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Operative Dentistry[JOURNAL]

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Comparison of the Time and Accuracy of Intraoral Scans Performed by Dentists, Nurses, Postgraduates, and Undergraduates.

Gao M, Guo X, Fu Y … +3 more , Li M, Ma X, Chen Z

Oper Dent · 2023 Nov · PMID 37881030 · Publisher ↗

OBJECTIVE: This study aimed to assess the scanning time (ST) and accuracy of 10 repeated upper and lower dentition scans by four groups of operators with different professional backgrounds. METHODS: There were a total of... OBJECTIVE: This study aimed to assess the scanning time (ST) and accuracy of 10 repeated upper and lower dentition scans by four groups of operators with different professional backgrounds. METHODS: There were a total of 32 participants, including dentists, nurses, postgraduates, and undergraduates (n=8). They received the same training about intraoral scanning and then performed 10 repeat scans on the plaster maxillary and mandibular dentition models in a manikin head, with the first five scans being the T1 phase and the last five scans being the T2 phase. Each ST was recorded. Trueness and precision were evaluated by root mean square (RMS) value gained from alignments of corresponding virtual models. For statistical analysis, the paired-sample t-tests, one-way ANOVA, and Pearson correlation tests were employed (α=0.05). RESULTS: Limiting the comparison in scan phase and scan target the sequence of STs for the four groups was the same (p<0.05), by which undergraduates, postgraduates, nurses, and dentists were in descending order. Undergraduates gained the best precision, followed by postgraduates, dentists, and nurses, in both maxillary and mandibular scanning (p<0.05). Compared with corresponding items of the T1 phase, the trueness of the T2 phase was much higher (p<0.05), while the ST of the T2 phase was much shorter (p<0.05). CONCLUSIONS: The operator's professional background affects the precision and scanning time but not the trueness. Most dental personnel have good access to the intraoral scanner. As the number of scans increased, the accuracy and scanning efficiency also improved.

Letter to the Editor.

Santos PB, Pinto ETF

Oper Dent · 2023 Sep · PMID 37721113 · Publisher ↗

Abstract loading — click title to view on PubMed.

Is It Time for Consolidation?

Bridgeman C

Oper Dent · 2023 Sep · PMID 37721112 · Publisher ↗

Abstract loading — click title to view on PubMed.

Clinical Tooth Color Matching: In Vivo Comparisons of Digital Photocolorimetric and Spectrophotometric Analyses.

Philippi AG, Sabatini GP, Freitas MS … +3 more , Oshima SN, Tango RN, Gonçalves T

Oper Dent · 2023 Sep · PMID 37721111 · Publisher ↗

OBJECTIVE: This study aimed to compare the tooth color matching of two dental colorimetric methods: the spectrophotometric analysis (SPM) and the standardized digital photocolorimetric analysis (DPC). METHODS: The color... OBJECTIVE: This study aimed to compare the tooth color matching of two dental colorimetric methods: the spectrophotometric analysis (SPM) and the standardized digital photocolorimetric analysis (DPC). METHODS: The color of 60 maxillary central incisors of 30 volunteers (22.5 ± 7.6 years) was analyzed. In the DPC method, tooth photographs were standardized with the eLABor_aid protocol, processed with Adobe Photoshop Lightroom software, and the values of L*, a*, and b* were obtained with a Digital Color Meter software. For the SPM, L*, a*, and b* were measured directly with a handheld spectrophotometer. Data were submitted to paired t-test and Pearson correlation test (α=0.05). Mean color difference between the two methods was calculated with CIELAB formula. RESULTS: All color coordinates revealed different values when comparing DPC to SPM in the same tooth (p<0.0001). Mean color difference (ΔEab) between SPM and DPC was 11.5 ±3.1. A positive correlation was observed for L* (R2=0.73,p<0.0001), a* (R2=0.31, p=0.017), and b* (R2=0.83, p<0.0001). CONCLUSIONS: Even though the color coordinate values were different in both methods, they were correlated, revealing that the DPC is a viable alternative to determine the tooth color matching.

Bleaching Gels Used After 1 Week of Mixing: Efficacy, Hydrogen Peroxide Penetration, and Physical-chemical Properties.

