Warm Air Delivery in Adhesive Application: Effect on Bonding Performance and Morphological Outcomes

Solvent evaporation within an adhesive layer is a crucial step during a bonding process. The aim of this current research was to test whether the use of different air temperatures (20 °C, 40 °C, and 60 °C) for solvent evaporation improves the performance of four adhesive systems to dentin. Sixty non-carious human molar teeth were randomly prepared for micro-tensile bond strength (μTBS) tests. Four different adhesive systems, Prime&Bond Universal (PBU), OptiBond Universal (OBU), OptiBond FL (OBFL), and Clearfil SE (CSE), were applied following the manufacturer's instructions. Three groups based on the air-drying temperature were used: solvent evaporation was performed with either of warm (40 °C), (60 °C), and cold air as control group (20 °C) for 10 s at a distance of 5 cm. In all bonded surfaces, three resin composite (Reflectys, Itena Clinical, Paris, France) layers of 2 mm thickness were built up. The resin-dentin samples were kept in distilled water at 37 °C for 24 h and 6 months, respectively, before μTBS testing. Failure analysis, scanning electron microscopy of resin-dentin bonded interface, and solvent evaporation rate were tested as secondary variables. All analyses were conducted using a significance level of α = 0.05. Bond strength (BS) values were similar among all the adhesive systems used (p > 0.05). Also, the aging factor did not affect the BS (p > 0.05). Only the factor of temperature used for solvent evaporation resulted in a statistically significant effect (p < 0.05), with the temperature of 60 °C being the highest value (p < 0.05). A failure mode evaluation revealed mostly adhesive or mixed modes of failures in all the different temperatures of air used for the solvent evaporation of each adhesive system. The thickness of the adhesive layer and the creation of resin tags varied amongst the temperatures evaluated. For all adhesive systems tested, the use of 40 °C or 60 °C air for solvent evaporation led to an increased mass loss. Warmer temperatures for solvent evaporation contributed positively to bonding performance, enhancing both the quality of the adhesive layer and its interaction with the dentin tissue. Optimizing solvent evaporation with warmer air temperatures (40 °C and 60 °C) significantly improved µTBS, offering a practical means to enhance the quality and longevity of adhesive restorations in esthetic dentistry.

Color stability of dual-cured and light-cured resin cements: A systematic review and meta-analysis of in vitro studies

PURPOSE

This systematic review and meta-analysis aimed to evaluate the difference in the color stability of light-cured and dual-cured resin cements.

MATERIALS AND METHODS

Two separate reviewers used the PubMed, Scopus, Web of Science, Embase, and Scielo databases to execute the systematic review. For the analysis, studies that evaluated the color stability of dual-cured and light-cured resin cements over time were used. The random effects model was used in the meta-analysis. Analyses of subgroups were carried out based on the aging technique. The methodological quality of each in vitro study was evaluated in accordance with the parameters of a prior systematic review.

RESULTS

From all databases, a total of 2223 articles were retrieved. Following the screening of titles and abstracts, 44 studies were selected for full text review, and a total of 27 articles were used for the qualitative analysis. Finally, 23 articles remained for the qualitative analysis. The majority of studies were labeled as having a medium risk of bias. The global analysis showed that the dual-cure resin cements had considerably greater differences in the color change (p = 0.006). A high heterogeneity index (86%) was found in the analysis.

CONCLUSIONS

The best available in vitro evidence suggests that dual-polymerizing cement has higher color variation than light-polymerized materials. To reduce the likelihood of color change after the luting of thin ceramic restorations, clinicians should employ light-polymerizable resin cements.

Red/Orange Autofluorescence in Selected Candida Strains Exposed to 405 nm Laser Light

BACKGROUND

Candida albicans and similar species are significant pathogens in immunocompromised and hospitalized individuals, known for mucosal colonization and bloodstream/organ invasion. Many pathogenic fungi, including these species, exhibit autofluorescence (R/OF) under specific light conditions, a feature crucial for their detection.

AIM

We investigated the use of a 405 nm diode laser for the direct observation of red/orange autofluorescence of Candida spp., common in the oral cavity, exploring its potential in health screenings.

METHODS

This study utilized cultures of Candida spp. on Sabouraud dextrose agar with Qdot 655 and 685 for fluorescence benchmarking, illuminated using a 405 nm diode laser (continuous wave, power 250 mW, 0.0425 J/cm² fluence, 0.0014 W/cm² power density). Images were captured using a yellow-filter camera at set intervals (48 to 144 h). Visual and computational analyses evaluated the R/OF in terms of presence, intensity, coloration, and intra-colony variation.

RESULTS

Most Candida strains displayed red/orange autofluorescence at all observation times, characterized by varied coloration and intra-colony distribution. Initially, there was an increase in R/OF intensity, which then stabilized in the later stages of observation.

CONCLUSIONS

The majority of the Candida strains tested are capable of emitting R/OF under 405 nm laser light. This finding opens up new possibilities for integrating R/OF detection into routine dental screenings for Candida spp.

Cytotoxicity and genotoxicity of bioceramic root canal sealers compared to conventional resin-based sealer

The aim of this study was to evaluate cytotoxicity and genotoxicity of calcium-silicate based sealers and comparing them with a gold standard-an epoxy-based sealant. Two experimental cell lines were used, gingival fibroblasts (hGF) and monocyte/macrophage peripheral blood cell line (SC). The cytotoxicity (XTT assay) and genotoxicity (comet assay) were evaluated both after 24-h and 48-h incubation. Additionally, after 48-h incubation, the cell apoptosis and cell cycle progression was detected. BioRoot Flow induced a significant decrease in hGF cells viability compared to the negative control groups both after 24-h (p < 0.001) and 48-h incubation (p < 0.01). In group with SC cells, after 24-h incubation significant increase in cells viability was detected for AH Plus Bioceramic Sealer in comparison to negative control (p < 0.05). BioRoot Flow and BioRoot RCS can be considered potentially genotoxic for the hGF cells after 48-h incubation (> 20% DNA damage). BioRoot Flow and BioRoot RCS, may have potential genotoxic effects and induce apoptosis in hGF cells which may irritate periapical tissues, resulting in a delayed healing. The findings of the study would be useful in selection of an appropriate sealant for root canal filling without causing cytotoxicity and genotoxicity.

Bonding performance and interfacial adaptation of modern bulk-fill restorative composites after aging in artificial saliva: an in vitro study

OBJECTIVES

This study aimed at comparing the microtensile bond strength (MTBS) and interfacial adaptation of a modern self-curing and a light-curing restorative bulk-fill composite to a conventional composite applied with the layering technique.

METHODS

Forty-eight occlusal cavities were divided in three main groups (16/group) based on tested materials: (i) STELA, bulk-fill self-curing restorative (STELA, SDI Ltd.); (ii) 3 M-BULK, bulk-fill composite (Filtek One Bulk-Fill, 3 M Oral Care); and (iii) 3 M-CTR, a conventional composite (Filtek Supreme XTE, 3 M Oral Care). These were used in combination with their adhesives in self-etch (SE) or etch-and-rinse (ER) mode. Specimens stored in artificial saliva (24 h or 12 months) were evaluated for MTBS and fractography. The interfacial analysis was performed through confocal microscopy. ANOVA and Fisher's LSD post hoc tests were performed with a level of significance of 5%.

RESULTS

All the tested materials applied in ER mode presented (24 h) greater bond strength than in SE mode. Although all materials showed a significant drop in the bond strength after prolonged storage, STELA showed the highest bonding performance and interfaces with few gaps. 3 M-BULK had the lowest bond strength and an interface with several voids and gaps.

CONCLUSIONS

All materials were affected by interface degradation and bonding reduction over prolonged aging. However, their use in combination with adhesives applied in ER mode may offer greater immediate bonding performance.

CLINICAL RELEVANCE

The use of restorative light-curing bulk-fill composites may generate gaps at the bonding interface and voids. STELA may represent a suitable alternative to avoid such issues.

