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Purpose: To determine whether the adverse interaction between a two-step/acidic etch-and-rinse adhesive (One-Step Plus [OS], Bisco) and chemically cured resin luting cement [Variolink II, Ivoclar Vivadent] can improve adhesive coupling by reducing the dentin permeability with an oxalate desensitizer (BisBlock, Bisco). Materials and Methods: After exposing dentin on the occlusal surfaces of human third molars, bonding was performed on either oxalate treated (BB) or nontreated (NB) demineralized dentin. A resin luting cement was placed in the format of a crown following the light-curing mode (only with the base syringe [LC]) or the chemically curing mode (mixture of base and catalyst syringes [CC]). The activation of the LC or CC cements was either immediately [IM], meaning soon after the placement of LC and the initial set of CC cement (5 min), or after a delay of 20 min [DP] for both modes of polymerization. Five teeth were assigned to each experimental condition. Teeth were sectioned to obtain sticks with a cross-sectional area of 0.95 mm², which were tested using the microtensile bond strength test soon after the specified periods of polymerization. The bond strength values of each adhesive were analyzed by three-way repeated measures ANOVA and Tukey's tests (α = 0.05). Fractographic analysis of the specimens was performed using SEM. Results: The delayed polymerization (for both LC and CC cements) produced low bond strength values compared to IM activation. When the BB was employed, the bond strength values of the CC cement was approximately doubled, while the BB did not affect the bond strength of the LC cement. Bond strength values of LC cements were higher than CC. The use of BB significantly improved the bond strength of CC cement only. The morphological observations confirmed the bond strength results. A myriad of voids could be detected in the luting cement side when BB was not applied, except for the immediately light-cured group. Conclusion: The use of an oxalate desensitizer (BisBlock) reduced the incompatibility between a two-step etch-andrinse adhesive and chemically cured resin cements and light-cured systems in the delayed polymerization mode. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the microtensile bond strength of a resin composite bonded to two heat-pressed ceramics after performing different post-etching cleaning techniques. Materials and Methods: Resin composite specimens were bonded to IPS Empress Esthetic (EE) and IPS Empress 2 (E2) heat-pressed ceramic disks after etching with 10% HF, surface cleaning, silanization and application of an un-filled hydrophobic resin. Resin composite specimens were fabricated using 4-mm (height) Tygon tubes of 0.8 mm diameter and bonded according to the post-etching cleaning technique employed (n = 30): no cleaning (NC); air-water spray for 30 s (AWS); 37% phosphoric acid etching for 30 s (PA); ultrasonic bath in distilled water for 5 mm (UB); PA + UB (PAUB); application of a self-etching silane/bonding system Clearfil Silane Kit (CSK). The resin composite specimens were subjected to tensile tension at a crosshead speed of 0.5 mm/min SEM observation and EDX analysis were performed for each group to determine elemental distribution in the samples. Results: Two-way ANOVA with random effect showed statistically differences between subgroups for E2, in which E2NC only showed bond strength significantly lower than E2AWS and E2BU, as indicated by Student's t-test and a contrast method. For EE, subgroups EENC and EECSK groups showed statistically significant differences between each other and among the other post-etching cleaning technique groups (p < 0.05). Conclusion: Air-water spray may be used as a post-etching cleaning technique for both ceramics. The presence of residues did not significantly reduce the bond strength of resin composite to IPS Empress 2 ceramic. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to determine the microtensile bond strength of three different simplified adhesive systems to caries-affected dentin. Materials and Methods: Fifteen extracted human molars with primary carious lesions were ground flat until dentin was exposed. Soft caries-infected dentin was excavated with the help of caries detector dye. On the remaining hard dentin, a standardized smear layer was created by polishing with 600-grit SIC paper. Teeth were divided into three groups and treated with one of the three tested adhesives: Adper Scotchbond 1 XT (3M ESPE), a 2-step etch-and-rinse adhesive, Clearfil 5? Bond (Kuraray), a 1-step self-etching or all-in-one adhesive, and Clearfil SE Bond (Kuraray), a 2-step self-etching adhesive. Five-mm-thick composite buildups (Z-250, 3M ESPE) were built and light cured. After water storage for 24 h at 37°C, the bonded specimens were sectioned into bars (1.0 × 1.0 mm; n = 20 to 30). Microtensile bond strength of normal dentin specimens and caries-affected dentin specimens was measured in a uni- versal testing machine (crosshead speed = 1 mm/min). Data were analyzed using two-way ANOVA and Tukey's post-hoc test (p < 0.05). Results: No significant differences in bond strength values to normal dentin between the three adhesives were found. Adper Scotchbond 1 XT and Clearfil S? Bond showed significantly lower bond strength values to caries-affected dentin. For Clearfil SE Bond, bond strength values to normal and caries-affected dentin were not significantly different. ConclusIon: All the tested simplified adhesives showed similar bond strength values to normal dentin. For the tested 2-step etch-and-rinse adhesive and the all-in-one adhesive, the bond strength values to caries-affected dentin were lower than to normal dentin. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the radiographic bone level and stability changes around early loaded chemically modified sandblasted and acid-etched implants with and without a machined collar. Materials and Methods: Seventy-two chemically modified sandblasted and acid-etched implants 4.1 mm in diameter and 8 mm in length were placed in six dogs. Thirty-six implants had no machined collar (NMC) and 36 had a 2.8-mm machined collar (MC). Resonance frequency measurements were obtained at placement and weekly for 3 weeks. All implants were loaded 21 days after surgery. Standardized periapical radiographs were obtained at baseline, at 3 weeks, and at 3, 6, 9, and 12 months. The radiographs were randomized and digitized, and linear measurements of the distance from the first bone-to-implant contact to the shoulder of the implant were performed at the mesial and distal aspects of each implant. For statistical analysis, mixed-model repeated-measures analysis of variance was used. Results: All implants achieved hard and soft tissue integration clinically and radio - graphically and were clinically immobile. From placement to week 3, the mean implant stability increased for MC implants by more than 5 ISQs and for NMC implants by more than 7 ISQs. Radio - graphically, there were significant differences between treatment groups beginning at 3 months. After 12 months of loading, the MC implants presented a mean bone loss of 1.00 mm and the NMC implants presented a mean bone gain of 0.11 mm. Conclusions: Chemically modified sandblasted and acidetched implants without a machined collar presented bone gain, and implants with a machined collar showed bone loss after a 1 year following early (21-day) loading. The tendency toward a coronal apposition of bone observed under these conditions may be attributed to the osteoconductive properties of the chemically modified surfaces of these implants and to the absence of the machined collar. [ABSTRACT FROM AUTHOR]

Purpose: To assess the long-term behavior of 980 implants placed in a private practice and evaluate the influence of periodontitis history and smoking habit on implant survival rates. Materials and Methods: A retrospective review of clinical records of consecutively treated patients with Astra Tech implants was conducted. This review included all patients treated between February 1994 and January 2005. Clinical histories were reviewed, and data were gathered on clinical and radiographic examinations. A record was kept on smoking habits, periodontitis history, length and diameter of implant(s), and whether the sinus was elevated. Cumulative survival proportions analysis was performed, and Cox regression multivariate analysis modified for correlated dependent observations was also used, with the implant as the unit of analysis. Results: A total of 323 patients (185 [57.3%] female; mean age, 55.4 ± 15.2 years) received 980 implants. Of the implants evaluated in this study, 71.1% were placed in patients who were undergoing periodontal maintenance care and 38.8% were placed in smokers. The cumulative survival rate was 96.2% at 5 years; 4.3% of implants failed; 57.1% of failures occurred before implant loading. Tobacco use and periodontitis did not affect the risk of failure, and their interaction did not show significance (P = .386). Implants from individuals with many implants and those placed in patients with sinus elevation showed a higher risk of failure (P < .05). Regression analysis showed no significant interaction between periodontitis history, tobacco use, and implant failure. Conclusions: Implant placement is an effective and reliable long-term treatment, even in periodontal patients under maintenance care and with a smoking habit. Combined analysis of tobacco use and history of periodontitis showed no significant interaction with implant failure in this sample. [ABSTRACT FROM AUTHOR]

