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The objectives of this study were to investigate the structural characteristics of open and closed elastomeric modules in the as-received condition, and following (a) 24-hour in vitro loading determined as a 50 per cent extension relative to their original length; (b) 24-hour intra-oral exposure; 3-week intra-oral exposure. Ten specimens of each type (open and closed) of the three brands of elastic chains were included in the study (total of 60). All specimens were subjected to (a) optical transmission microscopy utilizing phase contrast and polarized light modes, (b) micro MIR FT-IR spectroscopy, and scanning electron microscopy and electron probe X-ray microanalysis. Stretched elastomers demonstrated a honeycomb pattern of filament detachment corresponding to strained areas. The chains possessing a well-differentiated inter-modular link presented higher strain concentration gradients located in the link. Phase contrast imaging revealed that the stress adsorption mechanism of these materials involved macromolecular chain orientation and elongation co-axially to the applied load. The specimens retrieved after 24 hours had acquired a proteinaceous film rich in alcohol groups with minimal evidence of phosphate mineralization, while the 3-week retrieved specimens presented precipitation of Ca- and P-forming calcium phosphates. The high protein content of the biofilm organized on the surface of these materials, as well as the calcification pattern found, were similar to a non-specific mechanism of film adsorption of biomaterials exposed to body fluids. The results have clinical implications for aspects of retraction control through sliding mechanics with the use of elastomeric ligatures, and the potential detrimental effects on dental and periodontal tissues such as decalcification and gingival inflammation, respectively. In addition, the experimental protocols adopted for the in vitro study of the force decay of elastomerics should be modified to include para... [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the color changes and amount of remaining C = C bonds (%RDB) in three dental composites after hydrothermal- and photoaging. Methods and Materials: The materials tested were Estelite ∑, Filtek Supreme and Tetric Ceram. Specimens were fabricated from each material and subjected to L* a* b* colorimetry and FTIR spectroscopy before and after aging. Statistical evaluation of the ΔL,* Δa,* Δb,* ΔE and %ΔRDB data was performed by one-way ANOVA and Tukey's test. The %RDB data before and after aging were statistically analyzed using two-way ANOVA and Student-Newman-Keuls test. In all cases an 〈= 0.05 significance level was used. Results: No statistically significant differences were found in ΔL*, Δa*, ΔE and %ΔRDB among the materials tested. Tetric Ceram demonstrated a significant difference in Δb*. All the materials showed visually perceptible (ΔE>1) but clinically acceptable values ( ΔE<3.3). Within each material group, statistically significant differences in %RDB were noticed before and after aging (p<0.05). Filtek Supreme presented the lowest %RDB before aging, with Tetric Ceram presenting the lowest %RDB after aging (p<0.05). The %ΔRDB mean values were statistically significantly different among all the groups tested. No correlation was found between ΔE and %ΔRDB. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of healthy and inflammatory conditions and the presence of F anions on the galvanic coupling between the root surface and titanium abutments of commercially available titanium implants MATERIALS AND METHODS: Eight pairs of three dental root-abutment couples (BEGO, MIS, NOBEL) were exposed to a neutral (pH=7.4) (HE) and an acidic (pH=4.0) (IN) phosphate buffer solution (PBS) simulating healthy and inflammatory conditions respectively. In order to simulate the presence of F anions, which is commonly used in toothpastes, 3.12 gr of NaF was added in both solutions simulating healthy conditions (HEF) and inflammatoy conditions (INF) with the presence of F anions respectively. The galvanic potential difference was recorded for 48 h and averaged. Physical appearance of abutment and roots were tested under a stereomicroscope. Scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDX) was used to characterize the materials under reseach and compare the surfaces before and after galvanic testing., Results: All abutments are composed of Ti-6Al-4V alloy along with root of MIS system, while BEG and NOB are made of Ti according to the SEM/EDX analysis. No differences were identified in surface morphology before and after galvanic testing, while EDX analysis revealed only the presence of Na and F on the surface of MIS abutments after testing in INF conditions. All groups tested showed negligible potential difference and below the nominal threshold for triggering galvanic corrosion under HE, IN and HEF conditions. The same applies for BEG and MIS under INF conditions, while NOB presented an average potential difference value of -273 mV, which is above nominal thresshold for galvanic action. Only MIS abutment showed a color change from yellow to blue under INF conditions., Conclusions and Clinical Implications: BEG and MIS implant systems are not prone to galvanic corrosion in all conditions tested. NOB was found vulnerable to galvanic corrosion under inflammatory peri-implant conditions in the presence of F anions. Galvanic reactions is a possible scenario even between Ti base implant components., Competing Interests: Declaration of Competing Interest The authors Spiros Zinelis, Georgios Polychronis Spiridon Silvestros, Dimitris Karasoulos, and George Eliades declare no conflict of interest. Andreas Barbetseas is an international key opinion leader of BEGO Implant Systems., (Copyright © 2024. Published by Elsevier Inc.)

Plastic aligners have transformed orthodontics, offering a discreet, comfortable, and aesthetically pleasing alternative to traditional fixed appliances. While they have advantages over fixed appliances, they come with environmental and health concerns due to the use of nonbiodegradable plastics, such as the leaching of Bisphenol-A (BPA) and microplastics that can impact human health directly through ingestion. Studies have shown that plastic aligners release microplastics during use, raising concerns about their potential health effects and environmental pollution. The potential health effects of ingested microplastics extend beyond gut microbiota disruption to impact various systems in the body. Research suggests that microplastic exposure can lead to respiratory complications, cardiovascular risks, and implications for brain health and cognitive function. The mechanisms of microplastic uptake into the body through inhalation, ingestion, and skin contact are essential for understanding how these particles interact with human tissues and organs. By prioritizing patient safety, responsible practices, and advancing scientific knowledge the orthodontic community can work towards mitigating the potential health impacts associated with microplastic exposure from aligners., (Copyright © 2024. Published by Elsevier Inc.)