Forville H, Favoreto MW, Carneiro TS … +5 more , Terra R, Pinheiro LA, Borges C, Loguercio AD, Reis A

Oper Dent · 2023 Sep · PMID 37721110 · Publisher ↗

OBJECTIVES: This in vitro study aimed to evaluate the bleaching efficacy (BE), hydrogen peroxide penetration into the pulp chamber (HPP), and physical-chemical properties (concentration, pH, and viscosity) of in-office b... OBJECTIVES: This in vitro study aimed to evaluate the bleaching efficacy (BE), hydrogen peroxide penetration into the pulp chamber (HPP), and physical-chemical properties (concentration, pH, and viscosity) of in-office bleaching gels immediately and after 1 week of mixing. METHODS AND MATERIALS: We randomly divided 49 premolars into seven groups: control (no bleaching) and the following in-office bleaching (Opalescence Boost 40%, Total Blanc One Step 35%, and Whiteness HP Blue 35%) applied at two storage times: immediately and after 1 week. We evaluated the BE using a digital spectrophotometer and the HPP through UV-Vis spectroscopy. We measured the initial concentration, pH, and viscosity using titration, a Digital pH meter and Rheometer, respectively. For statistical analysis, we used a twoway analysis of variance and Tukey and Dunnet tests (α=0.05). RESULTS: We observed higher BE and HPP for Opalescence Boost and Total Blanc One Step after 1 week of mixing than for Whiteness HP Blue (p<0.001). We observed a significantly lower initial concentration for Whiteness HP Blue 1 week after mixing compared to immediately (p=0.00001). All bleaching gels showed a decrease in pH after 1 week of mixing (p=0.00003). However, Total Blanc One Step had a lower pH at both evaluation times (p<0.001). Only Opalescence Boost maintained viscosity 1 week after mixing. CONCLUSIONS: Opalescence Boost was the only bleaching gel able to keep bleaching efficacy, with the same characteristics of permeability and physical- chemical properties after 1 week of mixing.

Physical Properties and Clinical Performance of Short Fiber Reinforced Resin-based Composite in Posterior Dentition: Systematic Review and Meta-analysis.

Aram A, Hong H, Song C … +3 more , Bass M, Platt JA, Chutinan S

Oper Dent · 2023 Sep · PMID 37655625 · Publisher ↗

OBJECTIVE: This study compares the physical properties and clinical performance of short fiber reinforced composites (SFRC) to those of particulate-filled resin-based composites (PFRC) for class I and II direct restorati... OBJECTIVE: This study compares the physical properties and clinical performance of short fiber reinforced composites (SFRC) to those of particulate-filled resin-based composites (PFRC) for class I and II direct restorations in permanent dentition. METHODS: Systematic review and meta-analysis was conducted using PubMed, Embase (Elsevier), and Dentistry and Oral Sciences Source (EBSCO) databases. The outcomes evaluated were physical properties including flexural strength, flexural modulus, elastic modulus, microhardness, shrinkage, fracture toughness, degree of conversion, and depth of cure. Clinical performance was evaluated with a systematic review. RESULTS: The meta-analyses favored SFRC for flexural strength and fracture toughness compared to every PFRC subgroup, with a high quality of evidence. For all other properties, the meta-analyses favored SFRC to overall PFRC, with some non-significant differences with certain PFRC subgroups. The most recent clinical trial showed SFRC performed similarly to PFRC, however older studies suggest inferior surface texture and discoloration of SFRC compared to PFRC. CONCLUSION: This study can aid dental professionals in clinical decision making, supporting that SFRC offers improved physical properties, especially fracture resistance and flexural strength, compared to PFRC.

Accuracy of Selective Enamel Etching: A Computer-assisted Imaging Analysis.

