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Marcelle M Nascimento,1 Deborah A Dilbone,1 Patricia NR Pereira,1 Wagner R Duarte,2,3 Saulo Geraldeli,1 Alex J Delgado1 1Department of Restorative Dental Sciences, Division of Operative Dentistry, 2Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA; 3Private Practice, Brasilia, DF, Brazil Abstract: Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists’ management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons. Keywords: abfraction, tooth wear, noncarious cervical lesions, tooth restoration

The authors reflect on dental caries therapy and minimally invasive dentistry. They mention that when they were dental students they were instructed to remove all decayed tissue except at the axial wall to prevent exposure of dental pulp, at which point they treated the dentin with calcium hydroxide. They talk about studies concerning leaving affected dentin intact prior to placing restorations if the lesion is sealed off entirely, and comment on the use of chlorhexidine to eliminate bacteria.

Purpose: To evaluate the influence of substrate moisture on the clinical behavior of 2 dentin adhesives after 18 months. The null hypothesis tested was that drying dentin with air upon rinsing off the acid would not influence the clinical performance of two dentin adhesives as compared to leaving the preparation visibly moist. Materials and Methods: Thirty-five patients were enrolled in this study. One hundred twenty-eight restorations divided into 4 groups were inserted and evaluated at baseline: (1) NT/Moist - Prime & Bond NT, an acetone-based adhesive, applied on moist dentin; (2) NT/Dried - Prime & Bond NT applied on dentin dried with air for 3 to 4 s; (3) SB/Moist - Single Bond, an ethanol- and water-based adhesive, applied on moist dentin; (4) SB/Dried - Single Bond applied on dentin dried with air for 3 to 4 s. A microfilled composite resin was used for all restorations. Patients were recalled at 6 and 18 months. Results: At 18 months after initial placement, 110 restorations (86% recall rate) were re-evaluated. Retention rates at 18 months were 92% for NT/Moist, 93% for NT/Dried, 100% for SB/Moist, and 89% for SB/Dried. No statistically significant differences were found among groups for retention rate. Both NT/Moist and SB/Moist resulted in a significant decrease in sensitivity to air from baseline to 18 months. When data were pooled for the variable “substrate moisture,” SB resulted in an overall retention rate of 95%, while NT resulted in a retention rate of 92% (statistically similar). The marginal adaptation with SB was significantly worse at 18 months than at baseline. Conclusion: The moisture level of the dentin substrate in noncarious cervical lesions does not influence retention of composite restorations, but moist conditions caused less sensitivity to air. When applied as per manufacturers'' instructions (moist dentin), both adhesives resulted in Class V retention rates exceeding the ADA 18-month full acceptance guidelines.—Reprinted with permission of Quintessence Publishing. [Copyright &y& Elsevier]

The present study examined different concentrations of the butylated hydroxytoluene (BHT) inhibitor on the kinetics of conversion, polymerization shrinkage stress, and other correlated physicochemical properties of experimental resin composites (ERC). A model composite was formulated with 75 wt% filler containing 0.5 wt% camphorquinone and 1 wt% amine with BHT concentrations of 0.01 wt% (BHT-0.01); 0.1 wt% (BHT-0.1); 0.25 wt% (BHT-0.25); 0.5 wt% (BHT-0.5); 1 wt% (BHT-1), and control (no BHT). They were tested on polymerization shrinkage stress (PSS; n = 5), degree of conversion (DC; n = 3), maximum polymerization rate (Rp MAX ; n = 5), water sorption (W sp ; n = 0), and solubility (W sl ; n = 10), flexural strength (FS; n = 10), flexural modulus (FM; n = 10), Knoop microhardness (KH; n = 10), and microhardness reduction (HR; n = 10). Data concerning these tests were submitted to one-way ANOVA and Tukey's test (α = 0.05; β = 0.2). BHT-0.25, BHT-0.5, and BHT-1 showed a gradually significant decrease in PSS (p = 