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The aim of the study was to evaluate the effects of erosion and abrasion on resin-matrix ceramic CAD/CAM materials [CERASMART (GC); VITA ENAMIC (VITA Zahnfabrik); Lava Ultimate (3 M)] in comparison to feldspar ceramic (VITABLOCS Mark II, VITA Zahnfabrik) and resin composite materials (ceram.x universal, Dentsply Sirona). Daily brushing and acid exposure were simulated using a brushing apparatus and a solution of 0.5 vol% citric acid. Microhardness, surface roughness, and substance loss were measured at baseline and after simulation of 1 and 3 years of function. All materials showed a decrease in microhardness after 3 years and an increase in surface roughness (Ra) after 1 and 3 years. The Ra increase was statistically significantly lower for the resin-matrix ceramics than for feldspar ceramic and similar to composite material. After 3 years, only feldspar ceramic showed no significant substance loss. In conclusion, resin-matrix ceramics demonstrate reduced roughening compared to feldspar ceramics, potentially improving restoration longevity by preventing plaque buildup, but differences in abrasion resistance suggest the need for further material-specific research. Future research should aim to replicate clinical conditions closely and to transition to in vivo trials., (© 2023 The Authors. European Journal of Oral Sciences published by John Wiley & Sons Ltd on behalf of Scandinavian Division of the International Association for Dental Research.)

