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Objectives: The study aimed to assess the impact on the mechanical strength and failure patterns of implant-abutment complexes of choosing different abutment types, designs and manufacturers, aiding in selecting the optimal restorative solution. Stock and custom abutments from original and aftermarket suppliers were subjected to thermomechanical aging., Material and Methods: Stock and custom abutments from the implant manufacturer (original) and a aftermarket supplier (nonoriginal) were connected to identical implants with internal connection. Custom abutments were designed in a typical molar and premolar design, manufactured using the workflow from the respective suppliers. A total of 90 implants (4 mm diameter, 3.4 mm platform, 13 mm length) equally divided across 6 groups (three designs, two manufacturers) underwent thermo-mechanical aging according to three different regimes, simulating five (n = 30) or 10 years (n = 30) of clinical function, or unaged control (n = 30). Subsequently, all samples were tested to failure., Results: During aging, no failures occurred. The mean strength at failure was 1009N ± 171, showing significant differences between original and nonoriginal abutments overall (-230N ± 27.1, p < .001), and within each abutment type (p = .000), favoring original abutments. Aging did not significantly affect the failure load, while the type of abutment and manufacturer did, favoring original and custom-designed abutments. The most common failure was implant bending or deformation, significantly differing between original and nonoriginal abutments and screws. All failure tests resulted in clinically unsalvageable implants and abutments., Conclusions: Within the limitations of this study, original abutments exhibited a higher mechanical strength compared to the nonoriginal alternative, regardless of the amount of simulated clinical use. Similarly, custom abutments showed higher mechanical strength compared to stock abutments. However, mechanical strength in all abutments tested was higher than average chewing forces reported in literature, thus components tested in this study can be expected to perform equally well in clinical situations without excessive force., (© 2024 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Statement of Problem: The existing knowledge is insufficient for comprehending the fatigue survival and fracture resistance of molars that have deep approximal direct and indirect restorations, whether with or without deep margin elevation (DME)., Purpose: The aim of this laboratory and in silico study is to investigate the fatigue survival, fracture strength, failure pattern and tooth deformation of molars restored with DME in combination with a direct or indirect restoration., Material and Methods: This study utilized 45 extracted sound human molars, divided into three groups (n = 15). Standardized 100% inter-cuspal inlay preparations were performed, extending 2 mm below the CEJ and immediate dentin sealing (IDS) was applied. Group 1 (Co&#95;1) was restored with direct composite; Group 2 (Hyb&#95;2) with a 2 mm DME of direct composite and a glass-ceramic lithium disilicate restoration; Group 3 (Cer&#95;3) a glass-ceramic lithium disilicate restoration. All specimens were exposed to a fatigue process involving thermal-cyclic loading (50N for 1.2 × 10 6 cycles at 1.7 Hz, between 5 and 55 °C), if teeth survived, they were fractured using a load-to-failure test and failure types were analyzed. Finite element analysis (FEA) was conducted to assess tooth deformation and tensile stress in the restorations. Statistical evaluation of fracture strength was conducted using the Kruskal-Wallis test. Fisher's exact test was utilized to analyze the fracture types and repairability. A statistical significance level of α < 0.05 was set for all analyses., Results: All specimens successfully withstood the fatigue testing procedure, and no statistically significant differences in fracture strength were observed among the three groups (P > 0.05). The Fisher's exact test indicated a significant association between the restorative material and fracture type (F 2  = 18.315, df = 2, P = 0.004), but also for repairability (F 2  = 13.725, df = 2, P = 0.001). Crown-root fractures were significantly more common in the Cer&#95;3 group compared to the Co&#95;1 group (P = 0.001) and the Co&#95;1 group had significantly more repairable fractures (F 2  = 13.197, df = 2, P = 0.001). FEA revealed comparable outcomes of deformation among models and higher maximum tensile stress on models with higher frequency of catastrophic failures., Conclusions: All tested restoration materials exhibited comparable fatigue survival and fracture strength in this laboratory and in silico study. However, it is important to recognize the potential for more severe and irreparable fractures when opting for deeply luted glass-ceramic inlay restorations in clinical practice. In such cases, it would be prudent to consider the alternative option being a direct composite approach, because of its more forgiving fracture types and repairability., Clinical Implications: Molars with deep approximal direct and indirect restorations, whether with or without DME, are comparable in their fatigue survival and fracture resistance to withstand intra-oral forces. Deep direct restorations exhibit more repairable fractures compared to deeply luted glass-ceramics., 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 © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Deep subgingival margins are a much-debated topic in adhesive and restorative dentistry. The hydrophobic trait of direct composite resin materials challenges the restorative procedure of cavities with deep subgingival margins since isolation is complicated. A correct indication for a deep margin elevation (DME) treatment is the key to its clinical success, and adequate adaptation of the DME is crucial to its clinical performance. An adequate adaptation of the DME may potentially reduce bacterial accumulation and reduce the incidence of secondary caries as well as maintain periodontal health. The present case report aims to provide a step-by-step overview of the DME technique when applied in combination with a partial indirect glass-ceramic restoration and also provides clinical guidelines to tackle deep subgingival cavities. The indication for a DME and the selection of appropriate materials are explained, supported by the literature.

