Effects of silane coupling treatment on the clinical performance of direct repaired resin-based composite (RBC) restorations with or without prior surface sandblasting: A randomized controlled trial

OBJECTIVE

To evaluate the effects, of using silane coupling agent within the procedures of repairing old composite restorations with or without sandblasting their surfaces, on the clinical performance of repaired composite restorations.

METHODS

The study involved repairing 130 Class I and II defective composite restorations. After recurrent caries removal, the repair process included etching with 37 % phosphoric acid, Adper Single Bond 2 application for bonding and Filtek Z250 composite for restoring all defects. The restoration surfaces were subjected to one of the following additional surface treatments within the repair process: Control: No additional treatment; the Silane-Adhesive treatment: A separate step involved the application of a silane coupling agent after acid etching; and the Sandblast-Silane-Adhesive treatment: included intra-oral sandblasting of old composite surfaces followed by silane application. Two calibrated examiners evaluated all repaired restorations according to a modified USPHS criteria after 6 months. Comparisons of the clinical performance between the treatment groups were made using Chi-square test, while responses to cold tests before and after repair treatment were made using Wilcoxon's Signed Rank's (α = 0.05).

RESULTS

Of 130 cases, only 116 cases turned up for evaluation. The primary reasons for composite repair were recurrent caries and anatomical deficiencies. No statistically significant differences were found between the groups for all clinical criteria (p > 0.05). The control group experienced one total and two partial retention losses.

CONCLUSIONS

The application of a silane coupling agent, with or without intra-oral sandblasting, demonstrated no improvement on the clinical performance of repaired posterior composites after 6-months.

CLINICAL SIGNIFICANCE

Surface treatment of defective composite restorations using silane with intra-oral sandblasting within their repair process offered marginal improvement in their clinical performance over conventional etching technique, but insignificantly so. Repair reduced exaggerated cold test responses and eliminated POS within 6-months. Repair reduces cold sensitivity and promotes restoration longevity. This clinical trial was registered at ClinicalTrials.gov with the registration number NCT06005571.

The clinical effect of the digital guide in the early implant restoration of second molars

BACKGROUND

In the absence of contraindications to implants, implant repair is the preferred method to treat mandibular second molar loss.

OBJECTIVE

To compare the clinical effects of a traditional implant guide and digital implant guide in the early implant restoration of second molars.

METHODS

The study included 35 patients with second molar loss randomly divided into two groups. Eighteen patients in the experimental group had an implant procedure using a computer-aided design/computer-assisted manufacturing (CAD/CAM) digital implant guide, and 17 patients in the control group had the procedure using a traditional film pressing implantation guide. Then, the surgical procedure was completed using the two different implant guides. At 3 months after surgery, four parameters including screw hole exit position, coronal deviation of the implant site, disease improvement rate, and clinical effects, which included marginal adaptation, anatomic form, marginal discoloration, postoperative sensitivity, surface roughness, and secondary caries of the upper prosthesis were compared between the two groups.

RESULTS

The screw hole exit position in the experimental group was directed to the functional cusp of the opposite jaw, and there was a statistically significant difference between the two groups. There was no statistically significant difference in the rate of disease improvement and the clinical effect of the upper prosthesis between the two groups. There was no statistically significant difference in the bilateral coronal deviation and deviation direction of implants in the two groups. The bilateral coronal deviation of the experimental group was smaller than that of the control group.

CONCLUSION

The digital implant guide can effectively reduce the deviation of the screw hole and the upper prosthesis in the restoration of the second molar. The prosthesis used in the experimental group had a good clinical outcome, which provides a theoretical basis for the restoration of the posterior molar.

Influence of surface treatment on the performance of silorane-based composite resin in class I restorations: a randomized clinical trial

OBJECTIVES

The aim of this study was to evaluate the clinical performance of silorane-based composite restorations applied after different surface treatments.

MATERIALS AND METHODS

This controlled and randomized clinical trial included 26 patients with class I restoration indications. The teeth were randomly assigned to the following treatments: control 1/G1, silorane specific self-etching adhesive (P90 self-etch primer and bond) + silorane-based composite resin (Filtek™ P90 low shrink posterior restorative); G2, 37% phosphoric acid + silorane specific self-etching adhesive + silorane-based composite resin; G3, blasting with aluminum oxide + silorane specific self-etching adhesive + silorane-based composite resin; and control 2/G4, self-etching adhesive (Adper™ SE Plus self-etch adhesive) + dimethacrylate-based composite resin (Filtek™ P60 posterior restorative). The clinical performance was evaluated at baseline and after 1 year.

