Mineral density changes in bovine carious dentin after treatment with bioactive dental cements: a comparative micro-CT study

Objectives

To evaluate the potential of conventional glass ionomer cement (GIC), Biodentine™, MTA, and Portland cement to induce mineral density changes in carious dentin compared to zinc oxide eugenol control cement (ZOE).

Materials and methods

Fifty blocks of bovine root dentin were prepared and a biofilm model using ATCC strains of S.mutans, S.sobrinus, and L.casei was used to promote artificial dentin lesions. After demineralization, the blocks were randomly divided into the five cement groups. Half of the surface of each specimen received the tested material and the other half was covered with wax (control). Samples were stored in phosphate buffered saline solution for 30 days and after that were scanned in a micro-CT with standardized parameters. Dentin mineral density changes were calculated using differences in plot profiles of the exposed and control carious dentin. Friedman’s test, followed by Wilcoxon signed-rank test was used with 5% significance.

Results

Mean ΔZ values for the cements were 48.63 ± 19.09 for the control (ZOE), 63.31 ± 32.59 for Biodentine™, 114.63 ± 72.92 for GIC, 109.56 ± 66.28 for MTA, and 106.88 ± 66.02 for Portland cement. All cements showed a statistically significant increase in ΔZ values compared to the control, but Biodentine™ values were statistically significantly lower compared to GIC and the other calcium silicate cements.

Conclusions

Tested materials present potential to induce mineral density changes in carious bovine dentin. MTA, Portland, and GIC showed higher bioactivity potential than Biodentine™.

Clinical relevance

Based on minimally invasive concept, materials with remineralization potential can be used to preserve diseased but still repairable dental tissue.

     

The effect of radiotherapy delivery time and obturation materials on the fracture resistance of mandibular premolars

Objectives

This ex vivo study was performed to investigate the effect of radiotherapy (RT) delivery time on fracture resistance of mandibular premolars filled with Biodentine or gutta-percha/sealer (GPS).

Materials and methods

Seventy-two mandibular premolars were used in this study. Randomly selected 24 teeth were kept intact for the control groups (with and without irradiation). Then, the remaining 48 teeth were randomly assigned into 4 groups (n = 12) according to RT delivery time (irradiated before or after root canal treatment) and obturation materials as follows: Group RT + GPS, Group: GPS + RT, Group RT + Biodentine and Group Biodentine + RT. The samples were either initially endodontically treated and then irradiated or initially irradiated and then endodontically treated with one of the abovementioned materials. The samples were irradiated at 2 Gy per fraction, 5 times a week for a total dose of 60 Gy in 30 fractions over 6 weeks. The roots were embedded in self-polymerizing acrylic resin. The fracture resistance was evaluated in a universal testing machine. Data was analyzed by one-way ANOVA and Games-Howell post hoc test at p < 0.05.

Results

Radiation therapy significantly reduced fracture resistance of intact teeth (p < 0.05). The highest fracture resistance was observed in intact/non-irradiated teeth and the lowest fracture resistance in Biodentine + RT group (p < 0.05). The effect of RT delivery time was insignificant when GPS was preferred as the root canal filling material (p > 0.05); it was significant when preferring Biodentine (p < 0.05). When RT was applied to the teeth after Biodentine obturation, the fracture resistance decreased significantly compared to the teeth that were obturated with GPS after or before RT application (p < 0.05).

Conclusion

Both RT time and obturation materials (Biodentine or gutta-percha/sealer) affect the fracture resistance of the endodontically treated teeth.

Clinical relevance

Endodontic treatment could be completed with both materials after RT; however, when the endodontic treatment was initially completed and the teeth were subsequently exposed to RT, it was shown that the reinforcement effect of Biodentine decreased.

     

Physical and mechanical properties of dual functional cements—an in vitro study

Objectives

The aim of this study was to evaluate the physical and mechanical properties of different dual functional cements.

Materials and methods

Three dual functional cements (Allcem Core (FGM), Rebilda DC (VOCO), and LuxaCore Z (DMG)), a luting resin cement (Rely X ARC (3 M ESPE)), and a Core Buildup composite resin GrandioSo (VOCO) were used. Flexural strength (n = 10) and film thickness (n = 6) were evaluated according to ISO 4049:2009. Flow (n = 6) was evaluated according to ISO 6876:2001. Degree of conversion (DC) was assessed immediately and 24 h after polymerization (n = 5). For resistance to dislodgment (RD) analysis, bovine teeth were prepared to receive fiber glass posts, and a push-out test (n = 12) was used.

