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Patricia Maria Wiziack Zago,1 Ilza Maria Oliveira Sousa,2 Leila Servat-Medina,2 Michelle Pedroza Jorge,2 Lidio Gonçalves Lima Neto,3 Viviane Hass,4 Xin Li,5 Ana Lucia Tasca Gois Ruiz,2 Deepak Saxena,5 Mary Ann Foglio2 1Sao Leopoldo Mandic Medical School, Araras, São Paulo, Brazil; 2Faculty of Pharmaceutical Sciences at University of Campinas, Campinas, São Paulo, Brazil; 3Postgraduate Program in Parasitic Biology, CEUMA University, São Luis, Maranhão, Brazil; 4School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA; 5College of Dentistry, New York University, New York, NY, USACorrespondence: Mary Ann FoglioFaculty of Pharmaceutical Sciences at University of Campinas, Rua Candido Portinari 200, CEP: 13083-871, Campinas, São Paulo, BrazilTel +55 19 3521-8132Email maryann.foglio@fcf.unicamp.brIntroduction: Osteonecrosis of the jaw is a condition associated with intraoral ulceration and bone necrosis induced by antiresorptive medications, such as zoledronic acid, a bisphosphonate. Previous data on Arrabidaea chica (H&B.) Verlot wound healing activity prompted the study reported herein on A. chica standardized hydro alcoholic extract in vitro cytoprotective activity data on epithelial and osteoblastic cells exposed to zoledronic acid (ZA).Methods: Primary human gingival fibroblasts and murine pre-osteoblasts were treated with ZA 10 μM together with 5 or 10 μg.mL− 1 A. chica extract for 24h and 48 h. At both times, cells were submitted to viability assay and caspase 3/7 activation evaluation. Statistical analysis used one-way ANOVA and p=0.05.Results: In cell viability assay, a drastic damage effect of ZA appeared after 48 h in both epithelial (55.8%) and pre-osteoblastic cells (39.7%). When treated with ZA in combination with A. chica extract, cells showed higher viability values: 74.1%– 82.3% for fibroblasts and 66% for pre-osteoblasts. Furthermore, the combined treatment presented lower caspase 3/7 activation in fibroblasts and pre-osteoblasts.Conclusion: At low concentrations, A. chica extract showed promising cytoprotective effects against ZA-induced damage actions; however, further in vitro and in vivo studies are required to establish the mechanism of action.Keywords: Arrabidaea chica, zoledronic acid, epithelial cells, osteoblasts, fibroblasts

Viviane Hass,1 Stephanye Tavares Carvalhal,2 Suellen Nogueira Linares Lima,2 Andrés Alejandro Viteri-Garcia,3 Etevaldo Matos Maia Filho,2 Matheus Coelho Bandeca,2 Alessandra Reis,4 Alessandro Dourado Loguercio,4 Rudys Rodolfo De Jesus Tavarez2 1Postgraduate Program in Dentistry, UNOPAR-University Northern Parana, Londrina, PR, Brazil; 2Postgraduate Program in Dentistry, University Ceuma, São Luis, Brazil; 3Escuela de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador; 4Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, BrazilCorrespondence: Alessandro Dourado LoguercioUniversidade Estadual de Ponta Grossa. Departamento de Odontologia Restauradora, Avenida Carlos Cavalcanti 4748 – Uvaranas, Ponta Grossa 84030-900, PR, BrazilEmail aloguercio@hotmail.comObjective: The purpose of this single-blind (evaluators) and parallel design study was to evaluate whether exposure to a cola-based soft drink during bleaching treatment with 35% hydrogen peroxide (HP) affects color change and bleaching-induced tooth sensitivity.Material and methods: Forty-four patients with central incisors darker than A2 were selected. Participants who did not drink cola-based soft drinks were assigned to the control group (CG), while participants who drank a cola-based soft drink at least twice a day were assigned to the experimental group (EG). For the CG, foods with staining dyes were restricted. For the EG, there was no restriction on food and patients were asked to rinse their mouths with a cola-based soft drink for 30 s, 4 times daily. For both groups, 2 sessions with three 15 min applications of 35% HP were performed. Shade evaluation was assessed via subjective (VITA classical and VITA bleacheguide shade guides) and objective methods (Easyshade spectrophotometer) at baseline, during bleaching (first, second, and third weeks), and post bleaching (1 week and 1 month). Patients recorded their sensitivity perceptions using a numerical rating scale and 0–10 visual analog scales. Variation in shade guide units and the 2 colors (DE) were evaluated with a Student’s t-test (α = 0.05) and Mann–Whitney test (α = 0.05). Absolute risk of tooth sensitivity and intensity of tooth sensitivity were evaluated by a Chi-square test (α=0.05).Results: Effective bleaching was observed for both groups after 30 days, without statistical difference (p > 0.08). There was no significant difference in absolute risk of bleaching-induced tooth sensitivity between the 2 groups (p = 0.74). Higher and significant scores in pain scales were detected for the EG in comparison to the CG (p < 0.05).Conclusion: Even that the cola-based soft drink exposure during in-office bleaching treatments did not affect the bleaching’s effectiveness; patients reported a higher intensity in bleaching-induced tooth sensitivity.Keywords: dentin sensitivity, dental bleaching, hydrogen peroxide, cola-based soft drink, carbonated beverages, cola, soda

Purpose: To investigate the antibacterial effects of Terminalia catappa Linn (TCL) leaf extracts at different concentrations and the effects of these extracts used as primers on the long-term adhesive properties of two universal adhesives., Materials and Methods: After extract preparation, the antimicrobial and antibacterial activities of TCL against Streptococcus mutans (UA 159) were assessed in microdilution assays to provide the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Additionally, to provide quantitative data on the ability of TCL extract to reduce cell viability, colony forming units (CFU) were counted. To examine adhesive properties, 288 human molars were randomly assigned to 32 experimental conditions (n = 9) according to the following variables: (1) treatment agent: negative control (untreated surface), and primers at concentrations of 1xMIC, 5xMIC, and 10xMIC; (2) adhesives: Scotchbond Universal (SBU) and Futurabond Universal (FBU); (3) adhesive strategy: etch-and-rinse (ER) or self-etch (SE); and (4) storage time: 24 h or after 2 years. Primers were applied for 60 s, upon which the teeth were incrementally restored and sectioned into adhesive-dentin bonded sticks. These were tested for microtensile bond strength (μTBS) and nanoleakage (NL) after 24-h and 2-year water storage, as well as in-situ degree of conversion (DC) at 24 h. The chemical profile of the hybrid layer was determined via micro-Raman spectroscopy. Biofilm assay data were analyzed using the Kruskal-Wallis test; the pH of culture media and the chemical profile were analyzed by one-way ANOVA. The adhesive properties (µTBS, NL, DC) were evaluated using a four-way ANOVA and Tukey's test. Significance was set at 5%., Results: Similar values of MIC and MBC were observed (2 mg/ml), showing bactericidal potential. CFU analysis demonstrated that concentrations of 5xMIC and 10xMIC significantly inhibited biofilm formation (p < 0.001). The application of the TCL primer at all concentrations significantly increased the immediate μTBS and DC, and decreased the immediate NL values when compared to the control group (p < 0.05), regardless of the adhesive and adhesive strategies. Despite an increase in the NL values for all groups after 2 years (p > 0.05), in groups where the TCL primer was applied, the μTBS remained constant after 2 years for both adhesives, while a decrease in the μTBS was observed in the control groups (p < 0.05). Usually, 10xMIC showed better results than 1xMIC and 5xMIC (p < 0.05). The application of TCL promoted cross-linking; cross-linking rates increased proportionally to the concentration of TCL (p < 0.05)., Conclusion: Primers containing TCL promoted bactericidal and bacteriostatic action, as well as cross-linking with dentin, while maintaining the adhesive properties of the adhesive-dentin interface after 2 years of water storage.

