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Ceramic thickness and technicians' manipulative variables are critical factors affecting the resultant shade of dental ceramo-metallic restorations. This study investigated the effect of the following variables on shade duplication of ceramo-metallic specimens: (a) ceramic thickness; (b) differences between several technicians (inter-technician variability); and (c) the ability of each technician to repeat the resultant shade (intra-technician variability). Ninety ceramo-metallic specimens were prepared and divided into three main groups ( n = 30/gp) according to the different technicians who built up the veneering ceramic of the specimens. Each group was further subdivided into three subgroups ( n = 10/subgroup) according to the thickness of the ceramic (1, 1.5, and 2 mm built over a 0.5 mm-thick metal substructure). Three different technicians were asked to follow the same protocol as regards the same ceramic batch (Shade 3M2, Vita VM13, Zahnfabrik, Germany), firing temperature, and number of firing cycles. Meanwhile, each technician followed his own protocol with regard to other ceramic manipulative variables. The duplicated shades of the specimens were investigated using the Vita Easyshade spectrophotometer by using the verify shade mode. Color difference (∆E) values were calculated between the target shade (3M2) and the duplicated shades of the specimens automatically by the Vita Easyshade spectrophotometer (Vita, Zahnfabrik, Germany). The effect of ceramic thickness and inter- and intra-technician variability on the duplication of the target shade was investigated. The results showed that the effect of ceramic thickness on the duplicated shades depended on inter-technician variability. High inter-technician variability (∆E = 2-6.4) was noticed in contrast to low intra-technician variability (∆E = 0.2-1.5). It could be concluded that proper shade-duplication of ceramo-metallic restoration was a cumulative technique intimately related to manipulative variables and ceramic thickness.

Background: One of the crucial factors influencing the longevity of anterior aesthetic dental restorations is the colour stability of resin composites. Bleaching and whitening have become popular methods for enhancing dental aesthetics. Home whitening techniques, such as special pens, are widely available commercially. This in vitro study aimed to determine the efficiency of a whitening pen in removing tea stains from resin composite by measuring colour differences (ΔE 00 ). Additionally, the study aimed to evaluate the variations in colour parameters measured by extra-oral and intra-oral spectrophotometers., Methods: A total of 45 disc-shaped resin composite specimens were randomly divided into three groups; Group 1: stored in artificial saliva (control), Group 2: stored in artificial saliva followed by a whitening pen application, and Group 3: stored in tea followed by a whitening pen application. Colour measurements were taken three times for each specimen using two spectrophotometers (extra-oral and intra-oral devices); T1: before storage (baseline), T2: after storage in artificial saliva or tea for 6 days; and T3: after one week of whitening pen application in groups 2 and 3. The data were statistically analyzed using one-way ANOVA followed by the Tukey post hoc test ( p ≤ 0.05). The independent sample t -test was also employed. The equation of CIEDE2000 (ΔE 00 ) was used to calculate the colour difference between the dry, as-prepared specimens (baseline), and those after storage or bleaching. The colour changes exceeding the acceptability threshold (∆E 00 = 1.8) were considered unacceptable., Results: After whitening, the colour of the specimens stored in brewed tea (Group 3) remained unacceptable, as indicated by both the extra-oral and intra-oral spectrophotometers (ΔE 00 = 4 and 2.9, respectively). Groups 1 and 2 exhibited lower ΔE 00 values than Group 3 ( p = 0.01 *). No significant difference was observed between Group 1 (stored in artificial saliva) and Group 2 (stored in artificial saliva and then bleached) ( p = 0.3). Significant differences were consistently observed between the data obtained from the extra-oral spectrophotometer and the intra-oral one., Conclusions: The whitening pen proved ineffective in removing tea stains from resin composites. Although significant differences were found between the values obtained by the two spectrophotometers (extra-oral and intra-oral), both devices confirmed the unacceptable colour of the tea-stained resin composites after whitening.