The partial anterior ceramic restoration is a predictable and durable treatment modality that reestablishes not only esthetics but also strength and function. Bio-emulation, minimally invasive dentistry, and adhesive technology are key to a successful restoration. Partial restorations are only indicated when teeth have enough hard tissue on which to bond veneers. When there is more than 50% of dentin exposure, many clinicians still rely on macromechanical retention by performing a full-crown preparation. However, new research has shown good survival rates for partial restorations with extensive dentin exposure. The present article describes two cases in which a step-by-step protocol was applied to bond a laminate veneer to a tooth with dentin exposure.

The aim of this study was to evaluate the effect of 2% chlorhexidine digluconate (CHX) on microtensile bond strength (µTBS) between an adhesive system and under 3 dentin conditions. For that, this study evaluated the adhesive interface at initial, after 6 months and 1 year of storage. Forty-eight human third molars were prepared and randomly divided into 3 groups, according to dentin substrates: sound dentin (Sd), caries-infected dentin (Ci) and caries-affected dentin (Ca). The groups were subdivided into two according to the dentin pre-treatment: application of 2% CHX or without pre-treatment (control). The dentin surfaces were etched with 35% phosphoric acid gel and bonded with Adper Single Bond 2 (3M ESPE) adhesive system according to manufacturer's instructions. Subsequently, the specimens were stored in deionized water at 37°C for 24h, 6 months and 1 year. Two additional teeth were used to analyze the bonding interfaces by SEM. Data was submitted to three-way ANOVA in a split plot design and Tukey's test (α = 0.05). The results showed that Ci decreased µTBS values when compared to Ca and Sd, regardless storages time or treatment. Stored samples for 6 months and 1 year decreased the µTBS for the control group, but no difference was found between storages time for the CHX group. As a conclusion, the 2% CHX application after etching showed improved dentin bond strength in the storage time, regardless of the substrates evaluated.

In restorative dentistry, the in situ replication of intra-oral situations, is based on a non-invasive and non-destructive scanning electron microscopy (SEM) evaluation method. The technique is suitable for investigation restorative materials and dental hard- and soft-tissues, and its interfaces. Surface characteristics, integrity of interfaces (margins), or fracture analysis (chipping, cracks, etc.) with reliable resolution and under high magnification (from ×50 to ×5,000). Overall the current study aims to share detailed and reproducible information about the replica technique. Specific goals are: (a) to describe detailed each step involved in producing a replica of an intra-oral situation, (b) to validate an integrated workflow based on a rational sequence from visual examination, to macrophotography and SEM analysis using the replica technique; (c) to present three clinical cases documented using the technique. A compilation of three clinical situations/cases were analyzed here by means the replica technique showing a wide range of possibilities that can be reached and explored with the described technique. This guidance document will contribute to a more accurate use of the replica technique and help researchers and clinicians to understand and identify issues related to restorative procedures under high magnification., (© 2020 Wiley Periodicals LLC.)

Purpose: This study evaluates the micro shear bond strength of resin cement to an yttriastabilized zirconia ceramic and the survival probability of zirconia abutments and crowns after different surface treatments through a fatigue test., Materials and Methods: The study was divided into two parts. For part 1, 95 zirconia disks were divided into five groups (n = 19): control, untreated, airborne particle abrasion with Al 2 O 3 particles before sintering, airborne particle abrasion with Al 2 O 3 particles after sintering, silicatization before sintering, and silicatization after sintering. Three samples of each group were used for evaluation of surface roughness by confocal laser scanning microscopy and afterward were prepared for surface microstructural analysis by scanning electron microscopy. Ten samples of each group were subjected to micro shear bond strength testing, and the interfaces of the remaining six were examined by scanning electron microscopy. In part 2, 70 external hex zirconia abutments and copings were made by computer-aided design/computer-aided manufacturing (n = 14). Marginal fit of abutment/coping was measured in a confocal laser scanning microscope. Afterward, a fatigue test was carried out with progressive load of 80 up to 320 N (40 N steps), 5 Hz frequency, and 20,000 cycles at each step. Thermal cycling was simultaneously performed (5°C to 55°C)., Results: The group treated after sintering with SiO achieved statistically higher micro shear bond strength (P < .01). Higher failure loads were associated with a combined failure. The surface changes in the group treated with SiO before sintering suggest silica deposition, and there was a lack of homogeneity, which was more evident on the surface of the groups treated before sintering. The marginal gap was higher for the group treated before sintering with SiO (P < .01), and the survival probability of the sets was similar for all tested groups (P = .57)., Conclusion: The micro shear bond strength to zirconia was improved after silicatization after sintering, but the survival probability of crown/abutment/implant sets was not affected by different surface treatments.

Objectives: The survival and success rate and the quality of survival of partial ceramic restorations bonded employing Immediate (IDS) or Delayed Dentin Sealing (DDS) in vital molar teeth were evaluated in a randomized clinical trial with within-subject comparison study., Materials and Methods: 30 patients received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N = 60). The two teeth randomly received either IDS (test group, n = 30) or DDS (control group, n = 30). Partial ceramic restorations were luted (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. Evaluations were performed at 1 week, 12 months and 36 months post-operatively, using qualitative (FDI) criteria. Representative failures were evaluated microscopically (SEM) and by means of simplified qualitative fractography analysis., Results: One absolute failure occurred in the DDS group due to (secondary) caries. The overall survival rate according to Kaplan-Meier after 3 years was 98.3% (FDI criteria score 1-4, n = 59) and the overall success rate was 85% (FDI criteria score 1-3, n = 51), with no significant difference between restorations in the IDS and DDS group (p = 0.32; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%). For the quality of the survival, no statistically significant differences were found between IDS and DDS (p = 0.7; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%) restorations on any follow-up timepoints for any of the FDI criteria (Wilcoxon, McNemar, p > 0.05)., Conclusion: Adhesively luted partial ceramic restorations in vital molar teeth have a good prognosis, however IDS did not show any differences in success and survival rates after 3 years of function., (Copyright © 2019. Published by Elsevier Ltd.)