0.037); however, BHT-1 demonstrated a decrease in the physicochemical properties tested. Thus, within the limitations of this study, it was possible to conclude that BHT concentrations between 0.25 and 0.5 wt% are optimal for reducing shrinkage stress without affecting other physicochemical properties of ERCs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The aim of this work is to test experimental cements, doped with a silicate based bioactive nanoparticle (NanoBiosilicate). Methods, we synthesized a glass nanoparticle by Sol-Gel Stöber method, used to be incorporated in a dental material for endodontic uses., Materials and Methods: We assess the mineralizing properties and biocompatibility. Besides the crystallography characterization of the resultant new crystals. Results, After analysis, and comparison with commercial materials, the material tested was similar in mechanical properties required by ISO, The ion release was effective after 2 hr. of setting and the novel material was cell compatible accepted by ISO., Results: We found new formed Calcium Phosphate peaks in the spectroscopic analysis (FTIR), remarkably the crystals formed were comparable to hydroxyapatite when analyzed with a Selected Area Electron Diffractometer, with rings of 2.84 Å for 002, and the 2.77 Å is also visible for 210. The 6.83 Å and 6.88 Å, for respective 222 and 004. The incorporation of Chlorhexidine was not detrimental for this property, Significance, the features mentioned represented a progress in biomineralization field that was associated to an improved mineral structure formation with increased crystallographic similarity to natural hydroxyapatite. When chlorhexidine was added a favorable biomodification of the remaining collagen in dentinal walls and antimicrobial activity potential were also observed., Competing Interests: Declaration of Competing Interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.We confirm that the manuscript has been read and approved by the authors and that there are no other persons who satisfied the criteria for authorship but are not listed.We further confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Bioglass presents a standard biomaterial for regeneration of hard tissues in orthopedics and dentistry. The notable osteo-inductive properties of bioglass are largely due to the release of calcium ions from it. However, this release is not easily controllable and can often be excessive, especially during the initial interaction of the biomaterial with the surrounding tissues. Consequently, this excessive release can deplete the calcium content of the bioglass, ultimately reducing its overall bioactivity. In this study, we have tested if applying biopolymer chitosan coatings of different thicknesses would be able to mitigate and regulate the calcium ion release from monodisperse bioglass nanoparticles. Calcium release was assessed for four different chitosan coating thicknesses at different time points over the period of 28 days using a fluorescence quencher. Expectedly, chitosan-coated particles released less calcium as the concentration of chitosan in the coating solution increased, presumably due to the increased thickness of the chitosan coating around the bioglass particles. The mechanism of release remained constant for each coating thickness, corresponding to anomalous, non-Fickian diffusion, but the degree of anomalousness increased with the deposition of chitosan. Zeta potential testing showed an expected increase in the positive double layer charge following the deposition of the chitosan coating due to the surface exposure of the amine groups of chitosan. Less intuitively, the zeta potential became less positive as thickness of the chitosan coating increased, attesting to the lower density of the surface charges within thicker coatings than within the thinner ones. Overall, the findings of this study demonstrate that chitosan coating efficiently prevents the early release of calcium from bioglass. This coating procedure also allows for the tuning of the calcium release kinetics by controlling the chitosan concentration in the parent solution.