Poly (methyl methacrylate) (PMMA), is an acrylic polymer substance that is mostly used for denture base applications. The purpose of this laboratory study was to investigate the effect of adding 0.05 wt.% Ag-doped carbon nanotubes (CNT) to PMMA-based (PMMA and MMA) denture base material on the impact strength, microhardness, and antimicrobial activity. A total of 60 heat-cured acrylic resin specimens were prepared. The specimens were randomly divided into two main groups ( n = 30/group), according to the powder used: (a) control group, using heat-cured PMMA; (b) treatment group, using a powder prepared by blending 0.05 wt.% silver-doped CNT nanoparticles with heat-cured PMMA. The impact strength, microhardness and anticandidal activity for each group were assessed via the Charpy, Vickers and agar diffusion tests, respectively ( n = 10/test for each subgroup). Data were analyzed using independent-sample t -tests ( p ≤ 0.05). The results of the impact strength test revealed that the treated heat-cured PMMA-MMA with Ag-doped CNT (2.2 kJ/mm 2 ) was significantly higher than that of the control heat-cured PMMA (1.6 kJ/mm 2 ). Similarly, the Vickers microhardness of the treatment group (52.7 VHN) was significantly higher than that of the control group (19.4 VHN). Regarding the agar diffusion test, after 24 h of incubation, the treated heat-cured PMMA with the Ag-doped CNT exhibited significantly higher anticandidal activity than that of the control group. Therefore, Ag-doped carbon nanotubes could be considered as promising fillers for the dental heat-cured acrylic resin to improve the resistance of the resultant denture against sudden fractures, scratching, and candida invasion.

Background: Resin composite restorations are highly esthetic restorations, which should have and maintain high surface polish. However, esthetic restorations are subjected to different beverages at variable temperatures, which may affect their surface roughness. This study aimed to evaluate the surface roughness of single-shade (Omnichroma) and multi-shade (Filtek Z350XT) composite materials, following aging by immersion and thermocycling in different beverages, simulating one year of clinical service., Methods: Thirty specimens of each material were prepared and divided into 6 subgroups (n = 5). In each material, the grouping of the specimens was as follows: the first subgroup was the as-prepared specimens stored dry without immersion or thermocycling. The second, third, and fourth subgroups were immersed in saliva, tea, and red wine, respectively, for 12 days at 37 °C. The fifth and sixth subgroups were thermocycled for 10,000 cycles, in tea (the fifth between 37 and 57 °C) and in red wine (the sixth between 37 °C and12°C). The resultant surface roughness was measured by two different methods, stylus profilometer and atomic force microscopy (AFM). Intergroup comparison was performed using independent t test, while intragroup comparison was performed using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test., Results: Intergroup comparison between both composites showed no statistically significant differences in all groups using the stylus profilometer roughness measurements (P>0.05), while the AFM measurements showed significant difference (P ≤ 0.05) within all storage media except the as-prepared control (P = 0.0645), where nanofilled Filtek Z350 XT showed lower nano-roughness. Intragroup comparison data were variable, depending on the material, aging conditions, and roughness assessment tool. However, the resultant average surface roughness (R a ) values in all groups did not exceed the threshold value of R a 0.2 μm., Conclusions: Both resin composites attained and retained a clinically acceptable surface finish after immersion and thermocycling in different beverages., (© 2023. The Author(s).)

Background: The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions., Methods: A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test., Results: The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05)., Conclusion: Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material., (© 2023. The Author(s).)

Background: Surface microhardness and color stability of dental restorative material should be sustained throughout its functional lifetime to maintain the esthetic quality of the restoration. However, the frequent application of mouthwash may affect their surface microhardness and color stability. The aim of this study was to evaluate the effects of different types of mouthwashes with different contents on surface microhardness and color stability of dental nanohybrid resin-based composite., Methods: Disc specimens of nanohybrid resin composite (Luna Nano-Hybrid Composite) were prepared according to manufacturing instructions; specimens were incubated for 24 h in three types of mouthwash (Chlorohexidine, Listerine Green Tea, and Colgate Optic White Whitening Mouthwash). Artificial saliva was used as a control group. Surface microhardness was evaluated using Vickers microhardness device. Color stability after and before immersion in the different mouthwashes was evaluated using extra-oral spectrophotometer; the values of color change (ΔE 00 ) were subsequently calculated. Data were analyzed using one-way ANOVA and post hoc test ( p ≤ 0.05)., Results: There was no significant difference between microhardness of resin composite immersed in artificial saliva, CHX, and Green Tea mouthwashes (78.5, 78.4, and 73.5, respectively) ( p ≥ 0.1), while the bleaching mouthwash led to the lowest microhardness of resin composite, with significant difference compared to the three previous immersion media ( p = 0.002). Moreover, there were significant differences in the color changes (ΔE 00 ) of resin composite exposed to the various immersion media ( p = 0.0001)., Conclusions: The bleaching mouthwash led to a significant reduction in nanohybrid resin composite's microhardness compared to the chlorohexidine and Green Tea containing mouthwashes. The resin composite's color change was accepted in bleaching mouthwash but unaccepted in chlorohexidine and Green Tea containing mouthwashes.