Objective: Sound, natural dentin collagen can be stabilized against enzymatic degradation through exogenous crosslinking treatment for durable bonding; however, the effect on denatured dentin (DD) collagen is unknown. Hence, the ability of different crosslinkers to enhance/restore the properties of DD collagen was assessed., Methods: Demineralized natural and DD collagen films (7 mm × 7 mm × 7 µm) and beams (0.8 mm × 0.8 mm × 7 mm) were prepared. DD collagen was experimentally produced by heat or acid exposure, which was then assessed by various techniques. All specimens were then treated with 1 wt% of chemical crosslinker 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/n-hydroxysuccinimide (EDC/NHS) and two structurally different flavonoids-theaflavins (TF) from black tea and type-A proanthocyanidins from cranberry juice (CR) for either 30 s or 1 h. The controls were untreated. Dentin films were assessed for chemical interaction and cross-linking effect by FTIR, biostability against exogenous collagenase by weight loss (WL) and hydroxyproline release (HYP), and endogenous matrix metalloproteinases (MMPs) activity by confocal laser microscopy. Dentin beams were evaluated for tensile properties. Data were analyzed using ANOVA and Tukey's test (α = 0.05)., Results: Compared with natural collagen, DD collagen showed pronounced structural changes, altered biostability and decreased mechanical properties, which were then improved to various degrees that were dependent on the crosslinkers used, with EDC/NHS being the least effective. Surprisingly, the well-known MMP inhibitor EDC/NHS showed negligible effect on or even increased MMP activity in DD collagen. As compared with control, cross-linking induced by TF and CR significantly increased collagen biostability (reduced WL and HYP release, p < 0.05), MMP inhibition ( p < 0.001) and mechanical properties ( p < 0.05), regardless of denaturation., Conclusions: DD collagen cannot or can only minimally be stabilized via EDC/NHS crosslinking; however, the challenging substrate of DD collagen can be enhanced or restored using the promising flavonoids TF and CR.

Improving the longevity of composite restorations has proven to be difficult when they are bonded to dentin. Dentin demineralization leaves collagen fibrils susceptible to enzymatic digestion, which causes breakdown of the resin-dentin interface. Therefore, measures for counteracting the enzymatic environment by enhancing dentin collagen's resistance to degradation have the potential to improve the durability of dental composite restorations. This study aimed to evaluate the effects of polyphenol-rich extracts and a chemical cross-linker on the cross-linking interaction, resistance to digestion, and endogenous matrix metalloproteinase (MMP) activities of dentin collagen under clinically relevant conditions. Ten-µm-thick films were cut from dentin slabs of non-carious extracted human third molars. Following demineralization, polyphenol-rich extracts-including grape seed (GSE), green tea (GTE), and cranberry juice (CJE)-or chemical cross-linker carbodiimide with n-hydroxysuccinimide (EDC/NHS) were applied to the demineralized dentin surfaces for 30 s. The collagen cross-linking, bio-stabilization, and gelatinolytic activities of MMPs 2 and 9 were studied by using Fourier-transform infrared spectroscopy, weight loss, hydroxyproline release, scanning/transmission electron microscopy, and in situ zymography. All treatments significantly increased resistance to collagenase degradation and reduced the gelatinolytic MMP activity of dentin collagen compared to the untreated control. The CJE- and GSE-treated groups were more resistant to digestion than the GTE- or EDC/NHS-treated ones ( p < 0.05), which was consistent with the cross-linking interaction found with FTIR and the in situ performance on the acid-etched dentin surface found with SEM/TEM. The collagen films treated with CJE showed the lowest MMP activity, followed by GSE, GTE, and, finally, EDC/NHS. The CJE-treated dentin collagen rapidly increased its resistance to digestion and MMP inhibition. An application of CJE as short as 30 s may be a clinically feasible approach to improving the longevity of dentin bonding in composite restorations.

Purpose: To evaluate the effect of urethane methacrylate precursor (UMP) on the enzymatic resistance of demineralized dentin (DD) matrices. Materials and Methods: Experimental treatments containing 0 (control), 1, and 5 mmol/L UMP dissolved in an acetone (Ace) solution were formulated. Dentin matrix specimens were demineralized in vitro and immersed in the experimental treatments for 1 h. The treated specimens were then stored in 0.1 mg/mL collagenase solution for 24 h, after which their dry mass loss and hydroxyproline (HYP) release were assessed. The swelling ratios of specimens in each group were also evaluated. The interaction between UMP and the dentin matrix was observed using field-emission scanning electron microscopy (FE-SEM). Endogenous enzyme activity in dentin was evaluated using confocal laser scanning microscopy (CLSM). Results: Compared with the other treatment groups, treatment with 1 mM and 5 mM UMP-Ace significantly decreased the dry mass loss, HYP release and swelling ratio of the DD matrix (p < 0.05). FE-SEM and CLSM observations showed that treatment with UMP-Ace protected the structure of the dentin matrix and decreased porosity within the dentin-collagen network. Conclusion: Treatment with 1 mM and 5 mM UMP-Ace protects DD matrix against collagenase degradation and may be clinically useful for improving the durability of the hybrid layer. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of adhesive type and long-term aging on the shear bond strength (SBS) between silicabased ceramics and composite cement (CC). Materials and Methods: Lithium-silicate (LS), feldspathic (FD) and polymer-infiltrated ceramic (PIC) blocks were sectioned (10 x 12 x 2 mm) and divided into 24 groups considering the factors: "ceramics" (LS, FD, and PIC), "adhesive" (Ctrl: without adhesive; 2SC: 2-step conventional; 3SC: 3-step conventional; 1SU: 1-step universal), and "aging" (non-aged or aged [A]). After the surface treatments, CC cylinders (n = 15, ɸ=2mm; height = 2mm) were made and half of the samples were subjected to thermocycling (10,000) and stored in water at 37°C for 18months. The samples were submitted to SBS testing (100 kgf, 1mm/min) and failure analysis. Extra samples were prepared for microscopic analysis of the adhesive interface. SBS (MPa) data was analyzed by 3-way ANOVA and Tukey's test (5%). Weibull analysis was performed on the SBS data. Results: All factors and interactions were significant for SBS (p<0.05). Before aging, there was no significant difference between the tested groups and the respective control groups. After aging, the LS_1SU (22.18±7.74) and LS_2SC (17.32±5.86) groups exhibited significantly lower SBS than did the LS_Ctrl (30.30±6.11). Only the LS_1SU group showed a significant decrease in SBS after aging vs without aging. The LS_1SU (12.20) group showed the highest Weibull modulus, which was significantly higher than LS_2SC_A (2.82) and LS_1SU_A (3.15) groups. Conclusion: No type of adhesive applied after silane benefitted the long-term adhesion of silica-based ceramics to CC in comparison to the groups without adhesive. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the antibacterial effects of Terminalia catappa Linn (TCL) leaf extracts at different concentrations and the effects of these extracts used as primers on the long-term adhesive properties of two universal adhesives. Materials and Methods: After extract preparation, the antimicrobial and antibacterial activities of TCL against Streptococcus mutans (UA 159) were assessed in microdilution assays to provide the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Additionally, to provide quantitative data on the ability of TCL extract to reduce cell viability, colony forming units (CFU) were counted. To examine adhesive properties, 288 human molars were randomly assigned to 32 experimental conditions (n = 9) according to the following variables: (1) treatment agent: negative control (untreated surface), and primers at concentrations of 1xMIC, 5xMIC, and 10xMIC; (2) adhesives: Scotchbond Universal (SBU) and Futurabond Universal (FBU); (3) adhesive strategy: etch-and-rinse (ER) or self-etch (SE); and (4) storage time: 24 h or after 2 years. Primers were applied for 60 s, upon which the teeth were incrementally restored and sectioned into adhesive-dentin bonded sticks. These were tested for microtensile bond strength (pTBS) and nanoleakage (NL) after 24-h and 2-year water storage, as well as in-situ degree of conversion (DC) at 24 h. The chemical profile of the hybrid layer was determined via micro-Raman spectroscopy. Biofilm assay data were analyzed using the Kruskal-Wallis test; the pH of culture media and the chemical profile were analyzed by one-way ANOVA. The adhesive properties (pTBS, NL, DC) were evaluated using a four-way ANOVA and Tukey's test. Significance was set at 5%. Results: Similar values of MIC and MBC were observed (2 mg/ml), showing bactericidal potential. CFU analysis demonstrated that concentrations of 5xMIC and 10xMIC significantly inhibited biofilm formation (p < 0.001). The application of the TCL primer at all concentrations significantly increased the immediate pTBS and DC, and decreased the immediate NL values when compared to the control group (p < 0.05), regardless of the adhesive and adhesive strategies. Despite an increase in the NLvalues for all groups after2years (p > 0.05), in groups where the TCL primerwas applied, the pTBS remained constant after 2 years for both adhesives, while a decrease in the pTBS was observed in the control groups (p < 0.05). Usually, IOxMIC showed better results than 1xMIC and 5xMIC (p < 0.05). The application of TCL promoted cross-linking; cross-linking rates increased proportionally to the concentration of TCL (p < 0.05). Conclusion: Primers containing TCL promoted bactericidal and bacteriostatic action, as well as cross-linking with dentin, while maintaining the adhesive properties of the adhesive-dentin interface after 2 years of water storage. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated and compared the bond strengths, microleakage, microgaps, and marginal adaptation of self-adhesive resin composites (SAC) to dentin with or without universal adhesives. Materials and Methods: Dentin surfaces of 75 molars were prepared for shear and microtensile bond strength testing (SBS and μTBS). Silicon molds were used to build up direct restorations using the following materials to form 5 groups: 1. Surefil One; 2. Prime&Bond active Universal Adhesive + Surefil One; 3. Vertise Flow; 4. OptiBond Universal + Vertise Flow; 5. Scotchbond Universal + Filtek Z500 (control group). Bonded specimens were thermocycled 10,000x before being tested either for SBS or μTBS using a universal testing machine at a crosshead speed of 0.5mm/min. Direct mesial and distal class-II cavities were created on 100 sound premolars, with the gingival margin of distal cavities placed below CEJ and restored according to the five groups. After thermocycling, microleakage scores were assessed following immersion of restored premolars in 2% methylene blue dye for 24h, while marginal gaps and adaptation percentages were investigated on epoxy resin replicas under SEM at magnifications of 2000X and 200X, respectively. Results were statistically analyzed with parametric and non-parametric tests as applicable, with a level of significance set at a = 0.05. Results: Bond strengths, microleakage scores, microgaps, and percent marginal adaptation of Surefil One and Vertise Flow were significantly (p<0.001) inferior to the control group. Dentin preconditioning with universal adhesives significantly increased the study parameter outcomes of Surefil One and Vertise Flow, yet they were still significantly below the performance of the control group. Conclusion: Conventional resin composite outperformed the SAC whether applied solely or in conjunction with their corresponding universal adhesives. [ABSTRACT FROM AUTHOR]