This study aimed to evaluate the effect of an elastomeric urethane monomer (Exothane-24) in different concentrations on physicochemical properties, gap formation, and polymerization shrinkage stress of experimental resin composites. All experimental composites were prepared with 50 wt.% of Bis-GMA and 50 wt.% of TEGDMA, to which 0 wt.% (control), 10 wt.%, 20 wt.%, 30 wt.%, and 40 wt.% of Exothane-24 were added. Filler particles (65 wt.%) were then added to these resin matrixes. Ultimate tensile strength (UTS: n = 10), flexural strength (FS: n = 10), flexural modulus (FM: n = 10), hardness (H: n = 10), hardness reduction (HR: n = 10), degree of conversion (DC: n = 5), gap width (GW: n = 10), and polymerization shrinkage stress in Class I (SS-I: n = 10) and Class II (SS-II: n = 10) simulated configuration. All test data were analyzed using one-way ANOVA and Tukey's test (α = 0.05;  = 0.2). Exothane-24 in all concentrations decreased the H, HR, DC, GW, SS-I, and SS-II (p < 0.05) without affecting the UTS, and FS (p > 0.05). Reduction in FM was observed only in the Exothane 40% and 30% groups compared to the control (p < 0.05). Exothane-24 at concentrations 20% and 30% seems suitable since it reduced GW and polymerization SS without affecting the properties of the composite resins tested, except for H.

This study was aimed at analyzing the surface properties of a universal resin composite and evaluating the effect of preheating on its physicochemical properties. Two commercial resin composites were used under two conditions: Filtek Universal Restorative (UR); UR preheated (URH); Filtek Supreme (FS) and FS preheated (FSH). The film thickness (FT) test (n = 10) was done using two glass slabs under compression. Flexural strength (FLS) and modulus (FLM) were evaluated using a three-point flexion test (n = 10). Polymerization shrinkage stress (PSS) was evaluated in a universal testing machine (n = 5). Gap width (GW) between composite and mold was measured in internally polished metallic molds (n = 10). The degree of conversion (DC) was evaluated by Fourier Transform Infrared spectroscopy (n = 3). The morphology of the filler particles was checked by scanning electron microscope (SEM) and EDX analysis. Surface gloss (SG) and surface roughness (SR) were evaluated before and after mechanical brushing (n = 10). The outcomes were submitted to 2-way ANOVA and Tukey's test (α = 0.05). Lower mean values of FT were observed for the preheated groups when compared to the non-preheated groups. URH and FSH showed higher mean values of FLS and FLM when compared with UR and FS. No differences were observed between groups in the PSS test. The GW was higher for the UR and FS groups when compared with URH and FSH. The DC was higher for preheated resin composites when compared to the non-preheated groups. The SR of the UR composite was higher than the FS after mechanical brushing, while the SG was higher for the FS groups. In conclusion, the universal resin composite tested generally presented similar physicochemical properties compared with the nanofilled resin composite and either similar or slightly inferior surface properties. The preheating improved or maintained all properties evaluated.

This study investigated the effect of preheating an elastomeric urethane monomer (Exothane-24) experimental resin composite on its physicochemical properties. Two resin matrices were formulated: (a) 50 wt% Bisphenol-glycidyl methacrylate (Bis-GMA) and 50 wt% triethylene glycol dimethacrylate (TEGDMA); and (b) 20 wt% Exothane-24, 40 wt% Bis-GMA and 40 wt% TEGDMA. A photoinitiator system (0.25 wt% camphorquinone and 0.50 wt% ethyl-4-dimethylamino benzoate) and 65 wt% of the inorganic filler (20 wt% 0.05 μm silica and 80 wt% 0.7 μm BaBSiO 2 glass) were added to both matrices. These formulations were then assigned to four groups: Exothane-24 (E); Exothane-24 plus preheating (EH); no Exothane-24 (NE); and no Exothane-24 plus preheating (NEH). NEH and EH were preheated at 69 °C. The dependent variables were as follows: film thickness (FT); polymerization shrinkage stress (PSS); gap width (GW); maximum rate of polymerization (Rp max ); and degree of conversion (DC). Data were statistically analyzed by two-way ANOVA and Tukey's test (α = 0.05). Preheating reduced FT for both composites. PSS and GW were significantly lower for EH, when compared with E. The DC for EH and NEH and the Rp max for EH increased significantly. Preheating improved most of the physicochemical properties (FT, PSS, GW, and DC) of the experimental resin composite containing Exothane-24., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.