Objective: The aim was to investigate the effect of particles released during grinding of dental composites on human gingival keratinocytes (HGK)., Methods: Specimens from Filtek™ Supreme XTE and ceram.x® universal were prepared and ground to dust. The dust was filtered (≤ 5 µm) and the particle size distribution was examined using NANO-flex®-180° dynamic light scattering (DLS). Suspensions at five concentrations (3, 10, 30, 100 and 300 µg/mL) were prepared using keratinocyte growth medium (KGM). These suspensions, as well as a positive (CuO) and a negative control (KGM) were added to HGK. The cells treated with Filtek™ Supreme XTE suspensions were analyzed by real-time monitoring using RTCA iCELLigence™. In addition, light and scanning electron microscopic images of the exposed cells were taken. Indirect immunofluorescence staining was performed to detect the extracellular matrix protein fibronectin., Results: In distilled water, DLS showed similar particles' range (171.9 nm- 2.7 µm) for both composites. In saliva, larger particles were detected (Filtek™ Supreme XTE: 243 nm-6,5 µm; ceram.x® universal: 204 nm- 4,6 µm). iCELLigence™ revealed similar results of cell growth parameters for HGK incubated with composite dust (≤ 5 µm) at different concentrations. The microscopic images indicated unaltered cell structures and formation of large agglomerates with high particle concentration (> 100 µg/mL). Exposure to composite dust resulted in upregulation of fibronectin expression., Significance: Grinding of dental composite materials generates dust particles of different sizes. The particle size distribution seems to be more influenced by the suspending medium than the material itself. While cell growth of HGK seem not to be affected by the particles, an upregulation of fibronectin in the intercellular space concomitant by increasing particle concentration may indicate an increase of cell migration/mobility., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: The aim of this study was the development of a novel in-vitro method to evaluate the intraoral release of wear particles with a diameter< 1 µm from dental restorative materials., Methods: Test fixtures for a dual-axis chewing simulator (CS-4.8, SD Mechatronik, Feldkirchen-Westerham, Germany), consisting of three components to mount the specimens and a solvent (distilled water) as well as a zirconia antagonist to transfer the masticatory forces onto the specimen was developed. Ceram.x Spectra™ ST HV (CS) and Filtek™ Supreme XTE (FS) specimens (n = 3) were fixed into the mounts and immersed in 25 ml solvent. All specimens were subjected to 500.000 wear cycles with a load of 49 N. The particle size distribution of the suspensions were examined by dynamic light scattering (DLS). The collected particles were characterised by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). For wear quantification, the surfaces of the specimens were photo-optically scanned and the wear was measured. For the statistical analysis, one-way ANOVA and post-hoc Scheffé tests were applied., Results: DLS showed particle diameters< 1 µm (CS: 18.06 nm-1.64 µm, FS: 72.30 nm-2.31 µm). SEM/EDS indicated an association between the detected elements and the materials' composition. FS showed significantly higher volume loss (p = 0.007) and maximum depth of the wear profile (p = 0.005) than CS, but no significant differences in the surface loss (p = 0.668)., Significance: The novel method is able to detect material dependent particles to the size of nanoscale after in-vitro abrasion., (Copyright © 2023 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim was to evaluate the release of particles from dental materials during wet and dry grinding and test their effects on human lung epithelia cells in-vitro., Methods: Four dental restorative materials were used: two composites [Ceram.x® universal (Dentsply Sirona) and Filtek™ Supreme XTE (3 M)], one ceramic [VITABLOCS® Mark II (VITAy)] and a ceramic-resin material [Lava™ Ultimate (3 M)]. Material samples were ground to powder under standardized wet and dry conditions in an isolated dental room. During grinding, the particle concentrations were measured with LAS and CPC. Baseline values were measured before grinding. The particles' size was evaluated using DLS and SEM. Water was used as control. The cytotoxicity and inflammatory response of the lung cells (A549) after exposure to different concentrations (1, 3, 10, 30, 100, 300 μg/mL) of the generated dust were analyzed with LDH, WST-1 and ELISA., Results: LAS and CPC revealed a high concentration of particles< 10 µm and< 1 µm respectively, into the air. Particles showed high tendency to agglomerate. DLS showed particle size distribution between 150 nm and 18 µm independently of the material composition. All materials induced significant effects (p < 0.05) on the cell membrane integrity and viability of the A549 cells. Only the ceramic particles showed a significant increase in hydroxyl radical formation at low concentrations (p < 0.05), for both wet and dry conditions. All materials except ceramic, induced a significant release of IL-8 in A549 cells at 300 μg / mL (p < 0.05)., Significance: Wet and dry grinding of dental materials result in release of ultrafine and fine particulate matter into the air. The in-vitro findings on the cellular response of lung cells to generated dust indicate a potential risk for human health due inhalation of the released particles. The use of water-cooling seems to be beneficial resulting in reduced release of particles compared to dry grinding., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to investigate the influence of hybrid CAD/CAM-blocks on immortalized human gingival keratinocytes (HGK)., Methods: Samples of two different hybrid CAD/CAM materials [Lava™ Ultimate (3 M); VITA Enamic® (VITA Zahnfabrik)], a composite material [ceram.x® universal (Dentsply Sirona)] and a CAD/CAM ceramic [VITABLOCS® (VITA Zahnfabrik)] were stored in cell culture medium for 72 h to prepare eluates according to ISO-10993-12:2012. HGK were exposed to eluates for 6, 24 and 48 h. Cell monitoring was performed by RTCA iCELLigence™ system. The morphological changes were evaluated using phase contrast imaging. Specific biomarkers of apoptosis and terminal differentiation (Caspase-3, Involucrin) were analyzed semi quantitatively by indirect immunofluorescence (IIF). Protein levels and activation of MAP kinases ERK1/2 (p44/42) were quantified by Western blot. Data were statistically analyzed by unpaired t-test (p < 0.05)., Results: Regarding Vita Enamic® and Lava™ Ultimate, results of RTCA iCELLigence™ and Western blots showed no statistically significant differences (p > 0.05) compared to the negative control (HGK in native keratinocyte growth medium). No aberrant expression of Caspase-3 and Involucrin was detected in cells incubated with Vita® Enamic eluates Cells incubated with Lava™ Ultimate showed a higher expression of Involucrin after 24 h of incubation compared to the negative control. Statistically significant differences (p < 0.01) were found between cells incubated with ceram.x® universal and the negative control in RTCA iCELLigence™ assay and in quantitative measurements of Western blots after 6 h against phospho-p44/42 (p = 0.044). Increased expression of Caspase-3 and Involucrin were detected by IIF in cells after incubation with eluates of ceram.x® universal., Significance: The present data show no significant effect of hybrid materials on analyzed functions of cell behavior. A cytotoxic influence of ceram.x® universal eluates was observed in HGK in terms of a strong modulation of proliferation, morphology and protein expression., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objectives: This study investigated the putative activation of estrogen receptor β (ERβ) and possible effects related on gene expression in oral mucosal cells in response to the endocrine disruptor Bisphenol A (BPA) and its analogues Bisphenol F (BPF) and Bisphenol S (BPS)., Methods: Human gingival keratinocytes (HGK) were exposed to BPA-, BPF-, and BPS-solutions in concentrations of 1.3 μM, 0.16 μM and 11.4 nM as well as 200 pM and 100 nM estradiol (E 2 ) for 6 h, 24 h and 4 d. Indirect immunofluorescence (IIF) was performed to detect a possible ERβ activation. Additionally, transcription of keratinocyte-relevant biomarkers was analyzed by quantitative real-time PCR (qRT-PCR). A linear mixed model and pairwise comparisons were applied for statistical analyses., Results: The tested concentrations of BPA, BPF, BPS and E 2 revealed distinct activation of ERβ at all time periods, whereat 100 nM E 2 induced the most pronounced activation. Despite the detected ERβ activation, the concentrations of BPA and its analogues induced only moderate modulation of the tested keratinocyte-relevant biomarker genes at all time periods. This also applied to 200 pM E 2 , while in case of 100 nM E 2 significant changes (p < 0.05) were detected for almost all analyzed genes., Significance: Though BPA and its analogues induce activation of ERß irrespective from the chosen concentrations and incubation periods, they lack significant modulation of gene expression of keratinocyte-relevant biomarkers. Although limited to a selected number of genes, the sparse modulation of gene expression may give a hint that the substances do slightly affect transcription of gingival-keratinocyte-innate genes, since the concentrations applied to HGK were of physiological importance., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objectives: This study evaluated the release of bisphenol A (BPA) in wastewater after grinding of resin composites and tested three filtration materials., Methods: Three resin composites (Ceram X, Filtek Supreme XTE and Core-X flow) were used. Samples (5mm×2mm, n=10) were prepared using a metal mold and were polymerized for 20s according to manufacturers' instructions. A dental unit was disconnected from wastewater circulation and composite samples were ground under standardized procedures (200,000rpm; 90s). Wastewater was collected in glass bottles. Water samples were collected as control by performing the same procedure without grinding resin composite. All samples were stored at 7°C for 6 months to simulate storage. Then they were analyzed by HPLC-FLD. Three filtration materials (Zeosorb, Katalox Light and Catalytic Carbon) were used for water treatment to remove BPA. BPA-water solutions were prepared; corresponding to the highest amount released by the resin composites. These solutions were analyzed before and after filtration by HPLC-FLD and their efficacy (%) was calculated., Results: BPA was detected in all composite solutions: Ceram X and Filtek Supreme XTE showed similar findings (p>0.05) which were significantly higher than the control (p<0.001) and Core-X flow (p=0.001). The efficacy of the filtration materials was: Katalox Light (5.09%)