Amran T, Meier D, Amato J … +4 more , Connert T, Blatz MB, Weiger R, Eggmann F

Oper Dent · 2023 Sep · PMID 37635464 · Publisher ↗

OBJECTIVE: To assess the accuracy of selective enamel etching (SEE) in a laboratory setup simulating clinical conditions. METHODS AND MATERIALS: A model with permanent human teeth was fabricated. It included a first mand... OBJECTIVE: To assess the accuracy of selective enamel etching (SEE) in a laboratory setup simulating clinical conditions. METHODS AND MATERIALS: A model with permanent human teeth was fabricated. It included a first mandibular molar with a mesio-occlusal-distal inlay preparation, a maxillary central incisor, and a canine with a class IV and class V cavity, respectively. Two dentists (with 1 year and 10 years work experience) repeatedly (n=10 per cavity) performed SEE with a custom gel that had identical rheological properties as a commercially available phosphoric acid etchant. An intraoral scanner was used for image acquisition. To assess the accuracy of SEE, special software was used (OraCheck, Cyfex, Zurich, Switzerland). Two independent investigators analyzed baseline scans and scans taken of the cavities while the gel was in place. The statistical analysis comprised t-tests, Pearson correlation, and analysis of variance (α=0.05). RESULTS: The level of accuracy, whose average values ranged from 61.1% to 87.0%, showed significant differences between teeth, with the highest level observed in the class V cavity, followed by the class II inlay preparation and the class IV cavity (p<0.001). Across the cavities, no significant correlation was observed between the application time and the accuracy of SEE (p=0.07). CONCLUSION: This laboratory study suggests that inadvertent conditioning of dentin adjacent to enamel may be common during SEE. Investigations involving larger samples of dentists are needed to corroborate this finding.

Comparison of the Surface Properties of 3D-printed Permanent Restorative Resins and Resin-based CAD/CAM Blocks.

Karaoğlanoğlu S, Aydın N, Oktay EA … +1 more , Ersöz B

Oper Dent · 2023 Sep · PMID 37635458 · Publisher ↗

OBJECTIVE: This study aimed to investigate the surface roughness, microhardness, and color changes of resin-based computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printed permanent resins in dif... OBJECTIVE: This study aimed to investigate the surface roughness, microhardness, and color changes of resin-based computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printed permanent resins in different beverages. METHODS AND MATERIALS: Resin-based CAD/CAM blocks (Cerasmart 270 and Grandio Blocs) and 3D-printed permanent restorative resins (Crowntec and Permanent Crown) were used in this study. A total of 96 specimens were prepared from CAD/CAM blocks and 3D-printed permanent resins. The initial surface roughness, microhardness, and shade value of the specimens were measured. Then, the specimens prepared from each material were divided into three subgroups (n=8) and immersed in tea, coffee, and distilled water for 30 days. After the specimens were immersed in the beverages, the surface roughness, microhardness, and tone values were measured again. The data were statistically analyzed using a two-way analysis of variance test (p<0.05). RESULTS: No statistically significant difference was found in the surface roughness values of the resin-based CAD/CAM blocks and 3D-printed resins (p<0.05). Resin-based CAD/CAM blocks showed statistically significantly higher microhardness than 3D-printed permanent resins (p<0.05). Although the color changes in 3D-printed resins in tea and coffee were similar to those in resin-based CAD/CAM blocks on the first and seventh days, more color changes appeared in the 3D-printed resins after 30 days. The surface roughness and microhardness values of the specimens submerged in tea, coffee, and distilled water showed no statistically significant changes (p<0.05). CONCLUSIONS: Although the surface roughness of 3D-printed permanent resins was similar to that of resin-based CAD/CAM blocks, they had a lower microhardness value. Moreover, 3D-printed permanent resins showed more color changes in tea and coffee.

Surface Properties of Resin Composites and CAD/CAM Blocks After Simulated Toothbrushing.