Dentine Remineralisation Induced by "Bioactive" Materials through Mineral Deposition: An In Vitro Study

This study aimed to assess the ability of modern resin-based "bioactive" materials (RBMs) to induce dentine remineralisation via mineral deposition and compare the results to those obtained with calcium silicate cements (CSMs). The following materials were employed for restoration of dentine cavities: CSMs: ProRoot MTA (Dentsply Sirona), MTA Angelus (Angelus), Biodentine (Septodont), and TheraCal LC (Bisco); RBMs: ACTIVA BioACTIVE Base/Liner (Pulpdent), ACTIVA Presto (Pulpdent), and Predicta Bioactive Bulk (Parkell). The evaluation of the mineral deposition was performed through scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) on the material and dentine surfaces, as well as at the dentine-material interface after immersion in simulated body fluid. Additionally, the Ca/P ratios were also calculated in all the tested groups. The specimens were analysed after setting (baseline) and at 24 h, 7, 14, and 28 days. ProRoot MTA, MTA Angelus, Biodentine, and TheraCal LC showed significant surface precipitation, which filled the gap between the material and the dentine. Conversely, the three RBMs showed only a slight ability to induce mineral precipitation, although none of them was able to remineralise the dentine-material interface. In conclusion, in terms of mineral precipitation, modern "bioactive" RBMs are not as effective as CSMs in inducing dentine remineralisation; these latter represent the only option to induce a possible reparative process at the dentin-material interface.

Students' awareness of the bruxism causes, effects and therapies

Objectives

Bruxism is a repetitive activity of the masticatory muscles characterized by clenching or grinding teeth and/or mandibular stiffening. Bruxism manifests itself in two forms: during sleeping and waking. The etiology of bruxism is multifactorial. The treatment of bruxism is mainly based on making the patient aware of the presence of the condition. The aim of the study was to assess knowledge on the causes and the effects of bruxism among Polish students as well as the possible management.

Materials and methods

The anonymous online survey was conducted among students (aged between 18 and 25 years old) of universities across Poland, using the Google Forms platform. The survey contained questions concerning bruxism causes, effects and therapies. All variants of answers in these questions contained true information about bruxism.

Results

The study found significant differences in awareness of bruxism among genders in favor of females. The awareness of bruxism among population residing in cities and in villages was comparable (p > 0.05). However, the results should be taken with care due to limited number of students that participated in the study and uneven gender distribution among urban and village residents.

Conclusions

Within the limitations of the study it can be concluded that the knowledge of bruxism among Polish students is higher in comparison with the findings from the literature, as well as the superiority of women's awareness of bruxism over men. Future studies should be conducted on greater student population, with even distribution of participants among country areas and variety of universities.

Significance

The findings may indicate the need for further education of male young adults, on bruxism causes, possible effects and therapies to increase their awareness of bruxism and encourage early diagnosis and treatment.

Effect of contamination and decontamination methods on the bond strength of adhesive systems to dentin: A systematic review

INTRODUCTION

In a suitable condition, it is important to perform any dental restorative procedure using an operatory field isolated. Then, the aim of this study was to compare the bond strength of composite restorations to dentin affected by any contamination agent through a systematic review.

METHODS

This systematic review was performed following the PRISMA 2020 guidelines. The literature search was conducted until September 2022 by scanning the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts evaluated the bond strength of resin-based materials to permanent human dentin contaminated with blood or saliva were selected for full-text review. The risk of bias was assessed by the RoBDEMAT tool.

RESULTS

A total of 3750 papers resulted from the search from all databases. After the full-text reading, a total of 62 articles remained for the qualitative analysis. The contamination agents used were blood, saliva, and hemostatic agents. A great variety of protocols were used to contaminate the dentin surface, and the contamination process occurred in several steps of the bonding process, including before and after the etching process, after the primer application and after the adhesive application. Also, several decontamination procedures were tested, including reapplication of the etching material, rinsing with water, chlorhexidine or sodium hypochlorite and reapplication of the adhesive system.

CONCLUSION

Any contamination with blood or saliva impaired the bond strength of resin-based materials to dentin. Decontamination procedures including water-spray and reapplication of the bonding system could revert the impairment produced by the saliva or blood contamination. The use of hemostatic agents as a method of blood decontamination is not recommended.

CLINICAL SIGNIFICANCE

Clinicians should avoid contamination during a bonding procedure, otherwise, a reduction in the bond quality is expected.

Effect of scanning strategies on the accuracy of digital intraoral scanners: a meta-analysis of in vitro studies

PURPOSE

This study aimed to investigate whether the accuracy of intraoral scanners is influenced by different scanning strategies in an in vitro setting, through a systematic review and meta-analysis.

MATERIALS AND METHODS

This review was conducted in accordance with the PRISMA 2020 standard. The following PICOS approach was used: population, tooth impressions; intervention, the use of intraoral scanners with scanning strategies different from the manufacturer's instructions; control, the use of intraoral scanners following the manufacturers' requirements; outcome, accuracy of intraoral scanners; type of studies, in vitro. A comprehensive literature search was conducted across various databases including Embase, SciELO, PubMed, Scopus, and Web of Science. The inclusion criteria were based on in vitro studies that reported the accuracy of digital impressions using intraoral scanners. Analysis was performed using Review Manager software (version 5.3.5; Cochrane Collaboration, Copenhagen, Denmark). Global comparisons were made using a standardized mean difference based on random-effect models, with a significance level of α = 0.05.

RESULTS

The meta-analysis included 15 articles. Digital impression accuracy significantly improved under dry conditions (P < 0.001). Moreover, trueness and precision were enhanced when artificial landmarks were used (P ≤ 0.02) and when an S-shaped pattern was followed (P ≤ 0.01). However, the type of light used did not have a significant impact on the accuracy of the digital intraoral scanners (P ≥ 0.16).

CONCLUSION

The accuracy of digital intraoral scanners can be enhanced by employing scanning processes using artificial landmarks and digital impressions under dry conditions.

The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity-An In Vitro Study

The increasing demand for orthodontic treatments due to the high prevalence of malocclusion has inspired clinicians and material scientists to investigate innovative, more effective, and precise bonding methods with reduced chairside time. This study aimed at comparing the shear bond strength (SBS) of metal and ceramic brackets bonded to enamel using the indirect bonding technique (IDB). Victory Series metal brackets (Metal-OPC, Metal-APC) and Clarity™ Advanced ceramic brackets (Ceramic-OPC) (3M Unitek, Monrovia, CA, USA) were bonded indirectly to extracted human premolars through the etch-and-rinse technique. A qualitative assessment of the enamel surface using microscopic methods was performed, and the amount of residual adhesive was reported as per the adhesive remnant index (ARI). Moreover, the bracket surface was evaluated with SEM-EDS. The highest SBS mean values were observed in the Ceramic-OPC group (16.33 ± 2.01 MPa), while the lowest ones were obtained with the Metal-OPC group (11.51 ± 1.40 MPa). The differences between the Metal-AOPC vs. Metal-APC groups (p = 0.0002) and the Metal-OPC vs. Ceramic-OPC groups (p = 0.0000) were statistically significant. Although the Ceramic-OPC brackets bonded indirectly to the enamel surface achieved the highest SBS, the enamel damage was significantly higher compared to that of the other groups. Thus, considering the relatively high bond SBS and favourable debonding pattern, Metal-APC brackets bonded indirectly may represent the best choice.

Shear Bond Strength of Metal and Ceramic Brackets Depending on Etching Protocol in Direct Bonding Technique

Successful orthodontic therapy, apart from a proper treatment plan, depends on optimal bracket-enamel adhesion. Among numerous factors affecting adhesion, the type of bracket and preparation of the tooth's surface are crucial. The aim of this study was to compare the shear bond strength (SBS) of metal and ceramic brackets to the enamel's surface using direct bonding. Forty extracted human premolars were divided into four groups according to the etching method (etch-and-rinse and self-etch) and bracket type. The SBS and adhesive remnant index (ARI) were determined. The ceramic brackets achieved the highest SBS values both in the self-etch (SE) and etch-and-rinse (ER) protocols. Higher SBS values for ceramic and metallic brackets were found in the ER protocol. In all tested groups, the achieved SBS value was satisfactory to withstand orthodontic and occlusal forces. There was no significant difference in the ARI score between study groups (p = 0.71). The fracture occurred between the bracket base and adhesive material in both types of brackets, which decreased the risk of enamel damage during debonding.

