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The conventional radiotherapy protocol to treat head-and-neck cancer is usually followed by tooth-decay onset. Radiation impact on mineralized tooth structures is not well-understood. This systematic review aimed to collect the recorded effects of therapeutic radiation on tooth chemical, structural and mechanical properties, in relation with their means of investigation.Systematic search (January 01 2012 - September 30 2021) terms were "Radiotherapy", "Radiation effects", "Dental enamel", "Dentin", "Human" and "Radiotherapy" NOT "Laser".PubMed, DOSS and Embase databases were searched.Selected studies compared dental enamel, coronal and root dentin properties before and after in vitro or in vivo irradiation up to 80 Gy.The systematic search identified 353 different articles, with 28 satisfying inclusion criteria. Their reference lists provided two more. Twenty-two studies evaluated dental enamel evolution, nine assessed coronal dentin and eight concerned root dentin. Coronal and root dentin results indicate a major impact of the radiation on their organic matrix. Dental enamel's chemical properties are less modified. Enamel and root dentin's hardness are decreased by therapeutic radiation, but no consensus arises for coronal dentin.Our findings revealed some interesting information about enzymatic degradation mechanisms of dentin organic matrix and highlighted that dental hard-tissue characterization requires highly specific expertise in materials science. That scientific knowledge is necessary to design suitable protocols, adequately analyze the obtained data, and, thus, provide relevant conclusions.Better knowledge and understanding of the mechanisms involved in the degradation of enamel and dentin would enable development of new preventive and therapeutic methods for improved medical care of patients undergoing radiotherapy.

To evaluate in vitro the mechanical, biological, and polymerization behavior of a flowable bulk-fill composite with fibers as a dispersed phase.EverX Flow™ (GC Corporation) (EXF), one conventional bulk-fill composite (Filtek™ Bulk Fill Posterior Restorative, 3 M (FBF)), and one flowable bulk composite without fibers (SDR® flow+, Dentsply (SDR)) were tested. Samples were characterized in terms of flexural strength (ISO 4049), fracture toughness (ISO 20795-1), and Vickers hardness. Polymerization stress and volumetric shrinkage were evaluated. The in vitro biological assessment was achieved on cultured primary Human Gingival Fibroblast cells (HGF). The cell metabolic activity was evaluated using Alamar Blue assay at 1, 3, and 5 days of contact to the 3 tested composite extracts (ISO 10993) and cell morphology was evaluated by confocal microscopy. Data were submitted to One-Way analysis of variance (ANOVA) and independent t-test (α = 0.05).FBF showed statistically higher Vickers hardness and flexural modulus than EXF and SDR. However, EXF showed statistically higher KEXF had a significantly higher fracture toughness validating its potential use as a restorative material in stress bearing areas. EXF showed higher shrinkage stress values, and less cytotoxic effect. Fiber reinforced flowable composite is mainly indicated for deep and large cavities, signifying the importance for assessing its shrinkage stress and biological behavior.

The current study aimed to assess the topographical and physical properties of a minimally invasive implant (MagiCore®: MC®, InnosBioSurg, IBS) and to evaluate its biological behavior compared to a gold standard implant (NobelParallel™: NB™, Nobel Biocare™). After surface characterization, the biological behavior assessment was conducted regarding human gingival fibroblasts (hGF) and osteoblast-like cells (MG63). Roughness values for NBTM were Ra = 1.28 µm and for MC® they were Ra = 2.02 µm. Alamar BlueTM assay LIVE/DEADTM staining results indicated equivalent biological development regarding both cell types for the two implants. Significant enhancement was found for hGF ALP activity in the presence of the two tested implants in a time-dependent manner from day 7 to day 14 (** p < 0.01). Alizarin red staining demonstrated significant calcium deposition enhancement when cells were interfaced with the NB™ compared to the MC® implant (** p < 0.05). Moreover, SEM and confocal imaging revealed good cell adhesion with a denser cellular layer on the MC® than the NB™ surface. The MC® cytocompatibility was ranked as equivalent to the gold standard implant despite the surface properties differences. These findings provide new insights about the minimally invasive implant’s biological behavior and its potential clinical implication in different implantology situations.