Suzuki M, Miyano Y, Sato F … +1 more , Shinkai K

Oper Dent · 2023 Sep · PMID 37635455 · Publisher ↗

OBJECTIVES: This study aimed to evaluate the surface gloss, surface roughness, and color change of restorative materials after a three-body wear abrasion. METHODS AND MATERIALS: Four resin composites with different fille... OBJECTIVES: This study aimed to evaluate the surface gloss, surface roughness, and color change of restorative materials after a three-body wear abrasion. METHODS AND MATERIALS: Four resin composites with different filler particle size (Gracefil Flo [GFF, 0.7 μm], Gracefil LoFlo [GFL, 0.25 μm], Gracefil ZeroFlo [GFZ, 0.15 μm], and Gracefil Putty [GFP, 0.3 μm]), two CAD/CAM resin composite blocks with different filler particle size (Cerasmart 300 [CS3, 0.7 μm] and Cerasmart Prime [CSP, 0.3 μm], GC), and one CAD/CAM lithium disilicate glass-ceramic block (Initial LiSi Block [ILS], GC) as a control were evaluated. Twenty slab-shaped specimens were obtained from each material. Ten specimens were subjected to 80,000 toothbrushing strokes and measured for surface gloss (Gloss Unit, GU), surface roughness (Ra, μm), and color (L*, a*, and b* values) before toothbrushing and at every 20,000 strokes. Color differences (ΔL*, Δa*, Δb*, and ΔE00) before and after toothbrushing were calculated. After 80,000 strokes, abraded surfaces were observed using scanning electron microscopy. The other 10 specimens were measured for Vickers microhardness (VHN). RESULTS: After 80,000 toothbrushing strokes, the mean GU ranged from 60.43 to 16.12 (the highest for ILS and lowest for GFL), and the mean Ra ranged from 0.079 to 4.085 (the lowest for ILS and highest for GFL). At all measuring stages, the calculated ΔE00 values ranged from 0.31 to 0.92 for all materials. The mean VHN ranged from 632.34 to 39.08 (the highest for ILS and lowest for GFZ). The resin composite containing the largest filler particle (GFF) showed significantly lower Ra and higher VHN than other resin composites (GFL, GFZ, and GFP). The CAD/CAM resin composite block containing a smaller filler particle (CSP) retained significantly higher GU than that containing a larger filler particle (CS3). A negative correlation between GU and Ra was detected. CONCLUSIONS: Based on the findings, toothbrush abrasion induced a decrease in GU and an increase in Ra for all resin-based materials tested. Resin-based materials with larger filler size tended to show lower Ra, while resin-based materials with smaller filler size tended to show a smaller reduction in GU. These were more pronounced for light-cure resin composites than for resin composite blocks for CAD/CAM.

Evaluation of Bond Strength and Fracture Load of Teeth With Flared Root Canals Restored With Prefabricated, Anatomical, and Computer-aided Design and Computer-aided Manufacturing Fiber Posts.

Taques LV, Chidoski JC, Ávila BO … +3 more , Jitumori RT, Gomes JC, Gomes GM

Oper Dent · 2023 Sep · PMID 37635454 · Publisher ↗

PURPOSE: This study compared the use of anatomical glass fiber posts using bulk-fill composite resin with computer-aided design and computer-aided manufacturing (CAD/CAM) milled glass fiber post in oversized root canals,... PURPOSE: This study compared the use of anatomical glass fiber posts using bulk-fill composite resin with computer-aided design and computer-aided manufacturing (CAD/CAM) milled glass fiber post in oversized root canals, through bond strength (BS) and fracture resistance (FR) tests (fracture load). METHODS AND MATERIALS: A total of 48 mandibular premolars were selected, half of them had their crowns removed at the cemento-enamel junction (CEJ) and the other half were sectioned 2 mm above the CEJ. Subsequently, teeth were endodontically treated. After 1 week, the standard preparation of the canals was carried out, and the roots were divided into three groups (n=16), according to the use of different restorative techniques (control: prefabricated glass fiber post [PFP], direct anatomical glass fiber post [AFP], and CAD/CAM milled glass fiber post [MFP]). After luting procedures using Single Bond Universal and RelyX Ultimate (3M ESPE), for eight teeth in each group, six specimens were obtained (two slices from each root third: cervical, middle, and apical). For the remaining eight roots of each group, standardized preparations for metal-free crowns, milling of 5 mol% yttria-stabilized tetragonal zirconia polycrystalline, cementation of the crowns, and periodontal ligament simulation were performed. Then, for each group, the BS was evaluated through the push-out test, and the FR was evaluated in compression. The data obtained from BS were submitted to two-way analysis of variance (ANOVA; group vs root region) and Tukey (α=0.05) and from FR to one-way ANOVA (group) and Tukey (α=0.05). RESULTS: For the BS test, the MFP group was statistically superior to the PFP group in all root regions and was statistically superior to the AFP group only in the cervical region, being statistically similar in the middle and apical root regions. For the FR test, the MFP group was statistically superior to the PFP and AFP groups. CONCLUSION: The milled fiber post technique can be a legitimate alternative in the restoration of weakened roots with flared root canals.