The aim of this study was to evaluate the μTBS in different dentin substrates and water-storage periods. Twenty-four dentin blocks obtained from sound third molars were randomly divided into 3 groups: Sound dentin (Sd), Caries-affected dentin (Ca) and Caries-infected dentin (Ci). Dentin blocks from Ca and Ci groups were subjected to artificial caries development (S. mutans biofilm). The softest carious tissue was removed using spherical drills under visual inspection with Caries Detector solution (Ca group). It was considered as Ci (softer and deeply red stained dentin) and Ca (harder and slightly red stained dentin). The Adper Single Bond 2 adhesive system was applied and Z350 composite blocks were built in all groups. Teeth were stored in deionized water for 24 h at 37 ºC and sectioned into beams (1.0 mm2 section area). The beams from each tooth were randomly divided into three storages periods: 24 h, 6 months or 1 year. Specimens were submitted to µTBS using EZ test machine at a crosshead speed of 1.0 mm/min. Failure mode was examined by SEM. Data from µTBS were submitted to split plot two-way ANOVA and Tukey's HSD tests (a=0.05). The µTBS (MPa) of Sd (41.2) was significantly higher than Ca (32.4) and Ci (27.2), regardless of storage. Ca and Ci after 6 months and 1 year, presented similar µTBS. Mixed and adhesive failures predominated in all groups. The highest µTBS values (48.1±9.1) were found for Sd at 24 h storage. Storage of specimens decreased the µTBS values for all conditions.

This study sought to assess the effect of different surface finishing and polishing protocols on the surface roughness and bacterial adhesion (S. sanguinis) to polymethyl methacrylates (PMMA). Fifty specimens were divided into 5 groups (n = 10) according to their fabrication method and surface finishing protocol: LP (3 : 1 ratio and laboratory polishing), NF (Nealon technique and finishing), NP (Nealon technique and manual polishing), MF (3 : 1 ratio and manual finishing), and MP (3 : 1 ratio and manual polishing). For each group, five specimens were submitted to bacterial adhesion tests and analyzed by scanning electron microscopy (SEM). Two additional specimens were subjected to surface topography analysis by SEM and the remaining three specimens were subjected to surface roughness measurements. Data were compared by one-way ANOVA. The mean bacterial counts were as follows: NF, 19.6 ± 3.05; MP, 5.36 ± 2.08; NP, 4.96 ± 1.93; MF, 7.36 ± 2.45; and LP, 1.56 ± 0.62 (CFU). The mean surface roughness values were as follows: NF, 3.23 ± 0.15; MP, 0.52 ± 0.05; NP, 0.60 ± 0.08; MF, 2.69 ± 0.12; and LP, 0.07 ± 0.02 (μm). A reduction in the surface roughness was observed to be directly related to a decrease in bacterial adhesion. It was verified that the laboratory processing of PMMA might decrease the surface roughness and consequently the adhesion of S. sanguinis to this material.

We analyzed the effect of the crosshead speed of an applied load on failure load and failure mode of restored human premolars. Fifty intact, noncarious human premolars were selected. Class II mesio-occlusodistal preparations were made with a water-cooled high-speed preparation machine, and the teeth were restored with composite resin. The specimens were divided into five groups (n = 10 each) and tested individually in a mechanical testing machine, in which a 6.0-mm-diameter steel cylinder was mounted to vary the crosshead speed: v0.5: 0.5 mm/min; v1: 1.0 mm/min; v2.5: 2.5 mm/min; v5: 5.0 mm/min; and v10: 10.0 mm/min. The cylinder contacted the facial and lingual ridges beyond the margins of the restorations. Peak load to fracture was measured for each specimen (N). The means were calculated and analyzed with one-way analysis of variance followed by Tukey's test (a = 0.05). The mean load at failure values were (N) as follows: v0.5, 769.4 ± 174.8; v1, 645.2 ± 115.7; v5, 614.3 ± 126.0; v2.5, 609.2 ± 208.1; and v10, 432.5 ± 136.9. The fracture modes were recorded on the basis of the degree of the tooth structural and restorative damage: (I) fracture of the restoration involving a small portion of the tooth; (II) fractures involving the coronal portion of the tooth with cohesive failure of the composite resin; (III) oblique tooth and restoration fracture with periodontal involvement; and (IV) vertical root and coronal fracture. Varying crosshead speeds of 0.5-5.0 mm/min did not influence the failure load of restored maxillary premolars; however, increasing the crosshead speed to 10 mm/min decreased the failure load values and the degree of tooth structural damage.

