in Diabetes mellitus under clinical conditions. Cells were seeded on titanium SLA discs (Straumann AG, Waldenburg, Switzerland) and exposed to glucose concentrations and LPS (1μg/mL) in order to test inflammatory response (qPCR) and mineralization (Alizarin Red staining). Results: Osteoblast viability was severely decreased when exposed to higher glucose levels (≥12 mM) and LPS (P <.05) compared to control. When the osteoblasts were exposed to LPS and glucose at ≥8 mM, the gene transcripts of inflammatory cytokines were ≈2.5‐fold upregulated, while ≤8 mM glucose elicited no significant change compared to control without glucose treatment (P >.05). Osteoblasts exposed to LPS produced sparse extracellular matrix mineralization, especially combined with higher glucose values (≥12 mM), together with decreased calcium deposition compared to control (P <.05). Conclusions: High glucose levels combined with LPS inflammatory stimulation elicited an adverse effect on the volume and quality of mineralized hard tissue formation on SLA titanium surfaces in vitro. Hence, both normal glucose levels and infection control including low levels of circulating LPS during initial osseointegration period may be required to increase the success rate of dental implants. [ABSTRACT FROM AUTHOR]

Objective: There is not a clear understanding of the ultramorphology of enamel white spot lesions (WSLs). The purpose of this study is to characterize resin infiltration of enamel WSLs using electron microscopy. Materials and methods: Enamel sections with sound enamel and WSLs were sectioned from extracted teeth and assigned to three groups: (a) left untreated; (b) etched with 15% hydrochloric acid (Icon‐Etch); (c) restored with the resin infiltration sequence (Icon‐Etch, Icon‐Dry, and Icon‐Infiltrant). Restored specimens were demineralized to obtain replicas. Observations were carried out under a field‐emission scanning electron microscope. Results: Icon‐Etch resulted in an array of pits and funneled holes on the WSL. Replicas of WSLs depicted 0.5‐6.0‐μm‐thick shaggy resin tags up to a depth of 465 μm. Enamel crystallites were enveloped with resin at the bottom of the WSL forming a hybrid layer. Conclusions: The resin infiltrant filled the spaces between the crystallites and resulted in an enamel hybrid layer. Clinical significance: In addition to masking enamel WSLs, resin infiltration is able envelop residual enamel crystallites forming an enamel hybrid layer. This hybridization makes resin‐embedded enamel more resistant to acid attack than sound enamel. [ABSTRACT FROM AUTHOR]

Objective: To compare the contributions of implant hydrophilicity and nanotopography on anchorage in bone. The effect of elevated calcium surface chemistry on bone anchorage was also investigated. Materials and Methods: A full factorial study design was implemented to evaluate the effects of ultraviolet (UV) light and/or sodium lactate (SL) and discrete crystalline deposition of nanocrystals (DCD) treatments on the osseointegration of dual acid‐etched (AE) titanium alloy (Ti6Al4V) and grit blasted and AE (BAE) commercially pure titanium (CpTi) implants. Sodium hydroxide (NaOH)‐treated CpTi implants were immersed in simulated body fluid (SBF) to increase calcium surface chemistry. Implants were placed in the femora of Wistar rats and tested using pull‐out testing (BAE implants: 5, 9, 14 days) or tensile testing (AE implants: 9 days, NaOH implants: 28 days). Results: Ti6Al4V‐AE implants with DCD‐ and UV‐treated surfaces significantly increased bone anchorage compared with untreated Ti6Al4V‐AE alloy implants. Pull‐out testing of BAE‐CpTi implants with the DCD treatment showed increased disruption force values compared with surfaces without the DCD treatment at 5, 9 and 14 days by 4.1N, 13.9N and 15.5N, respectively, and UV‐treated implants showed an increase at 14 days by 8.4N. No difference was found between NaOH + SBF and NaOH + H2O groups. Conclusions: Bone anchorage of implants was found to be improved by UV‐treating implants or nanotopographically complex surfaces. However, implant nanotopography was found to have a greater contribution to the overall bone anchorage and is more consistent compared with the time‐dependent nature of the UV treatment. [ABSTRACT FROM AUTHOR]