While dental composite long-term aging has already been studied in the past, no data exist about the early aging while it might be detrimental regarding the composites' longevity. This study aims to better understand the effects of early water exposure on dental composites. Dental resin composites with different fillers ratio were subjected to water exposure during 24 h, 1 week, or 1 month. After photopolymerization, the samples were stored at different conditions, whether in wet or dry condition (W, D, respectively) and in wet conditions after a first 24 h storage in dry conditions (DW). Three-point bending tests were performed to measure the flexural modulus. The samples were then subjected to a sorption/desorption protocol. While the matrix alone did not undergo any mechanical degradation with exposure time, the composites matrices presented a decrease in elastic modulus. This decrease was the highest for the matrix with nonsilanized fillers. Interestingly, the DW condition was detrimental for all the samples. Regarding the sample with nonsilanized fillers in DW for 1 month presented an elastic modulus lower than the matrix alone. These results were assigned to the sorption capacity of the polymer matrix, suggesting that the diffusion mechanisms and the nature of water molecules are determinant in the composite degradation. This study showed that dental composite early degradation mechanisms after water exposure are involved in the polymer matrix postpolymerization process as soon as after 24 h. Such mechanisms are detrimental in terms of the dental composite efficiency and have to be understood.

Objective Resin-based composites are widely used in dental restorations; however, their volumetric shrinkage during polymerization leads to several issues that reduce the restoration survival rates. For overcoming this problem, a deep study of shrinkage phenomena is necessary. Methods In this study, micro-tomography (μ-CT) is combined with digital volume correlation (DVC) to investigate the effect of several factors on the polymerization strain of dental composites in model cavities: the presence/absence of an adhesive, the use of transparent/blackened cavities, and irradiation times between 1 and 40 s. Results The results indicate that the presence of an adhesive at the interface between the cavity and composite does not reduce the total strain but instead limits it to a preferential direction. In addition, regardless of the conditions, the main strain is generated along the axis parallel to the polymerization irradiation (the vertical axis). Finally, the total strain appears to occur in the first 5 s of irradiation, with no further evolution observed for longer irradiation times. Significance This work provides new insight into resin-based composite shrinkage and demonstrates the benefit of coupling DVC and μ-CT to better understand the degradation mechanisms of these materials.

Purpose To investigate the relationship between the microstructure of CAD/CAM blocks and the quality of adhesion as function of the surface treatment and resin cement type. Materials and methods Two nano-ceramic composite resin CAD/CAM blocks, Lava Ultimate (LU) and Cerasmart (CS), and two Leucite-reinforced glass ceramic CAD/CAM IPS blocks, Empress® CAD (EM) and InitialTM LRF (IR), received either Hydrofluoric acid (HF) or sandblasting (SB) surface treatments. The blocks were then luted using two dual-cure resin cements, LinkForce (LF) and Multilink Automix (ML) with their corresponding silanes, resulting in 16 study groups. The luted blocks were then thermal-cycling (TC) for 5000 cycles and subjected to a microtensile bond strength (μTBS) test. Scanning electron microscopy (SEM) micrographs of the treated surfaces were analyzed using ImageJ software and XRD analyses were performed for the two ceramic blocks. The data obtained were submitted to Games-Howell post-hoc nonparametric test to compare combinations of groups or treatments and a linear mixed-effects model for the factors surface treatment, block type, and resin cement, together with their first-degree interactions (α = 0.05). Results The lowest mean μTBS values were obtained with LU-HF, whereas the highest mean μTBS values were obtained with CS regardless of resin cement type and surface treatment method. IR-HF mean μTBS were significantly higher than IR-SB, EM-SB, and EM-HF. Analysis using ImageJ software demonstrated significant differences in the density and pore size after HF surface treatment. Conclusions The specific microstructure of each block material within the same family group impacted the micromechanical retention and the bonded interface strength.

International audience; Objective :To assess the impact of the quaternary ammonium antibacterial agent, Dimethyl-Hexadecyl-Methacryloxyethyl-Ammonium Iodide (DHMAI), on structural stability of an experimental resin composite after biological aging.Methods :Experimental resin composites containing 7.5% of DHMAI were incubated in a biological medium in the presence of a Streptococcus Mutans (SM) strain during 3 months. The physicochemical, mechanical, and thermal properties, before and after 3 months of aging, were evaluated using: Degree of Conversion (DC), Residual Functions (RF), Vitreous Transition (Tg), Thermal Expansion Coefficient (CTE) and thermal degradation using Fourier Transform Infrared Spectroscopy Analysis (FTIRATR), Differential Scanning Calorimetry (DSC), Thermo Mechanical analyses (TMA) and Thermo Gravimetric Analysis (TG).Results :Incorporation of DHAMI increased DC and decreased RF. After aging, DHMAI decreased and slowed RF release. Incorporation of 7.5% DHAMI provided significant modification of the thermal behavior (Tg and thermal degradation) but did not affect CTE. After aging, DHMAI enhanced the structural stability and improved resistance against biodegradation compared to the control composite.Significance :The development of an antibacterial dental composite based on DHMAI improved its physical, mechanical, and thermal behaviors, possibly enhancing dental composite longevity. Results suggest that DHMAI could be used in the composition of other bioactive dental materials.