In the event of the loss of an implant and to take advantage of the preexisting structures, a rescue procedure that allows continuous use of the original fixed restoration during the restoration of the tripod support at the implant level can be used. When nonphysiological occlusion forces are avoided, the success rate of this rescue procedure is very similar to any other rehabilitation made following a conventional protocol. Furthermore, the fact that the patient has already adapted to the prosthesis position and its vertical dimension results in easier functional adaptation in the postoperative period and, consequently, greater comfort., (© 2014 by the American College of Prosthodontists.)

The aim of this study was to evaluate the flexural strength of acrylic resin bars by varying the types of resin polymerization and reinforcement methods. Fourteen groups (N=10) were created by the interaction of factors in study: type of resin (self-cured (SC) or heat-cured (HC)) and reinforcement method (industrialized glass fiber (Ind), unidirectional glass fiber (Uni), short glass fiber (Short), unidirectional and short glass fiber (Uni-Short), thermoplastic resin fiber (Tpl), and steel wire (SW)). Reinforced bars (25×2×2 mm) were tested in flexural strength (0.5 mm/min) and examined by scanning electron microscopy (SEM). Data (MPa) were submitted to factorial analysis, ANOVA, and Tukey and T-student tests (a=5%) showing significant interaction (P=0.008), for SC: Uni (241.71±67.77)a, Uni-Short (221.05±71.97)a, Ind (215.21±46.59)ab, SW (190.51±31.49)abc, Short (156.31±28.76)bcd, Tpl (132.51±20.21)cd, Control SC (101.47±19.79)d and for HC: Ind (268.93±105.65)a, Uni (215.14±67.60)ab, Short (198.44±95.27)abc, Uni-Short (189.56±92.27)abc, Tpl (161.32±62.51)cd, SW (106.69±28.70)cd, and Control HC (93.39±39.61)d. SEM analysis showed better fiber-resin interaction for HC. Nonimpregnated fibers, irrespective of their length, tend to improve fracture strength of acrylics.

Objectives: Specific physical and chemical features of the membranes may influence the healing of periodontal tissues after guided tissue regeneration (GTR). The aim of the present investigation was to analyze the biological effects of three bioabsorbable membranes. The hypothesis is that all tested membranes present similar biological effects., Methods: Human osteoblast like-cells (SaOs-2) and gingival fibroblasts FGH (BCRJ -RJ) were cultured in DMEM medium. The viability of the cells cultured on the membranes was assesses using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). Quantitative determination of activated human Transforming Growth Factor beta 1 (TGF-β1) on the supernatants of the cell culture was observed. Samples were examined using scanning electron microscope (SEM)., Results: SaOs2, in 24 hours, PLA group showed higher values when compared to other groups (P < 0.05). All groups presented statistical significance values when compared two times. In 4 h and 24 h, for the fibroblasts group, significantly difference was found to PLA membrane, when compared with the other groups (p < 0.05). For TGFβ1 analyzes, comparing 4 and 24 h, for the osteoblast supernatant, COL1 and PLA groups showed statistically significant difference (p <0,008). On the analysis of culture supernatants of fibroblasts, in 24 hours, only PLA group presented significant difference (p = 0,008)., Conclusions: The biomaterials analyzed did not show cytotoxicity, since no membrane presented lower results than the control group. PLA membrane presented the best performance due to its higher cell viability and absorbance levels of proliferation. Both collagen membranes showed similar results either when compared to each other or to the control group.

The purpose of this study was to analyze the influence of the setting and the presence of solid lubricant on the abutment screw surface on the flexural strength of the joint implant/abutment/screw. Forty abutments were connected to external hex implants, divided into 4 groups (n = 10): FE (titanium alloy screw threaded in the extremity), LE (titanium alloy screw with solid lubricant and thread in the extremity), FT (titanium alloy screw with threaded in all its length), and LT (titanium alloy screw with solid lubricant and thread in all its length). Through the mechanical flexural test, the implant/abutment resistance was evaluated with load applied perpendicular to the long axis in a mechanical testing machine (EMIC) under a speed of 0.5 mm/min. Data were submitted to a statistics test, and results showed statistically significant differences between the FE group and the other groups, and the FE group showed the lowest values. The LE group showed greater values than the LT group, and the values were statistically significant. According to the methodology used, it can be concluded that within noncoated titanium screws, a screw threaded along its entire length provided greater rigidity to the implant set, while with the screw containing solid lubricant, the screw threaded in all its length provided less rigidity of the implant set than screws with the thread only on the end. Among screws with the same geometry, those with the solid lubricant are statistically higher than those which do not have threads just at the end, but those with threads along their entire length do not show statistically significant differences.

This study evaluated the effect of fiber addiction in flexural properties of 30 wt% silica filled BisGMA resin (FR) or unfilled Bis-GMA (UR). Ten groups were created (N = 10) varying the resin (FR or UR) and quantity of glass fibers (wt%: 0, 10, 15, 20, and 30). Samples (10 × 2 × 1 mm) were submitted to flexural strength test following SEM examination. Data were analyzed by two-way ANOVA, Tukey, and Student t-test (α = 0.05). Results for flexural strength (MPa) were FR-groups: 0% (442.7 ± 140.6)(C), 10% (772.8 ± 446.3)(ABC), 15% (854.7 ± 297.3)(AB), 20% (863.4 ± 418.0)(A), 30% (459.5 ± 140.5)(BC); UR-groups: 0% (187.7 ± 120.3)(B), 10% (795.4 ± 688.1)(B), 15% (1999.9 ± 1258.6)(A), 20% (1911.5 ± 596.8)(A), and 30% (2090.6 ± 656.7)(A), and for flexural modulus (GPa) FR-groups: 0% (2065.63 ± 882.15)(B), 10% (4479.06 ± 3019.82)(AB), 15% (5694.89 ± 2790.3)(A), 20% (6042.11 ± 3392.13)(A), and 30% (2495.67 ± 1345.86)(B); UR-groups: 0% (1090.08 ± 708.81)(C), 10% (7032.13 ± 7864.53)(BC), 15% (19331.57 ± 16759.12)(AB), 20% (15726.03 ± 8035.09)(AB), and 30% (29364.37 ± 13928.96)(A). Fiber addiction in BisGMA resin increases flexural properties, and the interaction between resin and fibers seems better in the absence of inorganic fillers increasing flexural properties.

