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This study aimed to compare the 48-month clinical performance and wear of Bis-GMA-based and Bis-GMA-free nanoceramic resin composites in Class I posterior restorations. In a randomized clinical trial, 64 patients received occlusal restorations with either Zenit (Bis-GMA-based) or Neo Spectra ST (Bis-GMA-free) nanoceramic composites ( n  = 32). Clinical performance was evaluated using modified USPHS criteria at four timepoints (baseline, 12, 24, 48 months). Intraoral scans were analyzed using 3D digital superimposition techniques to assess linear and volumetric quantification of wear across follow-up periods. The results revealed that marginal discoloration was slightly more frequent in the Zenit group at 48 months, though not statistically significant. Clinical outcomes were comparable between groups. The amount of linear deviation measured in Zenit samples was higher than in Neo Spectra, whereas the volumetric deviation was greater in Neo Spectra. However, neither difference was statistically significant. Both composites demonstrated clinically acceptable performance over a 48-month period in Class I posterior restorations. Some marginal discoloration was observed with both materials. The differing matrix-to-filler ratios of the two nanoceramic resin composites may have contributed to compensating for volumetric wear. Intraoral scanning and digital analysis enable accurate, non-invasive wear monitoring. Neo Spectra ST offers superior esthetic stability and clinical handling. Neo Spectra™ ST may offer a clinically advantageous option for posterior restorations requiring esthetic durability and operator-friendly handling. Additionally, digital intraoral scanning combined with registration software provides a promising, non-invasive approach for monitoring restorative wear in clinical practice. Clinical trial registration : This study was registered on clinical trial ( http://www.ClinicalTrials.gov ) at February 4, 2021 with ID: NCT04738604.

Degradation of denuded collagen within adhesive resin-infiltrated dentin is a pertinent problem in dentin bonding. A biomimetic remineralization scheme that incorporates non-classic crystallization pathways of fluidic amorphous nanoprecursors and mesoscopic transformation has been successful in remineralizing resin-free, acid-etched dentin, with evidence of intrafibrillar and interfibrillar remineralization. This study tested the hypothesis that biomimetic remineralization provides a means for remineralizing incompletely infiltrated resin-dentin interfaces created by etch-and-rinse adhesives. The remineralization medium consists of a Portland cement/simulated body fluid that includes polyacrylic acid and polyvinylphosphonic acid biomimetic analogs for amorphous calcium phosphate dimension regulation and collagen targeting. Both interfibrillar and intrafibrillar apatites became readily discernible within the hybrid layers after 2–4 months. In addition, intra-resin apatite clusters were deposited within the porosities of the adhesive resin matrices. The biomimetic remineralization scheme provides a proof-of-concept for the adoption of nanotechnology as an alternative strategy to extend the longevity of resin-dentin bonds.

The achievement of a strong and stable bond between composite resin and dentin remains a challenge in restorative dentistry. Over the past two decades, dental materials have been substantially improved, with better handling and bonding characteristics. However, little attention has been paid to the contribution of collagen structure/stability to bond strength. We hypothesized that the induction of cross-linking in dentin collagen improves dentin collagen stability and bond strength. This study investigated the effects of glutaraldehyde-and grape seed extract-induced cross-linking on the dentin bond strengths of sound and caries-affected dentin, and on the stability of dentin collagen. Our results demonstrated that the application of chemical cross-linking agents to etched dentin prior to bonding procedures significantly enhanced the dentin bond strengths of caries-affected and sound dentin. Glutaraldehyde and grape seed extract significantly increased dentin collagen stability in sound and caries-affected dentin, likely via distinct mechanisms.

Dentin collagen is a major component of the hybrid layer, and its stability may have a great impact on the properties of adhesive interfaces. We tested the hypothesis that the use of tannic acid (TA), a collagen cross-linking agent, may affect the mechanical properties and stability of the dentin matrix. The present study evaluated the effects of different concentrations of TA on the modulus of elasticity and enzymatic degradation of dentin matrix. Hence, the effect of TA pre-treatment on resin-dentin bond strength was assessed with the use of two bonding systems. Sound human molars were used and prepared according to each experimental design. The use of TA affected the properties of demineralized dentin by increasing its stiffness. TA treatment inhibited the effect of collagenase digestion on dentin matrix, particularly for 10%TA and 20%TA. The TA-dentin matrix complex resulted in improved bond strength for both adhesive systems.