Corrosion Resistance of Titanium Dental Implant Abutments: Comparative Analysis and Surface Characterization

Metals subjected to the oral environment are prone to corrosion over time and this can be harmful. Metallic restoration components such as dental subgingival implant abutments are exposed to pH changes and different ions while in contact with saliva. The aim of the study was to evaluate the corrosion resistance of titanium dental implant abutments and to compare and contrast the surface characteristics of these alloys before and after corrosion. The corrosion examination (Ecorr, jcorr, OCP, polarization curve) of two implant abutments (TiDesign EV, Astra Tech, Dentsply, York, PA, USA; Individual Titanium Abutment, Apollo Implants Components, Pabianice, Poland) was performed in 0.9% NaCl and 5% HCl. Moreover, specimens were investigated using SEM-EDS before and after the corrosion test. The value of jcorr in NaCl was higher for Astra (34.2 × 10-8 ± 2.5 × 10-8 A/cm2) than for Apollo (8.8 × 10-8 ± 2.5 × 10-8 A/cm2). Whereas, in HCl, the opposite relationship was observed (Astra 2.9 × 10-4 ± 0.8 × 10-4 A/cm2 and Apollo 62.7 × 10-4 ± 9.3 × 10-4 A/cm2). An average reactive anodic current density in NaCl for Astra amounted up to ~0.2 × 10-5-1.5 × 10-5 A/cm2, while for Apollo-up to ~3.3-9.7 × 10-7 A/cm2. The composition of both alloys after corrosion in NaCl demonstrated some changes: a decrease in the Ti, and Al and an increase in oxygen content. Hence, both alloys after corrosion in HCl demonstrated some minor changes in the elemental composition. Based on the results it can be concluded that: 1. Astra and Apollo abutments revealed good corrosion resistance and a passivation layer on the surface. 2. Apollo abutments exhibited better corrosion resistance in a neutral environment, suggesting that Astra abutments were found to be more resistant to corrosion in an acidic medium.

Micro-CT Evaluation of Microgaps at Implant-Abutment Connection

The assessment of microgaps at the implant-abutment interface is an important factor that may influence clinical success. Thus, the aim of this study was to evaluate the size of microgaps between prefabricated and customised abutments (Astra Tech, Dentsply, York, PA, USA; Apollo Implants Components, Pabianice, Poland) mounted on a standard implant. The measurement of the microgap was performed using micro-computed tomography (MCT). Due to 15-degree rotation of samples, 24 microsections were obtained. Scans were performed at four levels established at the interface between the abutment and the implant neck. Moreover, the volume of the microgap was evaluated. The size of the microgap at all measured levels varied from 0.1 to 3.7 µm for Astra and from 0.1 to 4.9 µm for Apollo (p > 0.05). Moreover, 90% of the Astra specimens and 70% of the Apollo specimens did not exhibit any microgaps. The highest mean values of microgap size for both groups were detected at the lowest portion of the abutment (p > 0.05). Additionally, the average microgap volume was greater for Apollo than for Astra (p > 0.05). It can be concluded that most samples did not exhibit any microgaps. Furthermore, the linear and volumetric dimensions of microgaps observed at the interface between Apollo or Astra abutments and Astra implants were comparable. Additionally, all tested components presented microgaps (if any) that were clinically acceptable. However, the microgap size of the Apollo abutment was higher and more variable than that of the Astra one.

Evaluation of Physical-Chemical Properties of Contemporary CAD/CAM Materials with Chromatic Transition "Multicolor"

The use of materials for computer-aided design/computer-aided manufacturing (CAD/CAM) has been rapidly increasing in daily practice. However, one of the main issues regarding modern CAD/CAM materials is their aging in the oral environment, which may lead to significant changes in their overall properties. The aim of this study was to compare the flexural strength, water sorption, cross-link density (softening ratio%), surface roughness, and SEM analysis of three modern CAD/CAM "multicolor" composites. Grandio (Grandio disc multicolor-VOCO GmbH, Cuxhaven, Germany), Shofu (Shofu Block HC-Shofu Inc., Kyoto, Japan), and Vita (Vita Enamic multiColor-Vita Zahnfabrik, Bad Sackingen, Germany) were tested in this study. They were prepared in stick-shaped specimens and submitted to different tests after several aging protocols, such as thermocycling and mechanical cycle loading challenge. Further disc-shaped specimens were also created and tested for water sorption, cross-link density, surface roughness, and SEM ultramorphology, before and after storage in an ethanol-based solution. For flexural strength and ultimate tensile strength, Grandio showed the greatest values both at baseline and after aging (p < 0.05). Grandio and Vita Enamic presented the highest modulus of elasticity and the lowest water sorption (p < 0.05). A significant reduction (p < 0.05) in microhardness after ethanol storage (softening ratio%) was observed especially in Shofu. Grandio had the lowest roughness parameters compared to the other tested CAD/CAM materials, while ethanol storage significantly increased the Ra and RSm values in Shofu (p < 0.05). Despite the comparable modulus of elasticity of Vita and Grandio, this latter showed greater flexural strength and ultimate tensile strength both at baseline and after aging. Hence, Grandio and Vita Enamic may be employed for the anterior teeth and for those restorations requiring load-bearing capacity. Conversely, aging seems to affect several properties of Shofu, so its use for permanent restorations should be well-pondered based on the clinical situation.

Evaluation of the Oral Bacterial Genome and Metabolites in Patients with Wolfram Syndrome

In Wolfram syndrome (WFS), due to the loss of wolframin function, there is increased ER stress and, as a result, progressive neurodegenerative disorders, accompanied by insulin-dependent diabetes. The aim of the study was to evaluate the oral microbiome and metabolome in WFS patients compared with patients with type 1 diabetes mellitus (T1DM) and controls. The buccal and gingival samples were collected from 12 WFS patients, 29 HbA1c-matched T1DM patients (p = 0.23), and 17 healthy individuals matched by age (p = 0.09) and gender (p = 0.91). The abundance of oral microbiota components was obtained by Illumina sequencing the 16S rRNA gene, and metabolite levels were measured by gas chromatography–mass spectrometry. Streptococcus (22.2%), Veillonella (12.1%), and Haemophilus (10.8%) were the most common bacteria in the WFS patients, while comparisons between groups showed significantly higher abundance of Olsenella, Dialister, Staphylococcus, Campylobacter, and Actinomyces in the WFS group (p < 0.001). An ROC curve (AUC = 0.861) was constructed for the three metabolites that best discriminated WFS from T1DM and controls (acetic acid, benzoic acid, and lactic acid). Selected oral microorganisms and metabolites that distinguish WFS patients from T1DM patients and healthy individuals may suggest their possible role in modulating neurodegeneration and serve as potential biomarkers and indicators of future therapeutic strategies.

Stress Experience, Depression and Neck Disability in Patients with Temporomandibular Disorder-Myofascial Pain with Referral

The etiology of temporomandibular disorders (TMDs) is firmly anchored in the biopsychosocial model in which a special role is attributed to the stress, depression, somatic symptoms, and anxiety. The aim of the study was to assess the level of stress, depression and neck disability in patients with temporomandibular disorder-myofascial pain with referral. The study group enrolled 50 people (37 women and 13 men) with complete natural dentition. All the patients underwent a clinical examination according to the Diagnostic Criteria for Temporomandibular Disorders and were diagnosed as individuals with myofascial pain with referral. The questionnaires were associated with stress, depression, and neck disability; Perceived Stress Scale (PSS-10), Beck Depression Inventory(BDI), and Neck Disability Index (NDI) were evaluated. Of the individuals evaluated, 78% showed elevated levels of stress, and the average value of the PSS-10 in the study group was 18 points (Me = 17). Furthermore, 30% of the subjects presented depressive symptoms, with the average value of BDI was 8.94 points (Me = 8), and 82% of the subjects showed neck disability. The multiple linear regression model revealed that BDI and NDI allowed explanations for the 53% differentiation of PSS-10. In conclusion, stress, depression, and neck disability coexist with temporomandibular disorder-myofascial pain with referral.