This study investigated the effect of butylated hydroxytoluene (BHT) inhibitor on degree of conversion (DC), flexural strength (FS), flexural modulus (FM), Knoop microhardness (KH), microhardness reduction (HR), and consistency of experimental resin composites at different BHT concentrations: C0 (control-0%); C0.01 (0.01%); C0.025 (0.025%); C0.05 (0.05%); C0.1 (0.1%); and C0.5 (0.5%). For the consistency, the composites were tested immediately after being exposed to a dental chair headlight (0, 20, 40 and 60 s). Data concerning DC, FS, FM, KH, and HR were submitted to one-way ANOVA, while the consistency data was submitted to 2-way ANOVA; mean values were then compared (Tukey's test; α=0.05). The KH, FS and FM analyses showed no significant difference among the composites tested. For DC, C0 showed the highest mean value (74.2%) and differed only from C0.5 (67.2%). For HR, C0.5 showed the lowest mean (13.09%) value and differed from C0 (26.4%) and C0.01 (24.87). The consistency analysis showed no difference among C0.05, C0.1 and C0.5, considering 0 and 20 s of light exposure, while C0 (14.07 mm), C0.01 (13.97 mm), and C0.025 (14.18 mm) showed higher mean values at 0 s when compared to 20 s (12.67, 12.77 and 13.05 mm, respectivelly). Polymerization occurred within 40 s of light exposure for C0, C0.01, C0.025, and C0.05 and within 60 s for C0.1. In conclusion, the BHT concentrations had no significant influence on FS, FM and KH. The higher the BHT concentration, the longer was its handling time under light, with a significant improvement in the HR, but a decrease in DC. Therefore, BHT at 0.1% showed the best outcomes concerning all the BHT concentrations tested.

Purpose: This study evaluated the effect of incorporating different concentrations of biosilicate in an experimental self-etch adhesive (SE)., Materials and Methods: Biosilicate microparticles (0, 2, 5, and 10 wt%) were incorporated into the primer, and degree of conversion (DC) and wettability were tested (one-way ANOVA, Tukey's test, p < 0.05). The two best concentrations were selected (2% and 5%) for µTBS evaluation. Sound human molars (n=20) were sectioned into quarters and randomly assigned to 4 experimental groups: 1. experimental SE + 0% biosilicate (Exp0%; negative control); 2. experimental SE + 2% biosilicate (Exp2%); 3. experimental SE + 5% biosilicate (Exp5%); 4. AdheSE (Ivoclar Vivadent, positive control). After adhesive application, Filtek Z350 (3M Oral Care) composite was built up incrementally to 5 mm. Each quarter tooth was sectioned into sticks (0.9 mm2) and stored in distilled water (37°C) for 24 h, 6 months, or 1 year. After storage, sticks were submitted to µTBS (0.75 mm/min). The Ca:P ratio was analyzed using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). Data were analyzed using two-way ANOVA with Bonferroni's correction, with statistical siginificance set at p < 0.05. Fracture patterns were observed under a digital microscope and adhesive interfaces with transmission electron microscopy (TEM)., Results: Exp2% presented the highest DC (p < 0.05), Exp5% exhibited the lowest µTBS (p < 0.05), and adhesive failures were predominant in all groups. TEM suggested remineralized areas in Exp2% and to a lesser degree in Exp5%. Exp2% and Exp5% showed a higher Ca:P ratio after aging (p < 0.05)., Conclusion: The incorporation of biosilicate microparticles can improve the properties of self-etch adhesives. It increased the DC of the experimental adhesive as well as mineral deposition. However, the adhesive properties are concentration dependent, as a higher concentration of microparticles can adversely affect the mechanical properties of an adhesive.