Restoration of a Vital Tooth With Extensive Crown Destruction Using Glass Fiber and Polyethylene Fiber-reinforced Composite Resin: A Clinical Case.

Saravia-Rojas MA, Espinoza-Jiménez G, Huanambal-Tiravanti VA … +1 more , Geng-Vivanco R

Oper Dent · 2023 Sep · PMID 37635452 · Publisher ↗

Conservative restorative dentistry has been evolving in the last 25 years, focusing mainly on the development of direct restorative materials. Resin-based composites remain an excellent conservative alternative for resto... Conservative restorative dentistry has been evolving in the last 25 years, focusing mainly on the development of direct restorative materials. Resin-based composites remain an excellent conservative alternative for restoration of teeth with extensive caries lesions. Over time, several strategies have been proposed to improve the mechanical properties of these composites so that they can adequately withstand masticatory forces. Glass fiber-reinforced resin-based composites and their use in situations where there is great loss of tooth structure have gained popularity due to their favorable mechanical properties. Combined techniques with polyethylene fibers can further enhance their clinical performance. This study presents a brief review of their most important qualities and potential use in direct restorative procedures. In addition, a clinical case is described where a vital tooth with extensive coronal destruction was restored using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. The reinforcement of both the remaining tooth structure and the restoration with fibers is a valid treatment option since the network structure formed by the fiber reinforcement can increase the longevity of the direct composite restorations. There are few reports in the literature describing the use of a combined technique using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. Thus, clinical follow-up of this case is required.

Effect of the Absence of HEMA on the Bonding Properties of Universal Adhesive Systems Containing 10-MDP: An In Vitro Study.

Wendlinger M, Nuñez A, Moreira P … +5 more , Carneiro TS, Cochinski GD, Siqueira F, Cardenas A, Loguercio AD

Oper Dent · 2023 Sep · PMID 37503689 · Publisher ↗

OBJECTIVES: To evaluate the absence of 2-hydroxyethyl methacrylate (HEMA) on the adhesive properties with enamel and dentin of universal adhesive systems containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP). MET... OBJECTIVES: To evaluate the absence of 2-hydroxyethyl methacrylate (HEMA) on the adhesive properties with enamel and dentin of universal adhesive systems containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP). METHODS AND MATERIALS: One hundred and twelve caries-free third molars were used to test adhesion to dentin (n=64) and enamel (n=48). For each substrate, teeth were divided into eight experimental groups: four different adhesives each using two adhesive strategies. The adhesives used were: (1) Scotchbond Universal (SBU, 3M Oral Care, St Paul, MN, USA) as a HEMA-containing universal adhesive; (2) Gluma Bond Universal (GBU, Kulzer, Hanau, Germany); (3) Solare Universal Bond (SUB, GC, Tokyo, Japan); and (4) Zipbond Universal (ZIP, SDI, Victoria, Australia) as HEMA-free universal adhesives. The adhesive strategies used were etch-and-rinse (ER) and self-etch (SE). For dentin tests, the occlusal third of the crown of all teeth was removed and an adhesive protocol was applied. After completing the restoration, specimens were sectioned into bonded sticks (0.8 mm 2) and tested for microtensile bond strength (μTBS), in situ degree of conversion (DC), and nanoleakage (NL) by scanning electron microscopy. For enamel tests, teeth were sectioned into four parts (buccal, lingual, and proximal), and an adhesive protocol was applied. After completing the restoration, the specimens were tested for their microshear bond strength (μSBS). For in situ degree of conversion (DC) and nanoleakage (NL) evaluation of enamel, the specimens were sectioned in slices to be evaluated. The data for each substrate were subjected to two-way ANOVA and Tukey's test (α=0.05) for each property evaluated. RESULTS: The SBU and ZIP adhesives showed the highest μSBS, and DC (dentin and enamel) and lower NL (dentin) values compared to GBU and SUB (p=0.001). However, SBU showed better results in terms of μTBS and μSBS (SE strategy), and DC (dentin and enamel) than ZIP. Strategy ER presented higher values of μTBS and μSBS when compared to strategy SE (p=0.001), except for SBU. CONCLUSION: The effect of the absence of HEMA in commercial universal adhesive systems on enamel and dentin adhesive properties appears to be material-dependent.