The aim of the study was to evaluate changes in the degree of C=C conversion (DC%), chemical structure, optical properties and roughness of one-shade composites before/after photoaging. Τhe one-shade materials tested were Charisma Topaz One (CHT), Clearfil Majesty ES-2 Universal (MES), Essentia Universal (ESU) and Omnichroma (OMN), with G-aenial Anterior (CNA) serving as control. Specimens (2 mm thickness) were prepared and tested for DC% and chemical structure (ATR-FTIR spectroscopy), optical properties (L*a*b*-ΔΕ, translucency parameter-TP, opalescence parameter-OP, contrast ratio-CR and total transmittance-TT by UV-Vis spectroscopy) and roughness (Sa, Sz, Sdr, Sds and Sc by optical profilometry) before and after photoaging (Xe-arc weatherometer). Significant differences were found in DC% between top-bottom surfaces (ESU, OMN before; ESU, CNA after). Photoaging improved DC%, reduced ester peaks implying photodegradation, reduced L* (CHT, OMN, CNA), a* (CHT, CNA), b* (OMN, CNA), TP (all, except for MES), OP (only MES), CR (only MES, but an increase in CNA) and TT (CHT, OMN). OMN, CNA and MES demonstrated ΔΕ > 3.3. Photoaging significantly increased all roughness parameters in all materials, except for MES (Sz, Sdr, Sc) and OMN (Sdr). Although listed in the same group, significant differences were found in one-shade composites before and after photoaging. Several products were strongly affected by photoaging, demonstrating evidence of photodegradation, an increased roughness and color changes exceeding the clinically acceptable levels.

Aim: The aim of the present study was to assess the alterations in morphology, roughness, and composition of the surfaces of a conventional and a flowable composite attachment engaged with aligners, and to evaluate the release of resin monomers and their derivatives in an aqueous environment., Methods: Zirconia tooth-arch frames (n = 20) and corresponding thermoformed PET-G aligners with bonded attachments comprising two composite materials (universal-C and flowable-F) were fabricated. The morphological features (stereomicroscopy), roughness (optical profilometry), and surface composition (ATR-FTIR) of the attachments were examined before and after immersion in water. To simulate intraoral use, the aligners were removed and re-seated to the frames four times per day for a 7-day immersion period. After testing, the eluents were analyzed by LC-MS/MS targeting the compounds Bis-GMA, UDMA, 2-HEMA, TEGDMA and BPA and by LC-HRMS for suspect screening of the leached dental material compounds and their degradation products., Results: After testing, abrasion-induced defects were found on attachment surfaces such as scratches, marginal cracks, loss of surface texturing, and fractures. The morphological changes and debonding rate were greater in F. Comparisons (before-after testing) revealed a significantly lower Sc roughness parameter in F. The surface composition of the aligners after testing showed minor changes from the control, with insignificant differences in the degree of C = C conversion, except for few cases with strong evidence of hydrolytic degradation. Targeted analysis results revealed a significant difference in the compounds released between Days 1 and 7 in both materials. Insignificant differences were found when C was compared with F in both timeframes. Several degradation products were detected on Day 7, with a strong reduction in the concentration of the targeted compounds., Conclusions: The use of aligners affects the surface characteristics and degradation rate of composite attachments in an aqueous environment, releasing monomers, and monomer hydrolysates within 1-week simulated use., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society.)

The clinical application of aligners is accompanied by the ageing of the polymer appliances and the attachments used, which may result in inefficiency in reaching the predicted range of tooth movement, and release of compounds and microplastics in the oral cavity as a result of the friction, wear and attrition of the aligner and composite attachment. The purpose of this review is to present the mechanism and effects of in vivo ageing; describe the hydrolytic degradation of aligners and enzymatic degradation of composite attachments; examine the ageing pattern of aligners in vivo , under actual clinical scenarios; and identify a link to the discrepancy between predicted and actual clinical outcome. Lastly, strategies to deal with three potentially critical issues associated with the use of aligners, namely the necessity of weekly renewal, the dissimilar mechanical properties of aligner and attachment resulting in wear and plastic deformation of the aligner, and the development of integuments and biofilms with microbial colonization of the appliance, are discussed.

Background: The aim of the present study was to investigate qualitatively and quantitatively the elution of substances from polyester-urethane (Invisalign™) aligners and resin composite attachments (Tetric EvoFlow) in vivo., Methods: Patients (n = 11) treated with the aligners and attachments (16 per patient, without other composite restorations) for an average of 20 months, who were planned for attachment removed were enrolled in the study. Patients were instructed to rinse with 50 mL of distilled water upon entry and the rinsing solution was collected (before removal). Then, the attachments were removed with low-speed tungsten carbide burs for adhesive residue removal, a thorough water rinsing was performed immediately after the grinding process to discard grinding particle residues, and subsequently, after a second water-rinsing the solution was collected for analysis (after removal). The rinsing solutions were analyzed for targeted (LC-MS/MS: Bis-GMA, DCDMA, UDMA, BPA) and untargeted (LC-HRMS: screening of leached species and their degradation products) compounds., Results: Targeted analysis revealed a significant reduction in BPA after attachment removal (4 times lower). Bis-GMA, DCDMA, UDMA were below the detection limit before removal but were all detectable after removal with Bis-GMA and UDMA at quantifiable levels. Untargeted analysis reviled the presence of mono-methacrylate transformation products of Bis-GMA (Bis-GMA-M1) and UDMA (UDMA-M1), UDMA without methacrylate moieties (UDMA-M2), and 4-(dimethylamino) benzoic acid (DMAB), the degradation product of the photo-initiator ethyl-4-(dimethylamino) benzoate (EDMAB), all after attachment removal. Several amino acids and endogenous metabolites were also found both before and after removal., Conclusions: Elevated levels of BPA were traced instantaneously in patients treated with Invisalign™ and flowable resin composite attachments for the testing period. BPA was reduced after attachment removal, but residual monomers and resin degradation products were found after removal. Alternative resin formulations and attachment materials may be utilized to reduce eluents., (© 2024. The Author(s).)

The aim of this study was to assess the percentage degree of cure (DC%) of 2-mm-thick resin composite attachments used for aligner treatment. Three types of aligner - two thermoformed aligners (Clear Aligner [CLA], polyethylene terephthalate glycol modified; and Invisalign [INV], polyester urethane) and a three-dimensional-printed aligner (Graphy TC-85DAC [GRP], an acrylate-methacrylate copolymer) - were selected, along with two universal resin composites (3M Filtek Universal [FTU] and Charisma Topaz ONE [CTO]). Samples of each composite were placed under each aligner, and the degree of cure of each composite was evaluated on the top (facing the aligner) and the bottom (facing the substrate) attachment surfaces after curing. Five specimens were used per combination of aligner and composite, and an additional group of composites irradiated without aligners served as the control. The DC% measurements were performed using attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. The DC% across the aligners were (median values) 33.8%-44.8% for CLA, 33.6%-40.8% for INV, 32.8%-40.6% for GRP, and 40.0%-51.7% for the control group. The DC% values of the attachments cured under any aligner were significantly lower than that of the corresponding control, with the values recorded on the top surfaces being 6% higher than those on the bottom surfaces after adjusting for aligner group and composite type., (© 2023 Scandinavian Division of the International Association for Dental Research. Published by John Wiley & Sons Ltd.)