Background: Polymethyl methacrylate (PMMA) is used in fabricating acrylic denture bases. Repairing a fractured acrylic denture base can be done by self-cured PMMA, yet this is still a weak point after repair. The aim of this study was to evaluate the effect of incorporating 5% weight titanium oxide nanoparticles (TiO 2 ) to self-cured PMMA on flexural strength, surface micro-hardness, roughness, and water sorption., Methods: A total of 160 acrylic-resin specimens were used in this study. They were divided in two main groups; (a) control group, prepared by mixing self-cured PMMA powder to its liquid monomer, (b) treated group, prepared by blending 5% weight TiO 2 nanoparticles to self-cured PMMA powder then this blend was mixed with the liquid monomer. Flexure strength, surface micro-hardness, roughness, and water sorption were evaluated. Data were analyzed using independent sample t -tests ( p ≤ 0.05)., Results: There was a significant increase in the flexural strength of PMMA of the treated group after the addition of TiO 2 (137.6 MPa) compared with the control (75.4 MPa) ( p ≤ 0.001). No significant difference between the two groups in terms of micro-hardness ( p = 0.385) and surface roughness ( p = 0.269). Water sorption showed a significant reduction in the treated group ( p ≤ 0.001)., Conclusions: Addition of 5% weight TiO 2 nanoparticles to the self-cured acrylic resin improved its flexural strength and reduced its water-sorption without impairing the surface micro-hardness and roughness.

The long-term color stability and gloss retention of resin composites are among the crucial factors that affect the clinical longevity of esthetic restorations, especially in anterior teeth. This study evaluated the effect of artificial aging by immersion in different storage media and thermocycling on color and gloss of dental single-shade resin composite (Omnichroma) versus multi-shade one (Filtek Z350XT). One hundred resin-composite disc-shaped specimens were used, 50 from each group, Omnichroma and Filtek Z350XT. Ten specimens from each material acted as control group (incubated in saliva). For each material, 40 specimens were divided according to the artificial-aging protocol (immersion at 37 °C for 12 days or thermocycling for 10,000 cycles) and storage media (tea, red wine). Color and gloss were measured before and after artificial aging. Color difference (∆E 00 ) was compared with perceptibility threshold and acceptability threshold. Data were statistically analyzed; independent t test was used to compare results between two tested materials, while two-way ANOVA was used to compare results among the different immersion media within the same material. Artificial aging (immersion or thermocycling) in tea and red wine led to significant color changes and gloss reduction in both materials (P < 0.05), in contrast to control group. Red wine produced highest color differences. Both dental resin-composites; the single-shade (Omnichroma) and multi-shade (Filtek Z350XT) displayed unacceptable discoloration and gloss reduction after artificial-aging in tea and red-wine by immersion or thermocycling simulating one-year clinical-service., (© 2022. The Author(s).)

Background: Alginate impression is a common dental polymeric material, presented as powder to be mixed with water., Aim: 1. To analyze the effect of alginate powder/water ratio variation on viscosity, tear strength and detail reproduction by in vitro tests, and 2. To evaluate this variation's effect on patients' impressions., Materials and Methods: Two commercial alginate products were mixed in different viscosities. Viscosity was measured by a viscometer. For the tear strength test, V-shaped specimens were used. For detail reproduction, a die with three scribed lines was used. Clinical dental impressions were examined by stereomicroscope., Results: The alginate specimens mixed with a higher powder/water ratio showed a higher viscosity and tear strength compared to those with a lower powder/water ratio. Both alginate mixtures reproduced two scribed lines in a detail reproduction test. On the other hand, no clear clinical difference was detected when examining dental impressions mixed with a different powder/water ratio., Conclusion: Although increasing the powder/water ratio of mixed alginate raised the resultant viscosity and tear strength by an in vitro test, clinically, no clear difference in tearing was detected. Detail reproduction was minimally affected by the variation in powder/water ratio.

Background: Contemporary nickel-titanium (NiTi) rotary endodontic instruments had a revolutionary impact on the success of root canal treatment., Aim: To evaluate the flexibility, microstructure and elemental analysis of four different recent NiTi rotary instruments, namely; Wave One Gold, TF adaptive, HyFlex EDM and Gr&#95;Reciproc Blue compared to conventional Protaper Universal (F2)., Material and Methods: The NiTi rotary files were subjected to cantilever bending test to evaluate their flexibility. The microstructural characteristics and elemental analysis were examined via scanning electron microscopy (SEM) and energy dispersive X-ray spectrometer (EDX)., Results: The TF adaptive, HyFlex EDM and Wave One Gold endodontic files showed significantly lower cantilever bending values (i.e., higher flexibility) than Protaper F2 and Gr&#95;Reciproc Blue (p < 0.05). The SEM micrographs showed that the bulk of all examined files showed multiple striations due to the cutting process, on the other hand, their external surfaces were different: The Protaper Universal F2 showed multiple voids, while the TF Adaptive surface exhibited more uniform structure. The Hyflex EDM had a crater-like surface, whereas Wave one Gold showed machining grooves with minimum defects, while Reciproc Blue displayed machining grooves with random scratch lines. There was a significant difference in bulk and surface elemental analysis of the various examined files, yet composed mainly of the same elements., Conclusion: Chemical composition, heat treatment, manufacturing process and geometrical design of the NiTi rotary instrument have a great influence on their flexibility and microstructure., (Copyright: © 2019 Tamer M. Hamdy, Manar Galal, Amira Galal Ismail, Rasha M. Abdelraouf.)