Recent attempts in the development of novel zirconia ceramics aim at improving its optical characteristics by increasing the yttria content to up to 5 mol% so that these ceramics can be used for the fabrication of stable and esthetic monolithic restorations. However, clinical evidence on the outcomes of such restorations is sparse. In this case report, monolithic inlays, partial crowns, tooth- and implant-supported single crowns, and fixed dental prostheses were fabricated out of a zirconia ceramic doped with 5 mol% yttria. The restorations in the present case history report showed a satisfying esthetic outcome and are in situ as inserted 18 months after insertion.

The aim of this in vitro study was to evaluate the long-term effect of bleaching on human enamel. Four groups of enamel specimens were prepared (n = 20): group 1: bleaching with Opalescence Boost [40% hydrogen peroxide (H 2 O 2 ), 3 × 20 min/week]; group 2: control group (the specimens were stored in human saliva); group 3: beaching with Vivastyle Paint on Plus (6% H 2 O 2 , 2 × 10 min/day), and group 4: bleaching with Opalescence PF 16% [16% carbamide peroxide (CP), 6 h/day]. After each bleaching session the specimens were stored in human saliva. Knoop microhardness and surface roughness were measured: before bleaching, after 2-week and after 8-week bleaching. After 2-week treatment, surface roughness was significantly increased in all experimental groups (p < 0.05), while among them no significant difference was found (p > 0.05). The roughness changes exerted after 8-week bleaching were not significantly higher than the ones after 2 weeks (p > 0.05). After 8-week treatment, the increase in roughness caused by 16% CP was significantly higher (p < 0.05) than the one caused by 40% H 2 O 2 . Microhardness increased in all groups including control; however, only 40% H 2 O 2 increased the microhardness significantly (p < 0.05). The effect of bleaching on enamel was not shown to be dependent on the method or the H 2 O 2 concentration. Bleaching with CP 16% resulted in higher roughness than bleaching with H 2 O 2 , while 40% H 2 O 2 caused the higher microhardness increase. The present study showed that in-office bleaching with 40% H 2 O 2 seems to be at least as safe as home bleaching as far as their effects on human enamel are concerned.

Objectives: Relating to low-dose Bisphenol-A (BPA), there is still a lack of mechanistic studies in oral cells, representing the first targets of BPA by oral intake. The objective of this study was to investigate an assumed mechanistic interrelationship between both low-dose BPA-modulated Calcium ion (Ca 2+ ) influx and cell behavior, and the estrogen receptor β (ERβ), in oral mucosal cells., Methods: Indirect immunofluorescence (IIF) was conducted on estrogen receptor beta (ERβ) activity after 1, 3, and 6days in response to 39nM BPA, 15μM BPA, and 200 pM 17β-Estradiol (E 2 ). In addition to Ca 2+ concentration measurement, qPCR for proliferation and differentiation biomarkers was performed, to examine cell behavior. Fulvestrant-mediated ER inhibition was employed to seek for a mechanistic role of ERβ in regulating BPA-emanating effects., Results: While both E 2 and BPA yielded ERβ activation, 39nM BPA and 200 pM E 2 did not change MKI67 proliferation marker expression, but reduced transcription of differentiation markers. Conversely, 15μM BPA reduced MKI67 transcription, but significantly increased differentiation gene expression and intracellular Ca 2+ levels. Fulvestrant-induced ERβ inhibition yielded complete elimination of all E 2 - and BPA-triggered modulatory effects, suggesting a mechanistic role of activated ERβ for BPA-mediated Ca 2+ influx and keratinocyte differentiation., Significance: Concerning cell behavior, these findings provide significant evidence of a threshold-dependent transcription of proliferation and differentiation-related genes as well as Ca 2+ influx in response to 39nM and 15μM low-dose BPA, which identify a mechanistic role of activated ERβ in oral keratinocytes., (Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Purpose: To evaluate and compare the mean surface roughness (Ra) of one ceramic and one resin composite material used for indirect restorations, after grinding and repolishing by intraoral means., Materials and Methods: The materials used were the lithium disilicate glass ceramic IPS e.max Press (EMP) and the indirect resin composite restoration system Gradia (GR). Twelve specimen disks were prepared from each material according to the manufacturer of each material. Five initial measurements of the Ra (Ra 1 ) were made on each specimen as a referral basis, and the specimens were ground with a fine (red) diamond bur. The specimens were repolished using (a) Komet Dialite Polishing Kit for EMP and (b) Enhance Finishing and Polishing System and Prisma Gloss Polishing Paste for GR. Five final Ra (Ra 2 ) measurements were performed on each specimen. All measurements were made using a laser profilometer. Scanning electron microscopy (SEM) was also used to visualize the initial surface morphology and the morphological changes on the specimens' surface after repolishing., Results: A highly significant difference was found between Ra 1EMP and Ra 2EMP (p < 0.001), between Ra 1GR and Ra 2GR (p < 0.001), as well as between Ra 2EMP and Ra 2GR (p < 0.001), when compared in pairs. A highly significant difference (p < 0.001) was also found between ΔRa EMP and ΔRa GR , with ΔRa GR being higher than ΔRa EMP . The Ra GR values were higher than the Ra EMP values at all times. SEM revealed that both EMP and GR repolished surfaces presented with irregularities; however, in GR specimens major voids and craters were present., Conclusions: EMP was found to perform better when polished by intraoral means compared with GR. Both materials exhibited Ra 2 above the critical threshold for increased plaque accumulation and periodontal inflammation. If enamel-to-enamel roughness found in occlusal contact areas is considered as baseline, both materials were clinically acceptable after repolishing., (© 2015 by the American College of Prosthodontists.)