Purpose: This longitudinal randomized controlled clinical trial evaluated direct composite restorations for clinical acceptability as posterior restoratives in single- or multi-surface cavities and provides a survey of the 4-year results. Materials and Methods: Three dentists placed 46 Quixfil (Xeno III) and 50 Tetric Ceram (Syntac Classic) composite restorations in stress-bearing Class I and II cavities in first or second molars (43 adult patients). Clinical evaluation was performed at baseline and after 4 years by 2 other dentists using modified USPHS criteria. At the last recall period, 37 Quixfil and 46 Tetric Ceram restorations were assessed. Results: A total of 89.2% of Quixfil and 97.8% of Tetric Ceram posterior composites were assessed to be clinically excellent or acceptable with predominating alfa scores. Up to the 4-year recall, four Quixfil restorations failed because of bulk fracture, partial tooth fracture (2x) and postoperative symptoms. One Tetric Ceram restoration was lost due to problems with tooth integrity. No significant differences between the two composites could be detected at 4 years for any of the evaluated clinical criteria (p > 0.05). The comparison of restoration performance with time within both groups yielded a significant increase in marginal discoloration and decrease in marginal integrity for both materials. After 4 years, small restorations exhibited significantly less marginal discoloration than large restorations. Conclusion: Clinical assessment of stress-bearing Quixfil and Tetric Ceram posterior composite restorations showed good clinical results with predominantly alfa scores for both materials. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the shear bond strength of brackets bonded with resin-modified glass-ionomer cement (RMGIC) using various methods of enamel conditioning. Methods: Forty-five human premolars were randomly divided into five groups. The roots of these teeth were fixed in acrylic resin cylinders, and brackets were bonded to the teeth's crowns using the following material combinations: RMGIC only; RMGIC and corresponding primer; RMGIC, acid etching, and Scotch-bond Multipurpose; RMGIC and two-step self-etching primer; and RMGIC and one-step primer. All specimens were submitted to pH cycling for 14 days before shear bond strength was assessed in a universal test machine. Results: The medians and standard deviations (in MPa) were RMGIC only = 8.34 ± 1.11; RMGIC and corresponding primer = 7.05 ± 2.24; RMGIC, acid etching, and Scotchbond Multipur - pose = 7.00 ± 4.79; RMGIC and two-step self-etching primer = 0.54 ± 0.30; and RMGIC and one-step primer = 10.61 ± 4.58. The value for RMGIC and two-step self-etching primer was significantly lower than all other values. Conclusion: It can be concluded that the tested RMGIC is suitable for bonding orthodontic brackets, even when used by itself. Different enamel preparations do not improve its performance. However, they can worsen its bonding capacity as the combination with the two-step primer system clearly shows. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effects of thermocycling on shear bond strengths (SBSs) of a self-etching primer (SEP) after 10,000 and 20,000 thermal cycles. The tested hypothesis was that 10,000 and 20,000 thermal cycles would affect the bond strength of metal brackets bonded to enamel with the self-etching primer. Materials and Methods: Brackets were bonded to bovine incisors with two etching protocols. In group CM (conventional method), teeth were etched with 37% phosphoric acid for 30 s. In group SEP, a self-etching primer (Transbond Plus, 3M Unitek) was applied. Brackets were bonded with light-curing adhesive (Transbond XT, 3M Unitek). The SBSs were determined after water storage at 37°C for 24 h, after 10,000 and 20,000 cycles of thermocycling. Results: For both groups (CM and SEP), SBSs decreased with 10,000 and 20,000 thermal cycles. These decreased SBSs were significantly different from the values obtained with no thermocycling. Highest SBSs were observed with no thermocycling for groups CM and SEP (18.6 and 18.0 MPa, respectively). These values were not statistically different from each other. Lowest SBSs were obtained with 10,000 and 20,000 thermal cycles for group SEP (14.2 and 14.7 MPa, respectively). These values were significantly different from all other SBSs. Conclusion: This study indicates that the SEP (Transbond Plus) provides clinically acceptable bond strength values compared with the conventional method after 10,000 and 20,000 thermal cycles. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of additional acid etching on the microtensile bond strength (μTBS) and Weibull modulus (m) of two adhesive systems applied to caries-affected dentin. Materials and Methods: Ninety human molars with coronal carious lesions were sectioned to produce flat coronal surfaces containing caries-affected (CAD) and sound dentin (SD). The teeth were allocated to 6 groups: SB-CT: Control - Single Bond applied according to the manufacturer's instructions; SB+15: Single Bond with additional 35% phosphoric acid etching for 15 s; SB+30: Single Bond with additional etching for 30 s; CF-CT: Control - Clearfil SE Bond applied according to the manufacturer's instructions; CF+15: Clearfil SE Bond with additional 35% phosphoric acid etching for 15 s; CF+30: Clearfil SE Bond with additional etching for 30 s. Composite crowns were incrementally built up. The teeth were sectioned after 24 h in order to produce 2 to 3 slices involving each dentin substrate. The slices were trimmed into hourglass-shaped specimens (n = 30) and tested in tension at a crosshead speed of 1 mm/min. Data were analyzed by three-way ANOVA, Tukey's test (p < 0.05) and Weibull statistics. Results: The μTBS to CAD was lower than to SD, except for SB+30. The additional etching increased the μTBS to CAD. The μTBS to SD increased with CF, but decreased with SB. CAD produced lower values of m with both adhesive systems. SB resulted in lower m in sound dentin than CF. The additional etching did not affect the m. Conclusion: The additional etching increases the μTBS to CAD, but not enough to reach the μTBS values obtained in SD. The structural reliability of the bond to CAD is not affected by the additional etching. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the compatibility between five self-etching bonding systems (SEBSs) and two resin luting cements (RLCs) assessed by use of an in vitro dentin shear bond test. Materials and Methods: The selected RLCs were: Variolink II in a dual-cure mode and Multilink in a self-cure mode. The SEBSs combined with the RLCs were: two one-step SEBSs (One Up Bond F and Xeno III) and three two-step SEBSs (Clearfil SE Bond, Unifil Bond, and Xeno III primer coupled with Clearfil SE Bond bonding resin as an experimental combination). One hundred fifty human molars were divided into ten groups of fifteen samples each. The samples were tested in shear after seven days of storage at 100% RH and 37°C. After each test, the failure mode was recorded. Results and conclusions: Significant differences in shear bond strength (SBS) were observed according to both the curing mode of the RLC and the adhesive. The one-step systems Xeno III and One Up Bond F revealed a total incompatibility when bonded with the chemical-curing RLC. Conversely, the two-step SEBSs were compatible with chemical and dual-curing RLC. Failure modes and shear values were in good agreement. A positive correlation was found between the pH of the tested adhesive solutions or resins and the SBS data. [ABSTRACT FROM AUTHOR]

With the introduction of the Er:YAG laser, it has become possible to remove enamel and dentin more effectively and efficiently than with other lasers. Thermal damage is reduced, especially in conjunction with water spray. Since FDA (Federal Drug Administration) approval of the Er:YAG laser in 1997 — for caries removal, cavity preparation and conditioning of tooth substance — there have been many reports on the use of this technique in combination with composite resins. Moreover, cavity pretreatment with Er:YAG laser (laser etching) has been proposed as an alternative to acid etching of enamel and dentin. Reports evaluating the adhesion of glass-ionomer cements to Er:YAG-lased tooth substance are scarce. This article reviews the literature regarding adhesion and sealing efficacy using different (pre)treatment protocols in association with Er:YAG laser preparation. Recent research has shown that lasing of enamel and dentin may result in surface and subsurface alterations that have negative effects on both adhesion and seal. It is concluded that at present, it is advisable to respect the conventional pretreatment procedures as needed for the respective adhesive materials. Although the majority of present day reports show that microleakage and bond strength are negatively influenced by laser (pre)treatment (compared with conventional preparation), there is ongoing discussion of how adhesion is best achieved on Er:YAG-lased surfaces. [ABSTRACT FROM AUTHOR]

Purpose: To determine the in vitro dentinal fluid movement produced by various osmotic stimuli, and evaluate fluid movement across human dentin in response to the application of various osmotic stimuli before and after the application of self-etching adhesive (Clearfil S3 Bond). Materials and Methods: The experiments were carried out on 10 extracted premolars. Each tooth was cut transversely below to the cementoenamel junction with a diamond disk and water coolant. Dentin was exposed at the tip of the buccal cusp by cutting a cavity and was etched with acid. The osmotic stimuli were solutions of saturated CaCl2, sugar syrup, chocolate, and sweet Thai dessert, used as osmotic test solutions, randomly applied to dentin. The fluid flow through dentin obtained after 15 s of application of each osmotic stimulus was measured before and after bonding with Clearfil S³ Bond single-dose. Results: Before bonding procedures, CaCl2 produced peak rates of fluid flow that were significantly higher (p < 0.001), when compared with normal saline, sugar syrup, chocolate, and sweet Thai dessert. During the applications of all osmotic stimuli, the amount of fluid movement across resin-bonded dentin was significantly lower than that without adhesives. There were no significant differences of fluid shifts across resin-bonded dentin obtained during the application of any osmotic stimuli. Conclusion: It appears that different osmotic stimuli produced different rates of outward fluid flow through dentin. Clearfil S³ Bond produced similar significant reductions of fluid movement in response to osmotic stimulation, irrespective of the chemical composition, or the osmotic pressure of stimuli. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the microshear bond strengths to ground enamel of three one-step self-etching adhesive systems, a self-etching primer system and an etch-and-rinse adhesive system. Materials and Methods: Three self-etching adhesives, Futurabond DC (Voco), Clearfil S Tri Bond (Kuraray) and Hybrid bond (Sun-Medical), a self-etching primer, Clearfil SE Bond (Kuraray), and an etch-and-rinse system, Admira Bond (Voco), were selected. Thirty human molars were used. The root of each tooth was removed and the crown was sectioned into halves. The convex enamel surfaces were reduced by polishing on silicone paper to prepare a flat surface. The bonding systems were applied on this surface. Prior to adhesive curing, a hollow cylinder (2.0 mm height/0.75 mm internal diameter) was placed on the treated surfaces. A resin composite was then inserted into the tube and cured. After water storage for 24 h, the tube was removed and shear bond strength was determined in a universal testing machine at a crosshead speed of 0.5 mm/min. The results were analyzed with ANOVA and the Tukey.-Kramer test at a 59° confidence level. The enamel of five additional teeth was ground, and the etching component of each adhesive was applied and removed with absolute ethanol instead of being light cured. These teeth and selected fractured surfaces were examined by SEM. Results: Adhesion to ground enamel of the Futurabond DC (25 ± 3.5 MPa) and Clearfil SE Bond (23 ± 2.9 MPa) selfetching systems was not significantly different from the etch-and-rinse system Admira Bond (27 ± 2.3 MPa). The two self-etching adhesives Clearfil S Tri bond and Hybrid Bond demonstrated significantly lower bond strengths (14 ± 1.4 MPa; 11 ± 1.9 MPa) with no significant differences between them (p < 0.05). Conclusion: Bond strengths to ground enamel of self-etching adhesive systems are dependant on the type of adhesive system. Some of the new adhesive systems showed bond strength values comparable to that of etch-and-rinse systems. There was no correlation between bond strength and morphological changes in enamel. [ABSTRACT FROM AUTHOR]