Unlabelled: The aim of this study was to evaluate the effect of low shrinkage monomers on physicochemical properties of dental resin composites. Two low shrinkage resin composites: one with a crosslink branching monomer (Kalore, GC Corp) and a novel monomer (Venus Diamond, Heraeus Kulzer) were compared to a conventional resin composite formulation (Filtek Z250, 3M/ESPE). The volumetric shrinkage was evaluated by µCT analysis (n=5) and the physicochemical properties by degree of C=C conversion (DC), flexural strength (FS) and Young's modulus (YM) (n=10). All samples were light cured by a LED device (Radii, SDI) with 16 J/cm2. The results were analysed by one-way ANOVA and Tukey test for multiple comparisons (α=0.05). No statistical difference was found between µCT shrinkage values to Kalore (1.8%) and Venus Diamond (1.7%) (p≥0.05); Z250 presented statistical highest shrinkage value (2.0%). Kalore presented higher statistical DC (60.8%) than Venus Diamond (49.5%) and Z250 (49.6%). No statistical difference was found between FS or YM properties to Venus Diamond and Z250; Kalore presented statistical lowest FS and YM properties (p≥0.05)., Conclusion: Using novel monomers seem to reduce polymerization shrinkage without affecting the physicochemical properties evaluated of resin composites rather than using crosslink branching monomers.

Background: Obtaining a perfect color match with resin composite presents a significant challenge. The chameleon effect has enabled resin composite to mimic the color of the adjacent tooth structure in vitro. This double-blind, split-mouth and equivalent randomized clinical trial evaluated the color matching of one-shade resin composite with chameleon effect versus multi-shade resin composite in non-carious cervical lesion restorations (NCCLs). Methods: One hundred twenty restorations were performed on NCCLs with two restorative materials (n = 60). After prophylaxis, the teeth were isolated with rubber dam and one universal adhesive was applied in the selective enamel etching strategy. For both groups, the restorations were inserted incrementally. The values of ΔEab and ΔE00 in the cervical and middle third were evaluated using a digital spectrophotometer before vs. after the restorations. The restorations were evaluated at baseline and after 7 days, 6-, 12- and 18-month of clinical performance according to the FDI criteria (Word Federation Criteria). Statistical analysis was performed using Chi-square test for all parameters. Color change was analyzed by two one-sided t-tests for paired samples (α = 0.05). Results: Regarding the color measurement no significant difference was observed when Vittra APS (FGM Dental Products, Joinville, SC, Brazil) was compared to Vittra Unique (FGM Dental Products, Joinville, SC, Brazil) for any of the comparisons performed (p > 0.05). However, the ΔEab and ΔE00 values for the cervical third, both before and after the restorations, were higher compared to the ΔEab and ΔE00 values observed when comparing the cervical and middle thirds after the restorations. After 18 months, five restorations exhibited minimal discrepancies in terms of marginal adaptation or marginal discoloration (p > 0.05). In all other criteria, including retention rate, no changes were detected at the 18-month recall. Conclusions: The one-shade resin composite used achieve the same color match when compared to a multi-shade resin composite after a period of 7 days in NCCLs. Overall, the restorations scored clinically very good (FDI) at baseline and after 18 months for all outcomes. Clinical Significance: The use of a one-shade resin composite in NCCLs can be recommended because it has the ability to simplify the restoration procedure and maintaining an excellent clinical performance. Registration of clinical trials: RBR-8txr4fw: 26/05/2022. [ABSTRACT FROM AUTHOR]

Statement of the Problem: One of the most important factors in the clinical longevity of composite resin restorations is proper adhesion, which is achieved using phosphoric acid. Different phosphoric acid products might affect the micro-shear bond strength of composite resin to enamel. Purpose: The present study aimed to evaluate the micro-shear bond strength of composite resin to sound enamel using six different brands of acid-etch agents. Materials and Method: The present in vitro study was carried out on 72 extracted sound human (mandibular and maxillary) first premolar teeth. The teeth crowns were divided into two equal parts with a mesiodistal cut and randomly assigned to six groups in terms of the acid etchant brand: Ultra-etch, SDI, Morvabon, FGM, Nik Darman, and Experimental. The bonding procedure was carried out using the Margin Bond enamel adhesive. Tygon tubes (1×0.7 mm) containing composite resin were bonded to each enamel surface. After 24 hours of storage in distilled water, each sample underwent a shearing force with a crosshead speed of 0.5 mm/min. The morphologic changes were evaluated using scanning electron microscopy. The data were analyzed with SPSS using one-way ANOVA and Tukey test (p< 0.05). Results: One-way ANOVA showed that micro-shear bond strength in different etchant agents have significant differences (p< 0.001). The highest and lowest composite resin micro-shear bond strengths belonged to Ultradent and SDI brands, respectively. The enamel surfaces in the SDI group revealed residual debris after dissolution. Conclusion: Preparation of the enamel surface with different phosphoric acid products might affect the micro-shear bond strength and enamel surface morphology differently. Further clinical studies are suggested to evaluate the effect of different types and concentrations of acid etching agents on the enamel and dentin bonds. [ABSTRACT FROM AUTHOR]

Purpose: To determine if there was a statistically significant difference between physician assistant (PA) faculty and nurse practitioner (NP) faculty cultural awareness and sensitivity (CAS) and cultural competence behaviors (CCB). Methods: This quantitative comparative analysis utilized the Cultural Competence Assessment (CCA), to measure participants' cultural competence (CC) subscales of CAS and CCB. PA and NP faculty, broadly defined as any PA or NP licensed to practice within a United States jurisdiction and functioning as full- or part-time faculty, adjunct faculty, guest lecturers, or clinical preceptors, participated online. Descriptive statistics were used to generate a depiction of the sample and central tendencies of the CAS and CCB scores. The data were then analyzed using the independent-samples t-test. Results: PA (n = 100) and NP (n = 102) responses were evaluated. For each of the subscales, NP faculty scored marginally higher than their PA counterparts. However, the differences in CAS (P = 0.463) and CCB (P = 0.353) scores failed to achieve statistical significance. The results uncovered that for both groups, CAS scores were higher than CCB scores. This finding may indicate that attitudes and desires regarding diversity and CC are greater than participants' ability or willingness to manifest CC. Conclusion: While there was not a statistically significant difference in the CC scores between PA and NP faculty, there are theoretical and practical implications for employers, NP and PA faculty, NP and PA program administrators, and accrediting organizations for each profession. [ABSTRACT FROM AUTHOR]