Objectives: The aim of this study was to investigate the mechanical, chemical, optical, and adhesive properties of BisGMA-free experimental resin composites containing Exothane-24-an elastomeric urethane monomer-and different co-initiators., Materials and Methods: A blend of urethane dimethacrylate (UDMA), extended dimethacrylate urethane (PEG 400), triethylene glycol dimethacrylate (TEGDMA), and camphorquinone was prepared. Two different co-initiators-dimethyl aminoethyl methacrylate (DMAEMA) or 4-N alcohol, N-dimethylamine phenylethyl (DMPOH)-were added to the blend. Exothane-24 monomer was added to the blend for each co-initiator and four groups were established as follows: DMAEMA; DMAEMA + Exothane; DMPOH; and DMPOH + Exothane. Specimens were photo-activated using a multi-wave LED light-curing unit (VALO; 954 mW/cm 2 of irradiance). Mechanical (ultimate tensile strength, flexural strength, flexural modulus and hardness), chemical (degree of conversion, hardness reduction, water sorption and solubility), optical (color change), and adhesive (microtensile bond strength) properties were analyzed. Data were submitted to two-way ANOVA and Tukey's test (α = 0.05)., Results: The resin composite containing DMPOH and Exothane-24 showed similar or superior performance to those of the other experimental composites for mechanical and chemical properties, except for flexural strength. It also showed less color change and greater micro-tensile bond strength., Conclusions: Among the combinations tested, the BisGMA-free resin composite containing Exothane-24 combined with the DMPOH co-initiator showed the best mechanical, chemical, optical, and adhesive properties. Clinical relevance Exothane-24 monomer and DMPOH co-initiator could be useful in the formulation of BisGMA-free resin composites in order to minimize exposure to BPA., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: This study investigated whether a sample of anterior resin composite restorations could be differently evaluated in different centers of evaluation by clinical and lay evaluators., Methods: Anterior resin composite restorations on high-quality intraoral digital photography were evaluated using FDI criteria (1-5 score) by pairs of clinical and lay evaluators in Brazil (BR), France (FR), Peru (PE), and the United States of America (USA). Scores were allocated as maintenance (1, 2, 3), repair (4) and replacement (5) when comparing clinical evaluators and, as acceptable (1, 2, 3) and unacceptable (4, 5) when comparing clinical vs. lay evaluators and lay vs. lay evaluators. The Chi-square test compared the frequencies of scores among the centers., Results: The frequencies of maintaining, repairing, or replacing anterior resin composite restorations given by clinical evaluators varied depending on the evaluation center. BR and PE showed the highest frequencies for repair and replacement, while FR and USA showed the highest frequencies for maintenance. The comparison of frequencies of anterior resin composite restorations accepted or unaccepted by the clinical vs lay evaluators in the same centers showed a significantly higher frequency of acceptable dental restorations coming from clinical evaluators. Comparison between lay evaluators from different centers showed significant higher frequency of unacceptable dental restorations by BR, compared to other centers., Conclusions: In the evaluation of anterior resin composite restorations, the maintenance, repair, or replacement trends can vary among different centers. The unacceptable rate came more frequently from lay than from clinical evaluators. Lay evaluators from different centers differed significantly., Clinical Significance: Clinical and lay evaluators in distant evaluation centers can present different trends when assessing anterior resin composite restoration. Multicenter evaluations can help to understand such differences and it is important because clinical decision-making based on scientific evidence comes from clinical studies done in different research centers., (Copyright © 2021. Published by Elsevier Ltd.)

