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Purpose: To evaluate through a systematic review and meta-analysis the bonding performance of adhesive materials to silver diamine fluoride (SDF)-treated dentin. Purpose: To evaluate through a systematic review and meta-analysis the bonding performance of adhesive materials to silver diamine fluoride (SDF)-treated dentin. Results: Twenty-two studies, including 11 new studies not included in our previous systematic review, met the eligibility criteria, and 21 studies were considered in the meta-analyses. SDF dentin pretreatment did not influence the bonding of GIC (Z = 0.53; p = 0.60), independent of dentin condition. SDF treatment significantly impaired the bonding of AD (Z = 2.43; p = 0.01). A rinsing step after SDF eliminated this effect in sound dentin (Z = 1.82; p = 0.07) and increased the bond strength to caries-affected dentin (Z = 2.14; p = 0.03). Conclusion: SDF pretreatment does not influence the bond strength of GIC. A rinsing step after SDF application can improve the bond strength of AD to caries-affected dentin. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of the etching strategy of universal adhesives on bond degradation to sound and artificially-induced caries-affected dentin. Materials and Methods: The universal adhesives (Scotchbond Universal Adhesive; All-Bond Universal; Prime&Bond Elect) and adhesives used as controls (Adper Single Bond 2 and Clearfil SE Bond) were applied to sound and artificially-induced caries-affected bovine dentin. Microtensile bond strength was evaluated immediately (24 h) and after one year of water storage (1 year). Representative specimens were also prepared to assess nanoleakage. Bond strength data (MPa) were analyzed using three-way ANOVA and post-hoc Tukey's test (α = 0.05), considering each substrate separately. Results: Bonding degradation was observed for all universal adhesives on caries-affected dentin, irrespective of the etching strategy. On sound dentin, bonding degradation was observed when adhesives were used on the etchand-rinse strategy. Conclusion: The universal adhesives were not capable of maintaining bond stability over time on caries-affected dentin. The self-etch strategy seems better able to maintain the durability of adhesive interfaces created on sound dentin. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review the literature to analyze the influence of endodontic irrigating solutions on the bond strength of adhesives to coronal enamel or dentin. Materials and Methods: The PubMed/MEDLINE, Web of Science and Scopus electronic databases were used to select laboratory studies related to the research question, without publication year or language limits. From 2461 potentially eligible studies, 2451 were selected for full-text analysis, and 97 were included in the systematic review. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. Pooling bond strength data were calculated using RevMan5.1 with random effects model (α = 0.05), comparing control (no endodontic irrigating solution) and experimental groups (one or more endodontic solutions). Results: No significant difference was found between the control and experimental groups (p = 0.12) in the overall meta-analysis and in the meta-analysis excluding chlorhexidine (p = 0.06). High heterogeneity was found in the meta-analyses. Most included studies in the systematic review were scored as having a high risk of bias. Conclusion: The different endodontic irrigating solutions evaluated showed no negative influence on the bond strength of dental adhesives to coronal dental substrates. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether the dimensions of cavitated dentin carious lesions on the occlusoproximal surfaces of primary teeth could predict the location of cement-enamel junction (CEJ). Material and Methods: Two hundred extracted primary molars were selected and digital images were obtained. The teeth were set in arch models for clinical measurement. The cervical-occlusal (CO) and buccal-lingual/palatal (BL/P) cavities’ dimensions were obtained by digital (Image J) and clinical (periodontal millimeter probe) assessments. The cervical margin location was also determined. The thresholds (cut-off points) were determined by sensitivity, specificity and the areas under the receiver operating characteristics curves (Az) for the two methods. Pearson's correlation coefficient was used to investigate the correlation between clinical and digital measurements. Logistic regression analysis was performed to evaluate the association between the dimensions and cervical margin location. Results: There was a strong correlation between methods for all measurements (CO: r=0.90, VL/P: r=0.95). Cavities with BL/P distance higher than 4.5 mm and CO dimension higher than 3.5 mm had a lower chance of presenting the cervical limit above the CEJ, irrespective of the measurement method. Conclusion: CO and VL/P dimensions could be used to predict the CEJ location and, ultimately, as a clinical parameter for restorative decision-making. [ABSTRACT FROM AUTHOR]