Results

Luxacore Z presented lower flexural strength when compared to GrandioSo (p < 0.001). No statistical difference was found between cements for film thickness (p = 0.66). Reduced flow values were found for Allcem Core (p = 0.006). No statistical difference was found for immediate DC for different cements (p > 0.05). After 24 h, DC increased for all groups, except for Luxacore Z (p = 0.054). The RD did not differ from the control Rely X ARC, regardless of the root third (p > 0.05). Luxacore Z showed lower mean values in the apical third compared to the coronal third (p = 0.046).

Conclusions

The dual functional cements (Allcem Core and Rebilda DC) possessed similar physical and mechanical properties of luting resin cement (RelyX ARC) and Core Buildup composite resin (GrandioSo). Hence, they could be used for one-stage post and core buildup restorations.

Clinical relevance

The dual functional cements could be used for one-stage post and core buildup restorations since they possess similar physical and mechanical properties of luting resin cements and Core Buildup composite resin.

     

Application of a direct pulp capping cement containing S-PRG filler

Objectives

To evaluate new pulp capping cements containing surface pre-reacted glass ionomer (S-PRG) filler and to investigate ion release kinetics and pH shift of eluates from the cement.

Materials and methods

Molars of Wistar rats were directly pulp capped using three kinds of cement containing S-PRG filler and mineral tri-oxide aggregate (MTA) was used as a control. After 1, 2, or 4 weeks, histological evaluation was performed and differences of tertiary dentin formation were analyzed. Release of Sr²⁺, BO₃³⁻, SiO₃²⁻, Na⁺, and Al³⁺ ions was determined by inductively coupled plasma-atomic emission spectrometry, and F⁻ ion release was measured using a fluoride ion selective electrode. The pH of the eluate from each cement after mixing was measured with a pH electrode.

Results

One of S-PRG cements promoted tertiary dentin formation to the same extent as the control (p > 0.05) and it showed a tendency of less inflammatory response. This cement released more BO₃³⁻ and SiO₃²⁻, but less Sr²⁺, Na⁺, and F⁻ than other S-PRG specimens. Each cement recovered nearly neutral compared with glass ionomer cement.

Conclusions

S-PRG cement induced tertiary dentin formation based on multiple ion releases, suggesting that it is suitable as a pulp capping material.

Clinical relevance

This new material can be an alternative pulp capping agent to MTA.

     

Influence of proximal box elevation on bond strength of composite inlays

Objectives

The objective of the present study was to evaluate the influence of proximal box elevation on microtensile bond strength (mTBS) of composite inlays to the proximal box floor, using either a total-etch or a self-adhesive resin cement.

Materials and methods

Twenty-five human molars were selected, and a class II OM (inlay) cavity preparation was performed in each tooth. Cavities were randomly assigned into four experimental groups, according to the location of the proximal cervical margin (located 1 mm below cementoenamel junction (CEJ), or with proximal box elevation with composite resin) and the resin cement used for luting (a total-etch resin cement RelyX ARC or a self-adhesive resin cement G-Cem). After 1-week water storage, samples were subjected to mTBS test. Results were analyzed by Kruskal–Wallis and Mann–Whitney U tests (p < 0.05).

Results

Kruskal–Wallis revealed statistically significant differences among experimental groups (p = 0.007). Both resin cements showed similar bond strength values when cervical margin was located below CEJ. The proximal box elevation improved the bond strength of composite inlays for both resin cements. However, only for G-Cem was this improvement statistically significant.

Conclusions

The proximal box elevation improved the bond strength attained by G-Cem resin cement. For RelyX ARC, the position of the cervical margin did not affect composite inlays bond strength.

Clinical relevance

Proximal box elevation does not decline bond strength of composite inlays to the proximal floor when a total-etch or a self-adhesive resin cement is used.

     

Clinical evaluation of direct pulp capping using a calcium silicate cement—treatment outcomes over an average period of 2.3 years

Objectives

This study aims to assess the treatment outcomes of direct pulp capping with a calcium silicate cement (Biodentine) after caries excavation.