(1) Background: The amino acid arginine is now receiving great attention due to its potential anti-caries benefits. The purpose of this in vitro study was to evaluate the shear bond strength (SBS), ultimate tensile strength (UTS), and antimicrobial potential (CFU) of two arginine-containing orthodontic resin cements. (2) Methods: Forty bovine incisors were separated into four groups (n = 10): Orthocem, Orthocem + arginine (2.5 wt%), Transbond XT, and Transbond XT + arginine (2.5 wt%). The brackets were fixed to the flat surface of the enamel, and after 24 h the SBS was evaluated using the universal testing machine (Instron). For the UTS test, hourglass samples (n = 10) were made and tested in a mini-testing machine (OM-100, Odeme). For the antibacterial test (colony forming unit-CFU), six cement discs from each group were made and exposed to Streptococcus mutans UA159 biofilm for 7 days. The microbiological experiment was performed by serial and triplicate dilutions. The data from each test were statistically analyzed using a two-way ANOVA, followed by Tukey's test (α = 0.05). (3) Results: The enamel SBS mean values of Transbond XT were statistically higher than those of Orthocem, both with and without arginine ( p = 0.02033). There was no significant difference in the SBS mean values between the orthodontic resin cements, either with or without arginine ( p = 0.29869). The UTS of the Transbond XT was statistically higher than the Orthocem, but the addition of arginine at 2.5 wt% did not influence the UTS for either resin cement. The Orthocem + arginine orthodontic resin cement was able to significantly reduce S. mutans growth, but no difference was observed for the Transbond XT ( p = 0.03439). (4) Conclusion: The incorporation of arginine to commercial orthodontic resin cements may be an efficient preventive strategy to reduce bacterial growth without compromising their adhesive and mechanical properties.

To evaluate the effect of three adhesive systems applied under electric current on microtensile bond strength (μTBS) and degree of conversion (DC). Molar teeth were restored with the aid of three adhesive systems (Adper Single Bond 2-SB2; Clearfil SE Bond-CSE; and Single Bond Universal-SBU) under different electric current intensities (0 μA; 25 μA; and 50 μA). Composite resin blocks were built up in increments (2 mm) and sectioned into 1 × 1 mm beams. The μTBS was tested after 24 h and 1 y distilled water storages. Samples (n = 10) from 24 h to 1 y storages were immersed in a 50% ammoniacal silver nitrate solution and submitted to scanning electron microscopy. The silver nitrate in the hybrid layer was quantified (ImageJ software). The adhesive systems' dentinal infiltration was analyzed using confocal laser scanning microscopy. Fourier transform near infrared spectroscopy was used to measure the DC. The μTBS data were submitted to two-way ANOVA (time vs. electric current) and Bonferroni's test (α = 0.05). Quantitative nanoleakage data were submitted to two-way ANOVA (electric current vs. adhesive) and Bonferroni's test (α = 0.05). DC data were submitted to one-way ANOVA and Tukey's test (α = 0.05) for each adhesive system. The electric current statistically increased the μTBS for SB2 and CSE in 24 h storage, as well as for SB2, CSE and SBU in 1 y storage. No significant difference was observed between storage time for CSE and SBU. When compared to the control, electric currents (25 μA and 50 μA) showed significantly higher DC mean values for SB2 and SBU, and had no effect on CSE. The electric currents (25 μA and 50 μA) reduced the adhesive system's nanoleakage after 1-year storage, and improved the infiltration of SB2 and CSE. Both electric current intensities improved dentinal interface stability., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: To a self-etch adhesive doped with nano-bioglass and evaluate its ability to bond and re-mineralize artificially demineralized dentin., Methods: Experimental Si, Ca, Na and PO 4 based nanobioglass particles were synthesized, doped into experimental self-etch adhesives, and divided into 3 groups: Clearfi SE2 (CSE2), experimental (EXC), and experimental doped with 10% of nanobioglass (ExNB). The adhesives were applied onto the caries-affected dentin (chemically simulated), and evaluated