Objective: To evaluate tensile bond strengths of 2 dentin bonding agents containing solvents on Nd:YAG and Er,Cr:YSGG laser-etched dentin surface. Method and Materials: Occlusal enamel of 146 molars was removed, and exposed surfaces were ground with a diamond bur to produce bur-cut dentin surfaces. Of those teeth, 120 were assigned to 3 groups of 40 samples in which dentin was conditioned with Er,Cr:YSGG laser, Nd:YAG laser, and 37% orthophosphoric acid (control). Each group was further divided into 2 subgroups, acetone- and ethanol-containing bonding agents, and 4-mm-long × 4-mm-wide composite rods were bonded to all specimens using a Plexiglas mold. Tensile bond strength testing of 120 samples was performed at a crosshead speed of 0.5 mm/min using a 50-kgf load cell. The remaining 26 samples were examined under SEM to evaluate the adaptation/penetration of the bonding materials and the alterations in mineral content. Data were analyzed using 1-way ANOVA and Kruskal-Wallis tests; P < .05 was considered statistically significant. Results: The difference between the mean tensile bond strength values obtained with bonding agents was statistically significant in the control group. The bond strength values of the acetone-containing agent in this group were found to be higher than the ethanol-containing agent (P < .001). When compared with Nd:YAG laser, bond strength values obtained with Er,Cr:YSGG laser were higher (P < .001). The bond strength values obtained in the acid-etched group were highest for both bonding agents and demonstrated statistical significance (P < .001). Conclusion: Although in this study laser etching is more influential than the solvent type on bond strengths of dentin bonding agents, it cannot be considered as an alternative to conventional acid etching. [ABSTRACT FROM AUTHOR]

Purpose: The etching of dental ceramics with a glassy matrix by means of hydrofluoric acid (HF) is highly effective and after the application of a silane coupling agent, a strong link between the adhesive and the ceramic is achieved. The purpose of this study was to investigate whether aqueous titanium tetrafluoride (TiF4) solution could be used as an alternative ceramic etchant or not. Materials and Methods: Seventy lithia-based all-ceramic specimens (IPS Empress 2, Ivoclar Vivadent) (diameter: 4 mm, height: 4 mm) were prepared and ultrasonically cleaned for 15 min in ethanol and deionized water, then divided into 1 control and 4 experimental groups (n = 14/group). The control group was acid etched with 4.9% HF for 20 s as described by the manufacturer. The experimental groups were treated with 2.5% TiF4 solution for 60 s, 2.5% TiF4 solution for 120 s and 5% TiF4 solution for 60 s, as well as 5% TiF4 solution for 120 s. Seven of the ceramic specimens in each group were luted to the other seven by a dual-curing cement (Variolink II, Ivoclar Vivadent,) with silane application (Monobond-S). After storage of luted specimens in deionized water at 37°C for 24 h, the specimens were embedded in plastic holders with cyanoacrylate, and the shear-bond strength (SBS) tests were performed with a Shimadzu universal testing machine at a crosshead speed of 0.5 mm/min. A one-way ANOVA and Bonferroni correction, followed by the Tukey test, were applied for statistical analysis. Scanning electron microscopic examination was performed to evaluate the pattern of debonding. Results: Significantly higher SBS values (p ≤ 0.05) were obtained for the control group (28.71 ± 9.74). The SBS for 2.5%-60 s (25.25 ± 5.13) and 2.5%-120 s TiF4 (22.65 ± 5.68) were significantly higher than 5%-60 s (16.77 ± 3.92) and 5%-120 s TiF4 (18.54 ± 3.52) groups (p ≤ 0.05). Differences between 60- and 120-s groups irrespective of TiF4 concentrations were insignificant (p > 0.05). Conclusion: Aqueous TiF4 solution exhibited similar shear bond strength values in comparison to commonly used HF and can be considered as an alternative ceramic etchant within the limitations of this preliminary report. [ABSTRACT FROM AUTHOR]