Materials and methods

A total of 245 teeth of 226 patients diagnosed to be clinical healthy or showing spontaneous pain were directly capped. The teeth were examined 0.19 to 7.4 (mean 2.3 ± 2.04) years after treatment. The following data were recorded: age and sex of the patient, type of tooth and restoration (glass ionomer cement [GIC], amalgam, composite resin, ceramic, gold) and symptoms before or after treatment. The evaluation of the treatment was carried out by sensibility and percussion testing and by the patient’s questioning. A positive sensibility test, a negative percussion test, the absence of swelling and discomfort were considered as treatment success. Survival analysis was performed using the Kaplan-Meier, log-rank, Chi-square and Fisher’s exact test, respectively.

Results

After an average period of 2.3 years, 86.0% of the teeth remained vital; the survival rate after 7.4 years was 83.4%. The treatment outcome was significantly worse for cavities restored with GIC compared to all other restorative materials (p < 0.05). All other evaluated factors had no significant influence on the success rate (p > 0.05).

Conclusion

Exposed pulps of asymptomatic vital permanent teeth and teeth with spontaneous pain before treatment can be successfully capped directly using Biodentine. A subsequent restoration with GIC does not appear to be suitable as it significantly reduces the success of the treatment.

Clinical relevance

Direct pulp capping can be done successfully with this type of calcium silicate cement.

     

Effect of temporary cements and their removal methods on the bond strength of indirect restoration: a systematic review and meta-analysis

Objectives

For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal strategy for minimizing its negative effects.

Material and methods

Databases such as PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for in vitro studies, involving the influence of immediate dentin sealing (IDS), different temporary cements, and their removal strategies on dentin bond strength. The meta-analysis used the inverse variance method with effect method of the standardized mean difference and statistical significance at p?≤?0.05. The I² value and the Q-test were used to assess the heterogeneity.

Results

A total of 14 in vitro trials were subjected to the meta-analysis. Within the study’s limitations, we assumed that IDS eliminated the negative effects of temporary bonding, achieving the comparable immediate bond strength with the control (p?=?0.46). In contrast, under delayed dentin sealing (DDS), temporary cementation statistically decreased bond strength (p?=?0.002). Compared with resin-based and non-eugenol zinc oxide cements, polycarboxylate and calcium hydroxide cements performed better on bond strength with no statistical difference from the control group (p?>?0.05). Among the removal methods of temporary cements, the Al₂O₃ abrasion restored the decreased bond strength (p?=?0.07) and performed better than hand instruments alone (p?=?0.04), while pumice removal slightly reduced the bond strength in contrast with the control group (p?=?0.05, 95% CI?=????1.62 to 0).

Conclusions

The choices of IDS, polycarboxylate and calcium hydroxide temporary cements, Al₂O₃ abrasion removal method were feasible and efficient to enhance the bond strength.

Clinical relevance

It is worthwhile applying IDS technique, polycarboxylate and calcium hydroxide temporary cements during indirect restoration. The Al₂O₃ abrasion of cleaning dentin can minimize the negative effects of temporary cement.

     

Coronal discoloration induced by calcium silicate-based cements used in full pulpotomy in mature permanent molars: a randomized clinical trial

Objectives

This study aimed to randomly compare in vivo coronal discoloration at 6 and 12 months after full pulpotomy in mature permanent molars using MTA, Biodentine, and TotalFill and to investigate the effect of variables such as remaining buccal wall thickness and time to achieve hemostasis.

Materials and methods

One hundred eight teeth that met the inclusion criteria received full pulpotomy and were randomly divided into 3 groups via a block randomization technique according to the calcium silicate cement (CSC): ProRoot WMTA, TotalFill, or Biodentine. Assessment of tooth color was carried out using a spectrophotometric device (VITA Easyshade Compact) after composite placement (T0), at 6- and 12-month follow-up. Buccal wall thickness and time to hemostasis were recorded. The primary outcome measure (color change ΔE) was calculated, and the results were analyzed by three-way ANOVA and crosstabulations in relation to material type and effect of variables.