Objectives: The aim of this study was to evaluate the antimicrobial effect of gaseous ozone compared to conventional methods against Enterococcus faecalis., Materials and Methods: One hundred twenty-five teeth were infected by E. faecalis and were incubated for 72 h to form biofilm. Teeth were distributed among five groups. In the first group, ozone was used; in the second group, teeth were rinsed with 20 % ethylenediaminetetraacetic acid (EDTA); in the third group, with 3 % sodium hypochlorite (NaOCl). Group 4 combined 20 % EDTA with ozone. NaOCl and ozone were combined in group 5. After treatment, the samples with paper points were taken, followed by dentin samples taken with K-file, and cultured for 24 h. Then bacterial colonies were counted., Results: All treatments reduced significantly (p < 0.05) the bacteria. Paper points' samples showed 85.38 % reduction after ozone. The highest reduction was observed in NaOCl group (99.98 %). EDTA reduced bacteria by 80.64 %. Combination of NaOCl and ozone eradicated 99.95 % of the bacteria. Combination of EDTA and ozone reduced E. faecalis up to 91.33 %. The dentin chips showed the following: the highest CFU counts were observed in EDTA group, followed by ozone and NaOCl group. The lowest CFU counts were found in NaOCl-ozone group and EDTA-ozone group., Conclusions: Ozone reduced E. faecalis, even organised in a biofilm, however, lower than NaOCl. No treatment reduced totally the bacteria., Clinical Relevance: Used as an adjuvant, ozone can increase the efficacy of conventional rinsing like EDTA and presents an alternative treatment when NaOCl cannot be used e.g. in teeth with a wide-open apical foramen.

Objectives: To investigate the effect of a zinc oxide/zinc sulphate-based cement as a temporary filling material during root canal treatment on the occurrence of cracks within the filling material or the tooth., Materials and Methods: Root canals of 122 extracted human molars were prepared using ProTaper instruments. Standardized occlusal-distal cavities were prepared. After placing calcium hydroxide into the root canals, the teeth were divided randomly into four groups containing 33 specimens each. In the Coltosol group, the cavity was completely filled with Coltosol® F. In the Coltosol-Clearfil group, a 2-mm layer of Coltosol® F was placed into the apical part of the pulp chamber, and in the Clearfil group, a foam pellet was placed into the coronal pulp chamber. The remaining cavities were filled with Clearfil™. In the control group, the cavities were not restored. The teeth were stored at 37 °C for 14 days and examined every 24 h under a stereomicroscope., Results: Fractures of the filling and/or the tooth were only observed in the Coltosol group. All Coltosol® F restorations had cracks after 24 h. Tooth fractures were found in 25 (76 %) teeth. Among these teeth, 21 (84 %) had crown fractures, four (16 %) had root-crown fractures. All root-crown fractures were vertical., Conclusion: Coltosol® F when used alone led to tooth fractures in two-surface class II cavities in teeth undergoing root canal treatment., Clinical Relevance: Coltosol® F solely used as restorative material may lead to tooth fractures in two-surface class II cavities.