The translation of pre‐clinical anti‐cancer therapies to regulatory approval has been promising, but slower than hoped. While innovative and effective treatments continue to achieve or seek approval, setbacks are often attributed to a lack of efficacy, failure to achieve clinical endpoints, and dose‐limiting toxicities. Successful efforts have been characterized by the development of therapeutics designed to specifically deliver optimal and effective dosing to tumour cells while minimizing off‐target toxicity. Much effort has been devoted to the rational design and application of synthetic nanoparticles to serve as targeted therapeutic delivery vehicles. Several challenges to the successful application of this modality as delivery vehicles include the induction of a protracted immune response that results in their rapid systemic clearance, manufacturing cost, lack of stability, and their biocompatibility. Extracellular vesicles (EVs) are a heterogeneous class of endogenous biologically produced lipid bilayer nanoparticles that mediate intercellular communication by carrying bioactive macromolecules capable of modifying cellular phenotypes to local and distant cells. By genetic, chemical, or metabolic methods, extracellular vesicles (EVs) can be engineered to display targeting moieties on their surface while transporting specific cargo to modulate pathological processes following uptake by target cell populations. This review will survey the types of EVs, their composition and cargoes, strategies employed to increase their targeting, uptake, and cargo release, and their potential as targeted anti‐cancer therapeutic delivery vehicles. [ABSTRACT FROM AUTHOR]

Introduction: Achieving strong bond strength of adhesive systems to deep dentin is challenging. Various methods to improve bond strength to deep dentin have been investigated. Chlorhexidine (CHX) enhances the longevity of the bond between adhesives and dentin by inhibiting the collagenolytic activity of Matrix Metalloproteinases (MMPs). Benincasa hispida is a natural plant-based functional food containing minerals and vitamins that help prevent osteoporosis and improve bone health. Aim: To evaluate the Microshear Bond Strength (MSBS) of a 10-methacryloyloxydecyl-dihydrogen Phosphate-based (10-MDP) universal adhesive system to coronal dentin with different dentin surface pretreatments, specifically CHX and Benincasa hispida. Materials and Methods: An in-vitro pilot study was conducted at the Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, from May 2023 to November 2023. Dentin discs (42) were prepared from human mandibular first molars. A standard etch-and-rinse protocol was performed on the discs. The specimens were assigned to different dentin pretreatments: Group-I (no pretreatment), Group-II (CHX) and Group-III (Benincasa hispida). CHX and Benincasa hispida were applied using micro applicator tips. A dentin bonding agent containing 10-MDP (DBA) was applied, photopolymerised and a composite restoration was fabricated. The MSBS to dentin was evaluated using a universal testing machine. The failure patterns were analysed using a stereomicroscope at 10x magnification. One-way Analysis of Variance (ANOVA) and Tukey's Honestly Significant Difference (HSD) HSD tests were used for statistical analysis, with a significance level set at α=0.05. Results: The mean MSBS values were 24.2732±5.41329 MPa for Group-III, 14.3848±4.23492 MPa for Group-II and 6.9724±3.15837 MPa for Group-I. Pretreatment of dentin with B. hispida resulted in significantly higher MSBS values compared to the other two groups (p<0.001*). Conclusion: Pretreatment with B. hispida significantly improved MSBS. Thus, B. hispida pretreatment may be beneficial in increasing dentin bond strength. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of applying a matrix metalloproteinase (MMP) inhibitor on the fracture resistance of root-filled teeth restored with Everstick fiber-reinforced composite resin. Subjects and Methods: After the selection of 60 freshly extracted human mandibular first molar, root canal access and standard uniformly sized mesio-occluso-distal (MOD) cavities were made and the teeth were randomly assigned into three groups (n = 20 each): Group I, the MOD cavity was first lined with flowable composite resin and then restored with composite resin. In Group II, Everstick fiber was placed into the bed of flowable composite in buccal–pulpal–lingual direction before the composite restoration was placed. In Group III, after etching of the cavity, a 2% chlorhexidine MMP inhibitor was applied. Then, the MOD cavity was restored same as group II. A universal testing machine was employed to compressively load the teeth at a cross-head speed of 0.5 mm/min till fracture. The maximum fracture loads were recorded in Newtons (N) and data were analyzed with one-way ANOVA and post-hoc Tukey tests. Results: Group III exhibited significantly higher fracture resistance compared to all other groups (P < 0.001), whereas Group I demonstrated the lowest fracture resistance. Conclusion: The utilization of Everstick glass fiber, combined with MMP inhibitor treatment, yielded the greatest fracture resistance. Hence, this method may be prioritized over conventional restoration techniques for strengthening root canal-treated teeth with structurally compromised crowns. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the effect of different surface treatment methods on the shear bond strength (SBS) of metal brackets bonded to two types of CAD/CAM composite restorations: milled and 3D-printed. Materials and Methods: A total of 160 flat-shaped specimens (10 × 10 × 2 mm3) were prepared from four different CAD/CAM composites; two milled (Lava Ultimate™ [LU] and Grandio™ [GR]) and two 3D-printed (Crowntec™ [CT] and C&B Permanent™ [CB]). These specimens underwent thermocycling (5000 cycles at 5–55 °C), then were categorized based on the surface treatment into four groups (n = 10): Group C (control, no surface treatment), Group HF (treated with 9.6% hydrofluoric acid), Group DB (mechanical roughening by a diamond bur), and Group SB (sandblasting using aluminum oxide). Metal brackets were bonded using Transbond XT Primer and universal adhesive, stored in artificial saliva for 24 h, then thermocycled again. Shear bond strength (SBS) was tested using a universal testing machine until bracket debonding occurred. The adhesive remnant index (ARI) was assessed using a stereomicroscope to quantify the residual adhesive following debonding. Result: Regarding material, GR and LU restorations had significantly higher SBS values compared to CT and CB, ranging from 13.90 MPa to 20.35 MPa. Regarding surface treatment, SB and HF groups showed significantly higher SBS values. The ARI scores showed different adhesive modes of failure, with higher instances of scores 0 and 1, which indicate no or minimal adhesive remaining. Conclusions: Both milled and 3D-printed materials had adequate SBS for clinical use, with milled materials showing superior results. Surface treatments like sandblasting and HF significantly improved bond strength, with adhesive failure being common. [ABSTRACT FROM AUTHOR]

The aim of this study is to present the characteristics and a comparison of four different commercial materials dedicated to the CAD/CAM technique in dentistry, all of which can be classified as ceramic materials. Its purpose is also to evaluate the impact of surface treatment on the cytotoxicity and microbiological properties of the materials. The CAD/CAM technique has a perpetually growing role in modern reconstructive dentistry. It requires a material's possession of peculiar characteristics, such as mechanical resistance, durability, functionality (similar to natural tissues), good aesthetics and biocompatibility. To critically evaluate a biomaterial, both manufacturer claims and in vitro tests should be considered. Further steps of evaluation may include animal tests and clinical trials. There are certain attributes of biomaterials that may be modified by surface treatment that can be crucial to the clinical success of the material. The evaluated materials were Vita Suprinity (VITA-Zahnfabrik, Germany), Vita Mark II (VITA-Zahnfabrik, Germany), Celtra Duo (Dentsply Sirona, USA) and Empress Cad (Ivoclar Vivadent, Liechtenstein). They are available in the form of prefabricated blocks of various diameters and are popular among operators performing clinical procedures using CAD/CAM. Standardized blocks of each material were prepared. Half of them had their surface polished. Further, half of all the samples were covered by a nano-copper layer. The samples were evaluated for cytotoxicity, presented on a 0–4 scale, adhesion susceptibility and potential of forming a biofilm on their surface. Physicochemical properties such as the water contact angle (WCA) were evaluated for the tested materials. The influence of copper coating on cytotoxicity cannot be unequivocally stated or denied. Surface polishing did not affect the materials' cytotoxicity, but it increased the WCA of all materials and, therefore, their hydrophobicity. Different degrees of adhesion ability and biofilm formation were dependent on the species of microorganisms and properties of the dental materials. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study aims to evaluate the microtensile bond strength (µTBS) of different resin composite restorations bonded to mid-coronal dentin and proximal root dentin using light-cured, chemical-cured, and dual-cured adhesives immediately and after aging. Nanoleakage and degree of cure were also assessed. Methods: Eighty-four molars were divided into mid-coronal dentin and proximal root dentin. Each group was further subdivided into three subgroups based on the restorative systems used, which involved the utilization of light-cured, chemical-cured, and dual-cured adhesives. Half of the specimens underwent µTBS testing after 24 h, while the other half after aging. Representative specimens were analyzed for nanoleakage. The degree of cure of the tested adhesive systems was also assessed. Results: Aging showed a significant negative effect on µTBS results and led to increased nanoleakage (p < 0.001). Furthermore, in all subgroups, the µTBS values of proximal root dentin were lower compared to mid-coronal dentin, except in the aged subgroup for the system utilizing the dual-cured adhesive. The restorative systems with chemical and dual-cured adhesives demonstrated comparable bonding properties. However, the system with the light-cured adhesive exhibited the worst bonding properties after aging when bonded to proximal root dentin and cured at a large distance (p < 0.05). Conclusions: All tested restorative systems were negatively affected by aging, and the regional dentin had variable effects on the bonding properties. Clinicians should exercise caution when using the tested light-cured adhesive in areas where the curing distance exceeds 3 mm. [ABSTRACT FROM AUTHOR]