The combined use of silane and solvated bonding agents on the bond strength to glass-fibre posts was investigated. A model Bis-GMA/HEMA adhesive was formulated with no solvent, 30% of ethanol or 80% of acetone. The surfaces of rectangular-shaped posts were silanated or not and one of the agents was applied, except for the control group. Cylinders of resin cement (RelyX ARC, 3M ESPE, Saint Paul, MN, USA) were built-up on the surfaces (n = 20) and submitted to shear testing. All groups showed higher bond strengths when the surfaces were silanated. When no silanization was carried out, the use of bonding agents, either solvated or non-solvated, increased the bond strengths. All groups treated with both silane and bonding agent showed higher bond strengths than the group that was only silanated. Control and ethanol-based adhesives were similar, whereas the acetone-based agent yielded higher bond strengths. Adhesive failures were predominant. Combination of silane and adhesive enhanced the bond to fibre posts., (© 2011 The Authors. Australian Endodontic Journal © 2011 Australian Society of Endodontology.)

This study focused on adhesive interface morphologic characterization and nanoleakage expression of resin cements bonded to human dentin pretreated with 1% chlorhexidine (CHX). Thirty-two non-carious human third molars were ground flat to expose superficial dentin. Resin composite blocks were luted to the exposed dentin using one conventional (RelyX ARC) and one self-adhesive resin cement (RelyX U100), with/without CHX pretreatment. Four groups (n = 8) were obtained: control groups (ARC and U100); experimental groups (ARC/CHX and U100/CHX) were pretreated with 1% CHX prior to the luting process. After storage in water for 24 h, the bonded teeth were sectioned into 0.9 × 0.9 mm(2) sticks producing a minimum of 12 sticks per tooth. Four sticks from each tooth were prepared for hybrid layer evaluation by scanning electron microscope analysis. The remaining sticks were immersed in silver nitrate for 24 h for either nanoleakage evaluation along the bonded interfaces or after rupture. Nanoleakage samples were carbon coated and examined using backscattered electron mode. Well-established hybrid layers were observed in the groups luted with RelyX ARC. Nanoleakage evaluation revealed increase nanoleakage in groups treated with CHX for both resin cements. Group U100/CHX exhibited the most pronouncing nanoleakage expression along with porous zones adjacent to the CHX pretreated dentin. The results suggest a possible incompatibility between CHX and RelyX U100 that raises the concern that the use of CHX with self-adhesive cements may adversely affect resin-dentin bond., (Copyright © 2013 Wiley Periodicals, Inc.)

Purpose: To evaluate the effect of two adhesive systems and different aging protocols on the bond strength of a -repaired microhybrid composite., Materials and Methods: Eighty test specimens (n = 20) and 10 control specimens measuring 8 x 4 mm were fabricated of a microhybrid composite (4 Seasons, shade A2) and grouped according to time/aging protocol: G1: 24 h in artificial saliva; G2: 7 days in artificial saliva; G3: 30 days in artificial saliva; G4: artificial accelerated aging (AAA) for 384 h; G5: control. After aging, samples were submitted to three types of surface treatment: SB2: Adper Single Bond 2, a two-step adhesive (3M ESPE); SB3: Adper Scotchbond Multi-Purpose, a three-step adhesive (3M ESPE); C: without application of adhesive (control). After this, test specimens were repaired with the same composite of a different shade (C3), and submitted to the microtensile test at a crosshead speed of 0.5 mm/min. Failure modes were analyzed by scanning electron microscopy (Jeol JSM 7500). Statistical analysis was performed using ANOVA and Tukey's test (p < 0.05)., Results: G2/SB2 presented significantly lower bond strength values in comparison with the other groups (p < 0.05). The control group presented the highest bond strength values, which differed statistically significantly from SB3, G3/SB2, and G4/SB2 (p < 0.05). Fractographic analysis demonstrated that most samples presented predominantly cohesive failures, excepting GI/SB2, which presented mixed and cohesive failures, and G4/SB2 and G1/SB3, which showed adhesive failures., Conclusion: The repair was more effective when performed after a short period of time and when the 3-step adhesive system (SB3) was used.