Aim: This study aimed to assess the shear bond strength of a self-adhering flowable resin composite versus a total-etch one to different surfaces of permanent-molars., Material and Methods: Thirty-six sound human permanent molars were used. The teeth were embedded in acrylic blocks, such that their buccal surfaces were shown. The teeth were divided into three groups: Group I: Uncut-Enamel, Group II: Cut-enamel-surfaces with minimal-grinding and Group III: dentin-surfaces. Half of the teeth in each group were used for bonding to a self-adhering flowable resin-composite (Dyad-flow, Kerr, USA). While the other half of each group was bonded to a total-etch flowable resin-composite (Filtek™Z350-XT,3M-ESPE, USA) which necessitate etching and bonding. Teflon-mold was used for constructing resin composite cylinders (3 × 3 mm) over the buccal surfaces. The Dyad-flow was applied in the central hole of the mould placed upon tooth-surface, and then light-cured for 20 seconds. The Filtek-Z350-XT was applied similarly after etching and bonding steps. The teeth were stored in 37°C distilled water for 24 hours. The strength was measured using a universal testing machine and statistically analysed. Modes of failure were studied using digital-microscope., Results: Mean values of shear bond strength for the Dyad and Filtek-Z350-XT in the uncut-enamel were 3.5 and 24.6MPa respectively, while that for cut-enamel were 4.5 and 12.7MPa respectively (Both highly statistically significant P ≤ 0.01) and in dentin were 4.3 and 6.7MPa respectively (Statistically significant P ≤ 0.05). The failure mode for Dyad was mainly adhesive (un-cut or cut-enamel 83.3% adhesive and 16.7% mixed, while in dentin 100% adhesive). While the modes of failure for Filtek-Z350-XT in enamel, either cut or un-cut, were 50% cohesive and 50% mixed, whereas in dentin 100% adhesive., Conclusion: Bonding of self-etch ″Dyad-flow″ flowable resin-composite was lower than the total-etch one in enamel and dentin. Thus further material improvement may be required.

Objectives . To assess visually color-matching and blending-effect (BE) of a universal shade bulk-fill-resin-composite placed in resin-composite-models with different shades and cavity sizes and in natural teeth (extracted and patients' teeth). Materials and Methods . Resin-composite-discs (10 mm × 1 mm) were prepared of universal shade composite and resin-composite of shades: A1, A2, A3, A3.5, and A4. Spectrophotometric-color-measurement was performed to calculate color-difference (Δ E ) between the universal shade and shaded-resin-composites discs and determine their translucency-parameter (TP). Visual assessment was performed by seven normal-color-vision-observers to determine the color-matching between the universal shade and each shade, under Illuminant D65. Color-matching visual scoring (VS) values were expressed numerically (1-5): 1: mismatch/totally unacceptable, 2: Poor-Match/hardly acceptable, 3: Good-Match/acceptable, 4: Close-Match/small-difference, and 5: Exact-Match/no-color-difference. Occlusal cavities of different sizes were prepared in teeth-like resin-composite-models with shades A1, A2, A3, A3.5, and A4. The cavities were filled by the universal shade composite. The same scale was used to score color-matching between the fillings and composite-models. BE was calculated as difference in mean-visual-scores in models and that of discs. Extracted teeth with two different class I-cavity sizes as well as ten patients' lower posterior molars with occlusal caries were prepared, filled by universal shade composite, and assessed similarly. Results . In models, the universal shade composite showed close matching in the different cavity sizes and surrounding shades (4 ≤ VS < 5) (BE = 0.6-2.9 in small cavities and 0.5-2.8 in large cavities). In extracted teeth, there was good-to-close color-matching (VS = 3.7-4.4 in small cavities, BE = 2.5-3.2) (VS = 3-3.5, BE = 1.8-2.3 in large cavities). In patients' molars, the universal shade composite showed good-matching (VS = 3-3.3, BE = -0.9-2.1). Conclusions . Color-matching of universal shade resin-composite was satisfactory rather than perfect in patients' teeth.