after 24 h and 28 days of immersion in simulated body fluid. The remineralization process was assessed using optical coherence tomography, nanoindentation, in situ zymography, transmission electron microscopy, confocal laser scanning microscopy, μ-tensile bond strength, and pH buffer., Results: The addition of nanobioglass particles into the experimental self-etch adhesives altered the μTBS in the short-term jeopardizing dentin bonding properties, when compared to the non-doped self-etch adhesive. The remineralization recovered the nanohardness, and volume lost by caries lesion (p = 0.02). Moreover, reduced the enzymatic activity (p = 1.24 E-4 ) and formed new crystals within of the hybrid layer., Conclusion: The use of nanobioglass was efficient to recover the properties of a caries affected dentin. Furthermore, the adhesive properties were not hampered and the probabilistic reliability increased., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: The purpose of this study was to synthesize chlorhexidine (CHX)-encapsulated aluminosilicate clay nanotubes (Halloysite®, HNTs) and to incorporate them into the primer/adhesive components of an etch-and-rinse adhesive system (SBMP; Scotchbond Multipurpose, 3M ESPE) and to test their effects on degree of conversion, viscosity, immediate and long-term bonding to dentin., Methods: CHX-modified HNTs were synthesized using 10% or 20% CHX solutions. The primer and the adhesive components of SBMP were incorporated with 15wt.% of the CHX-encapsulated HNTs. Degree of conversion (DC) and viscosity analyses were performed to characterize the modified primers/adhesives. For bond strength testing, acid-etched dentin was treated with one of the following: SBMP (control); 0.2%CHX solution before SBMP; CHX-modified primers+SBMP adhesive; SBMP primer+CHX-modified adhesives; and SBMP primer+CHX-free HNT-modified adhesive. The microtensile bond strength test was performed after immediate (24h) and long-term (6 months) of water storage. Data were analyzed using ANOVA and Tukey (α=5%) and the Weibull analysis., Results: DC was greater for the CHX-free HNT-modified adhesive, whereas the other experimental adhesives showed similar DC as compared with the control. Primers were less viscous than the adhesives, without significant differences within the respective materials. At 24h, all groups showed similar bonding performance and structural reliability; whereas at the 6-month period, groups treated with the 0.2%CHX solution prior bonding or with the CHX-modified primers resulted in greater bond strength than the control and superior reliability., Significance: The modification of a primer or adhesive with CHX-encapsulated HNTs was an advantageous approach that did not impair the polymerization, viscosity and bonding performance of the materials, showing a promising long-term effect on resin-dentin bonds., (Copyright © 2020 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study is to evaluate bond strength (BS), shrinkage stress (SS), flexural strength (FS), and elastic modulus (E) of three flowable bulk fill in comparison with conventional composites., Materials and Methods: Three bulk fill (Filtek Bulk Fill Flow, Surefil SDR, X-tra Base) and three conventional composites (Filtek Z250 XT, Grandioso, Dentsply TPH3) were used. For BS, conical cavities ( n = 10) were prepared in bovine dentine and restored with materials and were analyzed through push-out test in a universal testing machine (UTM). For FS/EM, 60 ( n = 10) bar specimens (7 mm × 2 mm × 1 mm) were prepared and evaluated with a UTM. SS was measured in UTM coupled to an extensometer ( n = 5). The data were statistically evaluated using one-way ANOVA/Tukey tests ( P < 0.05)., Results: Conventional composites showed higher E when compared to bulk-fill composites. Regarding FS, they showed similar results, except for (XBF) Xtra Bulk Fill that was inferior. SS and BS of bulk-fill composites were significantly lower and higher than conventional composites, respectively, except for XBF, which showed similar BS to conventional ones., Conclusions: Flowable bulk-fill composites, except XBF, showed higher BS, lower SS, similar FS, and lower E when compared to conventional ones., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Conservative Dentistry.)