This article comprehensively reviews the performance of simplified direct restorative materials that have the potential to be an alternative to amalgam. Following an understanding of the material structures and clinical performances, this review provides an analysis of the bonding mechanisms and influential factors on the bond strength. These factors include substrate-related variations, involving primary vs. permanent dentin, sound- vs. caries-affected/demineralized dentin comparisons and surface-related factors and pretreatments. Special attention is given to the factors changing the substrate surface, such as different contaminants, remedy methods after contamination and different conditioning methods related to the materials. Variations in sample preparation and bond strength test parameters are also evaluated for the analysis of the outcomes. This review aims to provide an overview of the factors involved in the application procedure of direct restorations together with in vitro testing variations to guide the selection of suitable materials by understanding strengths and shortcomings. [ABSTRACT FROM AUTHOR]

Background: In Denmark, the first standalone supervised injecting facility (SIF) opened in Copenhagen's Vesterbro neighborhood on October 1, 2012. The purpose of this study was to assess whether use of services provided by the recently opened SIF was associated with changes in injecting behavior and syringe disposal practices among people who inject drugs (PWID). We hypothesized that risk behaviors (e.g., syringe sharing), and unsafe syringe disposal (e.g., dropping used equipment on the ground) had decreased among PWID utilizing the SIF., Methods: Between February and August of 2013, we conducted interviews using a survey (in English and Danish) with forty-one people who reported injecting drugs at the SIF. We used descriptive statistics and McNemar's test to examine sociodemographic characteristics of the sample, current drugs used, sites of syringe disposal before and after opening of the SIF, and perceived behavior change since using the SIF., Results: Of the interviewed participants, 90.2% were male and the majority were younger than 40 years old (60.9%). Three-quarters (75.6%) of participants reported reductions in injection risk behaviors since the opening of the SIF, such as injecting in a less rushed manner (63.4%), fewer outdoor injections (56.1%), no longer syringe sharing (53.7%), and cleaning injecting site(s) more often (43.9%). Approximately two-thirds (65.9%) of participants did not feel that their frequency of injecting had changed; five participants (12.2%) reported a decrease in injecting frequency, and only two participants (4.9%) reported an increase in injecting frequency. Twenty-four (58.5%) individuals reported changing their syringe disposal practices since the opening of the SIF; of those, twenty-three (95.8%) reported changing from not always disposing safely to always disposing safely (McNemar's test p-value < 0.001)., Conclusions: Our findings suggest that use of the Copenhagen SIF is associated with adoption of safer behaviors that reduce harm and promote health among PWID, as well as practices that benefit the Vesterbro neighborhood (i.e., safer syringe disposal). As a public health intervention, Copenhagen's SIF has successfully reached PWID engaging in risk behavior. To fully characterize the impacts of this and other Danish SIFs, further research should replicate this study with a larger sample size and prospective follow-up.

Aim: The purpose of this study was to evaluate the 18-month retrospective study of self-etch adhesive (Prime&Bond One Select) and self-etch mode of universal adhesives (Single Bond Universal, Gluma Bond Universal) applied to non-carious cervical lesions according to the World Dental Federation criteria., Materials and Methods: Thirty patients without any systemic disease, good oral hygiene, having at least 20 teeth and six non-carious cervical lesions treated using a self-etch mode of adhesives operated between January and March 2017. Accordingly, 335 restorations were evaluated according to the World Dental Federation criteria at 3, 6, 12 and 18 months. Pillai's Trace test was used to determine the interaction of criteria with time and adhesive systems. IBM SPSS Statistics 21.0 program was used in the analysis. Value of P < 0.05 was accepted as a criterion for statistical significance., Results: At the end of 18 months, participation was 100%. There was a statistically significant difference P < 0.05 between Prime&Bond One Select and Single Bond Universal, Prime&Bond One Select and Gluma Bond Universal in the 18-month period. In terms of marginal staining, fracture of material and retention, recurrence of caries, erosion and abfraction, tooth integrity criteria at the end of the 18 months, Prime&Bond One Select performed clinically very good, Single Bond Universal and Gluma Bond Universal performed clinically good according to World Dental Federation criteria. Marginal adaptation criteria, Prime&Bond One Select, Single Bond Universal and Gluma Bond Universal performed clinically good. Retention loss rate was found to be the lowest in Prime&Bond One Select and the highest in Gluma Bond Universal., Conclusion: Accordingly, 18-month evaluation of all adhesives used in the study showed clinically acceptable results in all of the World Dental Federation criteria., (© 2023 Australian Dental Association.)

The central aim of adhesive dentistry is to improve the compatibility between current adhesives and a range of substrates by employing diverse application techniques. Therefore, the overarching objective of this review is to offer a comprehensive analysis of dentin bonding systems, starting with an introduction to adhesion and a detailed overview of enamel and dentin structures, their histology, and the impact of dentin structure on resin–dentin bonding. It covers the mechanisms of resin–dentin bonding, including resin adhesive application, bonding mechanisms, and factors influencing efficacy. Further, this review explores the composition of resin adhesive systems, including acidic components, cross-linking monomers, solvents, and other critical elements. It also examines various adhesive strategies—etch-and-rinse, self-etch, and universal adhesives—highlighting their applications and advantages. The review extends to clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), demonstrating the practical implications of adhesive systems in enhancing restoration longevity and performance. In conclusion, despite significant advancements, no gold-standard method for optimal adhesion exists. Each adhesive system has distinct strengths and limitations. The review emphasizes the importance of evaluating methods for achieving durable adhesion and staying current with technological advancements in adhesive systems. Summary: This review provides a thorough analysis of dentin bonding systems, delving into the structures and bonding mechanisms of both enamel and dentin. By exploring various adhesive systems and their components, it highlights the ongoing challenges in achieving optimal resin–dentin adhesion. The review also addresses the clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), illustrating how different adhesive techniques impact clinical outcomes. It underscores the necessity for continuous innovation and assessment of adhesive systems to enhance long-term bonding effectiveness in clinical practice. [ABSTRACT FROM AUTHOR]

Background and Aims: The bond strength of direct composite restoration to the caries affected dentin is a challenging issue. Preparation of dentin with an antibacterial agent is a method for creating durable bonded restorations. The aim of this study was to investigate the effect of curcumin photosensitizer on the bond strength of a universal adhesive to the caries-affected dentin (CAD). Materials and Methods: In this experimental in vitro study, forty-four decayed human molar teeth were selected. After removing the surface enamel and dentin by a water-cooled saw, the decayed mid-coronal dentin was stained with a caries detection solution. The green and soft infected dentin was removed and CAD and hard and healthy surrounding dentin were left. Then, the remaining dentin surfaces were treated by 600 grit silicon carbide papers and polished. The specimens were divided into two groups (n=22): dentin pretreatment group by curcumin and control with no dentin pretreatment group by curcumin. Each group was divided into two subgroups based on the method of application of All-Bond Universal adhesive (Bisco, USA) (etch and rinseand self-etching methods). After placing the Aelite All Purpose Body (Bisco, USA) composite, all specimens were placed in a universal testing machine for microshear bond strength (µSBS) test. The failure mode of the isolated surfaces was evaluated under a stereomicroscope. Two-way ANOVA analysis was used for statistical analysis. Results: Based on the obtained results, intervention with the adhesive application method and surface pretreatment with curcumin had no significant effect on the bond strength. Also, there was no significant difference in the bond strength of the curcumin group in both etch and rinse and self-etching methods (SE=56.3±27.11 MPa; ER=52.4±84.11 MPa) (P=0.847). In the curcumin-free group, there was no significant difference between the two different adhesive application methods (P=0.187). Conclusion: The results obtained in the present study showed that the pretreatment of dentin affected by caries with light-sensitive curcumin and also use of a universal adhesive by either self-etching or self-etchinf methods had no influence on the microshear bond strength of the composite restoration. [ABSTRACT FROM AUTHOR]