Statement of Problem: As the use of traditional posts has been associated with complications and failure outcomes, the introduction of novel materials and minimally invasive dentistry has shifted toward the use of composite resin post-and-core restorations for endodontically treated teeth. As a further process, to improve stress absorption environment in restored teeth, the invention of short fiber-reinforced composite resins (SFRCs) as post-and-core restorations has recently emerged. However, evidence regarding its performance is still scarce, and a synthesis of existing data is lacking., Purpose: The purpose of this systematic review and meta-analysis was to assess the performance of SFRC post-and-core restorations, regarding fracture resistance and failure mode and considering both cyclic and static loading., Material and Methods: An electronic search in 5 databases was conducted up to August 2022, and the protocol of the study was registered a priori. The search terms included "fiber reinforced composite," "core build-up," and "post." Studies were considered if they compared SFRC restorations with other types of conventional posts and teeth restored using bulk fill composite resin. The internal validity of the studies was assessed by using a custom-made risk of bias tool., Results: A total of 1271 records were identified, of which 13 were considered for full-text assessment. Eight were ultimately included, all being in vitro studies, and 7 of them were deemed eligible for quantitative syntheses. The results varied considerably across studies with divergent fracture resistance values and percentages of catastrophic failure being reported. Standard depth (6 mm) SFRCs presented fewer repetitions until fracture on average, compared with the individually made FRCs (3 studies: mean difference (MD): -4062; 95% CI: -6148, -1975; P<.001) under cyclic loading. Under static loading, SFRCs (standard depth) presented a nearly 300 N lower fracture force compared with that of intact teeth, (3 studies: MD: -297; 95%CI: -378, -216; P<.001)., Conclusions: Evidence on the laboratory fracture and failure performance of SFRCs is limited, and future studies should incorporate more standardized experimental conditions, as well as SFRCs with limited sacrifice of tooth substrate within the root canal of endodontically treated teeth., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Periodontitis is a microbially-induced inflammation of the periodontium that is characterized by the destruction of the periodontal ligament (PDL) and alveolar bone and constitutes the principal cause of teeth loss in adults. Periodontal tissue regeneration can be achieved through guided tissue/bone regeneration (GTR/GBR) membranes that act as a physical barrier preventing epithelial infiltration and providing adequate time and space for PDL cells and osteoblasts to proliferate into the affected area. Electrospun nanofibrous scaffolds, simulating the natural architecture of the extracellular matrix (ECM), have attracted increasing attention in periodontal tissue engineering. Carrageenans are ideal candidates for the development of novel nanofibrous GTR/GBR membranes, since previous studies have highlighted the potential of carrageenans for bone regeneration by promoting the attachment and proliferation of osteoblasts. Herein, we report the development of bi- and tri-layer nanofibrous GTR/GBR membranes based on carrageenans and other biocompatible polymers for the regeneration of periodontal tissue. The fabricated membranes were morphologically characterized, and their thermal and mechanical properties were determined. Their periodontal tissue regeneration potential was investigated through the evaluation of cell attachment, biocompatibility, and osteogenic differentiation of human PDL cells seeded on the prepared membranes.

Aim: To evaluate the fracture load and type of failure of two different monolithic restorative materials bonded to standardized titanium bases and fabricated by two different procedures regarding the bonding interface., Materials and Methods: All screw-retained implant crown specimens (n = 40), subjected to fatigue by thermomechanical loading, differed in the restorative material (lithium disilicate [LDS] or polymer-infiltrated ceramic network [PICN], referred to as 'hybrid ceramic' [HYC]) and the interface type between the restorative material and the titanium base abutment (prefabricated ex-factory or produced during a CAM-milling procedure). This resulted in the following groups (n = 10/group): 1) LDS-M: lithium disilicate crown with a CAM-milled interface; 2) LDS-P: lithium disilicate crown with a prefabricated interface; 3) HYC-M: PICN crown with a CAM-milled interface; and 4) HYC-P: PICN crown with a prefabricated interface. Aged specimens underwent static fracture load testing. The load (N) at which the initial crack occurred was denoted as Finitial, and the maximal load (N) at which the restorations fractured as Fmax. All specimens were examined under a stereomicroscope to determine the failure mode., Results: The median Finitial values were 180 N for LDS-M, 343 N for LDS-P, 340 N for HYC-M, and 190 N for HYC-P. The median Fmax values were 1822 N for LDS-M, 2039 N for LDS-P, 1454 N for HYC-M, and 1581 N for HYC-P. The intergroup differences were significant for Finitial (KW: P = 0.0042) and for Fmax (KW: P = 0.0010). The failure types also showed differences between the restorative groups., Conclusions: The choice of restorative material had a stronger influence on the fracture load than the abutment interface workflow. Lithium disilicate showed the highest load for initial crack appearance (Finitial) and for complete fracture of the restoration (Fmax).