Purpose: A high clinical and radiographic level of osseointegration has been reported for early and immediately loaded (IL) implants. The aim of this study was to analyze, histologically and histomorphometrically, the bone-titanium interface of IL and submerged titanium implants that were retrieved at 4 and 8 weeks after placement. Materials and Methods: Four patients underwent rehabilitation of the posterior mandible with fixed prostheses, and an additional implant was inserted distally in the mandible. In two patients, the additional implants were put into nonfunctional immediate loading with a fixed provisional prosthesis on the same day of the implant surgery, whereas in the other two patients, the implants were left submerged. The implant stability quotients at implant insertion were 70 and 67 for the submerged implants and 69 and 77 for the IL implants. Before retrieval, the IL implants were clinically osseointegrated and were not mobile. After 4 and 8 weeks, the four implants (two IL and two submerged) were retrieved with a 5-mm trephine and processed for histologic examination. Results: After 4 weeks, the IL implant showed a bone-implant contact percentage (BIC) of 65.6%, while the BIC for the submerged implant was 54.7%. After 8 weeks, the BIC was 76.2% for the IL implant, while for the submerged implant it was 62.3%. Conclusions: Very high BICs were present after 4 and 8 weeks around both submerged and IL implants, with the latter showing a higher quantity of bone. IL did not impede bone formation in the early healing periods. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the effect of an electrochemically deposited nanohydroxyapatite (EDHA) coating on the bone bonding of sandblasted and dual acid-etched titanium implants. Materials and Methods: One hundred EDHA-coated and uncoated sandblasted/dual acidetched implants (3 mm in diameter, 10 mm long) were inserted into the femoral condyles of 50 rabbits. The osteotomy sites were enlarged to 3 mm in diameter via a sequence of drills. After 2, 4, 6, 8, and 12 weeks of bone healing, removal torque testing was performed to evaluate the interfacial shear strength of each implant type. The removed implants were prepared and observed with an electron microscope equipped with an energy dispersive electron probe x-ray microanalyzer. Results: The mean removal torque values for the EDHA-coated implants were 39.6 Ncm at 2 weeks and 40.4 Ncm at 4 weeks; corresponding values for the control implants were 21.1 Ncm and 24.1 Ncm. Removal torque values of the EDHA-coated implants were 87% higher than those of control implants after 2 weeks of healing (P = .015). However, the mean removal torque values for both types of implants were similar after 6, 8, or 12 weeks of healing (no significant differences between the implant surfaces; P > .05). Conclusions: The EDHA nanocrystal coating had a beneficial effect on interfacial shear strength during the early stages of bone healing. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the biomechanical properties of periosteum-derived mineralized culture on different surface topographies of titanium. Materials and Methods: Titanium surfaces modified by machining or by acid etching were analyzed using scanning electron microscopy (SEM). Rat mandibular periosteum-derived cells were cultured on either of the titanium surfaces. Cell proliferation was evaluated by cell counts, and gene expression was analyzed using a reverse-transcriptase polymerase chain reaction. Alkaline phosphatase (ALP) stain assay was employed to evaluate osteoblastic activity. Matrix mineralization was examined via von Kossa stain assay, total calcium deposition, and SEM. The hardness and elastic modulus of mineralized cultures were measured using a nano-indenter. Results: The machined surface demonstrated a flat topographic configuration, while the acid-etched surface revealed a uniform micron-scale roughness. Both cell density and ALP activity were significantly higher on the machined surface than on the acid-etched surface. The expression of bone-related genes was up-regulated or enhanced on the acid-etched surface compared to the machined surface. Von Kossa stain showed significantly greater positive areas for the machined surface compared to the acid-etched surface, while total calcium deposition was statistically similar. Mineralized culture on the acid-etched surface was characterized by denser calcium deposition, more mature collagen deposition on the superficial layer, and larger and denser globular matrices inside the matrix than the culture on the machined surface. The mineralized matrix on the acid-etched surface was two times harder than on the machined surface, whereas the elastic modulus was comparable between the two surfaces. Conclusions: The design of this study can be used as a model to evaluate the effect of implant surface topography on the biomechanical properties of periosteum-derived mineralized culture. The results suggest that mandibular periosteal cells respond to different titanium surface topographies differently enough to produce mineralized matrices with different biomechanical qualities. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the osseointegration potential of surface-treated mini-implants retrieved from patients by examining bone-to-implant contact (BIC). Material and Methods: Five implants from four patients were inspected. The average patient age was 38.1 years, and the average treatment duration 11.4 months. The mini-implants were removed with a trephine bur under saline irrigation. After histologic preparation, the BIC was measured. Results: Under 300× magnification, an active adherence of bone cells to the treated surface was seen. The mean BIC was 52.6%. Conclusion: This pilot study confirms the osseointegration potential of a surface-treated mini-implant. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this prospective study was to evaluate the clinical performance of the restorative material Ceram.X in combination with an experimental one-bottle etch-and-rinse adhesive (K-0127). Materials and Methods: A single operator placed two Class I or II restorations in molars of 43 patients. One molar was restored with Ceram.X/K-0127 (Dentsply DeTrey), the other one with Tetric Ceram/Syntac Classic (Ivoclar Vivadent). At baseline, after one, two, and four years the restorations were evaluated by a second dentist using modified Ryge's criteria. After four years, 27 patients were examined. Results: In one patient, both restorations (Class II) had to be removed for root canal treatment due to pulpitis. Another Class II Ceram.X restoration (3.8%; 4.3% [1 of 23] of Class II restorations) showed score C with regard to wear/anatomical form. Thus, the cumulative failure rate was 7.4% in the Ceram.X group (8.3% of Class II restorations [2 of 24]) and 3.7% in the Tetric Ceram group (4.2% of Class II restorations [1 of 24]). Furthermore, three restorations (11.5%) in each group showed score B for anatomical form and marginal integrity. Slight marginal discoloration (score B) was found at five Ceram.X restorations (19.2%) and four Tetric Ceram restorations (15.4%). Two restorations (7.7%) in each group showed slight changes in color stability (score B). No sensitivity, recurrent caries, or changes in surface texture were recorded after four years. No statistically significant differences were found between the two restorative materials (p > 0.05). Conclusion: After four years of clinical service, 92.6% of Ceram.X/K-0127 and 96.3% of Tetric Ceram/Syntac Classic restorations performed clinically well. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the interfacial microtensile bond strength between a fiber-reinforced post (Rely × Post) and a core material (Multicore Flow) after placing different bonding agents. Materials and Methods: After post surface treatment, 50 posts were divided into 5 groups. Group 1: Adper Prompt-L-Pop; group 2: SingleBond2; group 3: ScotchBond Multipurpose Plus; group 4: experimental bonding system (wet ethanol bonding technique); group 5: control group. After core reconstruction, the samples were tested with the microtensile test. Fracture type examination and SEM observation followed. Data were statistically analyzed with Kruskall-Wallis non-parametric ANOVA. Results: Microtensile testing revealed significant differences (p < 0.001). There were no differences between groups 1 to 4, but there was a statistically significant difference between groups 1 to 4 and the control. Fracture type observations revealed more adhesive failures than cohesive or mixed ones. Conclusion: The experimental bonding technique did not improve bond strength compared to the different adhesive systems tested. However, placing a bonding agent beween the post and the core seems to significantly increase microtensile bond strength. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of high frequency ultrasonic agitation on the microtensile bond strengths of different self-etching adhesives. Materials and Methods: Thirty-six human molars were wet ground occlusally until dentin was exposed. The one-step self-etching adhesives Clearfil S³ Bond, G-Bond, and Futurabond NR were tested in this study. In the control groups, bonding procedures were performed according to the manufacturers' instructions. In the experimental groups, bonding materials were applied with a 1 MHz therapeutic ultrasonic device on the dentin surfaces. The composite crown was built up incrementally to a height of 5 mm. Each tooth was serially sectioned into rectangular beams, and the specimens were subjected to microtensile testing. Failure modes were observed under a stereomicroscope and classified. Randomly selected specimens from each group were observed with SEM. Results: Two-factor ANOVA indicated that both the adhesive system and the ultrasonic agitation effect influenced bond strength (p < 0.05). The bond strength of G-Bond adhesive to dentin was higher after ultrasonic agitation (p < 0.05), whereas ultrasonic agitation of Futurabond and S³ Bond did not affect bond strength values (p > 0.05). Failure after the test was commonly due to adhesive failure in the dentin. Conclusion: High-frequency ultrasonic agitation of self-etching adhesives during their application may enhance their bonding performance. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the dentin bonding durability of two one-step self-etching adhesive systems with and without the presence of surrounding enamel. Materials and Methods: Tri-S Bond (Kuraray) and G-Bond (GC), commercially available adhesive systems, were used in this study. The occlusal enamel was removed in order to form a flat, midcoronal dentin surface. The adhesives were applied to both the dentin and the surrounding enamel surfaces according to the manufacturers' instructions. Resin composite crowns (Clearfil AP-X, Kuraray) were incrementally built up with each layer being photocured for 40 s. Half the bonded teeth were sectioned perpendicular to the adhesive interface into 0.7-mm-thick slabs, and then trimmed to an hourglass shape with a 1 mm² cross-sectional area for microtensile bond strength testing, followed by storage in water for 6 months (direct water exposure group, DE). The other half were left untrimmed and stored in water for 6 months (indirect water exposure group, IE). As control groups, additional bonded teeth were prepared for water storage for 24 h. After the designated periods of water storage, the specimens were subjected to bond strength testing at a crosshead speed of 1.0 mm/min. The μTBS data were statistically analyzed using three-way ANOVA and post-hoc tests (t-test and Tukey's HSD comparison tests) (α = 0.05). Results: Indirect water exposure of the resin/dentin interface did not affect the μTBS of either adhesive after 6 months water storage (p < 0.05). However, direct exposure to water significantly reduced the μTBS of both adhesives to dentin (p < 0.05). In addition, there were no significant differences in μTBS between the two adhesive systems for each experimental storage condition (p > 0.05). Conclusion: The durability of resin-dentin bonds was found to be dependent on the method in which the bonded specimens were aged in water. Significantly lower bond strengths were observed for specimens that were sectioned into an hourglass shape before aging compared to those that were sectioned after water storage. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the effect of external hexagon height and commonly applied surface treatments on the fatigue life of titanium dental implants. Materials and Methods: Electropolished commercially pure titanium dental implants (seven implants per group) with three different external hexagon heights (0.6, 1.2, and 1.8 mm) and implants with the highest external hexagon height (1.8 mm) and different surface treatments (electropolishing, grit blasting with aluminium oxide, and acid etching with sulfuric acid) were tested to evaluate their mechanical fatigue life. To do so, 10-Hz triangular flexural load cycles were applied at 37°C in artificial saliva, and the number of load cycles until implant fracture was determined. Tolerances of the hexagon/abutment fit and implant surface roughness were analyzed by scanning electron microscopy and light interferometry. Transmission electron microscopy and electron diffraction analyses of titanium hydrides were performed. Results: First, the fatigue life of implants with the highest hexagon (8,683 ± 978 load cycles) was more than double that of the implants with the shortest hexagons (3,654 ± 789 load cycles) (P < .02). Second, the grit-blasted implants had the longest fatigue life of the tested materials (21,393 ± 2,356 load cycles), which was significantly greater than that of the other surfaces (P < .001). The compressive surface residual stresses induced when blasting titanium are responsible for this superior mechanical response. Third, precipitation of titanium hydrides in grain boundaries of titanium caused by hydrogen adsorption from the acid solution deteriorates the fatigue life of acid-etched titanium dental implants. These implants had the shortest fatigue life (P < .05). Conclusions: The fatigue life of threaded root-form dental implants varies with the height of the external hexagon and/or the surface treatment of the implant. An external hexagon height of 1.8 mm and/or a blasting treatment appear to significantly increase fatigue life of dental implants. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of three different root canal pretreatments on the retention of prefabricated titanium posts luted in the root canal with one of three resin cements. Materials and Methods: After removal of the clinical crowns of 216 extracted premolars, the root canals were prepared with the ParaPost system (length = 5 mm, diameter = 1.25 mm). The walls of the roots were subjected to either none (control) or one of three pretreatments: etching with citric acid, application of EDTA C, or mechanical roughening with a diamond-coated bur (n = 18 per group). CoJet-treated ParaPost XH posts were luted in the root canals with one of three resin cements: Panavia 2.0 F, Rely X Unicem, or ParaCem. Following water storage at 37°C for 7 days, retention was determined by extraction of the posts. Results: Mechanical roughening of root canal walls resulted in improved retention of posts, irrespective of the type of resin cement. Etching of root canal walls with citric acid resulted in improved retention only when Panavia 2.0 F was used. Depending on the resin cement, application of EDTA C had either no effect or a negative effect. Luting of posts with Panavia 2.0 F resulted in higher retention than did luting with Rely X Unicem or ParaCem. Conclusion: Mechanical roughening of the root canal walls with a diamond-coated bur was the most effective method to improve retention of posts. The use of Panavia 2.0 F resulted in higher retention than did the use of Rely X Unicem or ParaCem. [ABSTRACT FROM AUTHOR]

Purpose: The effect of three different bonding strategies on the shear bond strength of a resin composite to fluorotic enamel surfaces was investigated. Materials and Methods: Thirty-six noncarious extracted human molars with fluorosis and 36 without fluorosis were scraped clean from any remaining tissue, and then were divided into three subgroups according to the tested dentin bonding systems. The resin composite was bonded to the teeth using three different adhesive systems: Peak LC Bond with an etch-and-rinse technique (Ultradent Products), Peak LC Bond with a self-etching technique using Peak SE Primer (Ultradent Products), and Xeno V (Dentsply Caulk) using a one-bottle self-etching technique. Following the photopolymerization of the resin composites, thermocycling was performed 5000 times. Shear bond strengths were tested using the Shimadzu Universal Testing Machine until failure. The analysis of the fractured enamel surfaces was performed using an optical microscope (Nikon ECLIPSE ME 600) at 10X and 1000X magnification, and the images were analyzed with an image analyzer (LUCIA 4.21). The data obtained were analyzed with two-way ANOVA and the Bonferroni test at a significance level of p < 0.05 Results: Mean shear bond strengths in MPa of the groups were: Peak LC Bond, self-etching, on fluorotic enamel 13.23 ± 2.58 and on nonfluorotic enamel 17.81 ± 2.90; Peak LC Bond, etch-and-rinse, on fluorotic enamel 16.77 ± 2.32 and on nonfluorotic enamel 21.13 ± 2.74; one-bottle self-etching Xeno V on fluorotic enamel 10.79 ± 2.14 and on nonfluorotic enamel 14.58 ± 2.99. Conclusion: Fluorosis adversely affected the bonding performance of all the bonding systems to enamel. The use of the etch-and-rinse dentin bonding technique produced higher bond strengths of the resin composite tested to fluorotic and nonfluorotic enamel compared to both self-etching techniques. [ABSTRACT FROM AUTHOR]