Prior research has indicated that bisphosphonates (BPs) can improve periodontal disease because of their anti-osteoporosis properties. In vitro studies have shown that BPs induce cytotoxicity, inhibit wound healing, and thus affect periodontal disease. Denosumab and BPs have alternative indications. BP and denosumab are not known to correlate with gingival disorders. We assessed such a relationship by applying Bayesian and nonproportional analyses to data in the US FDA Adverse Event Reporting System (FAERS) database. The study analyzed BPs and denosumab-reported incidents with preferred terms found in the narrow Standardized MedDRA Queries for gingival disorders. A total of 5863 reported cases of gingival disorders were associated with five BPs (alendronate, pamidronate, ibandronate, risedronate, and zoledronate) and denosumab. More than 15% of patients with gingival disorders related to BPs and denosumab other than denosumab were hospitalized over short- or long-term periods. Our findings indicated BPs and denosumab had significant reporting odds ratios (ROR), proportional reporting ratios (PRR), and information components (IC) with respect to gingival disorders. Pamidronate had the highest association (ROR = 64.58, PRR = 57.99, IC = 5.71), while the weakest association was found with denosumab (ROR = 3.61, PRR = 3.60, IC = 1.77). Significant associations were found between the six drugs and gingival pain, gingival recession, gingivitis, periodontal disease, and periodontitis. In conclusion, our comprehensive overview of the correlations, clinical characteristics, and prognoses of BPs and denosumab-related gingival disorders suggests that these issues deserve continued surveillance and appropriate management. [ABSTRACT FROM AUTHOR]

Objective: This systematic review evaluated how different storage times and conditions affect universal adhesives' bond strength and degree of conversion (DC). Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for articles published from January 1st, 2000, until May 15th, 2022. The researchers comprehensively evaluated the articles using a multi-step process to identify articles relevant to the topic of interest. Quality assessment was performed through the ROBDEMAT tool. Due to the high heterogeneity in the preliminary data, performing a meta-analysis was not feasible. Results: A total of 3169 records were obtained, and after removing duplicates, 2267 remained. Following title and abstract screening, 2253 studies were excluded based on the predetermined exclusion criteria. Of the 14 remaining studies, seven were further excluded due to the use of non-universal adhesives, experimental adhesives, or lack of aging protocols. Ultimately, seven studies were included in this systematic review. All studies focused on bond strength, with only one addressing DC. The Findings showed that aging or different storage conditions generally led to reduced bond strength and DC values in universal adhesives, although exceptions with stable or improved properties were noted. Conclusions: Adhesives with higher pH and those containing methacrylamides, HEMA-free compositions, or hydrolytically stable monomers showed better durability than others. Strict adherence to storage instructions, lower storage temperatures, and immediate recapping of adhesive bottles after use is recommended to maintain adhesive properties. These findings provide insights for optimizing the long-term performance of universal adhesives in clinical settings. [ABSTRACT FROM AUTHOR]

This study examined research interest in copper materials for caries management. We conducted an exhaustive literature search of English publications on copper materials for caries management. We removed duplicate publications and screened the titles and abstracts to identify relevant publications. Then, we analyzed the bibliometric data of the publications using the Bibliometrix and VOSviewer programs. This study included 75 laboratory studies, six clinical trials, and 17 reviews. Most of the original research studied copper or copper oxide nanoparticles (45/81, 56%). The materials could be doped into topical agents, restorative fillers, dental adhesives, dental implants, and orthodontic appliances. Since the first paper was published in 1980, publication counts gradually increased and surged in 2019. Among publications on copper materials for caries management, the publication counts and citations from 2019 to 2024 accounted for 65% (64/98) and 74% (1677/2255) over the last 45 years. Cocitation analysis revealed that the two main keywords were nanoparticles and antibacterial activity, and their burst strengths (period) were 3.84 (2021–2024) and 2.21 (2020–2021). The topics of the top two publications with the highest citation burst strength (period) are the antimicrobial effect of copper oxide nanoparticles (3.14, 2021–2022) and the dental application of copper nanoparticles (2.84, 2022–2024). In conclusion, this study revealed a growing interest in copper materials for caries management. [ABSTRACT FROM AUTHOR]

The objectives of this study were to evaluate the bonding durability of four different self-etch adhesives to dentin after 24 h and thermal cycling (TC) and to measure the degree of polymerization conversion (DC) in situ. Two-step self-etch adhesives, Clearfil SE Bond 2 (SE2, Kuraray Noritake Dental) and G2-Bond Universal (G2B, GC), and one-step self-etch adhesives, Scotchbond™ Universal Plus Adhesive (SBU, 3M ESPE) and Clearfil Universal Bond Quick (UBQ, Kuraray Noritake Dental), were used. The labial surfaces of bovine teeth were ground to create flat dentin surfaces. The adhesives were applied according to the manufacturers' instructions. After resin composite buildup and 24 h water storage, the specimens were sectioned into beams and all groups were subjected to thermal stress for 0, 10,000 (10k), or 20,000 (20k) cycles followed by micro-tensile bond strength (µTBS) testing. In situ DC was investigated with a laser Raman microscope. The µTBS data were statistically analyzed and subjected to a Weibull analysis. The different groups were compared at the characteristic strength (63.2% probability of failure) (α = 0.05). Two-Way ANOVA was used to show the effect of different adhesives and thermal cycling on the mean DC% followed by Tukey's multiple comparison post hoc test. G2B/TC10k resulted in a significant increase in the µTBS compared to TC0. SBU/TC20k showed significantly higher µTBS compared to TC0. For comparison between different tested adhesives, SBU showed a significantly lower µTBS compared to G2B after TC10k. G2B and SBU showed a greater number of adhesive failures after TC. Mean DC% was different for each adhesive. The newly developed MDP- and HEMA-free 2-SEA showed similar bonding performance with the gold-standard 2-SEA. However, there is still room for further improvement in terms of SEAs. [ABSTRACT FROM AUTHOR]

Fucosterols have been widely studied for their antioxidant, anticancer, and anti-inflammatory properties. However, they have not yet been studied in the field of dentistry. This study aimed to determine whether pretreatment of dentin with fucosterol before resin restoration enhances bond stability in resin-dentin hybrid layers. After applying 0.1, 0.5, and 1.0 wt% fucosterol to demineralized dentin, microtensile bond strength (MTBS) and nanoleakage tests were performed before and after collagenase aging, and the surface was observed using scanning electron microscope (SEM). The fucosterol-treated group showed better bond strength and less nanoleakage both before and after collagenase aging, and the corresponding structures were confirmed using SEM. MMP zymography confirmed that the activity of MMPs was relatively low along the concentration gradient of fucosterol, and the FTIR analysis confirmed the production of collagen crosslinks. In addition, fucosterol exhibits cytotoxicity against Streptococcus mutans, the main cause of dental decay. The results of this study suggest that fucosterol pretreatment improves bond strength and reduces nanoleakage at the resin-dentin interface, possibly through a mechanism involving collagen cross-link formation via the inhibition of endogenous and exogenous MMP activity. This study demonstrates the potential of fucosterol as an MMP inhibitor in dentin, which contributes to long-term resin-dentin bond stability and can be used as a restorative material. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of neutral 10-methacryloyloxydecyl dihydrogen phosphate salt (MDP-Na) on the dentin bond strength and remineralization potential of etch-&-rinse adhesive. Methods: Two experimental etch-&-rinse adhesives were formulated by incorporating 0 wt% (E0) or 20 wt% (E20) neutral MDP-Na into a basic primer. A commercial adhesive, Adper Single Bond 2 (SB, 3 M ESPE), served as the control. Sixty prepared teeth were randomly allocated into three groups (n = 20) and bonded using either one of the experimental adhesives or SB. Following 24 h of water storage, the bonded specimens were sectioned into resin-dentin sticks, with four resin-dentin sticks obtained from each tooth for microtensile bond strength (MTBS) test. Half of the sticks from each group were immediately subjected to tensile loading using a microtensile tester at a crosshead speed of 1 mm/min, while the other half underwent tensile loading after 6-month incubation in artificial saliva (AS). The degree of conversion (DC) of both the control and experimental adhesives (n = 6 in each group) and the adsorption properties of MDP-Na on the dentin organic matrix (n = 5 in each group) were determined using Fourier-transform infrared spectrometry. Furthermore, the effectiveness of neutral MDP-Na in promoting the mineralization of two-dimensional collagen fibrils and the adhesive-dentin interface was explored using transmission electron microscopy and selected-area electron diffraction. Two- and one-way ANOVA was employed to assess the impact of adhesive type and water storage on dentin bond strength and the DC (α = 0.05). Results: The addition of MDP-Na into the primer increased both the short- and long-term MTBS of the experimental adhesives (p = 0.00). No difference was noted in the DC between the control, E0 and E20 groups (p = 0.366). The MDP-Na remained absorbed on the demineralized dentin even after thorough rinsing. The intra- and extra-fibrillar mineralization of the two-dimensional collagen fibril and dentin bond hybrid layer was confirmed by transmission electron microscopy and selected-area electron diffraction when the primer was added with MDP-Na. Conclusions: The use of neutral MDP-Na results in high-quality hybrid layer that increase the dentin bond strength of etch-&-rinse adhesive and provides the adhesive with remineralizing capability. This approach may represent a suitable bonding strategy for improving the dentin bond strength and durability of etch-&-rinse adhesive. [ABSTRACT FROM AUTHOR]