Aim: To quantitatively assess the degree of conversion and the water-leaching targeted compound from 3D-printed aligners., Materials and Methods: 3D-printed aligners were made of photopolymerized resin (Tera Harz TC85A). The molecular structure and degree of conversion of the set resin were investigated by ATR-FTIR spectroscopy (n = 5). The aligners (n = 10) were immersed in double distilled water for 1 week at 37°C and the eluents were analysed using liquid chromatography/mass spectrometry methods (LC-ESI-MS/MS for urethane dimethacrylate [UDMA] and LC-APCI-MS/MS for bispenol-A [BPA])., Results: The resin was composed of aliphatic vinyl ester-urethane monomers, with acrylate and/or methacrylate functionalization. The degree of conversion was estimated as to 83%. There was no detection of BPA in any of the assessed samples (0.25 µg/l). Quantifiable amounts of UDMA were detected in all the exposed samples, ranging from 29 to 96 µg/l., Conclusions: Although efficiently polymerized and BPA free, the great variability in the amount of UDMA monomer leached from the examined samples may raise concerns on potential health hazards after repeated intraoral exposure, which is indicated for this class of materials., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: To investigate the setting characteristics, wettability and bonding capacity with a lithium disilicate ceramic of a silane containing self-adhesive resin luting agent (Panavia SA Universal-PU)., Methods: The degree of conversion (DC %) and extent of acid neutralization (SY %) of PU were measured on dual- (DC) and self-cured (SC) specimens after 10, 30 and 60 min storage by ATR-FTIR spectroscopy, whereas the presence of silanols was traced by curve-fitting the 60 min spectra, using the silane-free analog (Panavia SA Plus-PS) as a control. The role of a dedicated adhesive (Clearfil Universal Bond Quick-CU) in assisting the early DC % in PU-SC was investigated on 10 min-stored specimens. The water contact angles on polished and HF acid-etched lithium disilicate surfaces (IPS e.max Press), were assessed before and after silanization by unset PU or a silane primer (Ultradent Silane-SL). Finally, the shear strength of PU-DC specimens bonded to the acid-etched ceramic surfaces was determined before and after SL treatment., Results: The DC % was higher in DC than SC (PU, PS; all time intervals), in PU-SC than PS-SC (30, 60 min) and in the CU assisted PU-SC group. The SY % was lower in DC than SC (PU, PS) and higher in PS-SC than PU-SC groups. Silanols were found only in unset PU and PU-DC groups. SL treatment provided higher water contact angles on polished and acid-etched ceramic surfaces and higher shear bond strength on acid-etched ceramic surfaces than PU (p < 0.05 for all comparisons)., Significance: Although the degree of conversion of the silane containing luting agent was improved in the self-curing mode, especially in the adhesive assisted group, it was still inferior to light-curing. Acid-neutralization and presence of silanols were affected by the setting modes. The use of a silane primer enhanced the hydrophobicity and bond strength of the silane containing luting agent with the etched ceramic substrate., (Copyright © 2022 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate the amount of methyl methacrylate (MMA) released in water from heat-cured polymethyl methacrylate (PMMA) denture base materials subjected to different cooling procedures., Methodology: Disk-shaped specimens (Ø:17 mm, h:2 mm) were fabricated from Paladon 65 (PA), ProBase Hot (PB), Stellon QC-20 (QC) and Vertex Rapid Simplified (VE) denture materials using five different cooling procedures (n=3/procedure): A) Bench-cooling for 10 min and then under running water for 15 min; B) Cooling in water-bath until room temperature; C) Cooling under running water for 15 min; D) Bench-cooling, and E) Bench-cooling for 30 min and under running water for 15 min. A, B, D, E procedures were proposed by the manufacturers, while the C was selected as the fastest one. Control specimens (n=3/material) were fabricated using a long polymerization cycle and bench-cooling. After deflasking, the specimens were ground, polished and stored in individual containers with 10 ml of distilled water for seven days (37oC). The amount of water-eluted MMA was measured per container using isocratic ultra-fast liquid chromatography (UFLC). Data were analyzed using Student's and Welch's t-test (α=0.05)., Results: MMA values below the lower quantification limit (LoQ=5.9 ppm) were registered in B, C, E (PA); E (PB) and B, D, E (QC) procedures, whereas values below the detection limit (LoD=1.96 ppm) were registered in A, D (PA); A, B, C, D (PB); C, D, E (VE) and in all specimens of the control group. A, B (VE) and A, C (QC) procedures yielded values ranging from 6.4 to 13.2 ppm with insignificant differences in material and procedure factors (p>0.05)., Conclusions: The cooling procedures may affect the monomer elution from denture base materials. The Ε procedure may be considered a universal cooling procedure compared to the ones proposed by the manufacturers, with the lowest residual monomer elution in water.

Objective: To investigate alterations in the mechanical properties of in-house three-dimensional (3D) printed orthodontic aligners after intraoral ageing., Materials and Methods: Sixteen 3D-printed aligners (TC-85DAC resin, Graphy, Seoul, Korea) were used for the purpose of the study, which were divided into 10 control (not used) aligners and 6 materials retrieved from 4 patients after 1-week service (retrieved group). Samples from the control group were analysed by attenuated total reflectance-Fourier-transform infrared (ATR-FTIR) spectroscopy. Samples from control/retrieved groups were embedded resin and subjected to instrumented indentation testing (IIT) to record force-indentation depth curves, calculating the following (as per ISO 14577-1, 2002 standard): Martens hardness (HM), indentation modulus (EIT), and elastic index (ηIT), and the indentation relaxation index (RIT). Differences between control and retrieved 3D-printed aligners were checked with Mann-Whitney/t-tests at an alpha = 5%., Results: ATR-FTIR analysis showed that aligners were made of a vinyl ester-urethane material. The results of the IIT testing were: HM (control: median 91.5 N/mm2, interquartile range [IQR] 88.0-93.0/as-retrieved: median 90.5 N/mm2, IQR 89.0-93.0); EIT (control, mean 2616.3 MPa, standard deviation [SD] 107.0 MPa/retrieved, mean 2673.2 MPa, SD 149.4 MPa); ηIT (control: median 28.6%, IQR 28.2-30.9%/as-retrieved: median 29.0%, IQR 28.7-29.2%); and RIT (control: median 45.5%, IQR 43.0-47.0%/as-retrieved: median 45.1%, IQR 45.0-45.3%). No differences between as-retrieved and control aligners were found for any of the mechanical properties tested (P > 0.05 in all instances)., Conclusion: The mechanical properties of the in-house 3D-printed aligners tested were not affected after 1 week in service period., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

To improve the self-curing capacity and interfacial strength with dentine of dual-cured composite materials, touch-cure activators have been introduced. The aim of the study was to evaluate the effect of these activators on the hardness and conversion of dual-cured resin composite core build-up restoratives. The materials tested were Clearfil DC Core Plus (CF) and Gradia Core (GC) with the corresponding adhesives Clearfil S 3 Bond Plus (for CF) and G-Premio Bond/G-Premio DCA activator (for GC). Disk-shaped specimens (n = 6/group) were prepared for the following groups: dual-cured, self-cured and self-cured in contact with the adhesive activators at the bottom surface. After a 3-week storage period (dark/dry/37 °C) the Martens hardness (HM) and degree of conversion (DC%) were determined for the previously mentioned groups and the top surfaces of groups in contact with the adhesives. A statistical analysis was performed by a one-way ANOVA and Holm-Sidak test per material and a Pearson's correlation analysis (HM vs. DC%) at an α = 0.05. The self-cured specimens resulted in significantly lower HM and DC% values from the dual-cured group, as expected. However, in the presence of the adhesives with touch-cure activators, the conversion of the self-cured groups showed insignificant differences in HM and DC% from the dual-cured in both composite materials. The improvements on the bottom composite surfaces in contact with the adhesives did not extend to the entire specimen length. Nevertheless, improved interfacial curing may improve interfacial durability.