Purposes: This study evaluated the effect of gamma radiation on the microtensile bond strength of resin-based composite restoration to human enamel and dentin performed either before or after radiotherapy., Methods: Thirty sound human third molars were sectioned mesio-distally into buccal and lingual halves and then randomly divided into enamel or dentin groups. Enamel and dentin substrates were randomly divided into three sub-groups (n = 10): Control, which received no irradiation; specimens were irradiated before restoration protocol; and specimens were irradiated after restoration protocol. Radiation therapy was defined by application of 60-Gy dose fractionally with daily exposures of 2 Gy, 5 days a week, over 6 weeks. Restorations were carried out using Adper Single Bond adhesive system and Filtek Z250 resin composite. The specimens were sectioned producing 4 sticks per specimen and submitted to microtensile on a testing machine. Data were submitted to two-way ANOVA followed by Tukey test (p < 0.05). Failure modes were examined under optical microscopy and SEM., Results: Bond strength to enamel was significantly higher than to dentin irrespective radiation therapy. Radiotherapy applied before restoration significantly reduced the bond strength to both substrates. A predominance of adhesive failures was detected for control groups and groups restored before radiotherapy. Cohesive failures in dentin and enamel increased when the specimens were restored after irradiation., Conclusions: The gamma radiation had a significant detrimental effect on bond strength to human enamel and dentin when the adhesive restorative procedure was carried out after radiotherapy.

Objective: The purpose of this study is to investigate the effects of intermittent parathyroid hormone (PTH) administration on the apposition rate and structural features of dentine from mouse incisors., Methods: Young male A/J Unib mice were treated daily for 6 and 10 days with 40 μg/kg of hPTH 1-34 or a vehicle. Dentine apposition rates measured by fluorescent labels (tetracycline and calcein) and alkaline phosphatase (ALP) plasma levels were evaluated after 6 days of treatment. Knoop microhardness testing and element content measurements in at.% of calcium (Ca), phosphorus (P), oxygen (O), and magnesium (Mg) in the peritubular and intertubular dentine were performed by Energy Dispersive X-ray (EDX) microanalysis via Scanning Electron Microscopy (SEM) after 10 days of treatment., Results: Histometric analysis revealed an increase of 5% in the apposition rate of dentine and 25% in the ALP plasma levels in the PTH treated group. In addition, knoop microhardness testing revealed that the animals treated with PTH had a greater microhardness (11%). EDX microanalysis showed that PTH treatment led to increases in P (23%) and Ca (53%) at.% content, as well as the Ca/P ratio (24%) in peritubular dentine. The chemical composition of intertubular dentine did not vary between the groups., Conclusions: These findings indicate that intermittent administration of hPTH (1-34) increases apposition and mineralization of the dentine during young mice incisor formation., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

In the past, the Branemark Novum protocol for the immediate functional loading of a mandibular fixed implant supported prosthesis provided an effective alternative for select patients. However, the manufacturer has discontinued this design, and only a few selected prosthetic-related replacement components are currently available. This clinical report presents the loss of an implant associated with a discontinued system. To take advantage of all of the preexisting components, it proposes a rescue procedure that allows continuous use of the original fixed restoration during the restoration of the tripod support at the implant level.

Aim: To evaluate the mechanical properties (ultimate tensile strength, elongation and hardness) of the commercially pure titanium (cp Ti) as casting and after ceramic firing cycles., Materials and Methods: Dumbbell-shaped specimens were prepared for the tensile strength testing. Disk-shaped cast specimens were used for microhardness testing. The ceramic firing cycles were made simulating a low fusion ceramic application. Tensile testing was conducted in a universal testing machine at a crosshead speed of 1 mm/min until failure. Ultimate tensile strength and elongation were recorded. The fracture mode was analyzed by scanning electron microscopy. Vickers hardness was measured in a hardness tester. The data from the tensile and hardness tests were subjected to a one-way analysis of variance and Tukey's test (α = 0.05)., Results: The mean values of tensile strength were not changed by the ceramic firing cycles. Lower hardness was observed for cp Ti as casting compared with Ti cast after the firing cycles., Clinical Significance: The ceramic firing cycles did not show any considerable prejudicial effects on the mechanical properties of the cp Ti.

Morphology, etching patterns, surface modification, and characterization of 2 different fiber posts: Gfp, Glass fiber post; and Cfp, carbon fiber were investigated by SEM analysis, after different surface treatments. Thirty fiber posts, being 15 Gfp and 15 Cfp were divided into a 5 surface treatments (n = 3): C-alcohol 70% (control); HF 4%-immersion in 4% hydrofluoric acid for 1min; H(3) PO(4) 37%-immersion in 37% phosphoric acid for 30s; H(2) O(2) 10%-immersion in 10% hydrogen peroxide for 20 min; H(2) O(2) 24%-immersion in 24% hydrogen peroxide for 10 min. Morphology, etching patterns, surface modification and surface characterization were acessed by SEM analysis. SEM evaluation revealed that the post surface morphology was modified following all treatment when compared with a control group, for both type of reinforced posts. HF seems to penetrate around the fibers of Gfp and promoted surface alterations. The Cfp surface seems to be inert to treatment with HF 4%. Dissolution of epoxy resin and exposure of the superficial fiber was observed in both post groups, regardless the type of reinforcing fiber, H(2) O(2) in both concentrations. Relative smooth surface area was produced by H(3) PO(4) 37% treatment, but with similar features to untreated group. Surface treatment of fiber post is a determinant factor on micromechanical entanglement to resin composite core. Post treatment with hydrogen peroxide resulted strength of carbon and glass/epoxy resin fiber posts to resin composite core., (Copyright © 2011 Wiley Periodicals, Inc.)