Purpose: To assess the influence of variations in the application technique of self-etching adhesive systems on the adhesive bond strength to enamel. Materials and Methods: One hundred thirty bovine teeth were used and divided into 13 groups. The teeth were embedded in acrylic resin, ground until a flat enamel area was exposed, and polished with 600-grit abrasive paper. The self-etching adhesive systems One Up Bond F, Clearfil SE Bond, Self & Etch were used, and the conventional adhesive Magic Bond and acid etching were used as the control group. One or two layers of the self-etching systems were actively or passively applied. Composite cylinders were made over the bonding area. The samples were submitted to shear bond testing at a speed of 1 mm/min. Statistical analysis of the data was performed using two-way ANOVA, followed by Tukey's test at a 5% level of significance. Results: Significant variations were observed for the factors type of adhesive (p = 0.001, F = 193,3594, df = 3) and application technique (p = 0.001, F = 29,9119, df = 1). No significant interaction was found between the two factors (p = 0.08). The adhesives Clearfil SE Bond and One Up Bond F presented significantly higher adhesive bond strength means than Self & Etch. The active application of two layers resulted in higher bond strength means than the other techniques. Conclusion: The application technique had a significant influence on adhesive bond strength to enamel. [ABSTRACT FROM AUTHOR]

Purpose: To compare the shear bond strength of stainless steel brackets bonded with two orthodontic adhesive systems, Transbond XT (3M Unitek) and Orthobond (Morelli Dental Products). Materials and Methods: Forty bovine teeth were randomly divided in two groups of 20 each: group 1 (control): Transbond XT primer + Transbond XT Adhesive paste (3M Unitek); group 2: Orthoprimer (Morelli Dental Products) + Orthobond. In each group all teeth were etched with 37% phosphoric acid, and all products were used according to manufacturers instructions. After 30 min, a universal testing machine was used to apply an occlusal shear force directly to the enamel/bracket interface at a speed of 0.5 mm/min. The groups were compared using Student's t-test. Results: Mean results and standard deviations for the groups were: group 1= 11.22 Mpa (1.68), group 2= 4.88 Mpa (1.18). A significant difference was observed in the bond strengths of the two groups evaluated (p < 0.0001). Conclusion: Under the conditions of this study, Orthobond system presented lower shear bond strength when compared to Transbond XT. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the effect of different titanium surface characteristics on the behavior and function of oral fibroblasts as well as the deposition pattern of collagen within the extracellular matrix. Materials and Methods: Titanium surfaces created by machining, acid etching with sulfuric acid (AE1), or acid etching with hydrofluoric acid (AE2) were analyzed using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy. Rat oral fibroblasts were cultured on different surfaces. Cell spread and morphology of extracellular matrix were evaluated using SEM. Attachment and proliferation of cells were examined by comparing the numbers of attached to detached cells and cell count, respectively. Gene expression was analyzed via reverse transcriptase polymerase chain reaction. Collagen production and deposition were examined via a Sirius red-based stain assay and confocal laser scanning microscopy. Results: The machined surface showed a flat profile with isotropic grooves, the AE1 surface showed a uniformly microscale roughened surface, and the AE2 surface had a grooved profile with intermediate surface roughness. The AE2 surface contained fluoride atoms (2.45% ± 0.44% as F/Ti atomic ratio). Cell attachment was significantly weaker on the machined surface than on the AE1 and AE2 surfaces, whereas no differences were observed between the AE1 and AE2 surfaces. The cell counts on the machined and AE2 surfaces were higher, with a parallel orientation, whereas the cell count was lower and randomly distributed on the AE1 surface. The expression level of fibroblastic genes was similar among surfaces for all time points tested. Collagen production was highest on the machined surface, followed by AE2 and AE1 surfaces. Collagen deposition displayed a parallel pattern on the machined surface, while it was multidirectional on the AE1 and AE2 surfaces. Conclusion: The surface characteristics of titanium affect attachment, spread, and proliferative activity of oral fibroblasts as well as the deposition pattern of collagen in vitro. [ABSTRACT FROM AUTHOR]