Purpose: To examine the influence of phosphoric acid containing chlorhexidine on the dentin bond stability of a universal and a 2-step etch-and-rinse adhesive. Materials and Methods: Eighty sound bovine incisors were randomly assigned to 8 groups (n = 10) according to: phosphoric acid (37% phosphoric acid [CTR] or 37% phosphoric acid with 2% chlorhexidine [CHX]); adhesive (Scotchbond Universal Adhesive [SBU]or Adper Single Bond 2 [SB2]); and water storage time (24 h and 6 months). Both acids and adhesives were applied to flat dentin surfaces (following manufacturer's instructions) upon which composite cylinders were built up (0.72 mm²). After storage in distilled water at 37°C for 24 h or 6 months, the composite cylinders were submitted to microshear bond strength (μSBS) testing. Bond strength data (MPa) were analyzed using three-way ANOVA and post-hoc Tukey's test (α = 5%). Results: The interaction among factors was significant (p = 0.012). Both adhesives showed similar 24-h bond strengths regardless of the phosphoric acid. After 6 months, similar values were found for both materials when control phosphoric acid was used, but CHX phosphoric acid produced statistically significantly lower bond strengths for SBU. SB2 bond strength was not affected by acid type. Conclusion: Phosphoric acid containing chlorhexidine induced premature bond strength degradation of Scotchbond Universal Adhesive. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review the literature on laboratory studies to determine whether the bond strength of adhesives to primary teeth is similar to that to permanent teeth. Materials and Methods: This systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42014015160). A comprehensive literature search was conducted considering in vitro studies published up to June 2015 in the PubMed/MEDLINE database, with no limit on year of publication. Two reviewers independently selected papers, extracted data and assessed the risk of bias. From 422 eligible studies, 42 were fully analyzed. Thirty-seven studies were ultimately included in the systematic review and meta-analysis. A global comparison was performed with a random-effects model at a significance level of p < 0.05, expressed by the difference of means between the groups. The mean bond strengths and standard deviations were tabulated and statistical analyses were conducted in RevMan 5.1 (The Cochrane Collaboration). Results: There was a significant difference between groups, with permanent teeth presenting higher bond strength than primary teeth (p = 0.0005). When the enamel and dentin substrates were considered separately, dentin presented the same trend (p = 0.002), while for enamel there was no significant difference between the dentitions (p = 0.11). The majority of the studies had a high bias risk. Conclusion: Adhesives have higher bond strengths when applied to permanent than to primary teeth. This difference was also valid when the comparison was made between permanent and primary dentin. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the colour changes of demineralized enamel after treatment with coloured fluoride gel.Materials and Methods: Enamel blocks obtained from bovine incisors were submitted to artificial caries induction by pH cycling followed by fluoride gel applications (2% sodium fluoride, pH 6.8) using a colourless gel (control group), pink or blue gels. The enamel optical properties were evaluated by spectrophotometry, using the CIE L*a*b* system at baseline (sound enamel), after artificial caries induction (demineralised enamel) and after each of the five fluoride gel applications (weekly intervals). Changes in enamel optical properties (ΔE) were analysed by two-way ANOVA and Tukey's test (α = 0.05).Results: No significant differences were found among fluoride gels (p = 0.476) regardless of the presence of pigments in the gel. ΔE values were significantly different (p < 0.001) between baseline evaluation and treated enamel (after fluoride gel application).Conclusion: This in vitro study demonstrated that colour changes in enamel do not occur during fluoride gel treatment, regardless of the presence or absence of coloured pigments in the gel. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the bonding performance of a universal adhesive to sound and artificially-created caries-affected dentin, using either the etch-and-rinse or self-etch strategy. Materials and Methods: Flat midcoronal dentin surfaces from 48 third molars were randomly assigned to eight groups according to the substrate (sound dentin and artificially-created caries-affected dentin [pH cycling for 14 days]) and the adhesive or application mode (Scotchbond Universal: self-etch or etch-and-rinse strategies; Adper Single Bond 2 and Clearfil SE Bond, a two-step etch-and-rinse adhesive and a two-step self-etch adhesive as controls, respectively). Then, composite blocks were constructed, the specimens were further stored in water for 24 h, and composite-dentin sticks were prepared (0.8 mm2) and tested under tension at 1.0 mm/min. Data were analyzed with two-way ANOVA and Tukey’s test (α = 0.05). Results: All adhesives tested on artificially-created caries-affected dentin presented similar μTBS (p > 0.05), and inferior bonding performance when compared to sound dentin (p = 0.000). On sound dentin, Scotchbond Universal presented higher bond strengths when applied in the etch-and-rinse than self-etch mode, but comparable bond strength in each application mode in relation to the respective control adhesive (p = 0.04). Conclusion: Scotchbond Universal can be used in different application modes when bonded to artificially-created caries-affected dentin; however, the etch-and-rinse strategy improves its bonding ability to sound dentin. Moreover, Adper Single Bond 2 and Clearfil SE Bond presented similar bond strengths, regardless of the dentin condition and comparable performance in relation to each strategy of Scotchbond Universal. [ABSTRACT FROM AUTHOR]