Peptides in Dentistry: A Scoping Review

Currently, it remains unclear which specific peptides could be appropriate for applications in different fields of dentistry. The aim of this scoping review was to scan the contemporary scientific papers related to the types, uses and applications of peptides in dentistry at the moment. Literature database searches were performed in the following databases: PubMed/MEDLINE, Scopus, Web of Science, Embase, and Scielo. A total of 133 articles involving the use of peptides in dentistry-related applications were included. The studies involved experimental designs in animals, microorganisms, or cells; clinical trials were also identified within this review. Most of the applications of peptides included caries management, implant osseointegration, guided tissue regeneration, vital pulp therapy, antimicrobial activity, enamel remineralization, periodontal therapy, the surface modification of tooth implants, and the modification of other restorative materials such as dental adhesives and denture base resins. The in vitro and in vivo studies included in this review suggested that peptides may have beneficial effects for treating early carious lesions, promoting cell adhesion, enhancing the adhesion strength of dental implants, and in tissue engineering as healthy promotors of the periodontium and antimicrobial agents. The lack of clinical trials should be highlighted, leaving a wide space available for the investigation of peptides in dentistry.

Porcelain Veneers in Vital vs. Non-Vital Teeth: A Retrospective Clinical Evaluation

Nowadays, the ceramic veneer approach can be considered more predictable than direct composite veneer. To date, there is a lack of studies comparing the clinical performance of anterior veneers cemented on vital teeth (VT) and non-vital teeth (NVT). This longitudinal clinical study investigated the performance of ceramic veneers in VT or anterior NVT. A total of 55 patients were evaluated in the study. Two groups were defined based on the vitality status of the teeth (93 teeth-vital and 61 teeth-non-vital). The United States Public Health Service (USPHS) criteria were used to assess the clinical status. The data were evaluated statistically with the Mann-Whitney U test. All restorations were considered acceptable, and only one veneer in VT failed for the criteria of secondary caries. There were no statistically significant differences in any of the criteria evaluated (p ≤ 0.671). The ceramic veneers evaluated showed a satisfactory clinical performance both in VT and NVT.

Evaluation of the Sensitivity of Selected Candida Strains to Ozonated Water-An In Vitro Study

(1) Background and Objectives: Oral candidiasis has increased significantly in recent years. Increasingly, we encounter treatment difficulties related to drug resistance. Therefore, it is necessary to search for other therapies such as ozone therapy, which has antimicrobial activity. The aim of this study was to determine the sensitivity of selected Candida strains to ozonated water based on concentration and contact time (2) Methods: The sensitivity of Candida strains to ozonated water with a concentration of 5 µg/mL, 30 µg/mL, and 50 µg/mL was assessed using Mosmann's Tetrazolium Toxicity (MTT) assay. Statistical differences were assessed by the analysis of variance (ANOVA) and the Newman-Keuls post-hoc test. A p-value of ≤0.05 was considered to indicate a statistically significant difference. (3) Results: In all the strains and research trials, the number of viable cells was reduced by ozonated water. The reduction depended on the exposure time and concentration of ozonated water. The highest percentage reduction (34.98%) for the tested samples was obtained for the C. albicans strain after 120 s of exposure at the highest concentration-50 µg/mL. (4) Conclusions: The selected strains of Candida spp. were sensitive to ozonated water at all tested concentrations (5 µg/mL, 30 µg/mL, and 50 µg/mL). The sensitivity of strains to ozonated water increased with concentration and application time. Moreover, the sensitivity of Candida strains to ozonated water is comparable to that of 0.2% chlorhexidine gluconate.

Triple scan evaluation of internal and marginal adaptation of overlays using different restorative materials

OBJECTIVE

Problems in the confection of indirect restorations may increase the marginal and internal gap. This study aimed to quantify the marginal and the internal fit of overlays fabricated with three different materials.

MATERIALS AND METHODS

Standardized cavities were prepared on endodontically treated human third molars and digital impressions were done using an intraoral camera (Trios 3). Restorations were designed (n = 15) and fabricated with three materials: Hybrid ceramic (Cerasmart; GC Corp, EUROPE), high-strength lithium disilicate (GC Initial® LiSi Press; GC Corp, Tokyo, Japan), and zirconia reinforced Lithium Silicate Glass Ceramic (Vita Suprinity; Vita, Germany). Axial, marginal, pulpal, and gingival gaps were calculated by measuring the distance between the restoration and the tooth at several reference points. Two-Way analysis of variance was used for statistical analysis. The significance level was set at α = 0.05.

RESULTS

Mean gap was significantly influenced by the material (p < 0.001), gap localization (p < 0.001), and interaction between the factors (p = 0.002). For all materials, the highest gap was observed at gingival and pulpal surfaces (p ≤ 0.015). LiSi Press achieved the overall lowest values at axial values measurements (p ≤ 0.003).

CONCLUSIONS

The performance of a CAD/CAM system relative to marginal adaptation is influenced by the restorative material used. High-strength lithium disilicate seems to be showed the best marginal adaptation.

CLINICAL SIGNIFICANCE

Marginal and internal adaptation of CAD/CAM restorations could be influenced by the type of material chosen.

A Micro-CT Analysis of Initial and Long-Term Pores Volume and Porosity of Bioactive Endodontic Sealers

The evaluation of the porosities within the interface of root canals obturated with endodontics materials is extremely important for the long-term success of endodontic treatments. The aim of this study was to compare initial and long-term volume of pores (total, open, closed) and porosity (total, regional) of three bioactive endodontic sealers: GuttaFlow Bioseal, Total Fill BC Sealer, and BioRoot RCS. Root canals were obturated with three “bioactive” sealers using the single-cone technique. The volume of open and closed pores and porosity were calculated using a micro-computed tomography (MCT) method. The measurements were performed after 7 days (initial) and after 6 months (long-term) of incubation. Statistical significance was considered at p < 0.05. The total volume of pores remained unchanged after the 6-month storage. GuttaFlow Bioseal exhibited significantly higher long-term volume in open pores than Total Fill BC Sealer. The total porosity in all the tested sealers presented no statistically significant change after the 6-month storage, except for BioRoot RCS. The total porosity values of this latter material significantly increased after long-term incubation, especially in the apical region. In conclusion, the use of bioactive sealers with excessive tendency to create porosities both in shorth- and long-term periods of storage may compromise the long-term success of endodontic treatments.

Complicated Crown Fracture of Permanent Incisors: A Conservative Treatment Case Report and a Narrative Review

Dental trauma may have a severe impact on the social and psychological wellbeing of a patient. Most cases of dental injuries involve anterior teeth, especially the maxillary upper incisors. Crown fractures, with or without pulp exposure, are the most common trauma in permanent dentition. There are many methods of management, in which the initial state of the pulp, the time since the injury, and the presence of an accompanying injury play a key role. This case report aimed at showing a possible conservative treatment after complicated tooth fracture that consisted of partial pulpotomy followed by adhesive reattachment of the tooth fragment using a technique based on heated resin composite. Such a specific procedure represents a conservative approach to traumatic coronal lesions, providing a suitable opportunity to maintain the tooth vitality, aesthetics, and function. Indeed, reattachment of tooth fragment using a composite/adhesive is a simple technique to achieve excellent results in terms of aesthetic and function.