RESULTS

A total of 141 restorations were made and evaluated. For all clinical criteria evaluated, no significant difference was found between the surface treatments at baseline and after 1 year (p > 0.05). After 1 year, only the group with 37% phosphoric acid + silorane specific self-etching adhesive (G2) showed a significant reduction in marginal adaptation (p < 0.05).

CONCLUSION

In general, all surface treatments showed an adequate clinical performance for silorane-based composite resin in class I restorations. However, a reduction in the marginal adaptation after 1 year was found when additional phosphoric acid etching was used prior to silorane specific self-etching adhesive.

CLINICAL RELEVANCE

The use of phosphoric acid etching prior to specific self-etching adhesive can adversely affect the marginal adaptation of silorane-based restorations.

Effect of decontamination on micro-shear bond strength of silorane-based composite increments

AIM

The aim of the present study was to evaluate the micro-shear bond strength of silorane-based composites after saliva/blood decontamination.

METHODS

A transparent mold (1 × 2 × 1 cm) was used to make 11 flat, silorane-based composite blocks. One block served as the control. After contamination, the blocks were treated as follows: group 1: 10-s air spray; group 2: 10-s water spray + 10-s air spray; group 3: 10-s water spray + 10-s air spray + 10-s etching with phosphoric acid; group 4: 10-s air spray + 10-s etching + bonding; group 5: 10-s water spray + 10-s air spray + 10-s etching + bonding; and groups 6-10: treated the same as groups 1-5, the only difference being that blood was used instead of saliva. Ten tubes (0.7 mm × 1 mm) containing silorane-based composites were attached to each decontaminated block and light cured for 40 s. After 24-h storage in distilled water, specimens were tested under micro-shear loading at a cross-head speed of 0.5 mm/min. Data were analyzed using one-way anova and Tukey's honest significant difference (HSD) test (P < 0.05).

RESULTS

One-way anova showed significant differences in the micro-shear bond strength among the experimental groups (P < 0.001). Tukey's HSD test revealed that the bond strengths in groups 5, 9, and 10 were similar to the control group (P > 0.05).

CONCLUSION

Decontamination by water and air spray, etching, and bonding was effective in restoring the bond strength of silorane-based composite increments.

The reparability of contemporary composite resins

Objective:

The objective was to investigate the way that various surface treatments could influence the bond strength of the repair of methacrylate (MC) and silorane (SIL) composites.

Materials and Methods:

A total of 160 MC and SIL cylindrical specimens were polymerized and aged in artificial saliva solution for 7 days. Depending on the following surface treatment (diamond bur or air abrasion), and the conditioning procedure (orthophosphoric acid or sodium hypochlorite), 16 groups were formed and repaired either with MC, either with SIL composite. Repaired specimens were subjected to an additional aging procedure in artificial saliva for 7 days, followed by thermo-cycling and then stressed in shear at a rate of 0.5 mm/min until failure. Failure patterns were analyzed using stereomicroscope and scanning electron microscopy.

Results:

MC composite showed statistically significant higher bond strength both as a base or repair material than SIL (P < 0.001). Statistically significant differences were not observed, when grinding and conditioning procedures was compared. Pretest failures were observed when aged MC-based composite was repaired with SIL-based.

Conclusions:

Type of composite seems to be the main factor influencing the bond strength of the repair. MC-based composite showed better repairability than SIL composite. Optimum repair conditions should include knowledge of the composite's composition.

Can repair increase the longevity of composite resins? Results of a 10-year clinical trial

OBJECTIVES

The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement.

METHODS

Twenty-eight patients aged 18-80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were "clinically judged" to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n=25) or Replacement (n=25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group.

RESULTS

Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p>0.05), secondary caries (SC) (p>0.05), anatomy (A) (p<0.05), and colour (C) (p>0.05).

CONCLUSIONS

Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations.

CLINICAL SIGNIFICANCE

The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term.