Objective A costly advantageous approach in composites development process is to limit experimental tests by predicting mechanical properties with respect to their filler ratio. Models exist for other fields than dentistry. They have been compared to 3-point bending test experimental results for yield stress, flexural modulus and flexural strength. Methods Five formulations of the same experimental material were made. They were composed of an organic matrix and different ratios of silanated barium glass particles. The samples were stored in distilled water for 24 h at 37 °C prior to the 3-point bending test. The Turcsanyi model for yield stress was notably investigated, and SEM was used to complete data analysis. Results The yield stress showed reproducible results and a good fit with Turcsanyi model with respect to filler ratio. The flexural modulus data are not scattered but did not fit with the existing models. No trend could emerge for flexural strength and strain because of scattering; these properties are more unpredictable. The SEM observations of fracture areas confirm a good matrix-filler interface quality. Significance SEM pictures validated the numerical parameter obtained from Turcsanyi model. The latter therefore seems to be applicable to dental composites. Firstly, it enables to predict the evolution of the material yield stress without testing all filler ratios. Secondly, this model provides a good way to get micro-information on the matrix-filler interface from macroscopic tests. The discrepancy between flexural modulus results and theory highlighted the necessity to include an “interface quality” parameter in accurate predictive models.

Statement of problem Different parameters can influence the adaptation of computer-assisted design and computer-assisted manufacturing (CAD-CAM) inlay/onlay restorations. However, systematic reviews to identify and discuss these parameters are lacking. Purpose The purpose of this systematic review was to summarize the scientific literature investigating all parameters that can influence both the marginal and internal adaptation of CAD-CAM inlay/onlay restorations. Material and methods An electronic search was conducted by 2 independent reviewers for studies published in English between January 1, 2007 and September 20, 2017 on the PubMed/MEDLINE, Scopus, and Web of Science databases and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Factors investigated in the selected articles included the type of CAD-CAM system, virtual space parameters, version of the software, type of block, luting procedure, type of restoration, sample size and aging procedure, evaluation method, and number of measurement points per specimen. Results A total of 162 articles were identified, of which 23 articles met the inclusion criteria. Nine studies investigated adaptation with different restorative materials, 2 evaluated adaptation according to the type of preparation design, 9 compared adaptation before/after thermomechanical loading, and 2 before/after cementation, 1 study investigated marginal adaptation based on whether the optical scan was made intraorally or extraorally, 1 compared adaptation with 5 and 3 axis CAM systems, and 1 assessed adaptation with 4 different intraoral scanners. The risk of bias was high for 7, medium for 15, and low for 1 of the studies reviewed. The high level of heterogeneity across the studies excluded meta-analysis. Conclusions Most of the studies reported clinically acceptable values for marginal adaptation. The performance of a CAD-CAM system is influenced by the type of restorative material. A nonretentive cavity preparation exhibited better adaptation than a retentive preparation. Most studies showed that thermomechanical loading affected the quality of marginal adaptation. Cementation increased marginal discrepancies. No statistically significant difference was found for marginal fit of onlays between intraoral and extraoral optical scans using a stone die. The number of milling axes, the type of digital camera, and the region measured were statistically significant in relation to marginal/internal adaptation. Values of adaptation recorded failed to reproduce the preestablished spacer parameters in the software. Clarification is needed concerning adaptation according to the type of preparation design, the type of material, the choice of intrinsic parameters for the CAD process, the type and shape of milling instruments, and the behavior of the material during milling. Adaptation of CAD-CAM inlay/onlays should be evaluated under clinical conditions.