Background: Calcium phosphate (CaP)‐coated surface showed enhanced contact osteogenesis around dental implant and finally accelerate osseointegration in early healing phase. Purpose: The aim of this randomized controlled trial was to compare the peri‐implant marginal bone level around uncoated and CaP‐coated sandblasted, large‐grit, acid‐etched (SLA) surface implants during the first year after placement. Materials and Methods: This study was performed upon 34 patients with randomized and double‐blinded design. Clinical and radiographic examinations were performed immediately after implant placement, at re‐entry after 3 months, and after 12 months to evaluate the initial stability and change in the marginal bone level. The distance from the implant shoulder to the top of the bone‐to‐implant contact was defined as the marginal bone level, and its alteration was measured at 1 year after implant installation. Results: None of the implants failed, and most of them showed a marginal bone loss of less than 1 mm. Small changes in the bone level were noted at all sites in the control and test groups, and there were no clinically significant differences in the changes in the marginal bone. Conclusion: Both CaP‐coated and uncoated SLA surface implants showed comparably successful marginal bone stability without any complications during the first year after placement. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the immediate bond effectiveness of universal adhesives to unground and ground enamel surfaces in different etching modes, through shear bond strength (SBS) tests and scanning electron microscopy observations. Three universal adhesives, a conventional two‐step self‐etch adhesive, and a conventional single‐step self‐etch adhesive were compared. Human enamel specimens from lower anterior teeth were divided into four groups and subjected to the following treatments: (i) unground enamel in self‐etch mode; (ii) ground enamel in self‐etch mode; (iii) unground enamel in etch‐&‐rinse mode; and (iv) ground enamel in etch‐&‐rinse mode. Bonded assemblies were subjected to SBS testing. All the adhesives showed significantly higher SBS values in etch‐&‐rinse mode than in self‐etch mode, regardless of whether enamel was unground or ground. The influence of the enamel surface condition on SBS was different in different etching modes. Without pre‐etching, all tested materials showed lower SBS values in unground enamel than in ground enamel. In etch‐&‐rinse mode, no significant differences in SBS values were observed between unground enamel and ground enamel for any of the adhesives tested. Phosphoric acid pre‐etching before application of self‐etch adhesives to an unground enamel surface is essential to enhance initial enamel bond effectiveness. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of the selective etching in the survival rates of indirect restorations cemented with self‐adhesive resin luting. Materials and Methods: The eligibility criteria were formulated based on PICOS strategy. The search without restrictions was performed in PubMed/Medline, the Cochrane Library, Web of Science, Scopus, LILACS databases and gray literature until May 2018. Cochrane Collaboration's tool was performed for assessing the risk of bias. According to the bias risk analysis, the studies were classified as low risk of bias and high quality of evidence. The systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42018091202). The meta‐analysis was performed using RevMan 5.3 software (RevMan, Copenhagen, Denmark) and the risk ration and confidence interval was obtained (p < 0.05). Results: After database screening, removal of duplicates and eligibility criteria application, two studies were selected for this systematic review, with 65 participants (34 in one and 31 in the other). The pooled meta‐analysis demonstrated no statistically significant difference in clinical longevity for selective etching in indirect restorations (P > .05; I2 = 0%) and risk ratio of 0.46 [0.19‐1.09]. Conclusions: Based on the findings, the results of this systematic review suggest that the selective enamel etching prior to application of self‐adhesive luting cements systems for indirect restoration do not influence the clinical longevity of indirect restorations. Clinical significance: The knowledge of the clinical steps of adhesive procedures is fundamental to the success of adhesive restorations and their longevity. Self‐adhesive resin cements simplify the luting procedure of indirect restorations. However, adding a step that could significantly improve long‐term survival would be of great value. Thus, the results of this systematic review will provide data so that the decision making regarding materials used for adhesive cementation is conducted based on scientific evidence. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the accuracy of implant placement with a digitally planned guided implant procedure. Two methods for identifying the actual postoperative positioning of the implants were compared: CBCT and IO scanning. Material and methods: Twenty‐eight implants with a sandblasted and acid‐etched surface were placed in thirteen patients using tooth‐supported surgical guides following a digital planning procedure. The implants were submerged for 12–15 weeks. New CBCT images were taken for identification of the implant position. After second stage surgery, scan bodies were mounted on the implants and scanned with an IO digital scanner. The recordings from the CBCT images and the IO scans were compared with respect to the identified positions of the implants. Results: The study did not resolve any significant differences of the identified positioning of the implants as measured by CBCT or IO, except for the apical deviations at the coronal and apical points. The angular difference between CBCT and IO scanning at the coronal point was −0.011 (±0.6) degrees, whereas the 3D deviation was 0.03(±0.17) mm. The distal deviation between CBCT and IO scanning was 0.01(± 0.16) mm, and the vestibular deviation 0.033(± 0.16) mm and the apical deviation difference was 0.09(± 0.16) mm. The 3D deviation at the apical point was 0.04(± 0.22) mm. The distal deviation between CBCT and IO scanning was 0.06(± 0.19) mm, and the vestibular deviation 0.032(± 0.23) mm and the apical deviation difference was 0.09(± 0. 16) mm. Conclusion: The study demonstrated that accuracy measurements using IO scanning yields comparable results to those obtained by CBCT. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the shear bond strength of resin cements to zirconia treated with the selective infiltration etching technique (SIE). Materials and Methods: Forty‐seven zirconia specimens were prepared with a sequence of silicon carbide abrasives, cleaned in an ultrasonic bath. Three samples were separated for atomic force microscope (AFM) analyses (one nontreated for control, one sandblasted, and one selective infiltration etched) and the remaining were randomly distributed in four groups, according to the combination of surface treatment and resin cement: group 1a (sandblasting + Variolink II), group 1b (sandblasting + Panavia SA Plus), group 2a (SIE + Variolink II), group 2b (SIE + Panavia SA Plus). A composite resin cylinder (3 mm × 3 mm) was cemented to the zirconia surface, as per each group's specific protocol. After storing 24 hours in distilled water at 37°C, the specimens were tested for shear bond strength and the results were subjected to statistical analysis. Results: At 24 hours, the highest SBS values were observed in group 2b, where the SIE technique was used in conjunction with Panavia SA Plus. Lowest values were found in group 1a. Increased surface roughness was observed with SIE. Conclusions: SIE significantly enhanced the resin bond strength to zirconia. However, cement selection was also an important factor, for both surface treatments tested. Clinical Significance: Use of SIE method combined with MDP monomer containing resin cement can provide clinically acceptable bond strength between zirconia and resin cement. [ABSTRACT FROM AUTHOR]

Objective: In the present study, the ability of posterior resin composite to repair aged bulk‐fill resin composite and vice versa were assessed by shear bond strength testing. Materials and Methods: Resin composite substrates were aged and surfaces were abraded with abrasive papers, then bulk‐fill substrates were repaired with posterior resin composite and vice versa using different surface treatments (no surface treatment [control]; etching with 37% phosphoric acid [H3PO4] for 20 seconds; etching with 10% hydrofluoric acid [HF] for 20 seconds; etching with 37% H3PO4 for 20 seconds + adhesive application; etching with 10% HF for 20 seconds + adhesive application; adhesive application only). Shear bond strengths (SBS) were then measured and surface roughness values (Ra) were determined. Cohesive strengths of nonaged resin composites were measured and used as reference groups. Resin composite surfaces after acid etching were evaluated by SEM. Data were analyzed using ANOVA and Fisher's LSD tests (P < .05). Results: ANOVA showed that resin composite repair type did not affect SBS significantly (P = .850), while it showed that surface treatments significantly affected the SBS (P = .000). Only a combination of etching with 10% HF for 20 seconds with resin adhesive application provided similar SBS values with those of the positive control. Conclusions: It was concluded that the aged bulk‐fill resin composite would be effectively repaired with conventional posterior resin composite or vice versa if proper repair protocol was deployed. Clinical Significance: The combination of 10% HF etching and adhesive application would provide efficient repair strength when the aged bulk fill resin composite is repaired with conventional posterior resin composite or vice versa. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate whether surface wetness would influence the bonding effectiveness of universal adhesives in etch‐and‐rinse mode. All‐Bond Universal (AB), G‐Premio Bond (GP), Prime & Bond Active (PB), and Scotchbond Universal Adhesive (SU) were evaluated. Initial bond strengths and bond‐fatigue strengths of universal adhesives to both wet and dry enamel and dentin in etch‐and‐rinse mode were determined. Scanning electron microscopy observations of the adhesive interfaces were also conducted. The bond‐fatigue durability of universal adhesive to enamel in etch‐and‐rinse mode was influenced by the surface wetness, unlike that to dentin. The bond fatigue durability of AB and GP to dentin in etch‐and‐rinse mode was different depending on the surface wetness, unlike that of PB and SU. The thicknesses of the adhesive or hybrid layer of resin–dentin interfaces were not influenced by the surface wetness, but the length of resin tags in the wet group was longer than in the dry group. Some universal adhesives with the addition of specific components and optimization of water content can achieve stable bonds regardless of surface wetness, but the surface wetness of dentin is still a significant factor for universal adhesive bonding in etch‐and rinse mode, unlike that of enamel. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the improvement in strength and durability of the bond between dentin and composite resins following plasma drying of the etched dentin surface using non‐thermal atmospheric pressure plasma. Plasma drying was applied to the etched dentin before applying adhesive. Conventional wet‐bonding and helium (He) gas‐dried bonding schemes were used as control groups. The bond strength of the composite resin to dentin was measured as the microtensile bond strength at 24 h after bonding and after 10,000 cycles of thermocycling. Hybrid layer formation was observed using micro‐Raman spectroscopy and scanning electron microscopy. Although the bond‐strength values were not statistically different either at 24 h after bonding or after thermocycling, the bond strength of the plasma‐dried bonding group was significantly higher than the conventional wet‐bonding group and He gas‐dried bonding group. Micro‐Raman spectral analysis revealed effective penetration of the adhesive and an improved polymerization rate of the adhesive after plasma drying. Plasma drying increased the penetration of hydrophobic resin into the collagen mesh structure, which improved mechanical bonding and long‐term durability between dentin and composite resin. [ABSTRACT FROM AUTHOR]

Aim: To assess the effect of acid‐etching duration time on the compressive strength, microstructure and shear bond strength of All‐Bond Universal adhesive to MTA‐Angelus (AMTA), and Biodentine (BD). Methodology: Forty‐eight cylindrical specimens (4 mm in diameter, 6 mm in height) of AMTA in four groups and 48 specimens of BD in four groups (n = 12) were prepared and stored for 72 h. The control groups were unetched whilst the three experimental groups were acid‐etched for 5, 10 and 15 s, respectively, followed by compressive strength testing. The effect of the various acid‐etching times on surface micromorphology was evaluated under a scanning electron microscope. Similar groups were bonded using All‐Bond Universal and Aelite Flo and shear bond strength was tested. Data were analysed using two‐way ANOVA and Tukey tests. Results: 10‐s and 15‐s acid‐etching reduced the compressive strength of AMTA and BD (P < 0.001), while 5‐s etching did not (P ≤ 0.86). In all the groups, BD had greater compressive strength compared to AMTA. Contrary to BD, the three etched AMTA groups had significantly higher shear bond strength compared to the control group (P < 0.001), with no significant differences between them. The etched groups of AMTA had shear bond strengths comparable to all the BD groups. Scanning electron microscope observations indicated variable surface morphologies such as remnant crystals and cracking/eroding in all our groups of AMTA; though these differences were less prominent for BD. Conclusions: Shortening the acid‐etching time to 5 s resulted in a beneficial effect in terms of resin bonding for AMTA while preventing the detrimental effect of 10‐s and 15‐s etching on the compressive strength of AMTA and BD. However, the three etching times had no effect on resin–BD bond. [ABSTRACT FROM AUTHOR]