The aim of the present laboratory study was to mechanically characterize the interface between two dental resin-based composite (RBC) increments, and to investigate if elevated temperatures have an influence on the quality of the interface mimicking clinical filling procedure. Four RBCs (CLEARFIL MAJESTY™ Posterior, Kuraray (CMP)/Filtek™ Supreme XTE, 3M (FSX)/Grandio®SO, VOCO (GSO)/VisCalor® bulk, VOCO (VCB)) were tested with a fracture toughness test using Chevron notched beams (K I,CNB ) at 23, 37 and 54 °C. K I,CNB specimens (3 × 4x25mm) with a V-shaped notch at the incremental interface were loaded until failure in a 4-point bending set-up. Failure modes were characterized using light microscopy, microstructural interface was analyzed using SEM. Statistical analysis was performed using Kolmogorov-Smirnoff test, two-way ANOVA and Tukey Post-Hoc test (p = 0.05). Mean K I,CNB ranged between 0.73 ±0.14 MPam 0.5 (VCB, 23 °C) and 1.11 ± 0.11 MPam 0.5 (FSX, 23 °C). The tested conventional highly filled RBCs presented fracture toughness at the incremental interface comparable to the cohesive strength of the bulk materials. VCB showed reduced interfacial fracture toughness at 23 and 37 °C, but performed well at elevated temperature of 54 °C., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: The purpose of the study was to evaluate the integrity of dentine type I collagen after self-etching (SE) treatments with strong and mild universal adhesives., Methods: Coronal dentine specimens (n=10/product) were imaged by optical microscopy and analyzed by ATR-FTIR spectroscopy before and after treatment with 32% phosphoric acid gel (PA-negative control), 17% neutral EDTA (ED-positive control) conditioners and Adhese Universal (AD), Clearfil Universal Bond Quick (CQ), G-Premio Bond (GP), Prelude One (PR) and Scotchbond Universal (SB) adhesives. From the spectroscopic analysis the following parameters were determined: a) Extent of dentine demineralization (DM%) and b) percentage area of the Amide I curve-fitted components of β-turns, 3 10 -helix/β-turns, α-helix, random coils, β-sheets and collagen maturation (R) index. Statistical analysis was performed by one-way ANOVA (DM%), paired t-test/Wilcoxon test (Amide I components) and Spearman correlation coefficient (DM% vs Amide I components) at an a=0.05 level., Results: PA, ED and GP removed the smear-layer and opened tubule orifices, whereas all other treatments removed only the intratubular smear-layer fraction. The ranking of the statistically significant differences in DM% was PA>GP>ED>AD, SB, CQ, PR, with AD being significantly different from PR. Regarding the Amide I components, PA demonstrated a significant reduction in β-turns, α-helices and an increase in β-sheets, GP a reduction in β-turns, AD an increase in β-turns and random coils, and CQ an increase in β-turns. PR, SB and ED showed insignificant differences in all the Amide I components. Significant correlations were found between DM%-random coils and DM%-R., Significance: The universal adhesives used in the SE mode induced none to minimal changes in dentine collagen structure, without evidence of the destabilization pattern observed after conventional phosphoric acid treatments., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Background: Durable bonding between resin composite luting agents (CLA) and zirconia is still a matter of controversy. The purpose of this study was to evaluate the effect of water storage on hardness and interfacial strength of three CLA, a non-adhesive (Multilink Automix/ML), an adhesive (Panavia F 2.0/PF) and a self-adhesive (PermaCem 2.0/PC), bonded to polished (CL) and grit-blasted (AL: 50 μm alumina, SJ: Sil-Jet + Monobond Plus silane) monolithic zirconia surfaces., Methods: CLA specimens ( n = 5/cement, condition) were prepared, stored under dry conditions or immersed in water, and Vickers hardness (VH) measurements were obtained at 1 h, 24 h, 1 week and 3 weeks intervals. Optical profilometry was used to determine the roughness parameters (Sa, Sz, Sdr, Sci) of zirconia surfaces ( n = 5/treatment). A shear strength test (SBS, n = 10 × 2/cement) was performed to assess the strength and fractography of the cements bonded to zirconia after isothermal water storage and thermal-cycling (TC)., Results: PF demonstrated significantly lower VHN after water storage at all time intervals, PC at 1 w, 3 w and ML at 3 w. SJ and AL showed significantly higher values from CL in all roughness parameters. Weibull analysis revealed the following significance in σ ο ranking within the same material: AL, SJ, ALTC > SJTC, CL > CLTC (PF); SJ, SJTC, AL, ALTC > CL, CLTC (PC) and SJ, SJTC > AL > ALTC > CL, CLTC (ML). Within the same surface treatment subgroups, the significance in σ o ranking was PC, ML > PF (before/after TC) for SJ; PC > PF > ML (before TC), PC, PF > ML (after TC) for AL, and PC > PF > ML (before/after TC) for CL. For the m ranking, the only significant difference within each material group was found in PC (AL > ALTC) and for the same surface treatment in AL (PC > ML)., Conclusion: There are significant differences in the water plasticization susceptibility of the CLA tested; the materials with adhesive monomers were the most affected. Tribo-chemical silica coating combined with a silane coupling agent was the most efficient bonding treatment for the non-adhesive and the self-adhesive materials. The adhesive CLA performed better on alumina-blasted than on tribo-chemically coated surfaces.