Objectives: Bleaching treatments can affect release of components from conventional composites. In this continuing study the influence of two different bleaching gels on the elution of bulk-fill composite components was investigated., Methods: The composites Tetric EvoCeram(®) Bulk Fill, QuiXFil™ and X-tra fil were treated with the bleaching gels Opalescence PF 15% (PF 15%) for 5 h and PF 35% (PF 35%) for 30 min and then stored in methanol and water for 24 h and 7 d. The eluates were analyzed by gas chromatography/mass spectrometry (GC/MS). Unbleached specimens were used as control group., Results: A total of 7 different elutable substances have been identified from the investigated composites after bleaching-treatment. Three of them were methacrylates: 2-hydroxyethyl methacrylate (HEMA), triethylene glycol dimethacrylate (TEGDMA) and trimethylolpropane trimethacrylate (TMPTMA). Compared to the unbleached controls an increase in elution after PF 15%-treatment of following compounds was found: HEMA (Tetric EvoCeram(®) Bulk Fill), TEGDMA (QuiXFil™, X-tra fil) and 4-N,N-dimethylaminobenzoic acid butyl ethoxy ester (DMABEE) (Tetric EvoCeram(®) Bulk Fill, QuiXFil™, X-tra fil). Following compounds showed a reduction in elution after PF 35%-treatment compared to controls: TEGDMA (QuiXFil™) and DMABEE (Tetric EvoCeram(®) Bulk Fill). The highest concentration of HEMA was 0.22 mmol/l (Tetric EvoCeram(®) Bulk Fill, methanol, 7 d, PF 15%), the highest concentration of TEGDMA was 0.3 mmol/l (X-tra fil, water, 7 d, PF 15%) and the highest concentration of DMABEE was 0.05 mmol/l (QuiXFil™, water, 7 d, PF 35%)., Significance: PF 15% and PF 35% can lead to reduced and/or increased elution of some bulk-fill components, compared to unbleached bulk-fill composites., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study was the detection of putative gene expression-related effects of dental composites in conventional and interactive gingival cell systems., Methods: Conventional monoculture (MC) and interactive cell systems (ICS) comprising human gingival fibroblast (HGF) and immortalized human gingival keratinocytes (IHGK) were exposed for 24h and 7 days according to ISO10993-12:2012 manufactured eluates of different composites (Ceram X(®), Filtek™ Supreme XT, Filtek™ Silorane, Fusio™ Liquid Dentin, and Vertise™ Flow). qRT-PCR-based mRNA analysis for biomarkers indicating cell proliferation, differentiation, apoptosis, inflammation, and adhesion was performed. Apoptotic cells were quantified by annexin-V labeling., Results: Due to low RNA amounts, qPCR could not be performed for Vertise™ Flow and Fusio™ Liquid Dentin at day 7. At 24h, flowables yielded increased transcription for biomarkers of inflammation and apoptosis in IHGK, irrespective of the cell system. HGF cultures displayed lower transcription for cell adhesion markers in both cell systems. Filtek™ Supreme XT showed increased differentiation by elevated filaggrin gene expression in both cell systems for IHGK at day 7, while Filtek™ Silorane and Ceram X(®) yielded elevation of inflammation biomarkers in both cell types. Annexin-V labeling revealed high apoptosis rates for both flowables and Filtek™ Supreme XT for IHGK, while low rates were detected for Filtek™ Silorane and Ceram X(®)., Significance: Among the composites evaluated, exposition of IHGK and HGF in conventional and interactive cell systems demonstrated most pronounced gene expression alterations in response to flowables, coinciding with elevated levels of apoptosis., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Statement of Problem: The long-term success of indirect restorations depends on the clinical behavior of luting cements. In the oral environment, properties such as water sorption and solubility negatively affect the cements' clinical performance over time, jeopardizing the restoration's longevity., Purpose: The purpose of this in vitro study was to compare the water sorption and solubility characteristics of self-etching, self-adhesive, and conventional resin cements., Material and Methods: One conventional (Calibra), 1 self-etching (Panavia F), and 2 self-adhesive (Clearfil SA, G-Cem Automix) dual-polymerized resin cements were used. Fourteen disks of each material were prepared. Water sorption and solubility were calculated according to International Organization for Standards (ISO) specification 4049:2009., Results: According to the water sorption test, all materials were found to interact with water. No statistically significant differences were found between the water sorption of Panavia F and Clearfil SA (P=.911). These cements exhibited higher water sorption values than the other materials (P<.05), whereas Calibra exhibited the lowest values (P<.05). Statistically significant differences were found among all materials regarding their water solubility (P<.05). Panavia F and Clearfil SA were found to have higher solubility values than the other materials. G-Cem Automix and Calibra exhibited negative solubility. However, all water sorption and solubility values were below the threshold values proposed by the ISO standard., Conclusions: Within the limitations of the present in vitro study, the interaction of resin cements with water is not type-related (conventional, self-etching, or self-adhesive)., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The aim of the present study was to evaluate the release of monomers from three bonding systems and to correlate it with their antibacterial effect. Three bonding systems (Optibond FL(®), Xeno III(®) and Clearfil™ Protect Bond) were tested after storage in ethanol 75 % and human saliva. Twenty samples (n = 10/medium) of each bonding material were prepared and polymerized according to the manufacturers' instructions. Each sample was stored in 1 ml of the respective storage medium. The medium was renewed after 24 h, 7 days, and 28 days and was analysed by LC-MS/MS for the release of substances. Additionally, the antibacterial effect of the unpolymerized components of each bonding system and their polymerized mixture was tested using agar disc-diffusion test with Streptococcus mutans. Only HEMA was found to be released. The amount of HEMA detected in the ethanol samples was significantly higher compared to the saliva samples (p < 0.0001). The release of HEMA was as follows: Clearfil™ Protect Bond < Optibond FL(®) < Xeno III(®.) According to the agar disc-diffusion test, all materials exhibited certain antibacterial activity. The release of HEMA from all tested materials even after storing in human saliva increases the concerns about their toxicity. Their antibacterial effect seems not be due to the release of substances.

The aim of this in vitro study was to evaluate the colour stability of bleaching after light activation with halogen unit, laser, LED unit or chemical activation up to 3 months after treatment. Four groups of teeth (n = 20) were bleached with Opalescence Xtra Boost (38% hydrogen peroxide) using four different methods: activation with halogen, LED, laser or chemical activation only. All teeth were bleached in one session for four times (4 × 15 min) and the colour was evaluated using a spectrophotometer at the following time points: before bleaching, immediately after bleaching, 1 day, and 1 and 3 months after the end of bleaching. Between the tested time points, the teeth were stored in 0.9% NaCl solution. Additionally, the temperature increase in the pulp chamber was measured using a measuring sensor connected to a computer. Bleaching with the halogen unit showed the highest colour change. Halogen unit, laser and chemical activation resulted in whiter teeth after 1 and 3 months compared to the colour after the end of the bleaching procedure (p ≤ 0.05). Three months after the end of bleaching, the shade changes observed were-halogen: 7.1 > chemical activation: 6.2 > LED: 5.4 > laser: 5.2. Halogen showed the highest temperature increase (17.39°C ± 1.96) followed by laser (14.06°C ± 2.55) and LED (0.41°C ± 0.66) (p < 0.0001). Chemical activation did not affect the temperature in the pulp chamber. The use of light activation did not show any advantages compared to chemical bleaching. Although halogen unit showed the higher shade's change, its use resulted also in the higher pulp temperature. According to the present findings, light activation of the bleaching agent seems not to be beneficial compared to bleaching without light activation, concerning the colour stability up to 3 months after bleaching and the pulp temperature caused during the bleaching procedure.