Effect of Collagen Crosslinkers on Dentin Bond Strength of Adhesive Systems: A Systematic Review and Meta-Analysis

This study aimed to identify the role of crosslinking agents in the resin–dentin bond strength (BS) when used as modifiers in adhesives or pretreatments to the dentin surface through a systematic review and meta-analysis. This paper was conducted according to the directions of the PRISMA 2020 statement. The research question of this review was: “Would the use of crosslinkers agents improve the BS of resin-based materials to dentin?” The literature search was conducted in the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts that reported the effect on the BS after the use of crosslinking agents were included. The meta-analyses were performed using Review Manager v5.4.1. The comparisons were performed by comparing the standardized mean difference between the BS values obtained using the crosslinker agent or the control group. The subgroup comparisons were performed based on the adhesive strategy used (total-etch or self-etch). The immediate and long-term data were analyzed separately. A total of 50 articles were included in the qualitative analysis, while 45 articles were considered for the quantitative analysis. The meta-analysis suggested that pretreatment with epigallocatechin-3-gallate (EGCG), carbodiimide, ethylenediaminetetraacetic acid (EDTA), glutaraldehyde, and riboflavin crosslinking agents improved the long-term BS of resin composites to dentin (p ≤ 0.02). On the other hand, the use of proanthocyanidins as a pretreatment improved both the immediate and long-term BS values (p ≤ 0.02). When incorporated within the adhesive formulation, only glutaraldehyde, riboflavin, and EGCG improved the long-term BS to dentin. It could be concluded that the application of different crosslinking agents such as carbodiimide, EDTA, glutaraldehyde, riboflavin, and EGCG improved the long-term BS of adhesive systems to dentin. This effect was observed when these crosslinkers were used as a separate step and when incorporated within the formulation of the adhesive system.

Adhesion of Resin to Lithium Disilicate with Different Surface Treatments before and after Salivary Contamination—An In-Vitro Study

The salivary contamination occurring at the try-in procedures of lithium disilicate (LDS) can jeopardize their bond strength. Various laboratory reports have concluded that applying 37% phosphoric acid (H₃PO₄) could be considered as a predictable way of removing salivary contaminants. An experimental method that consists of sealing the intaglio of the ceramic restorations with a layer of cured adhesive could allow consequent time saving for dental practitioners. It is, besides, necessary to establish an optimal decontamination protocol. Hence, this study aimed to determine the most efficient surface treatment, before and after salivary contamination, by comparing the adhesion between resin and LDS. In order to do so, five groups of ten specimens (n = 10) each underwent the different types of surface treatments before bonding, followed by 2500 cycles in the thermocycler. A shear bond strength (SBS) test was then conducted on a universal testing machine (YLE GmbH Waldstraße Bad König, Germany), followed by a fracture-type analysis on an optical microscope (Olympus BX53, Shinjuku, Tokyo, Japan). Statistical analysis was set with a level of significance of α = 0.05. The surface treatment significantly affected the SBS results. The decontamination with HF (12.59 ± 2.71 MPa) and H₃PO₄ (13.11 ± 1.03 MPa) obtained the highest values, silanizing only before contamination obtained intermediate values (11.74 ± 3.49 MPa), and silanizing both before and after the salivary contamination (10.41 ± 2.75 MPa) along with applying a bonding agent before contamination (9.65 ± 1.99 MPa) resulted in the lowest values. In conclusion, H₃PO₄ proved to be efficient, thus, allowing the practitioner to avoid the clinical use of HF; it can, therefore, be considered as a valid alternative. Presilanization and resilanization of specimens, along with applying a bonding agent before contamination, did not yield satisfying results.

Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic

The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. Temporomandibular disorders (TMD) are of multifactorial etiology, and manifest with jaw dysfunction, masticatory muscle tension or pain, as well as headache. Though bruxism can act as an exacerbating factor for TMD, stress can also play crucial role in the onset. The study aimed to measure occurrence of TMD and bruxism symptoms in the medical student population, asses the stress level, and evaluate adopted stress-coping strategies during the COVID-19 pandemic outbreak. A survey study was performed among 1018 students at Medical University of Lodz during April 2020. A self-designed questionnaire for screening TMD and bruxism symptoms, Perceived Stress Scale (PSS-10), and Brief-COPE questionnaires were applied. TMD and bruxism symptoms were observed in the majority of subjects during social isolation. The perceived stress levels were significantly higher in those experiencing TMD and bruxism symptoms. Mostly maladaptive, emotion-focused coping strategies were chosen by study subjects experiencing high levels of stress. Choosing Self-Blaming as a coping strategy is the strongest predictor of perceived stress.

Disinfection Procedures and Their Effect on the Microorganism Colonization of Dental Impression Materials: A Systematic Review and Meta-Analysis of In Vitro Studies

Dental impressions are contaminated with potentially pathogenic microorganisms when they come into contact with patient blood, saliva, and plaque. Numerous disinfectants are used; however, no sole disinfectant can be designated as universal for all the impression materials. Thus, the aim of this study is to systemically review the literature to evaluate the effect of the existing disinfection procedures on the bacterial colonization of dental impression materials. This systematic review and meta-analysis was conducted according to the PRISMA statement. PubMed (MEDLINE), Web of Science, Scopus, EMBASE, and SciELO databases were screened up to April 2021. Eligibility criteria included in vitro studies reporting the antibacterial activity of disinfectant solutions in dental impression materials. The meta-analysis was performed using Review Manager (version 5.3.5). A global comparison was performed with the standardized mean difference based on random-effect models at a significance level of α = 0.05. A total of seven studies were included in the meta-analysis. The included studies described the effect of disinfection processes with chlorhexidine gluconate, alcohol, sodium hypochlorite, glutaraldehyde, and hydrogen peroxide in alginate, polyvinyl siloxane, and polyether impression materials. The meta-analyses showed that the use of chlorhexidine, alcohol, glutaraldehyde, and sodium hypochlorite reduced the colony-forming units by a milliliter (CFU/mL) in alginate (p < 0.001). On the other hand, glutaraldehyde, sodium hypochlorite, and alcohol reduced the CFU/mL in polyvinyl siloxane (p < 0.001). Finally, alcohol and glutaraldehyde reduced the CFU/mL in polyether material (p < 0.001). High heterogenicity was observed for the alginate and polyvinyl siloxane materials (I2 = 74%; I2 = 90%). Based on these in vitro studies, the disinfection of impression materials with several disinfection agents reduces the CFU/mL count.

Effect of Active Bonding Application after Selective Dentin Etching on the Immediate and Long-Term Bond Strength of Two Universal Adhesives to Dentin

The objective was to evaluate the influence of active bonding applications (ABA) for different time intervals after selective dentin etching (SDE) for 3 s on the microtensile bond strength (μTBS) to dentin of two universal adhesive systems (UAs): one containing 2-hydroxyethyl methacrylate (HEMA) (Scotchbond Universal, SBU), and one that was HEMA-free (Prime&Bond Universal, PBU). Dentin bovine specimens were divided into four groups: self-etch as control (SE), SDE + ABA for 15 s (SDE15), SDE + ABA for 20 s (SDE20), and SDE + ABA for 25 s (SDE25). The μTBS test was performed after a water storage of 24 h and 6 months. Scanning electron microscopy (SEM) was used in order to examine the resin−dentin interface. For the PBU, the µTBS was significantly influenced only by the aging factor (p < 0.026). A statistically significant decrease in the µTBS after 6 months of aging was observed only for the SDE15 group. For SBU, µTBS was significantly influenced by the protocol application and the aging time (p ≤ 0.041). The groups SDE15, SDE20, and SDE25 achieved statistically significant higher values (after 24 h and 6 months). No considerable variances were noticed in the homogeneity and continuity of the hybrid layer (HL) among the groups. In conclusion, SDE and ABA improved the µTBS only of a HEMA-containing universal adhesive.