Purpose: To assess the immediate and six-month microshear bond strength (μSBS) of a universal adhesive applied using different etching strategies on sound and eroded dentin. Materials and Methods: Eighty bovine incisors were polished to obtain flat buccal dentin. Forty teeth were submitted to a pH-cycling model to simulate artificial erosion (3x/day cola drink for 7 days). Teeth from both dentin conditions (sound and eroded) were randomly assigned to four groups according to the adhesive and etching approach: a universal adhesive in self-etch and etch-and-rinse modes (Scotchbond Universal Adhesive), and as controls a twostep etch-and-rinse adhesive (Adper Single Bond Plus), and a two-step self-etch adhesive (Clearfil SE Bond). Four composite restorations (Z250) were built up on each dentin surface, using the area delimitation technique. Half of the specimens were evaluated in the μSBS test after 24 h of water storage, and the other half were evaluated six months later. Data (MPa) were analyzed with three-way repeated measures ANOVA and Tukey's post-hoc tests (α = 0.05). Results: The μSBS values of all adhesives significantly decreased after six months of aging (p = 0.01). Lower μSBS values were obtained in eroded dentin (p = 0.04). The universal adhesive showed similar μSBS to the selfetch adhesive used as control, irrespective of the etching strategy. However, Scotchbond Universal Adhesive applied in self-etch mode performed better than the control etch-and-rinse adhesive (p = 0.02). Conclusion: The universal adhesive does not provide the same bonding efficacy on eroded dentin as on sound dentin, and its performance does not depend on the etching mode. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of the etching strategy on the immediate and 1-year microtensile bond strength (µTBS) and structural reliability of a universal adhesive to sound and artificially-induced caries-affected dentin of primary teeth. Materials and Methods: Flat midcoronal dentin surfaces were exposed in 50 primary molars, which were then randomly assigned to 10 groups according to substrate (sound dentin [SD] and artificially-induced caries-affected dentin [CAD] with pH cycling for 14 days) and etching approach using Scotchbond Universal Adhesive (self-etching or dry or wet-bonding etch-and-rinse strategies) with Adper Single Bond Plus (two-step etch-and-rinse adhesive) and Clearfil SE Bond (two-step self-etching system) as controls. Composite buildups were constructed and sectioned to obtain bonded sticks (0.8 mm2) to be subjected to microtensile testing immediately or after 1 year of water aging. Data were analyzed using three-way repeated measures ANOVA and Tukey's test (α = 0.05). Weibull modulus and characteristic strength were also determined. Results: A decrease in bond strength was observed after 1 year of water aging, except when the universal adhesive was used in the dry-bonding etch-and-rinse and self-etching approaches. However, the self-etching approach resulted in lower µTBS values in SD, while no difference among experimental groups was observed in CAD. Overall, higher Weibull modulus values were achieved in the groups with higher bond strength. The relationship between characteristic strength and bond strengths was not linear for all groups. Conclusion: The bond longevity of the universal adhesive using the dry-bonding etch-and-rinse approach on sound and artificially-induced caries-affected primary dentin was better than the other bonding agents and approaches tested. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether the etch-and-rinse or self-etching mode of a universal adhesive is the best protocol to optimize bond strength to primary and permanent artificially-induced caries-affected dentin. Materials and Methods: Flat midcoronal dentin surfaces were exposed in 24 primary and 24 permanent molars and submitted to pH cycling for 14 days to induce artificial caries-affected dentin. For each tooth type (primary and permanent), the teeth were randomly assigned to 4 different groups according to the adhesive systems and bonding strategy: a universal adhesive, Scotchbond Universal Adhesive, in self-etching and etch-and-rinse modes; a twostep etch-and-rinse adhesive, Adper Single Bond 2 (control); and two-step self-etching system, Clearfil SE Bond (control). After bonding and restorative procedures, specimens were sectioned to obtain rectangular sticks (0.8 mm2) that were submitted to microtensile tests (crosshead speed: 1 mm/min). The data were analyzed using two-way ANOVA (α = 0.05). Results: The universal adhesive showed bond strengths similar to those of the control groups, irrespective of the bonding strategy. Likewise, statistically similar bonding performance was observed for all adhesives to either artificially- induced caries-affected primary or permanent dentin. Conclusion: The new universal adhesive, Scotchbond Universal Adhesive, can be used in both application modes in artificially-induced caries-affected primary and permanent dentin, as the bond strength was not influenced by the different substrates or application mode. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the influence of enamel condition and etching strategy on bond strength of a universal adhesive in primary teeth. Materials and Methods: Thirty-six primary molars were randomly assigned to six groups (n = 6) according to the enamel condition (sound [S] and demineralized [DEM]/cariogenic challenge by pH cycling prior to restorative procedures) and adhesive system (Scotchbond Universal Adhesive [SBU]) used in either etch-and-rinse (ER) or selfetching (SE) mode, with Clearfil SE Bond as the self-etching control. The adhesives were applied to flat enamel surfaces and composite cylinders (0.72 mm²) were built up. After 24-h storage in water, specimens were subjected to the microshear test. Bond strength (MPa) data were analyzed using two-way ANOVA and Tukey's post-hoc tests (α = 0.05). Results: Significant differences were found considering the factors adhesive system (p = 0.003) and enamel condition (p = 0.001). Demineralized enamel negatively affected the bond strength, with μSBS values approximately 50% lower than those obtained for sound enamel. SBU performed better in etch-and-rinse mode, and the bond strength found for SBU applied in self-etching mode was similar to that of CSE. Conclusions: Enamel etching with phosphoric acid improves the bond strength of a universal adhesive system to primary enamel. Demineralized primary enamel results in lower bond strength. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the bonding of a new universal adhesive applied using different etching strategies on sound and caries-affected dentin of primary teeth. Materials and Methods: Flat dentin surfaces from 50 primary molars were randomly assigned to 10 groups according to substrate (sound dentin [SD] vs caries-affected dentin [CAD] pH cycled for 14 days) and bonding approach (Scotchbond Universal Adhesive: self-etching, vs dry or wet-bonding etch-and-rinse strategies; Adper Single Bond Plus [two-step etch-and-rinse adhesive] and Clearfil SE Bond [two-step self-etching system] as controls). After 24 h of water storage, bonded sticks with cross-sectional areas of 0.8 mm² were tested for microtensile bond strength (μTBS). Two sticks from each tooth were immersed in silver nitrate solution in order to evaluate nanoleakage (NL) with SEM. The μTBS means were analyzed using two-way ANOVA and Tukey's tests. For NL, the Kruskal-Wallis and Mann-Whitney tests were used (α = 0.05). Results: The influence of the etching strategy on the bonding performance of the universal adhesive was substrate dependent. The self-etching approach resulted in lower μTBS values and higher silver nitrate uptake into hybrid layers for Scotchbond Universal Adhesive on SD, while no difference among experimental groups was observed in CAD. Conclusion: It is preferable to use the universal adhesive following either a dry- or wet-bonding etch-and-rinse approach on both sound and caries-affected primary dentin. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate the effect of cariogenic challenge on the bond strength of adhesive systems to sound and artificially demineralized enamel of primary and permanent teeth. Materials and Methods: Eighty molars (40 primary, 40 permanent) were randomly assigned to 16 groups (n = 5) according to the type of tooth (primary [PRIM] or permanent [PERM]), enamel condition (sound [S] or demineralized [DEM]), treatment after the restorative procedure (control [C] or cariogenic challenge [pH]), and adhesive system (Adper Single Bond [SB] or Clearfil SE Bond [SE]). Teeth from the DEM group were subjected to cariogenic challenge by pH cycling prior to restorative procedures and pH group specimens were subjected to cariogenic challenge before the microshear test. One of two adhesive systems was applied to the flat enamel surfaces and composite cylinders (0.45 mm²) were built. The microshear bond test was performed. The data (MPa) were subjected to ANOVA and Tukey's test (α = 0.05). Results: No statistically significant differences were detected between the adhesive systems. The S groups exhibited higher bond strength values than the DEM groups, as did C groups compared to pH groups. PERM groups also had higher bond strength values than PRIM groups, excluding PRIM S and PERM S, which had similar values. Conclusion: The bond strength to demineralized enamel of primary teeth was lower than to the demineralized enamel of permanent teeth. Cariogenic challenge negatively influenced enamel bond strength, regardless of the type of tooth and adhesive system. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate an alternative device using starch tubes to build up resin composite specimens for micro-shear bond tests. Materials and Methods: Twenty human molars were selected and sectioned mesiodistally to obtain two sections. The teeth were randomly divided into 4 groups (n = 10) according to the adhesive system - a two-step etch-and-rinse adhesive (Adper Single Bond) and a two-step self-etching adhesive (Clearfil SE Bond) - and the type of tube, starch or polyethylene. The tubes were evaluated under a stereomicroscope at 25X magnification to observe the variation in internal diameter. The resin composite was bonded to flat enamel surfaces using one of the adhesive systems and tube types. After 24 h storage in distilled water, the microshear bond strength (^iSBS) was determined and the fracture pattern was analyzed under a stereomicroscope (400X magnification). The microshear bond strength values were subjected to two-way ANOVA. The chi-square test was used to compare pre-test failures and fracture patterns between the groups (p < 0.05). Results: The type of tube, the adhesive system, and their interaction did not influence the bond strength values (p = 0.062, p = 0.122, and p = 0.301, respectively). No significant differences were observed for pre-test failures or fracture patterns (p = 0.320 and p = 0.561, respectively). Conclusion: Using starch tubes is an alternative to build up composite resin specimens for microshear bond strength testing with the two tested adhesive systems. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were 1) to compare the efficacy of biofilm removal with conventional (Bitufo 22) and triple-headed (DenTrust) toothbrushes on smooth and occlusal surfaces, and 2) to verify the influence of the person who performs the toothbrushing (mother vs dentist). Materials and Methods: Twenty children aged 4 years old with sound, complete primary dentition participated in this crossover study. The quantity of biofilm was evaluated using the bacterial plaque revealer Plaque Test (Vivadent) before and after toothbrushing by the mother or dentist for 1 minute per arch. This was done at two separate appointments, one week apart, with one type of toothbrush at the first and the other type at the second appointment. The Green & Vermillion index (1960) was used for smooth surfaces and Rodrigues et al (1999) indexes for the occlusal surfaces. Data were submitted to analysis of variance. Results: A statistically significant difference was observed on biofilm removal on occlusal and smooth surfaces, regardless of the toothbrush used or who performed the brushing (P < 0.0001). The triple-headed toothbrush showed a better performance than the conventional one on smooth and occlusal surfaces when the mother had brushed the teeth. The conventional toothbrush showed a better performance only on occlusal surfaces when the dentist performed the brushing (P < 0.0001). The dentist removed significantly more biofilm than the mother, 76% and 53%, respectively (P < 0.0001). Conclusion: It was concluded that effective biofilm removal was achieved with both toothbrushes; however , the triple-headed type had a better performance on surfaces when the mother brushed the teeth. The dentist removed more biofilm than the mother. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this crossover study was to compare the efficacy of conventional and end-tufted toothbrushes and two methods of plaque removal on partially erupted occlusal surfaces in schoolchildren.Materials and Methods: Thirty-seven subjects, aged 5-7 years, with at least one partially erupted lower permanent first molar, were randomly divided into three groups. Occlusal plaque (baseline) was scored using a disclosing solution applied to the occlusal surface of an erupting molar. Subjects were instructed to use a conventional toothbrush with horizontal scrubbing (conventional group); a conventional toothbrush with transverse technique (modified group); or an end-tufted toothbrush (end-tufted group). Subjects returned after a one-week washout period and brushed with the alternate toothbrush or technique. Final plaque condition was evaluated again using the same scoring as at baseline. Occlusal plaque reduction (baseline to final) percentiles were compared using paired t-test.Results: No statistically significant difference was found among transverse and end-tufted techniques (modified and end-tufted groups respectively) (p > 0.05). The conventional group was less effective on occlusal plaque removal in erupting first molars than the other groups (p < 0.05).Conclusion: The conventional toothbrushing technique was not satisfactory compared with other tested techniques on occlusal plaque removal. Moreover, the use of a conventional toothbrush with a modified technique was very effective on erupting first permanent molars without any additional costly device. [ABSTRACT FROM AUTHOR]

A technique for the restoration of carious primary maxillary incisors using indirect resin composite crowns and intracanal reinforcement fiber is described. Endodontic treatment was previously performed on each tooth. The advantages of using an intracanal reinforcement fiber include resin composite crown reinforcement, translucency, and relative manipulation facility. In addition, the use of indirect resin composite crowns provides good shape and esthetics, as well as reduced chair time for the child. The technique is illustrated in a case report in which indirect resin composite crowns and an intracanal reinforcement fiber are placed in a 3-year-old girl. (Quintessence Int 2004:35:263-268) [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effects of 2 aging methods on the dentin bond strength of different adhesive systems, including a universal adhesive. Seventy-two third molars were sectioned to create flat midcoronal dentin surfaces, which were randomly assigned to 12 groups (n = 6 each) according to the aging method (conventional aging, defined as 6 months of water storage; accelerated aging by means of a pH-cycling method; or negative control [immediate bond strength]) and adhesive system (Adper Single Bond 2, Clearfil SE Bond, Prime & Bond 2.1, or Scotchbond Universal). Composite resin blocks were constructed on the flattened dentin surfaces after application of the appropriate adhesive, and the specimens were stored in water for 24 hours. Specimens from the control group were immediately sectioned into resin-dentin sticks (0.8 mm2) and subjected to a microtensile bond strength test. Specimens from the experimental groups were sectioned and tested after undergoing the assigned aging method. Data were analyzed with 2-way analysis of variance and a Tukey test (α = 0.05). The study findings showed that neither aging method significantly affected the dentin bond strength (P = 0.917). Of the 4 adhesives, Adper Single Bond 2 had the highest bond strength value after aging (P < 0.001). Scotchbond Universal adhesive demonstrated statistically significantly higher bond strength values than Clearfil SE Bond and Prime & Bond 2.1, which had statistically similar values. Adhesive failures at the resln-dentin interface or adhesive failures mixed with cohesive failure of the adjacent substrate predominated in all groups. The 2 aging processes did not result in degradation of the adhesive interface or jeopardize the dentin bond strength of any of the adhesives tested. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the bond strength of a universal adhesive system to enamel surrounding real-life carious cavities. Twenty-eight permanent molars (n = 7) with carious lesions in dentin were subjected to selective carious tissue removal to firm dentin and had their crowns sectioned longitudinally. A universal adhesive system (Single Bond Universal [SBU] used in either etch-and-rinse and self-etch strategies) was compared with an etch-and-rinse Adper Single Bond 2 (ASB) and a self- etch Clearfil SE Bond (CSE) adhesive systems (control systems). Adhesives were applied on the enamel, assumed demineralized, surrounding the cavity margins and on sound enamel (control substrate). Composite cylinders were built (0.72 mm²) and microshear bond strength (µSBS) test was performed after 24 h of water storage. The µSBS values (MPa) were analyzed using two-way ANOVA and Tukey's post hoc tests (α = 0.05). Bond strength values obtained in demineralized enamel surrounding carious cavity margins were significantly lower than that obtained in sound enamel (distant from carious cavity margins) (p = 0.035). The bonding strategy of the SBU did not influenced the bond strength values, which were higher than that obtained with ASB. CSE showed similar µSBS values to ASB and SBU in the self-etch mode. In conclusion, the bond strength to enamel assumed demineralized is lower than to sound enamel. The enamel surrounding carious cavities jeopardize the bonding of universal adhesive system. The bond strength of universal adhesive is similar, regardless to bonding strategy. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate the impact of dentin condition on bond strength of multi-mode adhesive systems (MMAS) to sound and artificially induced caries-affected dentin (CAD). Methods: Flat dentin surfaces of 112 bovine incisors were assigned to 16 subgroups (n = 7) according to the substrate condition (sound and CAD- pH-cycling for 14 days); adhesive systems (Scotchbond Universal, All-Bond Universal, Prime and Bond Elect, Adper Single Bond Plus and Clearfil SE Bond) and etching strategy (etch-and-rinse and self-etch). All systems were applied according to the manufacturer's instructions and resin composite restorations were built. After 24 h of water storage, specimens were sectioned (0.8 mm2) and submitted to the microtensile test. Statistical Analysis: Data (MPa) were analyzed using three-way analysis of variance and Tukey's test (α = 0.05). Results: MMAS presented similar bond strength values, regardless etching strategy in each substrate condition. Bond strength values were lower when MMAS were applied to CAD in the etch-and-rinse strategy. Conclusion: The etching strategy did not influence the bond strength of MMAS to sound or CAD, considering each substrate separately. However, CAD impact negatively on bond strength of MMAS in etch-and rinse mode. [ABSTRACT FROM AUTHOR]

This study aimed to compare the longevity of different conventional restorative materials placed in posterior primary teeth. This systematic review was conducted following the PRISMA statement and registered in PROSPERO (CRD42016035775). A comprehensive electronic search without date or language restrictions was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, Turning Research Into Practice (TRIP) and Clinical Trials databases up to January 2017, selecting randomized clinical trials that assessed the longevity of at least two different conventional restorative materials performed in primary molars. Seventeen studies were included in this systematic review. Pairwise and network meta-analyses were performed and relative risks and 95% confidence intervals (CI) calculated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer, resin-modified glass ionomer cement, amalgam, and composite resin. Risk of bias was low in most studies (45.38% of all items across studies). Pediatric dentists should avoid conventional glass ionomer cement for restoring primary molars. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to evaluate the pH effect of doxycycline solutions on the immediate dentin bond strength of a total-etch adhesive system. Twenty human molars were divided into 4 groups (n = 5) after acid etching according to surface treatment: 10% acidic doxycycline, 10% neutral doxycycline, 2% chlorhexidine, and control. Composite resin blocks were made and subjected to microtensile testing. Mean bond strength values were submitted to a 1-way analysis of variance and a Tukey test (α = 0.05). No statistically significant differences between the experimental groups were found (P = 0.093). The chlorhexidine group showed the highest number of pretesting failures. The application of either acidic or neutral doxycycline solution prior to the dentin adhesive did not influence the bond strength of the total-etch adhesive system evaluated. [ABSTRACT FROM AUTHOR]

This in vitro study evaluated the effect of air-drying time on degree of solvent evaporation (DE), dentin microtensile bond strength (µTBS), and degree of conversion (DC) of 5 adhesive systems: Adper Single Bond 2, XP Bond, Prime & Bond 2.1, OptiBond Solo, and Adper Easy One. For DE testing, 20 µL of each material was submitted to measurements in a digital balance after an air stream of 3, 5, 10, 20, 30, or 60 seconds; the weight loss was computed and converted to a percentage (DE). For µTBS testing, 50 sound human molars were divided into groups (n = 5). The 5 adhesive systems were applied either in accordance with manufacturers' instructions for solvent drying time (control) or with a prolonged drying time (20-30 seconds). After composite resin was built up on the hybridized surfaces, the teeth were stored for 24 hours and then sectioned to obtain beams that were loaded until fracture. For DC testing, specimens of each adhesive and air-drying condition (n = 3) were evaluated by means of attenuated total reflectance Fourier transform infrared spectroscopy. Data were submitted to 2-way analysis of variance, f test, and Spearman test for correlation analysis. Prolonged air drying resulted in significantly greater DE than did the time suggested by the manufacturers. The adhesives XP Bond and Adper Easy One showed significantly greater µTBS with prolonged air drying. The DC was not affected by air-drying time. No statistically significant correlation was found between DC and µTBS values. Depending on the material, bond strength can be improved by prolonged air-drying times. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to compare the degradation of resin-dentin bonds of an etch-and-rinse adhesive system to primary and permanent teeth. Flat superficial coronal dentin surfaces from 5 primary second molars and 5 permanent third molars were etched with phosphoric acid and bonded with an adhesive system (Adper Single Bond 2, 3M ESPE). Blocks of resin composite (Z250, 3M ESPE) were built up and the teeth sectioned to produce bonded sticks with a 0.8 mm² crosssectional area. The sticks of each tooth were randomly divided and assigned to be subjected to microtensile testing immediately (24 h) or after aging by water storage (6 months). Data were analyzed by two-way repeated measures ANOVA and Tukey post hoc test (α = 0.05). Failure mode was evaluated using a stereomicroscope (400×). Microtensile values significantly decreased after the 6 months aging, independent of the dentin substrate. In 24 h, the values obtained to primary dentin were lower compared with permanent dentin. This difference was not maintained after aging. Adhesive/mixed failure was predominant in all experimental groups. In conclusion, degradation of resin-dentin bonds of the etch-and-rinse adhesive system occurred after 6 months of water storage; however, the reduction in bond strength values was higher for permanent teeth. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this clinical retrospective study was to assess survival and risk factors associated with failures of resin composite restorations placed in patients with early childhood caries. Methods: Seventy-eight restorations in primary teeth from records of 24 high caries risk children were included in the study. The restorations' longevity up to 30 months of follow-up was assessed using the Kaplan- Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (P<0.05). Results: Mean survival time was 26 months (95 percent confidence interval = 24.5 to 26.7). The survival of the restorations reached 34.8 percent up to 30 months, with an overall annual failure rate of 20 percent. Restorations involving two or more surfaces had 2.50 times more risk of failure than restorations involving single surface (P=0.03). Restorations performed in vital teeth had a lower risk of failure than those performed in teeth that underwent pulp intervention (hazard ratio equals 0.25; 95 percent confidence interval =0.10 to 0.65; P=0.00). Patients with a plaque index more than 20 percent had 3.63 times more risk of failure in their restorations (P=0.01). Conclusion: Clinical variables, such as the number of restored surfaces, pulp therapy, and poor biofilm control, may affect the survival of composite restorations performed in patients with early childhood caries. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 18-month clinical performance of a universal adhesive, applied under different adhesion strategies, after selective carious tissue removal in primary molars. Methods: Forty-four subjects (five to 10 years old) contributed with 90 primary molars presenting moderately deep dentin carious lesions on occlusal or occluso-proximal surfaces, which were randomly assigned following either self-etch or etch-and-rinse protocol of Scotchbond Universal Adhesive (3M ESPE). Resin composite was incrementally inserted for all restorations. Restorations were evaluated at one, six, 12, and 18 months using the modified United States Public Health Service criteria. Survival estimates for restorations' longevity were evaluated using the Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty to assess the factors associated with failures (P<0.05). Results: Estimated survival rates of the restorations were 100 percent, 100 percent, 90.6 percent, and 81.4 percent at one, six, 12, and 18 months, respectively. The adhesion strategy did not influence the restorations' longevity (P=0.06; 72.2 percent and 89.7 percent with etch-and-rinse and self-etch mode, respectively). Conclusion: Self-etch and etch-and-rinse strategies did not influence the clinical behavior of universal adhesive used in primary molars after selective carious tissue removal; although there was a tendency for better outcome of the self-etch strategy. [ABSTRACT FROM AUTHOR]

This clinical retrospective study evaluated the survival and risk factors associated with failures of resin-based composite restorations in primary teeth. Methods: A total of 212 restorations in primary teeth from records of 76 high caries-risk children were included. The restoration's longevity for up to six years of follow-up wasossessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (P<.0.05). Results: Mean survival time was 43years (95 percent confidence interval (Cl) equals 4.0to4.6). The survival of the restorations reached 353 percent, up to the sixth year, with an annual failure rate of 18.8 percent. Restorations placed in teeth with pulp treatment had a lower survival rate than those in vital teeth (hazard ratio [HR] equals 2.16, 95 percent Cl equals 1.02 to 4.58). Patients who did not use standard fluoride toothpaste had more risk of failure in their restorations (HR equals 6.12, 95 percent Cl equals 1.47 to 25.49). Conclusions: Composite restorations placed in high caries-risk children presented limited survival after six years of follow-up. Standard fluoride toothpaste use was a protection factor, while pulp treatment was a risk factor for restoration failure. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to verify the influence of prebrushing mouthwashes on dental plaque removal in children. Methods: This study had a double-blind, randomized, controlled, crossover, 25-day experimental design, including 38 12- to 14-year-olds. Four solutions were used as prebrushing mouthwashes (Colgate Plax Magic, Listerine Cool Blue Agent, water and dye, and water) by each participant with seven days' washout. The plaque index was evaluated before and after tooth-brushing during the experimental period. Results: Intergroup comparisons showed no significant differences in plaque reduction among evaluated solutions (Friedman test, P>.78). Significantly more plaque was present before vs. after tooth-brushing (Wilcoxon rank test, P<.001), independent of the surface (buccal or lingual/palatal). Conclusion: Use of prebrushing mouthwashes by children does not influence plaque removal by tooth-brushing. [ABSTRACT FROM AUTHOR]