Influence of Phosphoric, Glycolic, and Ferulic Acids on Dentin Enzymatic Degradation, Ultimate Tensile Strength, and Permeability.

Isabel C, Basting RT, França F … +3 more , Amaral FD, Turssi CP, Basting RT

Oper Dent · 2023 Sep · PMID 37503688 · Publisher ↗

This study evaluated dentin enzymatic degradation based on the total matrix metalloproteinase (MMP) activity of demineralized dentin matrices before and after exposure to phosphoric acid (PA), glycolic acid (GA), and fer... This study evaluated dentin enzymatic degradation based on the total matrix metalloproteinase (MMP) activity of demineralized dentin matrices before and after exposure to phosphoric acid (PA), glycolic acid (GA), and ferulic acid (FA). The release of hydroxyproline (HP), ultimate tensile strength (UTS), and dentin permeability (DP) were also evaluated. Dentin collagen matrices were assessed according to total MMP activity before and after treatment with the tested acids (n=10) for 15 seconds and compared with the control (GM6001 inhibitor). Dentin beams were analyzed for HP release and UTS after the treatments. Dentin discs were tested for DP at a pressure of 5 psi before and after treatment with the acids (n=10). The FA group had a lower percentage of enzymatic inhibition than the PA and GA groups (p<0.0001). No significant difference in UTS was found among the acids (p=0.6824), but HP release was significantly higher in the FA group than in the PA and GA groups (p<0.0001). No significant difference in DP was found for the acids (p=0.0535). GA led to less activation of MMPs and less release of HP, whereas the UTS and DP for GA were like those found for PA. In contrast, FA promoted greater enzymatic activity and greater release of HP, while having similar results to GA and PA regarding mechanical properties.

Restoration of a Microdont Using the Resin Composite Injection Technique With a Fully Digital Workflow: A Flexible 3D-printed Index With a Stabilization Holder.

Watanabe K, Tichy A, Kamoi K … +5 more , Hiasa M, Yonekura K, Tanaka E, Nakajima M, Hosaka K

Oper Dent · 2023 Sep · PMID 37503684 · Publisher ↗

Direct composite restorations are accepted as a treatment option for microdontia, which is a relatively prevalent condition that poses esthetic concerns. While free-hand composite placement is technique-sensitive and tim... Direct composite restorations are accepted as a treatment option for microdontia, which is a relatively prevalent condition that poses esthetic concerns. While free-hand composite placement is technique-sensitive and time-consuming, the resin composite injection technique is more straightforward and predictable. A fully digital workflow has been recently introduced, but the 3D-printed resin index is rigid and challenged by undercuts, as opposed to the silicone index. This case report presents a flexible 3D-printed resin index, which can accurately transfer the digitally simulated functional and esthetic form to the final restoration. In addition, a rigid stabilization holder was designed to stabilize the flexible index.

Effect of a Diode Laser (445 nm) on Polymerization Efficiency of a Preheated Resin Composite Used for Luting of Indirect Composite Restorations.

Michailidou S, Dionysopoulos D, Papadopoulos C … +4 more , Naka O, Andriotis E, Fatouros D, Tolidis K