Purpose: In clinical prosthetics procedures, including endodontics and post fixation, the presence of a smear layer can reduce the post bond strength. An Er,Cr:YSGG laser, which emits at 2780 nm, can promote a smear‐layer‐free surface due to the ablation process. Considering these aspects, the purpose of this work was to evaluate the influence of Er,Cr:YSGG laser irradiation using either a radial or an axial fiber tip on the bond strength of three resin cements to the fiber‐reinforced composite posts. Materials and Methods: Ninety recently extracted single rooted human teeth had their root canal instrumented and were randomly distributed into nine experimental groups, in which three resin cements (total‐etching Variolink II, self‐etching Panavia F, and self‐adhesive RelyX Unicem Aplicap) and three root canal treatments (no treatment, laser irradiation using the radial fiber tip, laser irradiation using the axial fiber tip) were used. Specimens were then sectioned into three sections (cervical, middle, and apical thirds) with two slices on each section. A push‐out test was performed on each slice, and the values were recorded as MPa. The push‐out data were analyzed by a Ryan‐Joiner normality test followed by a two‐way ANOVA test and Tukey pairwise comparison. The statistical analysis was performed on each third section separately, with a 5% significance level. Results: Laser irradiation with axial fiber tip significantly increased the post bond strength of RelyX Unicem Aplicap on middle third of specimens (p < 0.001) when compared to other root canal treatments (unlased or irradiated with radial tip). Considering the Panavia resin cement, laser irradiation with either axial or radial tips promoted a significant increase on the post bond strength of middle third when compared to unlased specimens (p < 0.001); however, laser irradiation did not influence the post bond strength of Variolink resin cement. Conclusions: The use of the Er,Cr:YSGG laser for clinical prosthetics procedures enhances the post bond strength of Panavia and RelyX Unicem Aplicap resin cements, mainly at middle third of roots, and does not interfere with the bond strength of Variolink resin cement. For the RelyX Unicem Aplicap system, the use of axial tip is most advantageous and can be recommended for future clinical application. [ABSTRACT FROM AUTHOR]

Using micro‐computed tomography (micro‐CT), this study assessed the inhibitory effect of three different types of restorations on root‐caries formation under a cariogenic challenge. Bovine‐root dentin blocks with a cylindrical cavity were divided into three restoration groups: a fluoride‐free self‐etch adhesive and a resin composite (SE‐ES); a self‐etch adhesive and a resin composite with multi‐ion release (FL‐BF); and a glass ionomer cement (Fuji‐VII). After the restorative procedures, the specimens were stored in artificial saliva for 1 d, then subjected to a demineralization solution for 4 d and a remineralization solution for 28 d. Mineral density and mean mineral loss of dentin around the restorations were measured using micro‐CT. The mean mineral loss values of dentin around the restorations were highest among SE‐ES restorations and lowest among Fuji‐VII restorations. Fuji‐VII showed the highest mineral density and the lowest mineral loss after 28 d of remineralization. The observations made by scanning electron microscopy demonstrated that Fuji‐VII created the smallest outer lesion followed by FL‐BF and SE‐ES. Fuji‐VII has a larger inhibitory effect on root caries around the restorations and enhances remineralization more effectively than either FL‐BF or SE‐ES. Multi‐ion and fluoride release from the restorative materials may be beneficial for inhibition of root‐dentin caries around the restorations. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to analyze and compare the topographical, chemical, and osseointegration characteristics of a sandblasted acid‐etched surface (SLA group), a sandblasted thermally oxidized surface (SO group), and a surface chemically modified by hydrofluoric (HF) acid (SOF group). Materials and methods: Following the preparation and characterization of the relevant surfaces, 90 implants (30 for each group) were placed on the pelvic bone of six sheep. Resonance frequency analysis (RFA), insertion (ITV), removal torque value (RTV), and histomorphometric analyses (BIC%) were performed after three and 8 weeks of healing. The results were analyzed by nonparametric tests (p < 0.05). Results: The roughness value (Ra) in the SOF group was significantly lower than the SLA and the SO group (p = 0.136, p < 0.001, respectively). This resulted in a substantially inferior ITV 14.83 N/cm (SD: 4.04) than those achieved in the SLA and SO groups (19.50 (SD: 6.07) and 20.17 N/cm (SD: 8.95), respectively; p = 0.001). A statistically significant change in the RFA from the baseline (47.36 ISQ, SD: 6.93) to the 3rd week (62.56 ISQ, SD: 5.29) was observed in the SOF group only (p = 0.008). The highest postplacement RFA and RTV values were measured from the SLA group (61.11 ISQ, SD: 7.51 and 78.22 N/cm, SD: 28.73). The early‐term (3rd week) BIC% was highest in the SO group (39.93%, SD: 16.14). After 8 weeks, the differences in BIC% values were statistically not significant. Conclusions: Adjunct HF acid application on the thermally oxidized surface did not provide an additional benefit compared to the sandblasted and acid‐etched surface (SLA group). [ABSTRACT FROM AUTHOR]