Traditional Microscopic Techniques Employed in Dental Adhesion Research-Applications and Protocols of Specimen Preparation

Microscopy is a traditional method to perform ex vivo/in vitro dental research. Contemporary microscopic techniques offer the opportunity to observe dental tissues and materials up to nanoscale level. The aim of this paper was to perform a literature review on four microscopic methods, which are widely employed in dental studies concerning the evaluation of resin-dental adhesive interfaces-confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and atomic force microscopy (AFM). The literature search was performed using digital databases: PubMed, Web of Science and Scopus. On the basis of key words relevant to the topic and established eligibility criteria, finally 84 papers were included in the review. Presented microscopic techniques differ in their principle of operation and require specific protocols for specimen preparation. With regard to adhesion studies, microscopy assists in the description of several elements involved in adhesive bonding, as well as in the assessment of the condition of enamel surface and the most appropriate etching procedures. There are several factors determining the quality of the interaction between the substrates which could be recognized and a potential for further implementation of microscopic techniques in dental research could be recognized, especially when these techniques are used simultaneously or combined with spectroscopic methods. Through such microscopy techniques it is possible to provide clinically relevant conclusions and recommendations, which can be easily introduced for enamel-safe bonding and bonding protocols, as well as optimal pretreatments in dentine preparation.

Residual Adhesive Removal Methods for Rebonding of Debonded Orthodontic Metal Brackets: Systematic Review and Meta-Analysis

Debonding of orthodontic brackets is a common occurrence during orthodontic treatment. Therefore, the best option for treating debonded brackets should be indicated. This study aimed to evaluate the bond strength of rebonded brackets after different residual adhesive removal methods. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Web of Science, The Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BVS databases were screened up to December 2020. Bond strength comparisons were made considering the method used for removing the residual adhesive on the bracket base. A total of 12 studies were included for the meta-analysis. Four different adhesive removal methods were identified: sandblasting, laser, mechanical grinding, and direct flame. When compared with new orthodontic metallic brackets, bond strength of debonded brackets after air abrasion (p = 0.006), mechanical grinding (p = 0.007), and direct flame (p < 0.001) was significantly lower. The use of an erbium-doped yttrium aluminum garnet (Er:YAG) laser showed similar shear bond strength (SBS) values when compared with those of new orthodontic brackets (p = 0.71). The Er:YAG laser could be considered an optimal method for promoting the bond of debonded orthodontic brackets. Direct flame, mechanical grinding, or sandblasting are also suitable, obtaining clinically acceptable bond strength values.

Shelf Life and Storage Conditions of Universal Adhesives: A Literature Review

This paper presents state of the art universal adhesive systems and the effect of shelf-life and storage conditions on their bond performance. Three topics are explored in this review: an introduction to the topic, the mechanisms responsible for the degradation of the hybrid layer, and the factors that play a role in the stability of universal adhesives. In addition, issues such as potential durability and clinical importance are discussed. Universal adhesive systems are promising but must be handled and stored according to the manufacturer's instructions, with careful attention given to the details of shelf-life and storage conditions for maximal success. It appears that the components of universal adhesives play an important role in their stability. Furthermore, HEMA-free formulations using methacrylamides lead to longer shelf-life. Further research is needed to prove these hypotheses.

The Toxicity of Universal Dental Adhesives: An In Vitro Study

There is no consensus in the literature regarding the potential toxicity of universal dental adhesives (UDA). Being used in close proximity to the pulp, their biocompatibility should be an important factor in dental research. The aim of the present study was to evaluate the biocompatibility of UDA in an in vitro model. The study was performed using a monocyte/macrophage peripheral blood SC cell line (ATCC CRL-9855) on four specific UDA, namely: All-Bond Universal (Bisco); CLEARFIL Universal Bond Quick (Kuraray); G-Premio BOND (GC); Single Bond Universal (3M ESPE). The cytotoxicity of the investigated UDA was measured using the XTT colorimetric assay. The genotoxicity of the analyzed compounds was evaluated using an alkaline version of the comet assay. Furthermore, flow cytometry (FC) apoptosis detection was performed using the FITC Annexin V Apoptosis Detection Kit I. FC cell-cycle arrest assessment was performed using propidium iodide staining. The study observed significant differences in the toxicity of the UDA that were tested, as G-Premio BOND showed significant in vitro toxicity in all of the tests performed, while All-Bond Universal, CLEARFIL Universal Bond Quick and Single Bond Universal did not present any significant toxic effects toward SC cell line. The in vitro toxicity of UDA should be taken into consideration prior to in vivo and clinical studies. The flow cytometry could improve the accuracy of dental materials research and should be incorporated into the standardization criteria.

Does Simulated Porcelain Firing Influence Corrosion Properties of Casted and Sintered CoCr Alloys?

The aim of the study was to evaluate how heat processing used for dental porcelain firing influences the surface properties of sintered and casted CoCr alloy. Two CoCr alloys, Soft Metal LHK (milling in soft material and sintering) and MoguCera C (casting), were used for the study. The samples were examined using SEM-EDS before and after heat treatment. Next, corrosion examinations (E_corr, j_corr, polarization curve, E_br) were performed. Finally, the samples were evaluated under SEM. Based on the results, the following conclusions might be drawn: 1. Thermal treatment (porcelain firing) did not cause chemical impurities formation on the surface of CoCr alloy; 2. The sintered metal exhibited significantly higher corrosion resistance than the casted one due to its homogeneity of structure and chemical composition; 3. Heat treatment (porcelain firing) decreased the resistance of casted and sintered CoCr alloy to electrochemical corrosion. The reduction in corrosion resistance was significantly higher for the casted alloy than for the sintered alloy; 4. The corrosion resistance decrease might be due to an increased thickness and heterogeneity of oxide layers on the surface (especially for the casted alloy). The development of corrosion process started in the low-density areas of the oxide layers; 5. The sintered metal seems to be a favourable framework material for porcelain fused to metal crowns.

Temporomandibular Myofascial Pain Syndrome-Aetiology and Biopsychosocial Modulation. A Narrative Review

This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treatment of MPS should be deliberated holistically as it is a complex disorder.

The One-Year In Vivo Comparison of Lithium Disilicate and Zirconium Dioxide Inlays

The objective of the present study was to evaluate the one-year clinical performance of lithium disilicate (LD) and zirconium dioxide (ZrO₂) class II inlay restorations. Thirty healthy individuals who met the inclusion criteria were enrolled for the study. The patients were randomly divided into two study groups (n = 15): LD (IPS e.max press) and ZrO₂ (Dentcare Zirconia). In the ZrO₂ group, the internal surfaces of the inlays were sandblasted and silanized with Monobond N (Ivoclar, Leichsteistein, Germany). In the LD group, the internal surfaces of the inlays were etched with 5% hydrofluoric acid. The ceramic inlays were cemented with self-cure resin cement (Multilink N). Clinical examinations were performed using modified United State Public Health Codes and Criteria (USPHS) after 2 weeks, 4 weeks, 6 months and 1 year. The one-year survival rate was evaluated. In total, one failure was observed in the ZrO₂ group. The survival probability after 1 year for the ZrO₂ inlays was 93%, and for the LD inlays was 100%, which was statistically insignificant. The differences between both groups for most USPHS criteria (except for colour match) were statistically insignificant. Within the imitations of the present study, the lithium disilicate- and zirconia dioxide-based inlays exhibited comparable clinical performances. However, the colour and translucency match was superior for the lithium disilicate restorations.