Background: Fetal growth restriction (FGR) has been associated with a higher risk of developing adverse perinatal outcomes and distinct neurodevelopmental and neurobehavioral disorders. The aim of the present study was to investigate the impact of prenatal food restriction on the brain proteome in both FGR and appropriately grown rats and to identify potential pathways connecting maternal malnutrition with altered brain development., Methods: Ten time-dated pregnant Wistar rats were housed individually at their 12th day of gestation. On the 15th day of gestation, the rats were randomly divided into two groups, namely the food restricted one ( n = 6) and the control group ( n = 4). From days 15 to 21 the control group had unlimited access to food and the food restricted group was given half the amount of food that was on average consumed by the control group, based on measurements taken place the day before. On the 21st day of gestation, all rats delivered spontaneously and after birth all newborn pups of the food restricted group were weighed and matched as appropriately grown (non-FGR) or growth restricted (FGR) and brain tissues were immediately collected. A multiplex experiment was performed analyzing brain tissues from 4 FGR, 4 non-FGR, and 3 control male offspring. Differentially expressed proteins (DEPs) were subjected to bioinformatics analysis in order to identify over-represented processes., Results: Proteomic analysis resulted in the profiling of 3,964 proteins. Gene ontology analysis of the common DEPs using DAVID (https://david.ncifcrf.gov/) showed significant enrichment for terms related to cellular morphology, learning, memory and positive regulation of NF-kappaB signaling. Ingenuity Pathway Analysis showed significant induction of inflammation in FGR pups, whereas significant induction of cell migration and cell spreading were observed in non-FGR pups., Conclusion: This study demonstrated that in both FGR and non-FGR neonates, a range of adaptive neurodevelopmental processes takes place, which may result in altered cellular morphology, chronic stress, poor memory and learning outcomes. Furthermore, this study highlighted that not only FGR, but also appropriately grown pups, which have been exposed to prenatal food deprivation may be at increased risk for impaired cognitive and developmental outcomes., Competing Interests: SG was Founder, President and CEO of Proteas Bioanalytics Inc., BioLabs at the Lundquist Institute. The authors declare that this study received funding from Procter & Gamble Hellas. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication., (Copyright © 2021 Potiris, Manousopoulou, Zouridis, Sarli, Pervanidou, Eliades, Perrea, Deligeoroglou, Garbis and Eleftheriades.)

Objective: To investigate the influence of pre-heating different classes of dental resin composites on viscosity and stickiness at five different temperatures., Methods: Six flowable, five conventional packable, and one thermo-viscous bulk-fill resin composites were heated up to 54°C in a plate-plate rheometer to determine their complex viscosity. Normal force measurements were carried out for the six packable materials to determine the unplugging force and unplugging work (stickiness) over the same temperature range. Data were analyzed using Kolmogorov-Smirnoff test, one-way ANOVA and Tukey Post Hoc test with α=0.05 as level of significance., Results: At 23°C packable composites showed viscosity between 6.75 and 19.14kPas, while flowable composites presented significantly lower viscosities between 1.31 and 2.20kPas. Pre-heating led to a drop of 30-82% in the viscosity of packable materials. The thermo-viscous material dropped to the level of flowables at 45 and 54°C thus behaving as a packable composite at room temperature with flowable-like viscosity at higher temperatures. No statistically significant differences for viscosity were observed among flowable composites at any temperature. The unplugging force decreased for packable composites, while their unplugging work generally increased at elevated temperature. At 23°C unplugging force was measured between 7.50 and 19.18N, while pre-heating up to 54°C led to values between 2.9 and 6.2N. Regarding unplugging work at 23°C the calculated values were between 3.0 and 8.9×10 -3 J and at 54°C between 8.8 and 13.0×10 -3 J., Significance: Pre-heating significantly reduced viscosity of highly viscous resin composites, while no influence was shown for flowable composites. In general stickiness, measured as unplugging work, increased at elevated temperatures. The thermo-viscous material showed low viscosity comparable to flowable composites at 45 and 54°C, yet its stickiness did not increase significantly compared to the values at 23°C., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Purpose: To investigate the effect of aging on the morphology of the interface between monolithic implant crowns and standardized titanium base abutments., Materials and Methods: Four groups of hybrid abutment crowns differing in restorative material (lithium disilicate [LD] or polymer-infiltrated ceramic network [PICN]) and in fabrication procedure of the interfacial zone for luting to a titanium abutment (milled during CAD/ CAM procedure [M] or prefabricated [P]) were formed: LDS-M, LDS-P, PICN-M, and PICN-P (n = 10 each). The morphology of the crown-abutment interface was examined before and after artificial aging using scanning electron microscopy. The total gap length per specimen was measured at both time points, and intergroup (Kruskal-Wallis [KW]) plus pairwise (Wilcoxon Mann-Whitney [WMW]) comparisons were performed (α = .05)., Results: Before aging, statistically significant differences in gap length were identified among groups (KW: P = .0369) for PICN-P > LDS-P (WMW: P = .0496) and LDS-M > LDS-P (WMW: P = .0060). The effect of aging among the groups, expressed as an increment of total gap length, was 50% in LDS-M, 30% in LDS-P, 20% in PICN-M, and 30% in PICN-P. After aging, the statistically significant differences in gap length identified among groups (KW: P = .0048) were for PICN-P > LDS-P (WMW: P = .0134); LDS-M > PICN-M (WMW: P = .0204); PICN-P > PICN-M (WMW: P = .0486); and LDS-M > LDS-P (P = .0022). However, comparison of the difference in gap length from before to after aging among the groups was not statistically significant (KW: P = .3549)., Conclusion: The cementation interfaces of CAD/CAM crowns on standardized titanium base abutments demonstrated a high percentage of gaps before and after thermomechanical loading. The composition of the restorative material and the nature of the interface influenced the interfacial gap dimension.

Objective: The characterisation of surface roughness and energy of contemporary thermoplastic materials used in manufacturing of orthodontic aligners., Design: In vitro, laboratory study., Materials and Methods: Four commercially available thermoplastic materials were selected (CA-medium/CAM, Essix-copopyester/COP, Duran/DUR and Erkodur/ERK). Five disks from each, as received, material were tested and subjected to: (1) reflected light microscopy; (2) optical profilometry for the estimation of Sa, Sz, Sq, Sdr, Sc, Sv surface roughness parameters (n = 5); and (3) contact angle measurements with a Zisman series of liquids for the estimation of critical surface tension (γ C ), total work of adhesion (W A ), as well as the work of adhesion due to polar (W P ) and dispersion (W D ) components employing the Zisman method (n = 5/liquid). Thermoformed disks were prepared against a dental stone model and the roughness parameters were calculated again Statistical analysis was performed by one-way ANOVA/ Tukey multiple comparison test and t-test (a = 0.05)., Results: Microscopic and profilometric analyses revealed a smooth surface texture in the as-received materials, but a very rough texture after thermoforming, with insignificant differences within each state. Significant differences in the as-received state were found in the surface energy parameters; CAM showed the lowest γ C and the highest W A , W P , W D , whereas ERK with the highest γ C demonstrated lower W A . COP and DUR were ranked in an intermediate group regarding γ C , with a statistically significant difference in W A between them, mainly attributed to the lower W P of the former., Conclusion: Given the differences in surface energy parameters and the lack of roughness differences within the as received or thermoformed groups, it may be concluded that variations in the plaque retaining capacity are anticipated, determined by γ C , W A and the W P , W D components.