Results

Four cases were excluded after pulpotomy failure; 81 teeth were evaluated at 6 months and 95 teeth at 12 months. All CSCs caused tooth discoloration (defined as ΔE > 3.7); MTA significantly caused the highest color change at 6- and 12-month follow-up (76% (19/25) and 87.5% (28/32), respectively) compared to Biodentine (41% (9/22), 48% (13/27)) and TotalFill (44% (15/34), 53% (19/53)) (p = 0.022, p = 0.002), while no significant difference was found between the Biodentine and TotalFill groups (p = 0.813, p = 0.8). Buccal wall thickness (above or below 2.7 mm) had a significant effect on the degree of discoloration (p = 0.004).

Conclusions

The 3 CSCs caused tooth discoloration based on the threshold of ΔE > 3; the remaining buccal wall thickness was a significant factor. The use of Biodentine and TotalFill instead of MTA is encouraged to minimize discoloration.

Clinical relevance

While experimental studies report coronal discoloration after CSCs use, clinical data is lacking. This study assessed discoloration using a spectrophotometric device. The use of materials with lower discoloration potential in pulpotomy is encouraged.

Trial registration

The study was registered with clinical trial registration number: NCT04346849 on 14.4.2020.

     

Influence of composition on setting kinetics of new injectable and/or fast setting tricalcium silicate cements

ObjectivesNew commercial tricalcium silicate based cements were elaborated to improve handling properties and setting time. The goals of the present work were: (i) to determine the composition of the new injectable and/or fast setting calcium silicate based cements, and (ii) to investigate the impact of the differences in composition on their setting kinetics.MethodsThe materials considered were Angelus MTA™, Biodentine™, MM-MTA™, MTA-Caps™, and ProRoot MTA™ as control.Elemental composition of materials was studied by Inductively Coupled Plasma-Atomic Emission Spectroscopy and X-ray Energy Dispersive analysis, whereas phases in presence were analyzed by Micro-Raman spectroscopy and X-ray Diffraction analysis and cement surface by Scanning Electron Microscope. Setting kinetics was evaluated using rheometry.ResultsElemental analysis revealed, for all cements, the presence of three major components: calcium, silicon and oxygen. Chlorine was detected in MM-MTA, MTA-Caps and Biodentine. Different radio-opacifiers were identified: bismuth oxide in ProRoot MTA, Angelus MTA and MM-MTA, zirconium oxide in Biodentine and calcium tungstate (CaWO₄) in MTA-Caps. All cements were composed of di- and tri-calcium silicate, except Biodentine for which only the latter was detected. Major differences in setting kinetics were observed: a modulus of 8 × 10⁸ Pa is reached after 12 min for Biodentine, 150 min for MM-MTA, 230 min for Angelus MTA and 320 min for ProRoot MTA. The maximum modulus reached by MTA-Caps was 7 × 10⁸ Pa after 150 min.SignificanceEven if these cements possess some common compounds, major differences in their composition were observed between them, which directly influence their setting kinetics.     

In vitro shear bond strength of 2 resin cements to zirconia and lithium disilicate: An in vitro study

Statement of problemThere is little evidence on how the multiple layers of zirconia (ZrO₂) or glazed material will affect the shear bond strength (SBS) of different resin cements.PurposeThe purpose of this in vitro study was to compare the SBS of 2 resin cements with the different layers of a monolithic polychromatic ZrO₂ ceramic, both glazed and nonglazed, and a lithium disilicate (LDS) ceramic.Material and methodsOne hundred and sixty-eight composite resin cylinders and 48 monolithic polychromic ZrO₂ plates were prepared. Twenty-four were milled and sintered, and 24 were milled and sintered and had a glaze cycle applied with no liquid glaze. These plates and 12 LDS plates were mounted in autopolymerized acrylic resin. Bonding surfaces were polished, airborne-particle abraded, and cleaned ultrasonically. The different layers (cubic, hybrid, and tetragonal) of the ZrO₂ plates were identified and marked. The plates were assigned to 2 cement groups: a self-adhesive, autopolymerized resin cement, and a dual-polymerizing, adhesive resin cement (DPRC). Bonding surfaces were cleaned and treated according to the cement manufacturer’s instructions. Three composite resin cylinders were luted to the ZrO₂ plates at the appropriate layer, and 2 cylinders were luted to each LDS plate. The specimens were stored in a moist environment for 24 hours at 37 °C. The SBS test was performed with a universal testing machine. Visual inspections of the debonded surfaces were compared under magnification. The data were analyzed with a 2-way ANOVA and a subsequent Student t test (α=.05).ResultsThe 2-way ANOVA found no difference among luting agent and LDS and ZrO₂. The SBSs of the nonglazed tetragonal and cubic layer to the ZrO₂ were higher than to the surface exposed to a glazing cycle (P=.001). The bonded surfaces were examined tactilely and under ×3.5 magnification, followed by light and scanning electron microscopy and recorded as either adhesive, cohesive, or mixed. Almost all failures in the glazed ZrO₂ were mixed and cohesive. However, more adhesive failures were observed in the DPRC group of nonglazed ZrO₂.ConclusionsNo differences were found between the 2 luting agents for the LDS. For the ZrO₂ cubic and tetragonal layers, the DPRC had higher bond strengths to the nonglazed surfaces.     