Objective: Restorative procedures of the dentin-pulp complex stimulate damages that, depending on the technique and materials used, may induce pulpal reactions. The purpose of this study was to evaluate immunochemistry, morphologic, and morphometric pulpal alterations of human teeth pulps capped with self-etching or total-etching adhesive systems. Method and Materials: Thirty human third molars were restored with a resinbased composite and adhesive system, either Clearfil (Kuraray; n = 10) or Scotchbond (3M ESPE; n = 10). After 7, 30, or 60 days, the teeth were extracted and longitudinally sectioned. The pulps were removed for histopathologic and immunochemistry evaluation for interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and inducible nitric oxide synthase (iNOS). Results: The density of fibrous connective tissue was significantly higher after 30 days in both groups (P < .001). Congestion, hemorrhage, calcification, and swelling of the odontoblasts were similar in both groups. The total capillary area was significantly higher after 7 and 30 days in both groups. Positive immunoreactions for iNOS were found in 1 case (20%) of the 30-day Scotchbond group. Immunoreactions for IFN-gamma were positive in a few cells in 1 case (20%) of the 7-day Clearfil group. There were no positive immunoreactions for TNF-alpha in any case. Conclusion: No inflammatory reactions, necrotic areas, or severe immunoreactions for proinflammatory cytokines were found, suggesting biocompatibility of self-etching or total-etching adhesive systems when placed directly on dentin. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the histopathological changes in mechanically exposed dog pulps capped with three self-etching adhesive systems. Material and Methods: Seventytwo Class V cavities were prepared under rubber dam isolation in dogs. The pulps were exposed and capped with Clearfil SE Bond (Kuraray), Imperva FluoroBond (Shofu), Prompt L-Pop (3M ESPE), and Dycal (Dentsply; control capping agent), respectively. Histopathological examination of the teeth was performed at 7, 14, and 30 days postoperatively. Hematoxylin-eosin staining was performed to assess the inflammatory cell response, tissue disorganization, and hard tissue formation. Brown & Brenn staining was used to detect the presence of bacteria. The data were analyzed by Kruskal-Wallis and Nemenyi tests. Results: Most pulps showed moderate to severe inflammatory response. Hard tissue formation appeared at 14 to 30 days. Positive bacterial staining was observed in most specimens in experimental groups. The histological changes in the pulps of the experimental groups were more pronounced than in the control group. Differences in inflammatory response, tissue disorganization, and hard tissue formation were observed among teeth treated with the three self-etching systems. Conclusion: Microleakage has a critical influence on pulpal repair. It is not beneficial to cap the pulp with self-etching adhesive systems. Diverse pulpal responses were observed to the self-etching adhesive systems, and the histological changes were more pronounced than in the control pulps treated with Dycal. The effects of the self-etching adhesive systems are such that these materials require further study to address issues of bacterial microleakage during placement of restorations. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the effect of surface treatments of the prepolymerized adhesive layer in the immediate dentin sealing technique (IDS) on the microtensile bond strength of two-step etch-and-rinse adhesive systems. Materials and Methods: The occlusal dentin surfaces of 60 human third molars were exposed and Adper Single Bond 2 (SB) or Prime & Bond NT (PB) adhesive systems were applied (control groups). Immediately afterwards, the temporary cement RelyXTemp NE was applied on the bonded dentin surface, and the teeth were stored in artificial saliva for 48 h or 4 months. After the storage time, the temporary cement layer was removed and the following surface treatments were applied: aluminum oxide (AO), 37% phosphoric acid (PA), or AO+PA. Next, a second adhesive layer was applied for each adhesive system, and a composite resin block restoration (Z250) was built. The specimens were cut and submitted to microtensile strength (μTBS) testing. The adhesive layer thickness (ALT) was evaluated in other specimens from all groups by SEM. The fracture pattern was evaluated in all sticks tested by SEM. μTBS and ALT values were analyzed with two-way ANOVA and Tukey's test (α = 0.05). Results: The highest μTBS, similar to the control, was obtained with aluminum oxide and phosphoric acid (AO+PA) for both adhesives systems. The use of aluminum oxide alone (AO) or associated with phosphoric acid (AO+PA) showed values close to those of the control groups in relation to the ALT. The failure pattern was the same for control groups and AO +PA groups. Conclusion: Dentin prehybridization can improve the adhesive bond strength if the bonded surface is treated with airborne aluminum oxide particle abrasion associated with 37% phosphoric acid, followed by application of a second adhesive layer. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this in vitro study was to compare the degree of microleakage of composite restorations performed by lasers and conventional drills associated with two adhesive systems. Materials and Methods: Sixty bovine teeth were divided into 6 groups (n = 10). The preparations were performed in groups 1 and 2 with a high-speed drill (HD), in groups 3 and 5 with Er:YAG laser, and in groups 4 and 6 with Er,Cr:YSGG laser. The specimens were restored with resin composite associated with an etch-and-rinse two-step adhesive system (Single Bond 2 [SB]) (groups 1, 3, 4) and a self-etching adhesive (One-Up Bond F [OB]) (groups 2, 5, 6). After storage, the specimens were polished, thermocycled, immersed in 50% silver nitrate tracer solution, and then sectioned longitudinally. The specimens were placed under a stereomicroscope (25X) and digital images were obtained. These were evaluated by three blinded evaluators who assigned a microleakage score (0 to 3). The original data were submitted to Kruskal-Wallis and Mann-Whitney statistical tests. Results: The occlusal/enamel margins demonstrated no differences in microleakage for all treatments (p > 0.05). The gingival/dentin margins presented similar microleakage in cavities prepared with Er:YAG, Er,Cr:YSGG, and HD using the etch-and-rinse two-step adhesive system (SB) (p > 0.05); otherwise, both Er:YAG and Er,Cr:YSGG lasers demonstrated lower microleakage scores with OB than SB adhesive (p < 0.05). Conclusion: The microleakage score at gingival margins is dependent on the interaction of the hard tissue removal tool and the adhesive system used. The self-etching adhesive system had a lower microleakage score at dentin margins for cavities prepared with Er:YAG and Er,Cr:YSGG than the etch-and-rinse two-step adhesive system. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the resin-dentin microtensile bond strength (μTBS) of ethanol/water- (Single Bond, [SB] 3M ESPE), ethanol- (Optibond Solo Plus, [OP] Kerr) and acetone-based (One-Step, [OS] Bisco) two-step etch-and-rinse adhesives in the presence or absence of their respective solvents to dry and wet dentin. The ultimate tensile strength (UTS) and the degree of conversion (DC) of the materials were also evaluated. Materials and Methods: Solvent-based and solvent-free adhesives were vigorously applied to occlusal dentin surfaces after phosphoric acid etching. Composite crowns were built up incrementally. After 24-h water storage, the specimens were sectioned in x and y directions to obtain bonded sticks (1.0 mm²) which were immediately tested in tension (0.5 mm/min). The data were analyzed by three-way ANOVA and Tukey's test (α = 0.05). For the UTS measurement, hourglass-shaped specimens of adhesives were prepared and tested in tension. FTIR analysis was used to verify the DC of adhesives. The data from UTS and FTIR was analyzed by two-way ANOVA and Tukey's test (α = 0.05). Results: High μTBS values were obtained for SB and OS, regardless of the presence or absence of solvents or the moisture condition of dentin. A lower μTBS mean was observed for the solvent-free OP compared to its solvent-based version. Significantly higher UTS values were obtained for all adhesives after removal of solvents. The DC of OS in the solvent-based condition was lower than SB and OP. After removal of solvents, only OS showed a significant increase in the DC. Conclusion: The presence of solvents was not essential for SB and OS to achieve high bond strength values to both dry and wet dentin when applied under vigorous application. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of 0.2% and 2% chlorhexidine (CHX) used as a therapeutic primer on the long-term bond strengths of two etch-and-rinse adhesive systems. Materials and Methods: Adper Scotchbond 1XT (SB1) and XP-Bond (XPB) were evaluated. Etched dentin substrates were assigned to 6 treatment groups: (1) 0.2% CHX + SB1; (2) 2% CHX + SB1; (3) SB1 (control); (4) 0.2% CHX + XPB; (5) 2% CHX + XPB; (6) XPB (control). Composite buildups were made and beams prepared for microtensile bond strength testing. Beams were divided into 3 subgroups and either immediately pulled to failure or stored in artificial saliva for 6 or 12 months prior to testing. Data were evaluated with three-way ANOVA. Additional adhesive interfaces were prepared to investigate nanoleakage expression by TEM. Results: SB1 and XPB showed similar immediate bond strength values with or without CHX pretreatment (p > 0.05). After 12 months, bonds fell from 43.9 ± 9.5 MPa to 20.1 ± 5.4 MPa and from 39.6 ± 9.4 MPa to 14.2 ± 5.0 MPa in control specimens for SB1 and XPB respectively, while bond fell only from 41.9 ± 9.6MPa to 33.2 ± 8.3 MPa and 38.3 ± 8.9 MPa to 26.5 ± 10.9 (for SB1 and XPB, respectively) when 0.2% CHX was previously used. CHX concentration did not affect bond strength values (0.2% vs 2%, p > 0.05). Nanoleakage increased during aging in controls, but reduced silver deposits were found in CHX-treated specimens. Conclusion: Chlorhexidine significantly reduced the loss of bond strength seen in control bonds. Since no bacterial growth was present in the aging conditions, the results of this study suggest that endogenous factors thought to degrade the adhesive interface can be inhibited by CHX. Further in vivo trials should confirm the role of CHX in bond durability. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to investigate the surface effects on dentin following laser "etching" with an Nd:YAG laser, and to determine the shear bond strengths of composite to untreated and laser-treated dentin. Materials and Methods: Dentin surfaces from freshly extracted permanent molars were subjected to laser treatment with an Nd:YAG laser. The results were analyzed using an SPSS/PC multiple range test. The shear bond strengths of laser-treated dentin/composite and untreated dentin/composite by dentin bonding were also determined. These results were also compared using the SPSS/PC multiple range test. Results: Shear bond strength in laser and acid groups were 6.70 ± 2.86 and 15.24 ± 8.51 MPa, respectively. Bond strength in the laser group was significantly lower than in the other group (p < 0.01). Conclusion: The Nd:YAG dental laser tested produced weaker shear bond strength than conventional acid etching. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the antibacterial activity of three adhesive systems - Prime & Bond 2.1 (PB), Clearfil SE Bond (CS) and One Up Bond F (OU) - on Streptococcus mutans in vitro. Materials and Methods: Adherence and agar disk-diffusion tests were performed. For the adherence testing, 40 human enamel specimens (4 mm2) were sterilized and the adhesive sytems were applied (n = 10). The control group did not receive the application of any adhesive system. Specimens were immersed in brain heart infusion broth (BHI) inoculated with S. mutans standardized suspension (106 cells/ml) for 48 h at 37°C and 5% CO2. The number of S. mutans cells adhered to each specimen was evaluated by the plating method on BHI agar. For agar disk-diffusion testing, adhesive disks and disks soaked in distilled water (negative control) or 0.2% chlorexidine (positive control) were incubated with S. mutans for 48 h. The diameters of the zones of bacterial inhibition were measured. Adherence data were transformed in logarithms of base 10 (log10). Data were submitted to Kruskal-Wallis and Student-Neuman- Keuls tests at the 5% level of significance. Results: The results of the adherence test showed that One Up Bond F (OU) and Clearfil SE Bond (CS) did not differ significantly from one another, but allowed significantly less adherence than Prime & Bond 2.1 (PB) and control [mean log10 (standard deviation) values: PB 6.10 (0.19); CS primer 4.55 (0.98); OU 4.65 (0.54); control group 6.34 (0.27)]. The disk-diffusion test showed no significant difference between OU (diameter in mm: 3.02 ± 0.13) and CS (3.0 ± 0.12), but both were significantly more effective in inhibiting bacterial growth than PB (1.0 ± 0.10). Conclusion: The self-etching systems Clearfil SE Bond and One Up Bond F presented a greater inhibitory effect against S. mutans, also in terms of adherence, than did the conventional system, Prime & Bond 2.1. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 2-year clinical performance of three self-etching adhesives and one etch-and-rinse adhesive (control) in posterior composite restorations. Materials and Methods: Upon approval by the Institutional Review Board, 121 restorations were inserted in 38 subjects. The adhesives were applied as per manufacturers' instructions. Preparations were restored with a nanofilled composite resin (Filtek Supreme, 3M ESPE) and evaluated at baseline, 6 months, 1 year, and 2 years. Statistical analyses included the McNemar and the Mann-Whitney non-parametric tests (p < 0.05). Results: At 2 years, 91 out of 121 restorations were evaluated using the USPHS modified criteria. The number of alpha ratings decreased significantly from baseline to 2 years for Adper Prompt L-Pop, Clearfil S3 Bond, and iBond in the categories color match, marginal staining, and marginal adaptation. For One-Step Plus, only marginal staining was significantly worse at 2 years than at baseline. Postoperative sensitivity to air improved significantly for One-Step Plus at 2 years, but this improvement was already detected at 1 year. When the 2-year evaluation criteria were pooled by pairs of adhesives, One-Step Plus resulted in a significantly greater number of alfa ratings for marginal adaptation than the other three adhesives. On the other hand, iBond resulted in a significantly lower number of alfa ratings than any of the other 3 adhesives for color match and marginal staining. Adper Prompt L-Pop, Clearfil S3 Bond, and One-Step Plus resulted in a statistically similar number of alfa ratings for marginal staining and color match. There were no significant differences in any of the evaluation criteria between Clearfil S3 Bond and Adper Prompt L-Pop. Conclusion: Only One-Step Plus, the etch-and-rinse adhesive, resulted in good marginal adaptation at 2 years. One of the self-etching adhesives, iBond, resulted in unacceptable clinical performance. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of endodontic irrigation regimens and calcium hydroxide root canal sealer (Sealapex) on the microtensile bond strengths (μTBS) of dual-curing resin composite (Clearfil DC Core Automix) to the intrapulpal dentin. Materials and Methods: Forty standardized coronal-half root canal dentin specimens obtained from human premolars were divided into 4 groups: group A, no treatment (control); group B, Sealapex; group C, NaOCl/Sealapex; group D, EDTA/NaOCl/Sealapex. After 7 days of storage in 100% relative humidity, Sealapex was removed. Dentin surfaces were bonded with adhesives, either etch-and-rinse (Single Bond) or self-etching (Clearfil SE Bond), and built up with resin composite. The bonded specimens were trimmed into an hourglass shape with a 1-mm2 cross-sectional area for microtensile testing (n = 20). The μTBS to intrapulpal dentin was analyzed using two-way ANOVA and Dunnett's TC test. Two teeth of each group were prepared for micromorphological analysis of dentin surface. Results: The root canal sealer with or without endodontic irrigation significantly affected the bond strengths of resin composite to intrapulpal dentin compared with the control group (p < 0.05). There were no significant differences in μTBS of each experimental group between etch-and-rinse and self-etching adhesives (p > 0.05). The dentin surface was covered with a mud-like material after sealer application for 7 days. Conclusion: The root canal sealer reduced the μTBS of dual-curing resin composite with etch-and-rinse and self-etching adhesive systems to intrapulpal dentin. Treatment with EDTA followed by NaOCl prior to obturation caused an additional reduction in μTBS of both adhesive systems to intrapulpal dentin. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of different surface treatments on the tensile bond strength (TBS) of immediately repaired anterior microfine hybrid restorative composite using nontrimmed hourglass-shaped specimens. Materials and Methods: Fifty-six nontrimmed hourglass composite specimens were prepared in this study. Eight specimens were used for the evaluation of the cohesive tensile strength as the control group. The remaining 48 were divided into 6 equal groups according to the method of proposed treatment. Groups IM1 and IM2: The specimens were repaired without intermediate treatment. Group IM3: A thin layer of Excite self-priming adhesive was applied to the proposed repaired area of each half-specimen. Group IM4: The repaired area was ground using an abrasive stone, each half-specimen was rinsed and dried, and the adhesive applied. Group IM5: Treatment consisted of 37% phosphoric acid etching of the proposed repair area. The adhesive was then applied. Group IM6: The repaired area was ground and acid etched before applying the adhesive. In all repaired groups except for IM2, repaired specimens were prepared and cured against a single layer of transparent polyester strip (matrix) to prevent the formation of an oxygen inhibition layer. In group IM2, specimens were cured in air without the polyester strip. Specimens were then tested for the repair tensile bond strength (TBS) in a universal testing machine at a crosshead speed of 0.5 mm/min until failure. Twelve more samples were used for SEM characterization of nontreated, ground, acid-etched, and ground/acid-etched samples. The failure mode was evaluated using a stereomicroscope at 30X magnification. All TBS data were expressed as mean and standard deviation, and were analyzed using StatsDirect 2.5.7. One-way ANOVA followed by Tukey-Kramer multiple-comparison post-hoc tests were used to compare the TBS between all tested groups. Differences were considered significant at p < 0.05. Results: Groups that were cured against a matrix and received no treatment or were repaired with adhesive only had significantly lower TBS than the control group. Groups which were cured without the matrix and received no treatment or grinding/adhesive, acid etching/adhesive, and grinding/acid etching/adhesive showed no significant difference in TBS compared to the control group. SEM evaluation showed that acid etching did not change the morphology of the composite surface. The ground specimens showed a grooved pattern with smeared grinding products. Ground/acid-etched specimens showed removal of the smeared products with a less distinct grinding-groove pattern. Stereomicroscopic evaluation of the debonded surfaces for all repaired groups showed that the failure mode was predominantly adhesive for all evaluated debonded surfaces in each repair group. Conclusion: In the absence of an oxygen inhibition layer, the immediate repair bond strength was decreased. In contrast, in the presence of an oxygen inhibition layer, the immediate repair bond strength of composite was improved. The application of a thin adhesive layer did not improve the immediate repair bond strength as the other surface treatments did. When the composite was cured against a matrix, chemical and/or mechanical treatments of composite surface prior to application of the adhesive proved to be an effective method to improve the immediate repair bond strength. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the clinical performance of a polyacid modified resin composite and a nanocomposite applied with an antibacterial adhesive system over a period of 2 years in noncarious Class V lesions. Materials and Methods: Twenty-four patients with at least two noncarious cervical lesions were enrolled in the study. The teeth were restored with a polyacid modified resin composite (Dyract eXtra, Dentsply DeTrey) or a nanocomposite (Filtek Supreme, 3M/ESPE). Fifty restorations of each material were placed with no marginal bevels and no mechanical retentions using an antibacterial self-etching adhesive system (Clearfil Protect Bond, Kuraray). All lesions were evaluated at baseline, 6, 12, and 24 months periods using the USPHS criteria for color match, marginal discoloration, marginal adaptation, caries formation, anatomic form, postoperative sensitivity, surface roughness, and retention. The changes across the four time points were assessed using Friedman and Wilcoxon Signed Ranks tests. The two restorative materials were compared in the same recall period for each of the criteria using chi-square test (p = 0.05). Results: Dyract eXtra restorations exhibited a significantly better color match than Filtek Supreme restorations; however, all restorations in both groups were clinically acceptable. Filtek Supreme's retention rate (100%) was found to be significantly better than that of Dyract eXtra (96%). Two Dyract eXtra restorations were completely lost while one was partially fractured (p = 0.05). Significant differences were observed in marginal adaptation and color match of Filtek Supreme restorations and marginal discoloration of Dyract eXtra and Filtek Supreme restorations between the baseline and the 2-year scores (p = 0.05). Conclusion: Both restorative materials showed acceptable clinical performance in Class V noncarious lesions after 2 years of clinical service. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of long-term water storage on the microleakage of a fissure sealant applied with or without different bonding agents. Materials and Methods: Extracted human third molars were randomly assigned into 8 groups (n = 24/each). The occlusal surfaces were sealed with a fluoride fissure sealant material (Helioseal F) after one of the following pretreatments: 1. phosphoric acid etching only; 2. phosphoric acid etching + Single Bond; 3. phosphoric acid etching + Prime & Bond NT; 4. Clearfil SE Bond; 5. FL Bond; 6. One Up Bond F; 7. Prompt L-Pop; 8. Mac Bond II. All specimens were thermocycled (1000X), after which half of them (n = 96) were stored in distilled water for 48 h (group A), and the remaining half (n = 96) for 48 months (group B). The specimens were immersed in 0.5% basic fuchsin solution, sectioned, and digitally photographed. Microleakage was evaluated quantitatively using an open-source image analysis toolkit (ImageJ), and the data were analyzed statistically. Results: Four-year water storage significantly increased the amount of leakage in all test groups (p < 0.001). In both the absence and presence of water aging, the etch-and-rinse adhesives yielded the lowest microleakage scores (p < 0.001). In the 48-h group, the following ranking was achieved in terms microleakage values: phosphoric acid + Prime & Bond NT = phosphoric acid + Single Bond < Prompt L-Pop = phosphoric acid etching only < FL Bond < Clearfil SE Bond < Mac Bond II = One Up Bond F. In the 48-month group, the ranking changed as follows: phosphoric acid + Prime & Bond NT = phosphoric acid + Single Bond < Prompt L-Pop = FL Bond < Clearfil SE Bond = Mac Bond II = One Up Bond F < phosphoric acid etching only. Conclusion: Long-term water storage significantly increased the microleakage of Helioseal F applied alone and with a bonding agent. Regardless of the storage term, the use of etch-and-rinse adhesives resulted in significantly less microleakage compared to that achieved with self-etching adhesives or acid etching alone. The sealants placed without a prior bonding agent showed the greatest amount of leakage after four years. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate acid-etching effects prior to the application of self-etching primer and the effect of different primer application techniques on dentin shear bond strength (SBS). Materials and Methods: Forty human third molar cervical regions were used in this study. The teeth were randomly divided into four groups (n = 10) of different tooth surface conditions: group A: Clearfil Protect Primer applied gently (inactive) + Clearfil Protect Bond; group B: 38% phosphoric acid for 15 s, rinsed 15 s, and dried 15 s + Clearfil Protect Primer applied gently (inactive) + Clearfil Protect Bond; group C: Clearfil Protect Primer applied with agitation by microapplicator brush (active) + Clearfil Protect Bond; group D: 38% phosphoric acid for 15 s, rinsed 15 s, and dried 15 s + Clearfil Protect Primer applied with agitation by microapplicator brush (active) + Clearfil Protect Bond. The SBS test was performed with a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with one-way ANOVA and Tukey HSD tests. Results: The mean SBS values (MPa) and standard deviations are as follows: group A: 36.0 ± 8.3; group B: 24.0 ± 3.9; group C: 35.0 ± 3.3; group D: 30.6 ± 6.7. Conclusion: Acid etching decreased the SBS of the self-etching bonding system to dentin. Active primer application increased the SBS only in acid-etched groups. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the marginal quality of differently bonded direct resin composite restorations in enamel and dentin, before and after thermomechanical loading (TML). Special attention was focussed on the performance of selective enamel etching, etch-and-rinse, and self-etching adhesives. Materials and Methods: Eighty MO cavities with proximal margins beneath the cemento-enamel junction were prepared in extracted human third molars. Direct resin composite restorations (Tetric EvoCeram, n = 8) were placed with 4-step selective enamel etching (Syntac SE), 4-step etch-and-rinse (Syntac ER), 2-step etch-and-rinse (XP Bond, Scotchbond 1 XT/Single Bond Plus), 2-step self-etching (AdheSE, Clearfil SE Bond), 2-step self-etching with selective enamel etching (AdheSE SE, Clearfil SE Bond SE), and 2-step self-etching with etch-and-rinse (AdheSE TE, Clearfil SE Bond TE). Marginal gaps were analyzed using epoxy resin replicas under a scanning electron microscope at 200X magnification. Results: Initially, high percentages of gap-free margins were identified for all adhesives. After TML, the results were as follows: A) Enamel margins: When phosphoric acid was used on enamel, results were constantly higher (∼90%) compared with two-step self-etchin adhesives (~70%; p < 0.05). B) Dentin margins: No statistical differences were found when etch-and-rinse and selective etch approaches were compared (59% to 64%; p > 0.05). When self-etching adhesives were used as per manufacturers' directions, dentin margins exhibited the best marginal quality (74% to 82%; p < 0.05). When self-etching adhesives were used under etch-and-rinse conditions, marginal quality in dentin was significantly reduced to 35% to 42% (p < 0.05). Conclusion: Enamel bonding was generally more effective with phosphoric-acid etching. Enamel bonding performance of 2-step self-etching adhesives was improved when phosphoric acid was applied on enamel selectively. [ABSTRACT FROM AUTHOR]