The aim of the study was to evaluate the bond strength of fibre glass and carbon fibre posts in the root canal walls cemented with self-adhesive (RelyX-Unicem) and chemical (Cement-Post) resin cements. Forty maxillary canines were divided into four groups according to the cement and post used and submitted to the push-out test (0.5 mm min(-1)). The data were submitted to statistical analysis (2-way ANOVA, Bonferroni--P<0.05) and fracture analysis by Scanning Electronic Microscopy. Fibre glass presented the best results when cemented with RelyX-Unicem and Cement-Post (P<0.05). RelyX-Unicem presented the highest bond strength values for both posts (P<0.05). Fracture analysis showed predominance of cohesive fracture of post for RelyX-Unicem and adhesive fracture between dentin/cement and mixed for Cement-Post. The bond strength values were significantly affected by the type of post and cement used and the highest values were found for fibre glass posts and RelyX-Unicem., (© 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.)

Objectives: To assess the in situ color stability, surface and the tooth/restoration interface degradation of a silorane-based composite (P90, 3M ESPE) after accelerated artificial ageing (AAA), in comparison with other dimethacrylate monomer-based composites (Z250/Z350, 3M ESPE and Esthet-X, Dentsply)., Methods: Class V cavities (25 mm(2) × 2 mm deep) were prepared in 48 bovine incisors, which were randomly allocated into 4 groups of 12 specimens each, according to the type of restorative material used. After polishing, 10 specimens were submitted to initial color readings (Easyshade, Vita) and 2 to analysis by scanning electronic microscopy (SEM). Afterwards, the teeth were submitted to AAA for 384 h, which corresponds to 1 year of clinical use, after which new color readings and microscopic images were obtained. The values obtained for the color analysis were submitted to statistical analysis (1-way ANOVA, Tukey, p<0.05)., Results: With regard to color stability, it was verified that all the composites showed color alteration above the clinically acceptable levels (ΔE ≥ 3.3), and that the silorane-based composite showed higher ΔE (18.6), with a statistically significant difference in comparison with the other composites (p<0.05). The SEM images showed small alterations for the dimethacrylate-based composites after AAA and extensive degradation for the silorane-based composite with a rupture at the interface between the matrix/particle., Conclusion: It may be concluded that the silorane-based composite underwent greater alteration with regard to color stability and greater surface and tooth/restoration interface degradation after AAA., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The effectiveness of mouthwash protocols in preventing gamma irradiation therapy damage to the ultimate tensile strength (UTS) of enamel and dentin is unknown. It was hypothesized that the use of chlorhexidine and fluoride mouthwash would maintain the UTS of dental structures. One hundred and twenty teeth were divided into 2 groups: irradiated (subjected to 60 Gy of gamma irradiation in daily increments of 2 Gy) and non-irradiated. They were then subdivided into 2 mouthwash protocols used 3 times per day: 0.12% chlorhexidine, 0.05% sodium fluoride, and control group (n = 10). The specimens were evaluated by microtensile testing. The results of the Tukey test (p < 0.05) indicated that the gamma irradiation therapy significantly reduced the UTS of the enamel, crown, and root dentin. Macromolecular alterations were suggested by optical retardation data in dentin. Structural alterations, in both substrates, were detected by scanning electron microscopy analysis. Mouthwash with 0.12% chlorhexidine partially prevented the damage to the mechanical properties of the irradiated crown dentin, whereas the 0.05% sodium-fluoride-irradiated enamel showed UTS similar to that of non-irradiated enamel.

Purpose: The aim of the study was to assess the in vitro bond strength (BS) of glass fiber posts (GF) and carbon fiber posts (CF) in the cervical, middle, and apical thirds of root canals cemented with RelyX-Unicem (RX) and Cement-Post (CP)., Materials and Methods: Forty maxillary canines were divided into 4 groups (n = 10) according to the cement and post used: group 1: GF and RX; group 2: CF and RX; group 3: GF and CP; group 4: CF and CP. The push-out test was applied in the cervical, middle and apical thirds of each specimen to assess bond strength of the cement/post complex to the root canal wall. The data obtained were submitted to ANOVA (Bonferroni test, p < 0.05), and fracture analysis was done with SEM., Results: The GF posts presented the best results when cemented with RX and with CP (p < 0.05). RX presented the highest BS values for both GF and CF (p < 0.05). For all the groups, BS was higher in the cervical third, followed by the middle and apical thirds. Fracture analysis showed a predominance of cohesive fracture of posts for RX, and a predominance of adhesive fracture between dentin/cement, and mixed failure mode for CP., Conclusion: GF posts cemented with RX presented the highest BS values in all root thirds.

The aim of this study was to assess bond strength of fiberglass posts to root canal dentin irradiated with a 980 nm diode laser at different parameters of power and frequency. Fifty human maxillary canines were separated into five groups (n = 10) according to the following parameters of laser power and frequency: Group 1 (1.5 W/100 Hz), Group 2 (1.5 W/continuous wave [CW]), Group 3 (3.0 W/100 Hz), Group 4 (3.0 W/CW), and Group 5 (no irradiation). Following post cementation, samples underwent a push-out test (0.5 mm/min); next, fracture analysis was performed with a light microscope at 50x and 100x magnification. All of the irradiated groups had increased bond strength values compared to the nonirradiated group. Groups 1 and 2 demonstrated the highest bond strength values; however, statistically significant differences were observed for only the cervical third of Group 4 and the cervical/apical thirds of Group 5. Fracture analysis showed a predominance of mixed failures for Groups 1 and 2 and adhesive failures between dentin and cement for the other groups.