Oper Dent · 2023 Sep · PMID 37503655 · Publisher ↗

PURPOSE: The aim of this study was to evaluate the polymerization efficiency of a preheated resin composite used as a luting agent for indirect restorations light-cured by a blue diode laser (445 nm). METHODS: Bronze mol... PURPOSE: The aim of this study was to evaluate the polymerization efficiency of a preheated resin composite used as a luting agent for indirect restorations light-cured by a blue diode laser (445 nm). METHODS: Bronze molds were used to prepare cylindrical specimens of a laboratory composite (Ceramage) with dimensions 2, 3, and 4 mm in height and 8 mm in diameter. The molds had additional height of 120 μm for the placement of the preheated resin composite. A nanohybrid resin composite (Enamel Plus HRi) was preheated at 55°C to use as a luting agent. Photopolymerization was followed for 20 seconds using three light sources: a diode laser emitting at 445 nm (SiroLaser Blue) and two light-emitting diode (LED) units (Bluephase Style and Valo). Degree of conversion (DC) of the preheated resin composite was evaluated using Fourier transform infrared spectroscopy. RESULTS: The results indicated that the main effects of the analysis were significant for both material thickness (p<0.001) and polymerization method (p<0.001). The preheated resin composite was not polymerized under 4-mm-thick specimens, independent of the light-curing unit. For 2-mm material thickness, there was no difference among the three light-curing units (p=0.383), while 3-mm Bluephase Style presented very low DC. CONCLUSIONS: Diode laser (445 nm) achieved better polymerization efficiency at the same fluence compared to the LED unit at 3-mm depth, implying a better mechanical behavior and potential improved adhesion of the luting material to dentin.

The Effect of Ground and Unground Enamel on the Clinical Performance of Direct Composite Build-up After Orthodontic Treatment: Five Years of Follow-up.

Demirci M, Tuncer S, Tekçe N … +2 more , Öztaş E, Baydemir C

Oper Dent · 2023 Sep · PMID 37503637 · Publisher ↗

PURPOSE: To assess the clinical performance of restorations with ground and unground enamel for diastema closure. METHODS AND MATERIALS: Twenty-four patients attended and received two to ten composite build-ups for diast... PURPOSE: To assess the clinical performance of restorations with ground and unground enamel for diastema closure. METHODS AND MATERIALS: Twenty-four patients attended and received two to ten composite build-ups for diastema closure. The restorations were performed separately by grinding and not grinding the enamel on the proximal surfaces on symmetric teeth. A nanofill direct composite (Filtek Ultimate Universal Restorative System, 3M ESPE, St Paul, MN, USA) was used with a three-step etch-and-rinse adhesive (Scotchbond Multi-Purpose, 3M ESPE) for restorations. Restorations were evaluated according to the modified United States Public Health Service (USPHS) criteria at baseline and 1-, 2-, 3-, 4-, and 5-year recalls. RESULTS: The cumulative success rate of direct composite build-up with ground and unground enamel was 100% and 88.7%, respectively. Six restorations with unground enamel failed due to fracture. No significant difference was found between the restorations with ground enamel and unground enamel with regard to the evaluation criteria. CONCLUSION: The 5-year success rates of restorations with ground and unground enamel were excellent. The success rate of restorations with ground enamel was higher than that of restorations with unground enamel. Fracture was the reason for failure in the restorations with unground enamel.

Effects of Different Primers on the Bond Strength to Properly and Excessively Etched Ceramic-coated Zirconia.

Deng J, Jin C, Zhu L … +4 more , Liu L, Huang Y, Zhao P, Gao S

Oper Dent · 2023 Sep · PMID 37482890 · Publisher ↗

PURPOSE: To determine the effects of various primers on the immediate and long-term bond strength of ceramic-coated ultratranslucent zirconia that is properly or excessively etched. METHODS AND MATERIALS: Ceramic-coated... PURPOSE: To determine the effects of various primers on the immediate and long-term bond strength of ceramic-coated ultratranslucent zirconia that is properly or excessively etched. METHODS AND MATERIALS: Ceramic-coated zirconia plates were etched with 9.5% hydrofluoric acid (HF) for 2 or 5 minutes, after which the surface morphology and elemental composition were examined. The etched specimens were treated with different primers including methacryloyloxydecyl dihydrogen phosphate (MDP)-only containing primer, silane-only containing primer, MDP and silane-containing ceramic primer as well as MDP and silane-containing adhesive system. For surface contact angle and shear bond strength (SBS) data, the difference between groups was evaluated by one-way analysis of variance (ANOVA) and three-way ANOVA factorial analysis, respectively. The statistical significance level of 0.05 was set and the Tukey test and the Dunnett-T3 test were used for post-hoc multiple comparisons. RESULTS: Excessive etching (9.5% HF for 5 minutes) led to overconsumption of the glass layer and exposure of zirconia substrate compared to proper etching (9.5% HF for 2 minutes). Among different primers, the surface contact angle of the silane-only containing primer group was the lowest. The silane-only containing primer and MDP and silane-containing ceramic primer produced higher shear bond strength of properly and excessively etched ceramic-coated zirconia, respectively, both before and after thermal aging. CONCLUSIONS: The silane-only containing primer and MDP and silane-containing primer can obtain better immediate and long-term shear bond strength for properly and excessively etched ceramic-coated zirconia, respectively.