Objective: Control of microleakage represents a challenge for posterior composite restorations. The technique for composite placement may reduce microleakage. The null hypothesis of this in vitro study was that centripetal incremental insertion of composite resin would result in less microleakage than that obtained with the oblique incremental technique or bulk technique. Method and Materials: Standardized Class 2 preparations were made in 60 caries-free extracted third molars and randomly assigned to 3 groups (n = 20): (1) oblique incremental insertion technique (control), (2) centripetal incremental insertion technique, and (3) bulk insertion. The teeth were restored with a total-etch adhesive and microhybrid composite resin. The specimens were isolated with nail varnish except for a 2-mmwide area around the restoration and then thermocycled (1,000 thermal cycles, 5°C/55°C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50% silver nitrate for 24 hours, followed by 8 hours of immersion in a photo-developing solution and subsequently evaluated for leakage. The microleakage scores (0 to 4) obtained from the occlusal and cervical walls were analyzed with median nonparametric tests (P < .05). Results: The null hypothesis was rejected. All techniques attained statistically similar dentin microleakage scores (P = .15). The centripetal insertion technique displayed significantly less microleakage than the oblique technique at the enamel margins (P = .04). Conclusion: None of the techniques eliminated marginal microleakage in Class 2 preparations. However, in occlusal areas, the centripetal technique performed significantly better than the other techniques. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the capability of different adhesive systems to inhibit in vitro caries formation. Method and Materials: Four materials were tested: Gluma Comfort Bond (GL; Heraeus Kulzer), Gluma Comfort Bond + Desensitizer (GL+; Heraeus Kulzer), iBond (iB; Heraeus Kulzer), and One-up Bond F (OUB; Tokuyama). Bovine roots were ground to obtain flat mesial and distal dentin surfaces. Nail varnish was applied to the entire root surface except for two 10 mm X 2 mm windows on the flattened surfaces. The adhesives were applied to the exposed areas according to the manufacturers' instructions. The roots were incubated at 37°C for 1 week in a suspension of Streptococcus mutans and Lactobacillus acidophilus. Control groups either received no root surface treatment or were etched with 37% phosphoric acid (without immersion in the bacterial suspension). Specimens were sectioned perpendicular to the long axis of the roots, stained for 24 hours with Rhodamine B, and analyzed with confocal laser microscopy. The data were analyzed by 1-way ANOVA and Fisher's PLSD test at 95% confidence level. Results: Lesions in the OUB, iB, and GL+ groups were significantly shallower than those in the notreatment group. Acid etching did not produce any measurable lesions. Mean lesion depth in the GL group was similar to that in the no-treatment group. There was no significant difference between mean lesion depths in the GL+, GL, and iB groups. Conclusion: Fluoride- and glutaraldehyde-containing adhesive systems might be an aid in root caries prevention. [ABSTRACT FROM AUTHOR]