This study evaluated the influence of etching periods on the surface/interface morphology and bond strength to glass ceramic with or without application of an unfilled resin after silane. Ceramic discs were divided into 12 groups, defined by etching time with 10% hydrofluoric acid: G1/G7--etching for 10 seconds, G2/G8--20 seconds; G3/G9--40 seconds; G4/G10--60 seconds; G5/G11--120 seconds and G6/G12--60 + 60 seconds. All the groups were silanated after etching and G7 - G12 received a layer of unfilled resin after silane. Microshear testing using resin cement was performed, with 12 resin cylinders tested per group. The data was submitted to two-way ANOVA and the Student-Newman-Keuls' test (p<0.05). Evaluation of the etching pattern and bonding interfaces was conducted by SEM. The bond strength means (MPa) were: 19.4 +/- 3.5, 22.3 +/- 5.1, 22.2 +/- 3.2, 17.8 +/- 2.1, 15.3 +/- 3.0 and 14.3 +/- 1.8 for G1-G6 and 17.4 +/- 4.8, 21.3 +/- 2.1, 21.1 +/- 2.3, 24.7 +/- 5.8, 20.4 +/- 2.2 and 18.5 +/- 4.6 for G7-G12. Poor etching was detected after 10 seconds of conditioning; whereas deep channels were extensively observed on surfaces etched for 120 and 60 + 60 seconds. Unfilled voids underlying the ceramic-cement interface were detected when only silane was applied. Full completion of the irregularities on G11 was detected using unfilled resin. When only silane was applied, the 60-second group and those etched for longer periods showed lower bond strengths. When both silane and unfilled resin were applied, all etching periods generally showed similar values. In conclusion, the etching period influenced the surface/interface topography and bond strength to ceramic. The application of unfilled resin was able to infiltrate all unfilled voids beneath the ceramic-cement interface, except on re-etched surfaces.

Objective: To assess the bond strength of Rely-X Unicem (RX), in comparison with Cement-Post (CP), to the cervical, middle and apical thirds of root canal dentin irradiated with a 980-nm diode laser., Material and Methods: Forty maxillary canines were separated into four equal groups according to the cement used and the laser surface treatment: RX/laser irradiation (LI) group; RX/no irradiation (NI) group; CP/LI group; and CP/NI group. Two slices (2-mm thick) of each root third were submitted to a push-out test to assess the bond strength of the cement to the root canal dentin. The data obtained were submitted to two-way ANOVA and fracture analysis was performed by scanning electron microscopy., Results: The type of cement as well as 980-nm LI at the different root canal thirds significantly affected the bond strength values (p < 0.05). LI promoted an increase in bond strength of RX in all root thirds (p < 0.05). For all groups, bond strength to the cervical third was highest, followed by the middle and apical thirds (p < 0.05). When the cements were compared, RX always presented the highest bond strength in comparison with CP, irrespective of the laser application (p < 0.05). Fracture analysis showed a predominance of mixed failures for RX and of adhesive failure between dentin and cement for CP, irrespective of the laser application., Conclusion: The 980-nm LI promoted an increase in bond strength of the self-adhesive resinous cement to root dentin.

The effect of gamma irradiation therapy on the ultimate tensile strength (UTS) of enamel and dentin in relation to prism orientation, dentin tubule orientation, and location is unknown. It was hypothesized that tubule and prism orientation, location, and irradiation have an effect on the UTS of dental structures. Forty human third molars were used, half of which were subjected to 60 Gy of gamma irradiation, in daily increments of 2 Gy. The specimens were evaluated by microtensile testing. Results showed that irradiation treatment significantly decreased the UTS of coronal and radicular dentin and of enamel, regardless of tubule or prism orientation. With or without irradiation, enamel was significantly stronger when tested parallel to its prismatic orientation. Coronal and radicular dentin of non-irradiated specimens presented significantly higher UTS when tested perpendicularly to tubule orientation. However, when the teeth were irradiated, the influence of tubule orientation disappeared, demonstrating that irradiation is more harmful to organic components.

Objective: In this study we investigated the degree of conversion (DC) of a dual-cured resin luting agent beneath a ceramic of different thickness., Material and Methods: The luting material (RelyX) was photo-activated for 40s through ceramic disks (Empress Esthetic, 0.7, 1.4, or 2mm thick). Dual (DUC) and chemically cured (CC) control groups were obtained. A delayed exposure (DE) procedure was tested in which the material was light-activated after 5 min without using ceramic. DC (%) was measured using infrared spectroscopy at 40 s, 1, 2, 4, 6, 8, and 10 min. Light irradiance and spectrum transmitted through ceramic were measured using a power meter and a spectrometer., Results: A decrease in irradiance was detected with increasing ceramic thickness, but no alteration in the emission profile was observed. At 10 min, all groups showed DC higher than at 40s. No significant differences were detected for DUC compared with the groups indirectly activated through the ceramic disks. Generally, CC showed the lowest DC values. No significant effect in DC was detected for DE after 10 min. A significant increase in DC was generally detected only up to 4 min., Conclusions: The luting agent was dependent on light exposure and time to obtain improved DC. Neither the indirect activation nor the DE procedure significantly influenced the final DC.