Objectives: The aim of this study was the characterization of siloran-derived composite eluates in conjunction with their putative impact on human gingival keratinocytes (HGK), i.e. levels of total RNA and induction of apoptosis compared to a methacrylate-based material., Methods: Standardized Filtek™ Silorane specimens (n = 20) were subjected to scanning ion monitoring to detect monomer masses between 100 and 1000, after storage in human saliva, and 75% ethanol for up to 28 days. In order to evaluate the effect on cells, HGK were exposed to eluates from Filtek™ Silorane, Filtek™ Supreme XT and control medium for 1 and 4 days, prior to isolation of total RNA, and Annexin-5 fluorescence labeling indicating induction of apoptosis., Results: Irrespective of the mode and storage time, SIM identified discrete peaks, corresponding to masses of "393" and "337". In response to both composite eluates, an effect on HGK was reflected by drastically reduced levels of isolated total RNA at each time period (after 1 day: control: 302 ng/μl; Filtek™ Silorane: 128 ng/μl, Filtek™ Supreme XT: 129 ng/μl and after 4 days: control: 528 ng/μl; Filtek™ Silorane: 162 ng/μl, Filtek™ Supreme XT: 166 ng/μl). Exposure to eluates from both composite materials yielded apoptosis induction in HGK, as demonstrated by a significant increase of cells exhibiting Annnexin-5 fluorescence., Significance: Two distinct peaks were identified, which indicated the presence of corresponding substances. The composite-derived effects on HGK strongly suggest a negative impact on cells, as revealed by a clear reduction of total RNA levels, and significant increase in induction of apoptosis., (Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was to evaluate the effect of HealOzone on two microorganisms, 4 and 8 weeks after treatment, using a tooth cavity model. Four groups of caries-free third molars (n = 12) were used (A, B, C and D). Three cavities were prepared into each tooth. After sterilization, groups A and B were inoculated with Streptococcus mutans, and groups C and D, with Lactobacillus casei for 48 h. One cavity of each tooth was used to evaluate the infection. After inoculation, groups B and D were treated with ozone (60 s), and groups A and C were used as controls. Then, the two cavities of each tooth were filled with composite, and the teeth were stored in sucrose medium. The restorations were removed after 4 and 8 weeks, respectively; dentin chips were collected, and the amount of microorganisms was determined. Ozone treatment reduced significantly the amount of S. mutans compared to the control group (p ≤ 0.05). This antibacterial effect was able to be seen after 4 (p = 0.0005) and 8 (p = 0.0002) weeks. No significant difference was found between the control and treated group as far as L. casei is concerned (p > 0.05). HealOzone (60 s) can provide some antibacterial treatment against S. mutans even after 8 weeks. However, an elimination of the microorganisms through HealOzone seems not to be possible. L. casei was more resistant to ozone. Although ozone exerts a significant antibacterial effect against S. mutans, it is probably not enough as the only antibacterial method, during the fillings therapy.

The aim of this study was to evaluate the effect of four different storage media on the elution of monomers from two composite materials. Samples (n = 10, diameter: 4.5 mm, thickness: 2 mm) of two different composite materials (Ceram X™ & Filtek™ Supreme XT) were stored after polymerization in four different media (NaCl, saliva, ethanol 75% & acetone) for 24 h, 7 days, and 28 days. From the storage medium of each tested time period, samples were prepared and analyzed by LC-MS/MS, for the elution of BisGMA, TEGDMA, HEMA, Bisphenol A, and two types of UDMA. No monomers were detected in the samples of Ceram X™, independently of the storage medium used. In the samples of Filtek™ Supreme XT, no Bisphenol A, HEMA, and UDMA 1 were found. BisGMA was detected only in the ethanol and acetone samples. The amount of BisGMA eluted in acetone was significant higher compared with ethanol 75% (p < 0.0001). TEGDMA was the only monomer that could be detected in all tested storage media. Storage in acetone resulted in higher release of TEGDMA when compared with other media. The amount of TEGDMA released in saliva was similar to the one released in ethanol 75%. It can be concluded that acetone is not a suitable medium for elution experiments and although ethanol 75% can simulate saliva concerning the elution of TEGDMA, it does not represent a laboratory substitute of saliva with respect to the elution of monomers like BisGMA., (Copyright © 2011 Wiley Periodicals, Inc.)