One-Year Clinical Performance of the Fast-Modelling Bulk Technique and Composite-Up Layering Technique in Class I Cavities

The aim of this study was to assess the one year clinical performance of a new application method, the Fast-Modelling Bulk Technique (FMBT), in comparison to the Composite-Up Layering Technique (CULT) in posterior cavities. Thirty patients with two class I cavities on permanent human molars were enrolled in the present study. A total of sixty class I cavities were prepared and randomly divided according to the restoration technique used: 30 cavities restored by incremental layering technique and modelling of the last layer with Composite-Up Technique (CUT) using the composite Filtek Z250XT (3M ESPE; St. Paul, MN, USA) and the other 30 restored by Bulk Filling technique and modelling of the last layer by Fast-Modelling Technique (FMT) using the composite Filtek Bulk Fill Posterior Restorative (3M ESPE; St. Paul, MN, USA). Restorations were evaluated for up to one year by two observers according to Federation Dentaire Internationale (FDI) criteria, through clinical and radiological exams. Exact Fisher tests were used for statistical analysis. (p ≤ 0.05). From a biological perspective, at baseline, teeth restored with both techniques did not reveal any postoperative sensitivity. However, with time, FMBT showed less postoperative sensitivity and therefore more desirable results than CULT with a nonsignificant difference after one year (p > 0.05). Concerning secondary caries, fracture of the material, and marginal adaptation, no significant difference was noted between both techniques (p > 0.05). Regarding marginal staining, CULT resulted in more staining with a significant difference, as compared to FMBT (p < 0.05). Upon radiological examination, FMBT showed a good marginal fit during the first year, whereas CULT showed small empty voids from baseline with a nonsignificant difference (p = 1.00). After one year of clinical function, both techniques showed promising results. The present study indicates that the new FMBT could have a positive effect on the marginal staining of resin composite.

Selected Spectroscopic Techniques for Surface Analysis of Dental Materials: A Narrative Review

The presented work focuses on the application of spectroscopic methods, such as Infrared Spectroscopy (IR), Fourier Transform Infrared Spectroscopy (FT-IR), Raman spectroscopy, Ultraviolet and Visible Spectroscopy (UV-Vis), X-ray spectroscopy, and Mass Spectrometry (MS), which are widely employed in the investigation of the surface properties of dental materials. Examples of the research of materials used as tooth fillings, surface preparation in dental prosthetics, cavity preparation methods and fractographic studies of dental implants are also presented. The cited studies show that the above techniques can be valuable tools as they are expanding the research capabilities of materials used in dentistry.

Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth-A Systematic Review and Meta-Analysis

The use of autologous platelet concentrates (APCs) in regenerative endodontic procedures is inconsistent and unclear. The aim of this meta-analysis was to evaluate the effectiveness of autologous platelet concentrates compared to traditional blood-clot regeneration for the management of young, immature, necrotic, permanent teeth. The digital databases MEDLINE, SCOPUS, CENTRAL, Web of Science, and EMBASE were searched to identify ten randomized clinical trials. The outcomes at postoperative follow-up, such as dentinal wall thickness (DWT), increase in root length (RL), calcific barrier formation (CB), apical closure (AC), vitality response (VR), and success rate (SR), were subjected to both qualitative synthesis and quantitative meta-analysis. The meta-analysis showed that APCs significantly improved apical closure (risk ratio (RR) = 1.17; 95% CI: 1.01, 1.37; p = 0.04) and response to vitality pulp tests (RR = 1.61; 95% CI: 1.03, 2.52; p = 0.04), whereas no significant effect was observed on root lengthening, dentin wall thickness, or success rate of immature, necrotic teeth treated with regenerative endodontics. APCs could be beneficial when treating young, immature, necrotic, permanent teeth regarding better apical closure and improved response to vitality tests.

Additive Effect of Platelet Rich Fibrin with Coronally Advanced Flap Procedure in Root Coverage of Miller's Class I and II Recession Defects-A PRISMA Compliant Systematic Review and Meta-Analysis

AIM

This systematic review and meta-analysis aims to assess the additive effect of leukocyte and platelet-rich fibrin (L-PRF) on coronally advanced flap (CAF) procedures in root coverage of Miller's class I and II gingival recession defects. Review methodology: A comprehensive search in MEDLINE (PubMed), Scopus and CENTRAL (the Cochrane Central Register of Controlled Trials), along with an additional hand search, provided eight randomized clinical trials to be included in this review. A total of 167 patients with 470 gingival recession defects were analyzed. A meta-analysis was carried out to assess the change in gingival thickness (GT), width of keratinized gingiva (WKG), root coverage percentage (%RC), clinical attachment level (CAL) and recession depth (RD) at all follow-ups between CAF alone and CAF + L-PRF groups for all included studies. A subgroup analysis was carried out based on recession type (single/multiple).

RESULTS

Overall, a significant improvement in GT, CAL and RD was found when treated with CAF + L-PRF. There was a trend for a positive effect in terms of an increase in WKG when using L-PRF, especially in the treatment of single recession, though significance was not achieved (p = 0.08 overall). The results of heterogeneity among the subgroups were varied and were found to be greater than 91.3% for GT and 32.8% for WKG.

CONCLUSION

L-PRF when used in addition to CAF showed favorable results for the treatment of class I and II gingival recession defects.

Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis

The objective of this systematic review and meta-analysis was to determine the clinical effectiveness of bulk-fill and conventional resin in composite restorations. A bibliographic search was carried out until May 2020, in the biomedical databases Pubmed/MEDLINE, EMBASE, Scopus, CENTRAL and Web of Science. The study selection criteria were: randomized clinical trials, in English, with no time limit, with a follow-up greater than or equal to 6 months and that reported the clinical effects (absence of fractures, absence of discoloration or marginal staining, adequate adaptation marginal, absence of post-operative sensitivity, absence of secondary caries, adequate color stability and translucency, proper surface texture, proper anatomical form, adequate tooth integrity without wear, adequate restoration integrity, proper occlusion, absence of inflammation and adequate point of contact) of restorations made with conventional and bulk resins. The risk of bias of the study was analyzed using the Cochrane Manual of Systematic Reviews of Interventions. Sixteen articles were eligible and included in the study. The results indicated that there is no difference between restorations with conventional and bulk resins for the type of restoration, type of tooth restored and restoration technique used. However, further properly designed clinical studies are required in order to reach a better conclusion.

The Cytotoxicity and Genotoxicity of Three Dental Universal Adhesives-An In Vitro Study

Dental universal adhesives are considered an useful tool in modern dentistry as they can be used in different etching techniques, allow for simplified protocol and provide sufficient bond strength. However, there is still no consensus as to their toxicity towards pulp. Thus, the present study aimed to evaluate the cytotoxicity and genotoxicity of three universal adhesives: OptiBond Universal, Prime&Bond Universal and Adhese in an in vitro experimental model, monocyte/macrophage cell line SC (ATCC CRL-9855). The cytotoxicity was measured by means of XTT assay, whereas the genotoxicity (comet assay) was evaluated based on the percentage of DNA present in the comet tail. Furthermore, the ability of the adhesives to induce apoptosis was analyzed using flow cytometry (FC) with the FITC annexin V/propidium iodide (PI) double staining. The analysis of the cell cycle progression was performed with FC using PI staining. OptiBond Universal presented significant, while Prime&Bond Universal and Adhese Universal had minimal cytotoxicity and genotoxicity towards human SC cells. Moreover, only OptiBond Universal increased the level of apoptosis in SC cell line. None of the adhesives showed significant cell cycle arrest, as revealed by FC analysis. Due to substantial differences in toxicity in in vitro studies of dental adhesives, there is a great need for further research in order to establish more reliable test protocols allowing for standardized methodology.

The Bruxoff Device as a Screening Method for Sleep Bruxism in Dental Practice

Sleep bruxism (SB) is a masticatory muscle activity during sleep and a common phenomenon. Severe SB can have a serious impact on the success of dental treatment. Reliable methods of screening and diagnosing patients with SB are crucial. Therefore, in this study, a Bruxoff device as a potential screening and diagnostic method for sleep bruxism was evaluated. A total of 60 adults participated in this study: 35 patients with symptoms of bruxism (study group) and 25 asymptomatic patients (control group). Data were recorded using Bruxoff. All symptomatic patients participating in the study turned out to be bruxers, while not all asymptomatic patients turned out to be non-bruxers according to the Bruxoff device. Bruxoff is a simple screening device that can be safely used to evaluate masseter muscle activity during sleep. Since the device does not have a built-in microphone and/or video camera and, therefore, cannot record grinding sounds, the objective capabilities of Bruxoff as a single diagnostic device for sleep bruxism are limited.