Copyright of Italian Journal of Health Education, Sport & Inclusive Didactics is the property of Edizioni Universitarie Romane and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To endow an implant surface with enhanced properties to ensure an appropriate seal with the host tissue for inflammation/infection resistance, next-generation bone implant collagen–polyphenol nanolayers were built on conventional titanium surfaces through a multilayer approach. X-ray Photoelectron Spectroscopy (XPS) analysis was performed to investigate the chemical arrangement of molecules within the surface layer and to provide an estimate of their thickness. A short-term (2 and 4 weeks) in vivo test of bone implants in a healthy rabbit model was performed to check possible side effects of the soft surface layer on early phases of osteointegration, leading to secondary stability. Results show the building up of the different nanolayers on top of titanium, resulting in a final composite collagen–polyphenol surface and a layer thickness of about 10 nm. In vivo tests performed on machined and state-of-the-art microrough titanium implants do not show significant differences between coated and uncoated samples, as the surface microroughness remains the main driver of bone-to-implant contact. These results confirm that the surface nanolayer does not interfere with the onset and progression of implant osteointegration and prompt the green light for specific investigations of the potential merits of this bioactive coating as an enhancer of the device/tissue seal. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the long-term push-out bond strength (PBS) and nanoleakage (NL) of universal adhesives with different photo-initiator systems in the root canals of teeth in which fiber posts were luted. Materials and Methods: One-hundred twenty endodontically treated human premolars were randomly divided into 12 groups based on the following factors: adhesives (Scotchbond Universal [SBU], Ambar Universal [AMB], and Ambar Universal APS [AMB-APS]); adhesive strategy (etch-and-rinse and self-etch), and time of testing (immediately vs after 2 years). The posts were cemented, sectioned into slices, tested for PBS at 0.5 mm/min, and examined for NL using scanning electron microscopy immediately thereafter or after 2 years of water storage. Data were evaluated using a four-way ANOVA (root thirds vs time vs universal adhesive vs adhesive strategies) and Tukey's test (1 = 5%). Results: For both evaluation times, AMB-APS demonstrated no significant difference in the PBS or NL when different radicular thirds were compared (p > 0.05). However, for SBU and AMB, the cervical third demonstrated higher PBS and lower NL than those of the apical third at both time points (p < 0.0001). AMB-APS exhibited higher PBS and lower NL in the apical third in comparison with SBU and AMB (p < 0.0001). SBU and AMB displayed a significant decrease in the PBS and increased NL after 2 years (p < 0.0001), whereas AMB-APS demonstrated no significant signs of degradation even after 2 years of water storage (p > 0.05). Conclusion: Independent of the root third evaluated, the universal adhesive containing APS photo-initiator system demonstrated bonding stability at the adhesive interface between the root canal and fiber posts, even after 2 years of water storage. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this randomized controlled clinical trial was to evaluate the 3-year clinical performance of a universal adhesive (Clearfil Universal Bond Quick (CUBQ); Kuraray Noritake) when restoring non-carious cervical lesions (NCCLs) using two different application modes (etch-and-rinse vs self-etch with prior selective enamel etching). Materials and Methods: Fifty-one patients participated in this study. A total of 251 NCCLs (n = 251) were assigned to two groups: 1) CUBQ applied in etch-and-rinse mode (n = 122; CUBQ-ER) and 2) CUBQ applied in self-etch mode with prior selective etching of enamel with phosphoric acid (n = 129; CUPQ-SEE). The same resin composite, Clearfil Majesty ES-2 (Kuraray Noritake), was used for all restorations. The restorations were evaluated at baseline, 1 and 3 years using FDI criteria: marginal staining, fracture and retention, marginal adaptation, post-operative sensitivity and recurrence of caries. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). Materials and Methods: Fifty-one patients participated in this study. A total of 251 NCCLs (n = 251) were assigned to two groups: 1) CUBQ applied in etch-and-rinse mode (n = 122; CUBQ-ER) and 2) CUBQ applied in self-etch mode with prior selective etching of enamel with phosphoric acid (n = 129; CUPQ-SEE). The same resin composite, Clearfil Majesty ES-2 (Kuraray Noritake), was used for all restorations. The restorations were evaluated at baseline, 1 and 3 years using FDI criteria: marginal staining, fracture and retention, marginal adaptation, post-operative sensitivity and recurrence of caries. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). Results: The patient recall rate at 3 years was 90%. After 3 years, both groups presented an increase in the percentage of small but still clinically acceptable marginal defects (CUBQ-ER: 67%, CUBQ-SEE: 63.2%) and marginal staining (CUBQ-ER: 32.6%, CUBQ-SEE: 31.7%). The overall success rate was 82.6% and 83.8% for CUBQ-ER and CUBQ-SEE, respectively. In total, 38 restorations (19 CUBQ-ER, 19 CUBQ-SEE) failed because of loss of retention, fracture, severe marginal defect and/or marginal discoloration. A retention rate of 87.2% and 86.3% was recorded for CUBQ-ER and CUBQ-SEE, respectively. No significant difference was observed between the two bonding-mode groups for any of the evaluated parameters. Conclusion: After 3 years of clinical service, Clearfil Universal Bond Quick performed similarly in etch-and-rinse and selfetch modes with prior selective enamel etching. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of carbodiimide (EDC) and chitosan (CHI) on the enzymatic activity (EA) and bond strength (BS) of different composite cements to root dentin. Materials and Methods: Ninety (90) maxillary canines were sectioned, standardizing the length of the roots. The roots were endodontically treated, prepared, divided into 3 groups according to dentin treatment (distilled water [DW], CHI 0.2 wt%, or EDC 0.5M), and further subdivided into 3 subgroups according to composite cement (RelyX ARC [3M Oral Care], Panavia F 2.0 [Kuraray Noritaki], or RelyX U200 [3M Oral Care]). Of the slices obtained by sectioning, the most cervical of each third were subjected to a push-out test and the most apical were subjected to in-situ zymography. Half of the slices were analyzed immediately, and the other half after 6 months. The results were analyzed with ANOVA or the chi-squared test. Results: RelyX ARC showed higher BS associated with CHI, while RelyX U200 showed higher BS associated with EDC (p = 0.044). For Panavia F 2.0, the treatment did not influence BS (p > 0.05). For the cervical and middle thirds, no differences were observed between the cements, while the apical third revealed higher BS for RelyX U200 (p < 0.001). The highest percentage of adhesive-to-dentin failures was observed for Panavia F 2.0. EDC showed the lowest percentage of adhesive-to-dentin failures. According to zymographic analysis, DW and CHI showed greater fluorescence for RelyX ARC, while EDC exhibited the lowest fluorescence of all cements (p > 0.05). Conclusion: The different mechanisms of action of solutions for pre-treatment of intraradicular dentin yielded different results depending on the adhesive used. EDC resulted in higher bond strength and higher enzyme inhibition for RelyX U200, while the treatment with chitosan resulted in higher bond strength and lower enzymatic activity for RelyX ARC. Although EDC and chitosan treatments did not influence the bond strength for Panavia F 2.0, both resulted in higher enzyme inhibition for this composite cement. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of etching mode (self-etch and etch-and-rinse) on acid-base resistant zone (ABRZ) formation at the resin cement/enamel interface and enamel etching pattern, as well as the effects of thermocycling (0, 5000, and 10,000 cycles) on the enamel microshear bond strength (µSBS) mediated by dual-cure resin cements (DCRC). Materials and Methods: Two DCRC were used in 4 groups: Panavia V5 in self-etch (V5NE) and etch-and-rinse mode (V5E); and Estecem II in self-etch (ENE) and etch-and-rinse mode (EE). For ABRZ observation, the bonded interface was subjected to a demineralizing solution. The morphological attributes of the interface and etching patterns were observed using FE-SEM. For µ-SBS, cylinders with a 0.79-mm internal diameter and 0.5-mm height were made with DCRC and tested in shear after 0, 5000, and 10,000 thermal cycles (TC) (5°C and 55°C) (n = 10). Results: The formation of an enamel ABRZ was observed in all groups with different morphological features between selfetch and etch-and-rinse groups. A funnel-shaped erosion beneath the interface was present using V5NE and ENE modes where enamel was dissolved, while ABRZ formation was confirmed and no funnel-shaped erosion was noticed using V5E and EE. No significant differences in µSBS were observed between resin cements. However, significantly lower µSBSs were recorded when the self-etching mode was used. Thermocycling resulted in a significant reduction in µSBS for all groups. Conclusion: Selective enamel etching should be recommended to improve the interfacial quality when dual-cure resin luting cements are used. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively evaluate the clinical behavior of direct anterior composite restorations performed with a universal adhesive or with a three-step etch-and-rinse (E&R) adhesive. Material and Methods: Patients were randomly treated with a three-step E&R adhesive (Optibond FL, Kerr) or a universal adhesive (Clearfil Universal Bond Quick, Kuraray Noritake) applied in E&R mode. All restorations were performed with a nanohybrid composite (ClearFil Majesty ES-2, Kuraray Noritake) by the same experienced operator. Two calibrated examiners evaluated the restorations using a dental mirror and explorer, in accordance with modified United States Public Health Service (USPHS) procedures. Clinical events were registered and classified as either failure (F), survival (SR), or success (S). Results: 168 restorations were evaluated in 90 patients with an average follow-up period of 37.9 (± 22.9) months. A total of 132 restorations were performed on vital teeth, and 36 were performed on endodontically treated teeth (ETT). A total of 128 Class-IV and 40 Class-III restorations were performed. In 89 restorations, a three-step E&R adhesive was applied (14 Class-III and 75 Class-IV), while in 79, a universal adhesive was used (26 Class-III and 53 Class-IV, p = 0.0091). A Cox regression analysis was performed (p < 0.05) to analyze which factors were involved in the failure of the restorations, considering failure (F) as restorations that needed re-intervention at the follow-up period of 37.9 (± 22.9) months. No statistically significant differences were observed when considering parameters directly involved with the adhesives tested. Endodontically treated teeth were more prone to fractures (p = 0.0006) compared to vital teeth. Restorations made with universal adhesives failed by fracturing significantly more frequently (p = 0.0234), while restorations made on endodontically treated teeth had a significantly worse outcome (p = 0.0001). Restorations made on canines also failed significantly more frequently (HR = 3.8, 95% CI = 1.4-10.1, p = 0.0062). Conclusions: Based on the obtained results, both the universal adhesive and the three-step E&R adhesive proved to be good treatment choices for direct anterior restorations after 37.9 (± 22.9) months of follow-up. Tooth vitality seems fundamental for the prognosis of a direct anterior composite restoration over time. [ABSTRACT FROM AUTHOR]