Antimicrobial effect of bioceramic cements on multispecies microcosm biofilm: a confocal laser microscopy study

Objectives

To assess the viability of multispecies microcosm biofilm after contact with NeoMTA Plus, Biodentine, and MTA Angelus.

Materials and methods

Fifty-four human dentin blocks (4 × 5 × 4 mm) were allocated to Hawley retainers, worn by six volunteers for 72 h. The blocks were then individually incubated in BHI broth for 21 days at 37 °C. At the end of experimental time for biofilm growth, the samples were randomly divided into four groups (n = 12): NeoMTA Plus, Biodentine, MTA Angelus, and negative control. The materials were placed in contact with the blocks. All samples were placed in cell-culture plate wells and incubated in BHI broth for 7 days at 37 °C. One sample from each volunteer (n = 6) was analyzed by SEM to describe the biofilm morphology. CLSM was performed to determine the percentage of viable biofilm biovolume. The data were statistically analyzed by one-way ANOVA and Tukey’s multiple comparison test (α = 5%).

Results

SEM showed biofilm formed by spherical and rod-shaped bacteria surrounded by an extracellular matrix. No material was able to kill all biofilm cells, and all groups had more than 50% of viable bacteria. NeoMTA Plus was significantly different from the negative control group (P < .05).

Conclusions

All tested materials were not effective against multispecies microcosm biofilm.

Clinical relevance

NeoMTA Plus, Biodentine, and MTA Angelus were not effective against multispecies microcosm biofilm. It is essential to understand that these bioceramic cements are indicated for infected clinical situations. Thus, complementary disinfection procedures should be conducted prior to filling with these materials.

     

Effect of different gutta-percha solvents on the microtensile bond strength of various adhesive systems to pulp chamber dentin

Objectives

The aim of this study was to evaluate the effect of different endodontic solvents on the microtensile bond strength (μTBS) of various adhesives to pulp chamber dentin.

Material and methods

A total of 120 human third molars were selected. Canals were prepared with the ProTaper Universal system and obturated. The access cavities were then restored with resin composite. After 1 week, a retreatment procedure was applied as follows: control, no solvent was applied to the pulp chamber and experimental groups, three different solvents (chloroform, eucalyptol, and orange oil) were applied to the pulp chamber for 2 min. The canal filling was removed and calcium hydroxide (Ca[OH]₂) was placed into the canals. After 7 days, the Ca(OH)₂ was removed from the canals and the canals were re-obturated. Teeth were then divided into three subgroups according to the adhesive used. The samples were restored with a nanohybrid resin composite using three different adhesives: Clearfil SE Bond (CSE), Adper Easy One (AEO), and Single Bond 2 (SB2). The samples were aged with thermocycling. Teeth were sectioned, and a total of 20 dentin sticks were obtained for each subgroup. μTBS testing was then performed. The debonded surfaces were evaluated using scanning electron microscopy (SEM) analysis. Data were analyzed using two-way ANOVA and Tukey’s post hoc tests.