Flow Cytometry Analysis of Antibacterial Effects of Universal Dentin Bonding Agents on Streptococcus mutans

There is no consensus on the antibacterial activity of dentin bonding systems (DBS). Many study models have been used to evaluate the antimicrobial activity of dental materials. In this study, a novel detection method, flow cytometry, was introduced. It allows for evaluation of the antibacterial activity of DBS, based on assessment of the disruption of the bacterial physical membrane induced by DBS. The aim of the study was to evaluate the antibacterial properties of selected dentin bonding systems against Streptococcus mutans. The highest antibacterial activity against S. mutans was observed for Adhese Universal (99.68% dead cells) and was comparable to that of Prime&Bond Universal, OptiBond Universal, or Clearfil Universal Bond Quick (p > 0.05). The lowest activity of all tested systems was displayed by the multi-mode adhesive, Universal Bond (12.68% dead bacteria cells), followed by the self-etch adhesive, OptiBond FL (15.58% dead bacteria cells). The present study showed that in the case of two-component DBS, the primer exhibited higher antimicrobial activity than the adhesive (or bond) itself.

Effect of Surface Cleaning Regimen on Glass Ceramic Bond Strength

This study investigated the effect of saliva contamination on chemical changes of ceramic surface as well as the influence of saliva cleaning methods on ceramic-resin bond strength. Saliva was used to contaminate leucite (LGC) and lithium disilicate (LDGC) glass ceramic surfaces. The following cleaning methods were tested: water spray, cleaning with orthophosphoric acid, universal cleaning paste, ultrasonic cleaning with water, re-etching with hydrofluoric acid. Non-contaminated ceramic sample served as control. Chemical analysis of ceramic surfaces was performed using time-of-flight secondary ion mass spectrometry (TOF-SIMS). Shear bond strength (SBS) of ceramics to resin material was tested after 24-hour water storage and after thermocycling. The most effective cleaning method of saliva-contaminated ceramic surface was cleaning LGC surface with orthophosphoric acid or re-etching the LDGC surface with hydrofluoric acid. The application of the following methods resulted in obtaining reliable bond strength.

Multi-Layer Application of Self-Etch and Universal Adhesives and the Effect on Dentin Bond Strength

Contemporary self-etch and multi-mode adhesives were introduced to ensure a fast and reliable bonding procedure. Yet, in terms of bond strength and stability they failed to perform as well as two-bottle, etch-and-rinse adhesives, which remain the gold standard in terms of durability. The purpose of this study was to assess the shear bond strength (SBS) of dental adhesives to dentin with different application protocols. Two self-etch (Adper Easy One and Xeno V) and two multi-mode adhesives (Single Bond Universal and Prime&Bond One Select) were used in the study. The highest SBS was obtained for Single Bond Universal applied in three layers, while the lowest, for Xeno V applied in one layer. Other tested adhesives obtained the highest SBS when applied in three layers. For all tested adhesives, multi-layer application resulted in an increase in adhesive layer thickness, as observed in SEM. The increased thickness of the adhesive layer produced by triple application of unfilled adhesives corresponded with higher SBS values. The present study showed that using triple adhesive layers with simplified adhesive systems can be recommended to improve their performance. Due to differences in the composition of self-etch and universal adhesives, the exact application protocol is product dependent.

Contraction and Hydroscopic Expansion Stress of Dental Ion-Releasing Polymeric Materials

Ion-releasing polymeric restorative materials seem to be promising solutions, due to their possible anticaries effect. However, acid functional groups (monomers) and glass filler increase hydrophilicity and, supposedly, water sorption. The purpose of the study was to evaluate the influence of water sorption of polymeric materials on the stress state at the restoration-tooth interface. Beautifil Bulk Fill Flow, Beautifil Flow Plus F00, Beautifil Flow F02, Dyract eXtra, Compoglass Flow, Ionosit, Glasiosite, TwinkiStar, Ionolux and Fuji II LC were used for the study. The stress state was measured using photoelastic analysis after: 0.5, 24, 72, 96, 168, 240, 336, 504, 672, 1344 and 2016 h. Moreover, water sorption, solubility and absorption dynamic were assessed. The water sorption, solubility and absorption dynamic of ion-releasing restorative materials are material dependent properties. The overall results indicated that the tested restorative materials showed significant stress decrease. The total reduction in contraction stress and water expansion stress was not observed for materials with low value of water sorption (Beautifil Bulk Fill, Dyract eXtra, Glasionosit and Twinky Star). The photoelastic method turned out to be inadequate to evaluate stress changes of resin modified glass-ionomer cement (RMGI, Fuji II LC and Ionolux).

Dentine Surface Morphology after Chlorhexidine Application-SEM Study

Chlorhexidine (CHX) is a widely known and a very popular antibacterial agent that decreases the level of cariogenic bacteria. CHX applied on the cavity surface of dentine may influence adhesive bond strength. The aim of the study was to evaluate the dentine surface after different chlorhexidine digluconate (CHG) application protocols. Different CHG application protocols were introduced. A concentration of 0.2% or 2.0% CHG was applied on the etched or unetched dentine surface for 15 or 30 s, then water rinsed or drained. Scanning electron microscopy (SEM) observations and energy disperse spectrometer (EDS) analysis of the dentine surfaces were performed. The application of 0.2% CHG for 15 s, followed by draining, on either etched or unetched dentine surface effectively removed the smear layer, leaving the surface enriched with CHG deposits. Conclusions: The concentration of CHG and its application time influenced the amount of CHG deposits and the degree of smear layer removal from the dentine surface.

The Influence of Water Sorption of Dental Light-Cured Composites on Shrinkage Stress

The contraction stress generated during the photopolymerization of resin dental composites is the major disadvantage. The water sorption in the oral environment should counteract the contraction stress. The purpose was to evaluate the influence of the water sorption of composite materials on polymerization shrinkage stress generated at the restoration-tooth interface. The following materials were tested: Filtek Ultimate, Gradia Direct LoFlo, Heliomolar Flow, Tetric EvoCeram, Tetric EvoCeram Bulk Fill, Tetric EvoFlow, Tetric EvoFlow Bulk Fill, X-tra Base, Venus BulkFil, and Ceram.X One. The shrinkage stress was measured immediately after curing and after: 0.5 h, 24 h, 72 h, 96 h, 168 h, 240 h, 336 h, 504 h, 672 h, and 1344 h by means of photoelastic study. Moreover, water sorption and solubility were evaluated. Material samples were weighted on scale in time intervals to measure the water absorbency and the dynamic of this process. The tested materials during polymerization generated shrinkage stresses ranging from 6.3 MPa to 12.5 MPa. Upon water conditioning (56 days), the decrease in shrinkage strain (not less than 48%) was observed. The decrease in value stress in time is material-dependent.

Antibacterial Activity of Commercial Dentine Bonding Systems against E. faecalis-Flow Cytometry Study

Literature presents inconsistent results on the antibacterial activity of dentine bonding systems (DBS). Antibacterial activity of adhesive systems depends on several factors, including composition and acidity. Flow cytometry is a novel detection method to measure multiple characteristics of a single cell: total cell number, structural (size, shape), and functional parameters (viability, cell cycle). The LIVE/DEAD^® BacLight™ bacterial viability assay was used to evaluate an antibacterial activity of DBS by assessing physical membrane disruption of bacteria mediated by DBS. Ten commercial DBSs: four total-etching (TE), four self-etching (SE) and two selective enamel etching (SEE) were tested. Both total-etching DBS ExciTE F and OptiBond Solo Plus showed comparatively low antibacterial activity against E. faecalis. The lowest activity of all tested TE systems showed Te-Econom Bond. Among SE DBS, G-ænial Bond (92.24% dead cells) followed by Clearfil S3 Bond Plus (88.02%) and Panavia F 2.0 ED Primer II (86.67%) showed the highest antibacterial activity against E. faecalis, which was comparable to isopropranol (positive control). In the present study, self-etching DBS exhibited higher antimicrobial activity than tested total-etching adhesives against E. faecalis.