The aim of this study was to evaluate of pre-heating, filler contents and ceramic thickness on film thickness, microshear bond strength, degree of conversion and color change on ceramic veneers. Two experimental composites were prepared (Bis-GMA/UDMA/BisEMA/ TEGDMA), with different amounts of filler (65% or 50%wt) simulating a conventional and a flowable composite. The flowable (F) was used at room temperature and, the conventional either at room temperature (C) or pre-heated (CPH). Disk-shaped ceramics with different thickness (0.4 mm, 0.8 mm, 1.5 mm) were prepared. The film thickness was evaluated according to the ISO 4049 (n=10). The microshear bond strength (n=10) was evaluated in enamel using tubing specimens light-cured through the ceramic veneer. The degree of conversion was evaluated using Raman spectroscopy. The color change of the ceramic restorations (n=10) was evaluated by spectrophotometry. The results were submitted to 2-way ANOVA and Tukey's post hoc test (a=5%). For the film thickness 1-way ANOVA was used (a=5%). The C presented the thicker film thickness; the CPH produced a similar film thickness in comparison to the F. All composites showed similar microshear bond strength. The degree of conversion of the F was higher than the C and CPH. The degree of conversion of the composites photo-activated through a 0.4 mm was higher than the composites photo-activated through thicker ceramics. The C showed the highest color change, while the CPH showed similar color change to the F. In conclusion, pre-heated conventional composites seem to be a potential alternative to lute ceramic veneers such as the flowable composites.

The main of the study was quantify the effect of two ceramics with two underlying resin cements on apparent fluorescence levels. Buccal surfaces of two bovine incisors were ground flat producing one enamel and one dentin substrate. The veneers were fabricated (0.5 and 1.0 mm thickness) using two ceramics (IPSe.max Press and IPSe.max Zirpress, Ivoclar Vivadent). Veneers were cemented using either light-cured (Variolink II, Ivoclar Vivadent) or self-adhesive dual (Rely X U200, 3M ESPE) cement. The layered Control group materials had no cement application. Semi-quantitative fluorescence image analysis (Matlabs software, Matworks) involved processing the images as captured under each daylight (DL, Gretagmacbeth) and ultraviolet illuminants (UVA, Sylvania) within a neutral-gray lightbox (Macbeth Spectral Light). Statistical analysis of the quantitative fluorescence values was performed using two-way ANOVA and Tukey's test (p < 0.05). The e.max Zirpress on the dentin substrate produced greater fluorescence (p < 0.05) when subjected to UV illumination and more fluorescence (p < 0.05) than e.max Press in both cement groups. Light-cured cement produced higher (p < 0.05) fluorescence than the dual-cement with e.max Press on enamel under UV illumination. The fluorescence for e.max Press on the dentin substrate was greater (p < 0.05) than for e.max Zirpress using dual self-adhesive cement subjected to daylight illumination. Thus, it is possible to conclude that the combination of ceramic and cement produce definite, significant effects on the apparent fluorescence, vital quality for restorative dentistry.

A commercially available three-step (etch-and-rinse) adhesive was modified by adding chlorhexidine (CHX)-loaded nanotubes (Halloysite®, HNT) at two concentrations (CHX10% and CHX20%). The experimental groups were: SBMP (unmodified adhesive, control), HNT (SBMP modified with HNT), CHX10 (SBMP modified with HNT loaded with CHX10%), and CHX20 (SBMP modified with HNT loaded with CHX20%). Changes in the degree of conversion (DC%), Knoop hardness (KHN), water sorption (WS), solubility (SL), antimicrobial activity, cytotoxicity, and anti-matrix metalloproteinase [MMP-1] activity (collagenase-I) were evaluated. In regards to DC%, two-way ANOVA followed by Tukey's post-hoc test revealed that only the factor "adhesive" was statistically significant (p < 0.05). No significant differences were detected in DC% when 20 s light-curing was used (p > 0.05). For Knoop microhardness, one-way ANOVA followed by the Tukey's test showed statistically significant differences when comparing HNT (20.82 ± 1.65) and CHX20% (21.71 ± 2.83) with the SBMP and CHX10% groups. All adhesives presented similar WS and cytocompatibility. The CHX-loaded nanotube-modified adhesive released enough CHX to inhibit the growth of S. mutans and L. casei. Adhesive eluates were not able to effectively inhibit MMP-1 activity. The evaluation of higher CHX concentrations might be necessary to provide an effective and predictable MMP inhibition. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 868-875, 2019., (© 2018 Wiley Periodicals, Inc.)