Purpose: This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model. Materials and Methods: The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm2, crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM. Results:CTRL exbited significantly higer UTBD At baseeline in comparison to PRIM p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL. Conclusions: CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effect of carbodiimide (EDC) combined with Clearfil SE self-etch adhesive on the shear bond strength (SBS), crosslinking degree, denaturation temperature, and enzyme activity of dentin in vitro. Materials and methods: Collected human sound third molars were randomly divided into different groups with or without EDC treatment (0.01–1 M). The specimens (n = 16)were stored for 24 h (immediate) or 12 months (aging) before testing the SBS. Fine dentin powder was obtained and treated with the same solutions. Then the crosslinking degree, denaturation temperature (Td), and enzyme activity were tested. Statistical analysis was performed using a one-way analysis of variance (ANOVA) to compare the differences of data between groups (α = 0.05). Results: There was a significant drop in immediate SBS and more adhesive fracture of 1.0 M EDC group, while there were no significant differences among the other groups. SEM showed a homogeneous interface under all treatments. After 12 months of aging, the SBS significantly decreased. Less decreases of SBS in the 0.3 and 0.5 M groups were found. Due to thermal and enzymatical properties consideration, the 0.3 and 0.5 M treatments also showed higher cross-link degree and Td with lower enzyme activity. Conclusion: 0.3 and 0.5 M EDC may be favorable for delaying the aging of self-etch bond strength for 12 months. But it is still needed thoroughly study. [ABSTRACT FROM AUTHOR]

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Objective: This study investigated the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the shear bond strength (SBS) of a universal adhesive in self-etch mode to demineralized dentin. Methods: Seventy-five dentin specimens were randomly divided into five groups (n=15) as follows: Group 1, intact dentin; Group 2, demineralized dentin receiving no remineralization agent; and Groups 3-5, demineralized dentin receiving CPP-ACP for 30, 90, and 180 seconds, respectively. All groups were bonded by Adper Single Bond Universal adhesive in self-etch mode. After 24 hours, the SBS test was conducted, and failure modes were recorded. The data were analyzed by one-way ANOVA, Tukey post-hoc test, and chi-square test at the significance level of P<0.05. Results: The highest and lowest mean SBS values were observed in groups 1 (intact dentin: 29.58 ± 8.13 MPa) and 2 (demineralized dentin: 13.41 ± 4.85 MPa), respectively. ANOVA revealed a significant difference in SBS among the groups (P< 0.001). A pairwise comparison revealed that the SBS of demineralized groups (groups 2-5) was significantly lower than that of the intact samples (P< 0.05). Group 5, with CPP-ACP, applied for 180 seconds, showed a significantly higher SBS (20.74 ± 4.54 MPa) compared to group 2 (P< 0.05). Conclusions: Applying CPP-ACP paste for three minutes can increase the bond strength of the universal adhesive in self-etch mode to demineralized dentin, whereas shorter application times are not effective. [ABSTRACT FROM AUTHOR]

Modern conservative dentistry is taking the lead in daily clinical practice and is relying on adhesion. Whether it is a simple composite, ceramic inlays, onlays, veneers or crowns, the common factor for a successful outcome is a good bonding of these elements to dental structures. Thus, the purpose of this study was to evaluate the bond strength of resin composite to dentin when using a new device, the DENTIPURE KM™ (KM, Beirut, Lebanon), which provides a pure air flow, free of any contaminants and without humidity, when compared to other dental equipment. One hundred and eighty extracted human molars were equally divided into three groups according to the device used, the DENTIPURE KM™ (KM, Beirut, Lebanon), the KAVO™ (ESTETICA E30/E70/E80 Vision, KAVO, Biberach, Germany), or the ADEC™ (A-dec Performer 200, Newberg, OR, USA). The shear bond strength (SBS) was evaluated after 24 h of storage in distilled water on a universal testing machine. Statistical analysis was set with a level of significance at p ≤ 0.05. The results revealed that significantly different bond strength was imparted by the DENTIPURE KM™ device and the ADEC™ dental unit (p = 0.042). In conclusion, while the DENTIPURE KM™ device shows promise in providing contaminant-free air during bonding, its impact on dentin bond strength compared to devices like the KAVO™ appears minimal. Further research is needed to fully assess its potential in enhancing dentinal adhesion procedures. [ABSTRACT FROM AUTHOR]

Matrix metalloproteinases (MMPs) have been identified as agents that disintegrate the collagen structures of dental hybrid layers, resulting in reduced restorative bond strength. Multiple MMP inhibitors (MMPIs) are known to counteract this degenerative mechanism, thereby preserving bond strength and promoting the longevity of resin-based restorations. Additionally, literature suggests that certain MMPI materials possess antimicrobial/anticariogenic properties, potentially reducing the risk of secondary caries development. Therefore, this review article aims to narrate on the integration of matrix metalloproteinase inhibitors into adhesive systems and their impact on bond strength. [ABSTRACT FROM AUTHOR]