Results

Chloroform showed statistically lower mean μTBS values (14 ± 7.2 MPa) than control group did (19.2 ± 6.1 MPa) (p < 0.05). Orange oil (18.1 ± 6.3 MPa) and eucalyptol (16.9 ± 6.8 MPa) did not reduce the mean μTBS statistically (p > 0.05). Chloroform showed significantly lower bond strength for all adhesives (p < 0.05). Whereas orange oil did not reduce the mean μTBS values of all adhesive systems significantly (p > 0.05), eucalyptol reduced the μTBS values of all the groups, but the results were only statistically significant for SB2 (p < 0.05). CSE showed statistically higher bond strength (20.4 ± 6.8 MPa) than AEO (14.6 ± 5.3 MPa) and SB2 (16.3 ± 7.2 MPa) did (p < 0.05). There were no statistical differences between AEO and SB2 (p > 0.05). According to the SEM analysis of the debonded surfaces, adhesive failures were the most common type in all the groups, followed by mixed failures.

Conclusions

While chloroform reduced the mean bond strength of the adhesive resins, orange oil did not affect the bond strength of the adhesives. The effect of eucalyptol on bond strength depended on the type of adhesive system.

Clinical relevance

This study shows that endodontic solvents could affect the microtensile bond strength of adhesives to pulp chamber dentin.

     

Physicochemical,biological, and antibacterial evaluation of tricalcium silicate-based reparative cements with different radiopacifiers

ObjectiveTo evaluate tricalcium silicate-based (TCS) experimental materials, associated with zirconium oxide (ZrO₂), calcium tungstate (CaWO₄) or niobium oxide (Nb₂O₅) radiopacifiers, in comparison with MTA Repair HP (Angelus).MethodsPhysicochemical tests: setting time, radiopacity, pH and solubility. In vitro assays: cytotoxicity: MTT and Neutral Red – NR; cell bioactivity: alkaline phosphatase activity (ALP), Alzarin red staining (ARS) and real time PCR (qPCR). Antibacterial activity: direct contact on Enterococcus faecalis in the planktonic form. Physicochemical and ARS data were submitted to ANOVA/Tukey tests; antibacterial activity, to Kruskall–Wallis and Dunn tests; MTT, NR, ALP and qPCR were analyzed by ANOVA/Bonferroni tests (α = 0.05).ResultsTCS + CaWO₄ presented the longest setting time and MTA HP the shortest. Except for TCS, all the materials presented radiopacity above 3 mmAl. The cements had alkaline pH, antibacterial activity, low solubility and no cytotoxic effects. The highest ALP activity occurred in 14 days, especially to TCS, TCS + ZrO₂ and TCS + CaWO₄. TCS + ZrO₂, TCS + Nb₂O₅ and MTAHP had higher mineralized nodule formation than those of the negative control (NC). After 7 days, there was no difference in mRNA expression for ALP, when compared to NC. However, after 14 days there was no overexpressed ALP mRNA, especially TCS + Nb₂O₅, in relation to the CN. All the materials presented antimicrobial action.SignificanceThe pure tricalcium silicate associated with ZrO₂, CaWO₄ or Nb₂O₅ had appropriate physicochemical properties, antibacterial activity, cytocompatibility and induced mineralization in Saos-2, indicating their use as reparative materials.     

Glass-ionomer and calcium silicate-based cements interactions with human dentine in health and disease: Two-photon fluorescence microscopy and Raman spectroscopy analysis.

ObjectivesTo investigate the potential mineralising effects of calcium silicate-based dentine replacement material (Biodentine?) in comparison with glass-ionomer cement (GIC) (Fuji IX?) on different human dentine substrates using a multimodal non-invasive optical assessment.MethodsCements were applied on artificially demineralised or naturally carious dentine and stored for 4 weeks in phosphate-rich media +/- tetracycline used for mineralisation labelling. Interfacial dentine was examined from the same sample and location before and after aging using two-photon fluorescence microscopy, fluorescence lifetime imaging (FLIM) and second harmonic generation (SHG) imaging. Additionally, Raman spectroscopy was used to detect changes in the mineral content of dentine.ResultsSignificant changes in the fluorescence intensity and lifetime were detected in partially demineralised dentine and caries-affected dentine underneath both tested cements, after storage (p < 0.001). This was associated with a significant increase in the mineral content as indicated by the increased intensity of the phosphate Raman peak located at 959 cm^?1 (p < 0.0001). Caries-infected dentine showed significant fluorescence changes under Biodentine? after storage (p < 0.001), but not under GIC (p = 0.44). Tetracycline binding induced a reduction in the fluorescence lifetime with comparable increase in the fluorescence intensity in both cements’ groups within the affected dentine (p < 0.001). SignificanceTwo-photon fluorescence microscopy can be used efficiently for non-destructive in-vitro dentine caries characterisation providing a technique for studying the same dentine-cement interface over time and detect changes. Biodentine? demonstrated comparable remineralising potential to GIC, in addition to inducing remineralisation of caries-infected dentine. This may suggest using Biodentine? as part of minimally invasive operative dentistry (MID) in caries management.     