Purpose: To evaluate the release of monomers from four different composite materials (Ceram X, Filtek Supreme XT, Tetric Flow, Tetric EvoCeram), polymerized using either halogen or LED unit., Methods: Ten specimens were made for each material/unit combination. Each specimen was stored in 1 ml 75% ethanol. The storage medium was renewed after 1, 7 and 28 days. Aliquots of this medium were analyzed by LC-MS/MS., Results: The effect of the curing unit on monomers' release differed significantly among the materials (P < 0.0001). The amount of BisGMA and TEGDMA released from Ceram X was not influenced by the unit used (P > 0.05). Curing with LED reduced the amount of Bisphenol A released from Ceram X compared to halogen. For Filtek Supreme XT, the type of unit exerted a significant effect on the elution of BisGMA (P < or = 0.05). LED curing resulted in a higher release of TEGDMA and UDMA compared to halogen (P < or = 0.05). For Tetric Flow, LED curing resulted in lower monomer release (P < 0.0001). For Tetric EvoCeram, the amounts of BisGMA, UDMA and Bisphenol A were higher when polymerizing with LED compared to halogen. The release of substances was more material dependent and less influenced by the curing unit used.

Objective: To determine the formation and dissolution of calcium fluoride on the enamel surface after application of two fluoride gel-saliva mixtures., Method and Materials: From each of 80 bovine incisors, two enamel specimens were prepared and subjected to two different treatment procedures. In group 1, 80 specimens were treated with a mixture of an amine fluoride gel (1.25% F-; pH 5.2; 5 minutes) and human saliva. In group 2, 80 enamel blocks were subjected to a mixture of sodium fluoride gel (1.25% F; pH 5.5; 5 minutes) and human saliva. Subsequent to fluoride treatment, 40 specimens from each group were stored in human saliva and sterile water, respectively. Ten specimens were removed after each of 1 hour, 24 hours, 2 days, and 5 days and analyzed according to potassium hydroxide-soluble fluoride., Results: Application of amine fluoride gel resulted in a higher amount of potassium hydroxide-soluble fluoride than did sodium fluoride gel 1 hour after application. Saliva exerted an inhibitory effect according to the dissolution rate of calcium fluoride. However, after 5 days, more than 90% of the precipitated calcium fluoride was dissolved in the amine fluoride group, and almost all potassium hydroxide-soluble fluoride was lost in the sodium fluoride group. Calcium fluoride apparently dissolves rapidly, even at almost neutral pH., Conclusion: Considering the limitations of an in vitro study, it is concluded that highly concentrated fluoride gels should be applied at an adequate frequency to reestablish a calcium fluoride-like layer.

In recent years, the elution of monomers from dental materials has been a cause for public concern. Urethane dimethacrylate, commonly abbreviated to UDMA, is one of the monomers that are most often tested with regard to elution from and cytotoxicity of resin-based materials. Although each chemical name represents the chemical type, chemical structure, and molecular weight of a molecule, it does not seem to be the same with UDMA. In the present paper, the different forms of UDMA are presented. These include those used by dental manufacturers to produce composite materials and the different types of urethane dimethacrylate used in studies concerning the elution of monomers from composite materials. High-performance liquid chromatography (HPLC) is usually used to detect the eluted monomers, but it does not appear to be adequate in determining the different forms of UDMA. The combination of HPLC with mass spectrometry is shown to be able to specifically identify the compounds eluted in addition to those compounds used as standards in the various studies. The fact that the same name is given to different molecules causes confusion about the results of studies testing the elusion of monomers from composite materials and their possible toxicity., ((c) 2009 Wiley Periodicals, Inc.)

The elution of monomers from composite materials influences the biocompatibility of dental restorations. The purpose of the present study was to investigate the elution of monomers [bisphenol A glycidyl methacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), urethane dimethacrylate (UDMA), and bisphenol A (BPA)] from two light-cured materials (nanohybrid and ormocer) and from a chemically cured composite material, after different curing times (0, 20, 40 and 80 s) and different storage periods (24 h, 7 d, 28 d, and 1 yr after curing). Each specimen was stored in 1 ml of 75% ethanol. This medium was renewed after 24 h, 7 d, 28 d, and 1 yr. The ethanol samples were analyzed using liquid chromatography tandem mass spectrometry (LC-MS/MS). The amount of monomers released from the nanohybrid and the chemically cured composite was significantly higher than released from the ormocer. The curing time exerted a significant effect on the release of monomers. For the nanohybrid, less monomer was released after increasing the curing time. For the ormocer, 80 s of curing resulted in a higher degree of monomer release. The effect of storage differed between the monomers. Although the elution of TEGDMA was significantly decreased after storage for 28 d and 1 yr, a similar amount of BisGMA was released at each storage time-point analyzed, even after 1 yr. The present study showed that ormocer released a very small amount of monomers compared with the other materials.

Objective: The aim of this study was to evaluate the effect of bleaching on the elution of monomers from two modern composite materials., Methods: Two different resin composites (a nanohybrid the Filtek Supreme XT and an ormocer the Ceram X) were bleached with two products (hydrogen peroxide 38% for 45 min and carbamide peroxide 15% for 56 h). Four groups (n=10, diameter: 4.5 mm, thickness: 2 mm) of each material were fabricated, two for each bleaching product. One group was used as unbleached control and the other one was bleached. Then the samples were stored in 1 ml of 75 vol% ethanol at room temperature, and the storage medium was renewed after 24 h, 7 days, and 28 days. From the storage medium that was removed samples were prepared and analysed with LC-MS/MS., Results: None of the bleaching products had an effect on the amount of Bis-GMA and TEGDMA released from Ceram X. The amount of Bisphenol A released from the bleached samples of Ceram X was significantly lower compared to the control samples. Bleaching reduced significantly the amount of Bis-GMA released from Filtek Supreme XT. The amount of TEGDMA released from Filtek Supreme XT was not affected by bleaching., Significance: The bleaching agents tested in the present study reduced the amount of some of the monomers released from the two composite materials. Bleaching of modern composite materials does not increase the release of monomers.