Background and objectives A current public health issue is preventing post-surgical complications by designing antibacterial implants. To achieve this goal, in this study we evaluated the antibacterial activity of an animal-free chitosan grafted onto a titanium alloy. Methods Animal-free chitosan binding on the substrate was performed by covalent link via a two-step process using TriEthoxySilylPropyl Succinic Anhydride (TESPSA) as the coupling agent. All grafting steps were studied and validated by means of X-ray Photoelectron Spectroscopy (XPS), Time-of-Flight secondary ion mass spectrometry (ToF-SIMS) analyses and Dynamic-mode Secondary Ion Mass Spectrometry (DSIMS). The antibacterial activity against Escherichia coli and Staphylococcus aureus strains of the developed coating was assessed using the number of colony forming units (CFU). Results XPS showed a significant increase in the C and N atomic percentages assigned to the presence of chitosan. A thick layer of polymer deposit was detected by ToF-SIMS and the results obtained by DSIMS measurements are in agreement with ToF-SIMS and XPS analyses and confirms that the coating synthesis was a success. The developed coating was active against both gram negative and gram positive tested bacteria. Conclusion The success of the chitosan immobilization was proven using the surface characterization techniques applied in this study. The coating was found to be effective against Escherichia coli and Staphylococcus aureus strains. © 2017 D'Almeida et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

International audience; Statement of problemRecent polymer-based computer-assisted design and computer-assisted manufacturing (CAD-CAM) materials have been commercialized for inlay restorations, a polymer-infiltrated ceramic-network (PICN) and composite resin nanoceramics. Little independent evidence regarding their mechanical properties exists. Internal adaptation is an important factor for the clinical success and longevity of a restoration, and data concerning this parameter for inlays made with these blocks are scarce.PurposeThe purpose of this in vitro study was to evaluate and compare the mechanical properties (flexural strength, flexural modulus, Vickers hardness, fracture toughness) and the internal adaptation of these recent polymer-based blocks with a lithium disilicate glass-ceramic block.Material and methodsThe materials tested in this study were a PICN material (Vita Enamic), 2 composite resin nanoceramics (Lava Ultimate; 3M ESPE and Cerasmart; GCDental Products), and a lithium disilicate glass-ceramic (IPS e.max CAD). Mechanical properties were evaluated according to ISO norm DIS 6872:2013. Bar-shaped specimens (18×3×3 mm) were prepared and submitted to a 3-point bend test using a universal testing machine at a cross-head speed of 0.5 mm/min. In addition, identical cavities were prepared in 60 human mandibular extracted molars (n=15) and optically scanned to receive mesioocclusodistal inlays milled with the 4 materials tested in a CEREC Inlab milling machine. The replica technique and a stereomicroscope (×20) were used to measure the internal fit of the inlays at 9 preselected locations. All data were statistically analyzed using 1-way ANOVA and the post hoc Tukey multiple comparison or Games-Howell test (α=.05).ResultsThe mean flexural strength of the tested blocks ranged from 148.7 ±9.5 MPa (Vita Enamic) to 216.5 ±28.3 MPa (Cerasmart). The mean flexural modulus ranged from 23.3 ±6.4 GPa (Vita Enamic) to 52.8 ±10.5 GPa (IPS e.max CAD). The mean Vickers hardness ranged from 0.66 ±0.02 GPa (Cerasmart) to 5.98 ±0.69 GPa (IPS e.max CAD). The mean fracture toughness ranged from 1.2 ±0.17 MPa.m1/2 (Cerasmart) to 1.8 ±0.29 MPa.m1/2 (IPS e.max CAD). The values for internal discrepancy ranged from 119 ±55 μm to 234 ±51 μm. The mean internal discrepancy was significantly higher for Lava Ultimate (P

International audience; Aim: To study the effect of thermal shock on the enamel – composite restoration interface as compared to standard thermal cycling protocol.Methodology: Box shaped cavities were prepared in thirty mandibular third molars, the cavities were restored using two step etch and rinse adhesive: Adper™ Scotchbond™ 1 XT (3M™ ESPE™, St. Paul, USA), and nano-hybride resin composite Filtek™ Z250 (3M™ ESPE™, St. Paul, USA). Specimens were divided in 3 groups. The first group was thermal cycled for 600 cycles, the second group was submitted to 600 thermal shock cycles using Oral B waterjet device, and the third group was a control group. Teeth specimens were evaluated for dye leakage using 2% Basic Fuchsin dye for 24 hours, all bonded teeth were subsequently sectioned perpendicularly into 0.9 ± 0.1 mm2 sticks that were loaded on universal testing machine to obtain the ultimate tensile strength. Values were analyzed with one way ANOVA post hoc Tukey HSD (SPSS version 23) with 95% confidence interval.Results: Both thermal shock and thermal cycling groups had significantly higher dye leakage values along the interface as compared to the control group. The microtensile bond strength values were significantly lower for the thermal shock group as compared to the control group, no significant difference was found between the thermal cycling and the control group.Conclusion: Thermal shock was shown to induce more stress on the interface, which may lead to cracks and gap formation overtime.