Effects of refractive index solutions on the color of different luting cements

Abstract

Purpose. The purpose of this study is to determine the effects of refractive index solutions on the color of different luting cements at different periods. Materials and methods. Fourteen disc-shaped specimens were prepared for three different universal shade luting cements. All specimens were divided into two groups and a phthalate ester and glycerol refractive index solution was applied to the specimens at different periods. Color differences (ΔE*) were calculated for before and after 5, 15, 60 min and 24 h periods of applying refractive index solutions. Data were analyzed with multiple analysis of variance (ANOVA) and mean values were compared by the Tukey HSD test (α = 0.05). Results. Periods and periods–cement interaction were statistically significant (p ≤ 0.05). There was no statistically significant difference between the mean ΔE values of refractive index solutions and cement groups (p > 0.05). Conclusion. Refractive index solutions affected the color of luting cements.     

Effects of non-thermal atmospheric plasma treatment on dentin wetting and surface free energy for application of universal adhesives

Objectives

The study aims to evaluate the effects of non-thermal atmospheric plasma (NTAP) treatments on dentin wetting and surface free energy (SFE) and compare the effects of NTAP treatment, etch-and-rinse, and self-etch protocols for application of universal adhesives.

Materials and methods

Mid-coronal dentin of intact third molars was used to measure contact angles of distilled water, ethylene-glycol, and diiodomethane and calculate SFE following different NTAP preset treatments (feeding gas consisting of pure He, He + 1% O₂, He + 1.5% O₂), power input (1 or 3 W), and tip-to-surface distance (2, 4, or 8 mm). Contact angles of reference liquids and SFE of dentin following He + 1.5% O₂ at 3-W and 4-mm treatment was compared to phosphoric acid etching. Contact angles of Single Bond Universal (SBU; 3M ESPE) and Clearfil Universal Bond (CUB; Kuraray Noritake) were measured following NTAP, etch-and-rinse, and self-etch protocols.

Results

NTAP significantly reduced contact angles of reference liquids and increased dentin SFE compared to untreated dentin (p < 0.05). O₂ intensified the effect of He NTAP (p < 0.05). NTAP and phosphoric acid increased dentin polarity and Lewis base surface characteristics. Phosphoric acid increased contact angles of adhesives compared to the self-etch protocol (p < 0.05). NTAP resulted in lower adhesive contact angles than phosphoric acid, the difference being statistically significant for CUB (p < 0.05). Compared to the self-etch protocol, NTAP slightly reduced CUB contact angle but not that of SBU (p > 0.05).

Conclusions

He NTAP with and without O₂ increased dentin wetting and SFE, surpassing the effect of phosphoric acid and lowering adhesive contact angles. NTAP produced no apparent micro-morphological changes on dentin surface comparable to acid etching.

Clinical significance

NTAP treatment of dentin prior to adhesive application increases dentin wetting and surface free energy facilitating better adhesive distribution on dentin surface compared to phosphoric acid etching and similar to the “self-etch” application protocol.

     

A comparison of stress relaxation in temporary and permanent luting cements

PurposeThe stress relaxation and compressive strength of resin, resin-modified glass ionomer, glass ionomer, polycarboxylate, and zinc oxide eugenol cements were measured to determine the characteristics of these materials after setting.MethodsA total of 19 luting cements including 12 permanent cements and 7 temporary cements were used. Cylindrical cement specimens (10 mm long and 6 mm in diameter) were obtained by chemical setting or light curing. The specimens were stored for 24–36 h in water at 37 °C and were then used for the stress relaxation and compression tests. The stress relaxation test was carried out using three constant cross-head speeds of 5, 50, and 100 mm/min. Upon reaching the preset dislocation of 0.5 mm, the cross-head movement was stopped, and the load was recorded for 60 s. Fractional stress loss at 1 s was calculated from the relaxation curves. The compressive strength and modulus were measured at a cross-head speed of 1 mm/min. Data were analyzed with the Kruskal–Wallis test and Holm's test.ResultsA zinc oxide eugenol cement [TempBOND NX] exhibited the largest fractional stress loss. A resin cement [ResiCem] showed the largest compressive strength, while a glass ionomer cement [HY-BOND GLASIONOMER CX] showed the largest compressive modulus among all tested cements (p < 0.05).ConclusionThe fractional stress loss could not be classified by the cement type. Two implant cements [Multilink Implant and IP Temp Cement] showed similar properties with permanent resin cements and temporary glass ionomer cements, respectively. Careful consideration of the choice of cement is necessary.     