The purpose of this study was to investigate the surface characteristics and color stability of gingiva-colored composite restorative materials (Anaxgum-ANG, Ceramage-CMG and Gradia Gum-GRG). The microstructure, composition, degree of conversion (DC %) and 3D roughness (Sa, Sz, Sdr, Sc) were examined by LV-SEM/EDS, ATR-FTIR and optical profilometry, respectively. For the color stability (CIE L*, a*, b* system) and hardness (HV), measurements were performed at baseline and after 30 days storage in distilled water, coffee and red wine. The ANG and GRG contain prepolymerized particles in aromatic and aliphatic resin matrices, respectively, whereas CMG contains inorganic zirconia silicate/silica particles, in an aromatic resin matrix, with a smaller particle size and a higher surface area fraction. Urethane monomers were mainly identified in CMG and GRG. The DC% showed statistically insignificant differences between the materials. The same applied for the roughness parameters, except for the greatest Sdr in CMG. ANG showed a color difference (ΔE) of > 3.3 after immersion in all media, CMG in coffee and wine and GRG only in coffee. Sc was the only roughness parameter demonstrating correlations with the ΔL*, Δb* and ΔE*. The HV values showed insignificant differences between the storage conditions per material. There are important differences in the color stability of the materials tested, which were mostly affected by the roughness parameters due to variations in their microstructure.

Composite dust generation is most likely a continuous and daily procedure in dental practice settings. The aim of this systematic review was to identify, compile and evaluate existing evidence on interventions and composite material properties related to the production of aerosolized dust during routine dental procedures. Seven electronic databases were searched, with no limits, supplemented by a manual search, on 27 April 2020 for published and unpublished research. Eligibility criteria comprised of studies of any design, describing composite dust production related to the implementation of any procedure in dental practice. Study selection, data extraction and risk of bias (RoB) assessment was undertaken independently either in duplicate, or confirmed by a second reviewer. Random effects meta-analyses of standardized mean differences (SMD) with associated 95% confidence intervals (CIs) were employed where applicable. A total of 375 articles were initially identified, resulting in 13 articles being included in the qualitative synthesis, of which 5 contributed to meta-analyses overall. Risk of bias recordings ranged between low and high, pertaining to unclear/raising some concerns, in most cases. All types of composites, irrespective of the filler particles, released significant amounts of nano-sized particles after being ground, with potentially disruptive respiratory effects. Evidence supported increased % distribution of particles < 100 nm for nanocomposite Filtek Supreme XTE compared to both conventional hybrid Z100MP (SMD: 1.96, 95% CI: 0.85, 3.07; p-value; 0.001) and nano- hybrid Tetric EvoCeram (SMD: 1.62, 95% CI: 0.56, 2.68; p-value: 0.003). For cytotoxicity considerations of generated aerosolized particles, both nanocomposites Filtek Supreme XTE and nanohybrid GradiO revealed negative effects on bronchial epithelial cell viability, as represented by % formazan reduction at 330-400 μg/ml for 24 hours, with no recorded differences between them (SMD: 0.19; 95% CI: -0.17, 0.55; p-value: 0.30). Effective and more rigorous management of dental procedures potentially liable to the generation of considerable amounts of aerosolized composite dust should be prioritized in contemporary dental practice. In essence, protective measures for the clinician and the practices' personnel should also be systematically promoted and additional interventions may be considered in view of the existing evidence., Competing Interests: The authors declare no conflict of interest

The aim of this study was to estimate possible differences in the chemical composition and relaxation of orthodontic aligner materials. Four commercially available thermoplastic materials CAM (Scheu-Dental, Iserlohn, Germany), COP (Essix, Dentsply Raintree Essix Sarasota,FL, USA), DUR (Great Lakes Dental Technologies, Tonawanda, NY) and ERK (Erkodent Erich Kopp, Pfalzgrafenweiler Germany) were included in this study. Rectangular strips from each material were prepared according to the manufacturer's instructions and subjected to attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy and stress relaxation characterization. The reduction in applied stress (RAS) after one week was estimated and statistically analyzed by one-way ANOVA at the 0.05 level of significance. All specimens were subjected to optical microscopy before and after stress relaxation testing under transmittance polarized illumination. ATR-FTIR microscopy revealed that all materials are made of polyethylene terephthalate glycol (PETG) while no significant differences were identified in RAS values among materials tested, which ranged from 6%-10% (p ≥ 0.05). All samples illustrated the developments of shear bands during relaxation testing according to optical microscopy findings. The tested materials illustrated similar chemical composition and relaxation behavior and thus no differences in their clinical efficacy are anticipated., Competing Interests: The authors declare no conflict of interest.

The aim of the study was to evaluate the stability, reactivity, and bond strength with a lithium disilicate ceramic of a self-etch silane primer (Monobond Etch and Prime/MEP). The stability was evaluated by 1 H-, 31 P-NMR spectroscopy (before/after aging), and the reactivity by micro MIR-FTIR spectroscopy on Ge surfaces (0, 1, 24 h) using a prehydrolyzed silane primer (Calibra Silane Coupling Agent/CLB), as a control. The effect of MEP vs. 5% HF-etching on ceramic roughness was assessed by optical profilometry. The shear bond strength (SBS) of a resin composite bonded to polished ceramic surfaces treated with MEP, HF without silane (HF+NS), HF+CLB, and HF+MEP (n = 20) was evaluated after storage in water (A: 37 °C/1 week, B: 5000×/5-55 °C and C: 100 °C/24 h). Aging did not affect the silanol groups of MEP, but only the phosphate co-monomer. Silanols were reactive forming siloxanes, but exhibited lower consumption rate than CLB. HF-etching induced significantly higher values than MEP, in all the roughness parameters tested (Sa, Sz, Sdr, Sc, Sv), with the greatest differences found in Sdr and Sv. For SBS, MEP was inferior to all treatments/storage conditions, except of HF+NS in A, where the values were similar. However, on a HF-etched substrate, MEP provided highest strength and reliability.