International audience

International audience

The aim of this study was to assess the effect of radiotherapy on bond efficiency of two different adhesive systems using tensile bond strength test. Twenty extracted teeth after radiotherapy and twenty nonirradiated extracted teeth were used. The irradiation was appliedin vivoto a minimal dose of 50 Gy. The specimens of each group were randomly assigned to two subgroups to test two different adhesive systems. A three-step/etch-and-rinse adhesive system (Optibond FL) and a two-steps/self-etch adhesive system (Optibond XTR) were used. Composite buildups were performed with a nanohybrid composite (Herculite XTR). All specimens were submitted to thermocycling ageing (10000 cycles). The specimens were sectioned in 1 mm2sticks. Microtensile bond strength tests were measured. Nonparametric statistical analyses were performed due to nonnormality of data. Optibond XTR on irradiated and nonirradiated teeth did not show any significant differences. However, Optibond FL bond strength was more effective on nonirradiated teeth than on irradiated teeth. Within the limitations of anin vitrostudy, it can be concluded that radiotherapy had a significant detrimental effect on bond strength to human dentin. However, it seems that adhesive choice could be adapted to the substrata. According to the present study, the two-steps/self-etch (Optibond XTR) adhesive system tested could be more effective on irradiated dentin compared to three-steps/etch-and-rinse adhesive system (Optibond FL).

Objectives: The aim of this study was to evaluate the mechanical and physical properties of a newly developed fiber reinforced dental composite. Materials and Methods: Fiber reinforced composite EverX Posterior (EXP, GC EUROPE), and other commercially available bulk fill composites, including Filtek Bulk Fill (FB, 3M ESPE), SonicFill (SF, Kerr Corp.), SureFil (SDR, Dentsply), Venus Bulk Fill (VB, HerausKultzer), Tetric evoceram bulk fill (TECB, Ivoclar Vivadent), and Xtra Base (XB, Voco) were characterized. Composite samples light-cured with a LED device were evaluated in terms of flexural strength, flexural modulus (ISO 4049, n = 6), fracture toughness (n = 6), and Vickers hardness (0, 2, and 4 mm in depth at 24 hr, n = 5). The EXP samples and the fracture surface were observed under a scanning electron microscopy. Data were statistically analyzed using one-way ANOVA and unpaired t-test. Results: EXP, FB, and VB had significantly higher fracture toughness value compared to all the other bulk composite types. SF, EXP, and XB were not statistically different, and had significantly higher flexural strength values compared to other tested composite materials. EXP had the highest flexural modulus, VB had the lowest values. Vickers hardness values revealed SF, EXP, TECB, and XB were not statistically different, and had significantly higher values compared to other tested composite materials. SEM observations show well dispersed fibers working as a reinforcing phase. Conclusions: The addition of fibers to methacrylate-based matrix results in composites with either comparable or superior mechanical properties compared to the other bulk fill materials tested. (Restor Dent Endod 2015;40(4):262-270)

The aim of this study was to concentrate all the loading forces of a bond strength test on the dentin-adhesive interfaces either bonded with an etch-and-rinse or a one-step self-etch adhesive system; the results were compared to that of a glass ionomer cement. Superficial and deep dentin discs were prepared from freshly extracted teeth and bonded to a one with two-step etch-and-rinse Adper™ Scotchbond™ 1XT (3M ESPE, Seefeld, Germany), and onestep self-etch Adper™ Easy Bond (3M ESPE, Seefeld, Germany), and a control group with glass ionmer cement GC Fuji IX (GC Corp, Leuven, Belgium). The 4 by 4 mm bonded areas were subjected to shear stress and targeted only at the thickened adhesive layer. Bond strength and crack length measurements were obtained. Interface morphology and fracture mechanisms were observed using scanning electron microscopy. Deep and superficial dentin bond strength measurements were statistically significant difference showing higher values for the deep dentin than for the superficial dentin. Crack length measurements for Adper™ Easy Bond showed a higher value than with Adper™ Scotchbond, GC Fuji IX. Scanning electron microscopy demonstrated cohesive failures inside the adhesive layer for both adhesive types. The test setup, with the thickened adhesive layer, made the results more dependent on the mechanical properties (stiffness) rather than on the adhesive properties of the adhesive material itself and reflects its ability to resist the fracture load.