Effect of temporary cements on the microtensile bond strength of self-etching and self-adhesive resin cement

Objective. The aim of this study was to evaluate the microtensile bond strength (µTBS) of self-etching and self-adhesive resin cement systems to dentin affected by the presence of remnants of either eugenol-containing or eugenol-free temporary cements. Materials and methods. Thirty extracted teeth were obtained and a flat dentin surface was exposed on each tooth. Acrylic blocks were fabricated and cemented either with one of two temporary cements, one zinc oxide eugenol (ZOE) and one eugenol free (ZOE-free), or without cement (control). After cementation, specimens were stored in water at 37°C for 1 week. The restorations and remnants of temporary cements were removed and dentin surfaces were cleaned with pumice. Resin composite blocks were cemented to the bonded dentin surfaces with one of two resin cements, either self-etching (Panavia F 2.0) or self-adhesive (RelyX U-100). After 24 h, the specimens were sectioned to obtain beams for submission to µTBS. The fracture mode was evaluated under a stereoscopic loupe and a scanning electron microscope (SEM). Data from µTBS were submitted to two-way repeated-measure ANOVA and the Tukey test (alpha = 0.05). Results. The cross-product interaction was statistically significant (p < 0.0003). The presence of temporary cements reduced the bond strength to Panavia self-etching resin cements only (p < 0.05). Fracture occurred predominantly at the dentin–adhesive interface. Conclusions. The presence of eugenol-containing temporary cements did not interfere in the bond strength to dentin of self-adhesive resin cements.     

Effect of CAD/CAM aesthetic material thickness and translucency on the polymerisation of light- and dual-cured resin cements

ObjectivesThis study investigated potential variations in polymerisation of light- and dual-cured (LC and DC) resin cements photoactivated through four CAD/CAM restorative materials as a function of substrate thickness.MethodsFour CAD/CAM materials [two resin composites CeraSmart (CS) and Grandio Blocs (GB); a polymer infiltrated ceramic Vita Enamic (VE) and a feldspathic ceramic Vita Mark II (VM)], with five thicknesses (0.5, 1, 1.5, 2, and 2.5 mm) were prepared and their optical characteristics measured. 1 mm discs of LC and DC resin cement (Variolink® Esthetic, Ivoclar AG) were photoactivated through each specimen thickness. After 1 h post-cure, polymerisation efficiency was determined by degree of conversion (DC%) and Martens hardness (H_M). Interactions between materials, thicknesses and properties were analysed by linear regressions, two-way ANOVA and one-way ANOVA followed by post hoc multiple comparisons (α = 0.05).ResultsAll substrates of 0.5- and 1.0-mm thickness transmitted sufficiently high peak irradiances at around 455 nm: (I_t = 588–819 mW/cm²) with translucency parameter TP = 21.14 – 10.7; ranked: CS> GB = VM> VE. However, increasing the substrate thickness (1.5–2.5 mm) reduced energy delivery to the luting cements (4 – 2.8 J/cm²). Consequently, as their thicknesses increased beyond 1.5 mm, H_M of the cement discs differed significantly between the substrates. But there were only slight reduction of DC% in LC cements and DC cement discs were not affected.Significance: Photoactivating light-cured Ivocerin? containing cement through feldspathic ceramics and polymer-infiltrated ceramics achieved greater early hardness results than dual-cured type, irrespective of substrate thickness (0.5 – 2.5 mm). However, only 0.5 and 1 mm-thick resin composites showed similar outcome (LC>DC). Therefore, for cases requiring early hardness development, appropriate cement selection for each substrate material is recommended.