The aim of the present study was to quantitatively assess changes in enamel roughness parameters before and after lingual bracket debonding. The lingual surface of 25 sound premolars extracted for orthodontic reasons was studied by 3D optical interferometric profilometry before and after debonding of lingual brackets following enamel finishing (with fine diamond) and polishing (with 12- and 20-fluted carbide burs). The roughness parameters tested were the amplitude parameters Sa and Sz, the hybrid parameter Sdr, and the functional parameters Sc and Sv. The parameter differences (after debonding-reference) were calculated, and statistical analysis was performed via a Wilcoxon signed-rank test. Statistically significantly higher values were observed in all the surface roughness parameters of enamel surfaces after finishing and polishing, with the mostly affected parameter being the Sdr. Under the conditions of the present study, the finishing and polishing instruments used after debonding of lingual noncustomized brackets created a surface texture rougher than the control in all the tested roughness parameters., Competing Interests: The authors declare no conflict of interest.

The purpose of this study was to investigate the bonding capacity of composite core build-up materials with prefabricated glass fiber-reinforced posts possessing different coronal morphologies. Five post types (Archimede Line (ARL), Fibrekleer (FBK), Glassix (GLX), Matrix Plus (MTP), and ParaPost White (PRW) and three core build-up materials (ClearfilPhoto Core (CPC), ClearfilDC Core (CDC), ClearfilNew Bond (CNB) of different curing modes (light-, self-, dual-cured respectively) were selected. The coronal part was embedded in the core build-up materials and the specimens were loaded under tensile force up to failure. The reliability (β) and characteristic life (σο, in Ν) of the debonding force were evaluated by Weibull statistics and the debonded specimens were subjected to failure mode analysis. The results showed that ARL, MPT posts were the most and GLX the least retentive, despite the core build-up material used. CPC provided the highest retention with four posts (FBK, GLX, MTP, and PRW), without statistically significant differences from CDC in two (FBK and MTP) and CNB in one (PRW). CPC and CDC were the most reliable core materials for two posts (ARL and PRW), with no statistically significant difference from CNB in three (FBK, GLX, and MTP). GLX and PRW demonstrated the highest (93%) incidence of post detachment from core, whereas FBK demonstrated the highest percentage of core material fracture, with most fractures occurring in CDC (57%). Post fractures were most prominent in MTP when combined with CNB. The presence of specific coronal retentive features did not essentially ensure increased strength with the core material, due to their delamination.

Tooth wear may be described as a side-effect of occlusal forces that may be further induced by the common use of contemporary prosthetic materials in practice. The purpose of this systematic review was to appraise existing evidence on enamel wear from both in vitro and clinical research and explore whether evidence from these study designs lies on the same direction. Five databases of published and unpublished research were searched without limitations in August 2019 and study selection criteria included in vitro and clinical research on enamel tooth wear. Study selection, data extraction, and risk of bias assessment were done independently and in duplicate. Random effects meta-analyses of standardized mean differences (SMDs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were conducted while a Monte Carlo permutation test for meta-regression on the exploration of the effect of the study design on the reported outcomes was planned. A total of 27 studies (23 in vitro and 4 clinical) were eligible while 12 contributed to meta-analyses. Overall, some concerns were raised for the quality of the existing evidence and the potential for risk of bias. Enamel wear (mm) of antagonist teeth was more pronounced when opposed to conventional porcelain compared to machinable ceramics (SMD = 2.18; 95%CIs: 1.34, 3.02; p < 0.001). Polished zirconia resulted in decreased volumetric enamel wear (mm 3 ) of opposing teeth compared to pure natural enamel (SMD = -1.06; 95%CIs: -1.73, -0.39; p = 0.002). Monolithic zirconia showed evidence of enhanced potential for antagonist wear (μm) compared to natural teeth (WMD = 107.38; 95%CIs: 30.46, 184.30; p = 0.01). Study design did not reveal an effect on the tooth wear outcome for the latter comparison when both clinical and in vitro studies were considered (three studies; Monte Carlo test, p = 0.66). In conclusion, there is an overriding need for additional evidence from clinical research to substantiate the findings from the already existing laboratory simulation studies.

Objective: To evaluate the silane status in commercially available products and their bonding capacity with polished glass-ceramic surfaces before and after hydrofluoric (HF) acid-etching., Methods: The products tested were Calibra Silane Coupling Agent/CS, G-Multi Primer/GM, Kerr Silane Primer/KS, Monobond Plus/MB and Scotchbond Universal Adhesive/SB. The silane status was studied by 13 C nuclear magnetic resonance spectroscopy ( 13 C-NMR). The roughness parameters of polished (group A) and HF acid-etched (group B) lithium disilicate glass-ceramic surfaces were measured by optical profilometry (n = 5/group). The interaction of the products with group A and B ceramic surfaces was examined by attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). The shear strength (SBS) of a flowable composite bonded to the ceramic surfaces (groups A, B) was assessed before (NS) and after silane treatment (n = 20/group, product)., Results: The NMR analysis showed the presence of silanol monomers only in CS. Methoxylated-siloxane adducts were found in GM, silanol-siloxane adducts in MB, SB, and siloxane polymers in KS. Acid-etching greatly increased Sa, Sz, Sdr, Sc and Sv parameters (p < 0.001) and ATR-FTIR analysis demonstrated evidence of bonding with the substrate in CS. Weibull analysis of SBS revealed the following rankings in characteristic life (p < 0.05): CS > SB,KS,MB > GM > NS (group A) and CS > GM > SB,KS,MB,NS (group B). The most reliable treatment in both groups was CS. For the same silane treatment, the SBS of group B were significantly higher from group A. Failures were mainly of adhesive type, except of several partial resin cohesive failures found in group B., Significance: The chemical bonding capacity of the silanes was highest in products with silanol monomers. Acid-etching increased bond strength to a level that neutralized the silane contribution in products with silanol-siloxane adducts and siloxane polymers, providing thus bond strength values similar to silane-free treatments., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)