This in vitro study evaluated the influence of one halogen and two light-emitting diode (LED) curing units on the curing depth of a conventional hybrid and two translucent resin composites by measuring the Knoop microhardness. In the first part of the study, a conventional hybrid resin composite and three curing units (one halogen: 40 s polymerization time, two LEDs: 10 and 20 s) were used. Ten cylindrical resin composite samples were prepared for each curing unit and each polymerization time tested. After polymerization, the soft part of the samples was removed. The samples were embedded in a polyacrylic resin and separated in the middle towards the direction, top-bottom. On the section plane, Knoop microhardness measurements were performed every 1 mm, starting at 0.5 mm under the surface. In the second part of the study, two translucent resin composites and a conventional hybrid composite resin were cured with the three curing units, and the microhardness was measured as mentioned above. The difference between the curing units tested was found statistically significant (p = 0.0009), as well as the difference between the materials concerning curing depth (p = 0.0001). Both translucent materials achieved microhardness values equal to the 80% of the surface values, in depths 3.5-5.5 mm, depending on the curing units used.

Background: The authors conducted an in vitro study to evaluate the effect of an at-home bleaching product on the microhardness of six restorative materials under different surface treatments., Methods: Four resin-based composite materials (a hybrid, flowable, microhybrid and nanohybrid), an ormocer (organic modified ceramic) material and a ceramic material were bleached with 15 percent carbamide peroxide. The authors prepared two groups of samples (polished and unpolished) (n = 7) from each resin-based composite material and the ormocer. The authors polished all of the samples in the ceramic group. Two samples from each group served as negative controls. The authors measured the microhardness of the samples before bleaching, after eight hours and 56 hours of bleaching, and 24 hours and one month after the end of bleaching., Results: The statistical analysis showed that the at-home bleaching technique did not have a statistically significant effect on the microhardness of any of the restorative materials tested (hybrid, P = .0679; flowable, P = .5088; microhybrid, P = .0601; nanohybrid, P = .6166; ormocer, P = .2154; ceramic, P = .9943)., Conclusion: At-home bleaching with 15 percent carbamide peroxide did not cause any harmful changes to the microhardness of tooth-colored restorative materials., Clinical Implications: Clinicians do not need to replace resin-based composite, ormocer or ceramic restorations after at-home bleaching treatment when the restorations are in posterior teeth.

Objectives: The aim of this in vitro study was to evaluate the effect of the in-office bleaching technique on the microhardness of six dental esthetic restorative materials., Methods: Four composite resins (a hybrid, a flowable, a micro-hybrid and a nano-hybrid), an ormocer and a ceramic were tested, after the use of an in-office bleaching product. Fourteen specimens of each composite and the ormocer were fabricated and randomly divided into two groups of seven samples each. One group was polished and the other group remained unpolished. For the ceramic, seven polished samples were fabricated. Two samples of each group were used as negative controls. The specimens were bleached for 15, 30 and 45min. Five Knoop microhardness measurements were made on each sample, for each of the following periods tested: before bleaching, after 15, 30 and 45min of bleaching, 24h and 1 month after the bleaching procedure. Data were analyzed by the repeated measures analysis of variance with three between factors and one within., Results: The differences in the microhardness values between the bleached and the control samples for the composites and the ceramic, were not statistically significant (hybrid: p=0.264; flow: p=0.584; micro-hybrid: p=0.278; nano-hybrid: p=0.405; ceramic: p=0.819). For the ormocer, although bleaching did not have any significant effect on the unpolished samples (p=0.115), it caused an increase on microhardness of the polished samples., Significance: Bleaching with 38% hydrogen peroxide does not reduce the microhardness of the restorative materials tested. Therefore, no replacement of restorations is required after bleaching.

Microorganisms remaining beneath restorations can cause secondary caries and pulp damage. Because of this, antimicrobial treatment could be useful. The aim of this study was to evaluate the antibacterial effect of the HealOzone device on Streptococcus mutans and to compare it with the already proven activity of two dentin-bonding systems. Thirty-five human molars were divided into 5 groups. Cavities were then cut into the teeth (n = 28 cavities per group). After sterilization, the teeth were left in broth cultures of 10(6) colony-forming units (CFU) ml(-1) of S. mutans at 36 degrees C for 48 h. The appropriate treatment followed (group A, control; group B, Clearfil SE Bond; group C, Clearfil Protect Bond; group D, 40 s of treatment with ozone; and group E, 80 s of treatment with ozone), and the cavities were then filled with composite resin. After 72 h, the restorations were removed, dentin chips were collected with an excavator, and the total number of microorganisms was determined. All treatments significantly reduced the number of S. mutans present compared with the control group. The antimicrobial effect of both bonding systems and treatment with 80 s of ozone was significantly higher than the 40 s ozone treatment. In conclusion, HealOzone and the bonding systems show striking antimicrobial effects against S. mutans.