Effect of RMGI Roughness and Dentin Bonding Primer on Shear Bond Strength of Sandwich-type Restorations.

Bloomquist R, Villalobos V, Patel C … +2 more , Olson J, Rueggeberg F

Oper Dent · 2023 Sep · PMID 37415337 · Publisher ↗

BACKGROUND: The open sandwich technique is a reliable alternative to amalgam placement in deep proximal box preparations, where proper isolation and enamel bonding may not be possible. It is often difficult to prepare th... BACKGROUND: The open sandwich technique is a reliable alternative to amalgam placement in deep proximal box preparations, where proper isolation and enamel bonding may not be possible. It is often difficult to prepare the box for composite placement without affecting the resin-modified glass ionomer (RMGI) that has been placed in the gingival portion. We hypothesized that RMGI surfaces that are roughened or those that use all steps in the manufacturing bonding protocol, including the priming solution, applied before placing a bonded composite increment, would have greater composite/RMGI shear bond strength. DESIGN AND METHODS: Shear bond strengths (SBS) of RMGI tested in the presence and absence of SiC roughening and primer-coating were tested using a fourth-generation dentin bonding agent to composite after thermocycling. Twenty specimens for four test conditions were fabricated and investigated. Data were subjected to a two-way ANOVA and the Holm-Sidak post-hoc test. RESULTS: Placing dentin primer on unabraded RMGI provided a statistically significant improvement in SBS, but only modestly. Furthermore, because bond failure consistently occurred within the RMGI itself, none of the surface modifications have a clinically relevant impact on SBS at the RMGI to the composite interface. CONCLUSIONS: Clinicians should be aware that they need not avoid RMGI abrasion and do not need to incorporate all components of a fourth-generation bonding system when covering an RMGI sandwich layer with composite.

Errata.

Oper Dent · 2023 Jul · PMID 37399005 · Publisher ↗

Abstract loading — click title to view on PubMed.

Optical and Mechanical Properties of New Ceramic CAD/CAM Materials.

Reid DA, Matis JI, Lien W … +4 more , Raimondi CJ, Arnason SC, DuVall NB, Vandewalle KS

Oper Dent · 2023 Jul · PMID 37399004 · Publisher ↗

OBJECTIVE: The purpose of this study was to compare the optical and mechanical properties of newer ceramic CAD/CAM materials to more established materials on the market. METHODS AND MATERIALS: The following ceramic mater... OBJECTIVE: The purpose of this study was to compare the optical and mechanical properties of newer ceramic CAD/CAM materials to more established materials on the market. METHODS AND MATERIALS: The following ceramic materials were tested: lithium disilicate/lithium-aluminum silicate (Tessera, Dentsply/Sirona), lithium disilicate (Initial LiSi Block, GC), IPS e.max CAD, Ivoclar Vivadent), and 4Y polycrystalline stabilized zirconia (IPS e.max ZirCAD MT, Ivoclar Vivadent; Katana STML, Kuraray; YZ ST, VITA). Optical properties (translucency, opalescence) were determined using a dental spectrophotometer on 0.5-, 1.0-, 1.5-, or 2.0-mm specimens. Mechanical properties (flexural strength, flexural modulus, flexural fatigue strength, Weibull modulus, and characteristic strength) were determined with beams undergoing 3-point bend testing. The data were analyzed with multiple analyses of variance and Tukey's post hoc tests (α=0.05). RESULTS: Significant differences were found between groups based on type of ceramic or property (p<0.05). CONCLUSIONS: In general, the lithium disilicate based-ceramic materials had greater optical properties and lower mechanical properties than the zirconia-based ceramic materials.
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