Purpose: The study provides a systematic review of the literature to determine the long-term survival characteristics of single implant-supported crowns and fixed partial dentures. Materials and Methods: A search of the MEDLINE, EMBASE, and Cochrane Collaboration databases was conducted to identify articles that compared survival and success of fixed partial dentures and single implant-supported crowns. In addition to comparative cohort studies, articles that pertained specifically to single implant- sup ported crowns or fixed partial dentures were included in this review. Inclusion criteria for implant and fixed partial denture articles included a minimum 2-year study, primary publication in the English language, a minimum of 12 implants, implants designed to osseointegrate, and inclusion of data regarding implant and prosthetic performance. Data were analyzed using cumulative proportions of survival and success for both prosthetic types and for individual implants. Wilson score method was used to establish 95% confidence intervals for each population. The chi-square test for homogeneity was performed. Results: The literature search failed to identify any articles that directly compared sur- vival or success of single implant-supported restorations with fixed partial dentures. Following the search criteria, and independent analysis by reviewers, 51 articles were identified in the implant litera- ture (agreement, 95.42%; kappa coefficient, 0.8976), and 41 were identified in the fixed partial den- ture literature (agreement, 90.97%; kappa coefficient, 0.7524). Pooled success of single-implant restorations at 60 months was 95.1% (CI: 92.2%-98.O%), while fixed partial dentures of all designs exhibited an 84.0% success rate (CI: 79.1%-88.9%). Conclusions: This systematic review of the scien- tific literature failed to demonstrate any direct comparative studies assessing clinical performance of single implant-supported crowns and tooth-supported fixed partial dentures. The analysis suggested differences at 60 months between survival of implant-supported single crowns and natural to 0th-sup- ported fixed prostheses when resin-bonded and conventionally retained fixed prostheses were grouped. This difference disappeared when implant-supported single crowns were compared with con- ventionally retained fixed partial dentures at 60 months. For other time periods, direct comparative data were unavailable. INT J ORAL MAXILLOFAC IMPLANTs 2007;22(5uPPL):71-95. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the effect of primary stability on the osseointegration of turned and acid-etched screw implants in a rabbit model. Materials and Methods: One pair of turned and acid-etched implants (3.75 in diameter, 5.5 mm long) was placed in each tibia of 15 rabbits. In the right tibial metaphysis the implants were inserted according to a standard surgical protocol. In the left tibia, the osteotomy sites were enlarged using a sequence of drills, and 2 implants were placed with reduction of primary stability. Animals were sacrificed 9 weeks after surgery. Histomorphometric and removal torque analyses were performed to evaluate bone-implant contact and strength of osseointegration. Results: Surface texture had a significant effect on percentage of bone-implant contact (P = .001). Acid-etched implants with high primary stability showed the highest percentage of bone- implant contact (77%), followed by acid-etched implants with low primary stability (61%), turned implants with low primary stability (56%), and turned implants with high primary stability (46%). For removal torque, acid-etched implants had higher peak mean values than turned implant groups (P < .001). Reduction of primary stability was not significant to either percentage of bone-implant contact (P = .645) or removal torque values (P = .214). Conclusion: Acid-etched implants had higher bone response and implant fixation than turned implants, regardless of primary stability. [ABSTRACT FROM AUTHOR]

Purpose: To examine the etching efficacy of three self-etching systems to unconditioned enamel and to phosphoric acid conditioned enamel using scanning electron microscopy (SEM), and to investigate the microtensile bond strength (µTBS) of three self-etching adhesives to unconditioned enamel used according to the manufacturers' instructions, on phosphoric-acid conditioned enamel, and when their different adhesives were replaced with a control resin after etching. Materials and Methods: Clearfil SE Bond (CSE), Tyrian SPE/One-Step Plus (TY), and Adper Prompt L-Pop (AD) were employed. Scotchbond Multi-Purpose Plus (SBMP), an etch-and-rinse adhesive, was used as control. For µTBS evaluation, the buccal or lingual mid-coronal enamel of 30 molars was used. In the first group, self-etching adhesives were applied conventionally, according to manufacturers' directions (group C). A second group of specimens was etched with 35% phosphoric acid before application of the self-etching adhesives (group PA), and the third group of specimens was etched with the self-etching adhesives, rinsed, but bonded using a control bonding resin (group CR). Following restoration with Z250, they were sectioned into beams (0.8 mm²), and stressed to failure. Data were subjected to two-way ANOVA and Tukey's test. The etching efficacy of the self-etching adhesives, phosphoric acid, and prior phosphoric acid + SE application was evaluated under SEM. Results: All self-etching adhesives applied as recommended by the manufacturers showed lower µTBS values than those obtained in PA and CR groups, although this difference was only significant for TY and AD. The means of all self-etching adhesives under PA and CR groups were similar to SBMP. The enamel conditioned with self-etching adhesive showed a less distinct pattern. CSE exhibited the mildest etching pattern. All self-etching adhesives applied after phosphoric acid exhibited a more retentive etching pattern. Conclusion: The bond strength values of low-pH self-etching adhesives can be improved by the adjunctive use of phosphoric acid or replacement of the bonding resin. [ABSTRACT FROM AUTHOR]

Complete prosthodontic rehabilitation using single-tooth crowns is an invasive therapy, even though the success of single-tooth crowns is well proven. In some cases, adhesively luted glass-ceramic restorations with reduced preparation depths might be a less invasive alternative. In the case presented, a 40-year-old female patient with multiple cement restorations, erosions, dysfunctional abrasion, and gap formation in the maxillary anterior region received treatment to restore function and esthetics. Minimally invasive glass-ceramic full-coverage crowns, partial crowns, and veneers were placed using the adhesive luting technique. The functional rehabilitation included increasing the occlusal height by about 2 mm. The patient was clinically followed for 4.5 years at annual examinations, which included dental and periodontal evaluations and a clinical quality assessment applying modified California Dental Association (CDA) criteria. Observations yielded only marginal discolorations and gingival recession of minor clinical importance. No adverse events occurred; the patient was highly satisfied with the esthetic result and had no complaints. [ABSTRACT FROM AUTHOR]