Purpose: As clinical diagnosis of secondary caries is the most common reason for restoration replacement, fluoride-releasing restorative materials have been developed to address this problem. The purposes of this study were to verify demineralization inhibition produced by 5 restorative materials submitted to two methods of in vitro cariogenic challenge and verify whether these methods influence material behavior by means of polarized light microscopy and microhardness. Methods: Class V cavities were prepared on buccal surfaces of 100 extracted primary molars and randomly restored with 1 of the 4 fluoride-releasing materials, Fuji IX, Vitremer, Dyract, Tetric Ceram, and Filtek Z250 as control material (N=10). Specimens were submitted to in vitro caries induction by two different methods, acid gel immersion, and pH cycling. Teeth submitted to gel were then sectioned and prepared for polarized light microscopy in water, while teeth cycled were prepared for microhardness evaluation. Results: Polarized light microscopy: Means of demineralization areas (μm²) differed significantly, depending on the restorative material. Tukey's test revealed the smallest demineralization areas adjacent to Fuji IX and Vitremer restorations, with no difference between them (P>.05). The greatest demineralization area mean values were verified us- P ing Dyract and Filtek Z250, without differences between them (P>.05). Microhardness: P Glass ionomer cements (GICs) performed better on the area of great cariogenic challenge, closer to the surface, than other materials indicating minor mineral loss during pH cycling. The compomer Dyract presented similar performance to GICs and composite resin Tetric Ceram, but it was better than Filtek Z250. Conclusion: The experimental model of caries lesion induction may influence material performance. GICs, however, are superior in preventing in vitro demineralization independently of the method. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic review and meta-analysis was to assess the impact of dental caries on the oral health-related quality of life (OHRQoL) of preschool children. Methods: A literature search was undertaken through PubMed/MEDLINE, Scopus, and TRIP databases to verify available studies about the topic. Two reviewers independently selected the studies, extracted the data, and assessed the bias risk. Global meta-analysis was carried out comparing means and standard deviations of the OHRQoL overall score from preschool children with and without caries. Subgroup analysis was conducted using different cutoff points for caries: decayed, missing, or filled teeth (dmft) greater than or equal to one and greater than or equal to six. Results: From 597 potentially eligible studies, 63 were selected for full-text analysis and 29 were included in the review: 12 for quantitative analysis and 17 for qualitative analysis. Most studies were conducted in Brazil; Early Childhood Oral Health Impact Scale (ECOHIS) was the instrument used in most studies to evaluate OHRQoL. A dmft index at least of one was sufficient to negatively impact the OHRQoL of preschool children, although a higher cutoff point for caries augmented the difference between groups. Bias risk was low. Conclusions: Caries might be associated with negative impact on the oral health-related quality of life of preschool children, and this association tends to increase as the disease severity worsens.

Purpose: To evaluate the 18-month clinical performance of a universal adhesive, applied under different adhesion strategies, after selective carious tissue removal in primary molars., Methods: Forty-four subjects (five to 10 years old) contributed with 90 primary molars presenting moderately deep dentin carious lesions on occlusal or occluso-proximal surfaces, which were randomly assigned following either self-etch or etch-and-rinse protocol of Scotchbond Universal Adhesive (3M ESPE). Resin composite was incrementally inserted for all restorations. Restorations were evaluated at one, six, 12, and 18 months using the modified United States Public Health Service criteria. Survival estimates for restorations' longevity were evaluated using the Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty to assess the factors associated with failures (P<0.05)., Results: Estimated survival rates of the restorations were 100 percent, 100 percent, 90.6 percent, and 81.4 percent at one, six, 12, and 18 months, respectively. The adhesion strategy did not influence the restorations' longevity (P=0.06; 72.2 percent and 89.7 percent with etch-and-rinse and self-etch mode, respectively)., Conclusion: Self-etch and etch-and-rinse strategies did not influence the clinical behavior of universal adhesive used in primary molars after selective carious tissue removal; although there was a tendency for better outcome of the self-etch strategy.

Aim: This in vitro study compared the mineral loss of natural and artificially-created caries-affected dentin in primary and permanent teeth using the same protocol to induce caries lesions., Materials and Methods: Twenty molars presenting natural occlusal dentin caries lesions (10 primary-PriC and 10 perma-nent-PermC; control group), and 20 sound molars (10 primary -PripH and 10 permanent-PermpH; experimental group), were selected. Occlusal cavities were prepared in teeth of the experimental group that were submitted to pH-cycling for 14 days to simulate caries-affected dentin. All specimens were longitudinally sectioned and prepared in order to obtain Knoop micro-hardness values from 15 to 250 urn depth, starting in bottom of center of natural lesions or cavities. The microhardness (KHN) data were submitted to three-way repeated measures analysis of variance (ANOVA) and Tukey's tests (α = 0.05)., Results: Considering all depths, there was no statistically significant differences (p > 0.05) between the mineral loss of the control (PriC = 30.9 ± 6.4 and PermC = 40.8 ± 8.6) and experimental (PripH = 27.3 ± 11.1 and PermpH = 35.5 ± 14.0) groups, neither between primary and permanent teeth., Conclusion: The mineral loss of the artificially-created caries-affected dentin is similar to that from naturally developed dentin caries lesions., Clinical Significance: The pH-cycling model may be a suitable method to simulate caries-affected dentin in both permanent and primary teeth.