Aim: To compare 24-month pulp health outcomes of partial caries removal (PCR) and total caries removal (TCR) with composite restoration in primary molars. Methods: 48 children aged 3-8 years with at least one molar with a deep carious lesion were included. 120 teeth were randomized to control (TCR; n = 54; 69% class II) and test (PCR; n = 66; 63% class II) groups. Total absence of carious tissue was confirmed using a blunt-tipped probe in the TCR group. For PCR, excavation was stopped when hardened, dried dentin with a leathery consistency was achieved. Pulpotomy was performed in cases of pulp exposure. Results: Pulp exposure occurred in 2 and 27.5% of teeth treated with PCR and TCR, respectively (p < 0.01). The operative time was significantly higher for TCR than PCR. Success rates were 92 and 96% in the PCR and TCR groups, respectively (p = 0.34). The success rate tended to be lower in occlusoproximal (92%) than in occlusal (100%) lesions (p = 0.08). Conclusion: The clinical and radiographic success rates of PCR and TCR in primary teeth with deep carious lesions were high and did not differ significantly, indicating that PCR is a reliable minimally invasive approach in primary teeth and that the retention of carious dentin does not interfere with pulp vitality. Moreover, PCR provided other clinically relevant advantages over TCR, especially lower incidence of pulp exposure and lower operative time.

Background The resin-based pit and fissure sealant is considered a successful tool in caries prevention, however there is a growing evidence of its use in controlling already established caries in posterior teeth. The aim of this clinical trial is to verify the efficacy of pit and fissure sealants in arresting dentinal caries lesions compared to partial excavation and restorative treatment in primary molar teeth. Methods Thirty six patients with occlusal cavitated primary molar reaching outer half of dentin were selected. The patients were randomly allocated into two groups: sealant application (experimental group – n = 17) and restoration with composite resin (control group – n = 19). Clinical and radiograph evaluation were performed after 6, 12 and 18 months. The chi-square test was used to verify the distribution of characteristics variables of the sample among the groups. The survival rate of treatments was evaluated using Kaplan–Meier survival and log-rank test. Fisher’s Exact and logistic regression tests were calculated in each evaluation period (α = 5%). Results The control group showed significantly better clinical survival after 18 months (p = 0.0025). In both groups, no caries progression was registered on the radiographic evaluations. Conclusions Sealing had similar efficacy in the arrestment of caries progression of cavitated occlusal lesions compared to partial excavation of the lesions, even though the frequency of re-treatments was significantly higher in sealed lesions. Trial registration Registro Brasileiro de Ensaios Clínicos (ReBEC): RBR-9kkv53

Er-YAG laser irradiation has been claimed to improve the adhesive properties of dentin. We tested the hypothesis that dentin adhesion is affected by Er-YAG laser conditioning. Superficial or deep dentin from human molars was: (a) acid-etched with 35% H3PO4; (b) irradiated with an Er-YAG laser (KaVo) at 2 Hz and 180 mJ, with water-cooling; and (c) laser- and acid-etched. Single Bond (3M ESPE) and Z100 composite (3M ESPE) were bonded to the prepared surfaces. After storage, specimens were tested in shear to failure. Bonded interfaces were demineralized in EDTA and processed for transmission electron microscopy. Two-way ANOVA revealed that conditioning treatment and interaction between treatment and dentin depth significantly influenced shear bond strength results. Acid-etching alone yielded shear bond strength values that were significantly higher than those achieved with laser ablation alone, or in combination with acid-etching. The Er-YAG laser created a laser-modified layer that adversely affects adhesion to dentin, so it does not constitute an alternative bonding strategy to conventional acid etching.

The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25–38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2–3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression ( p  > 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations ( p  > 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health.

Background The aim of this prospective clinical study was to compare the mean durability and the failure rates of two types of orthodontic retainers. Methods Orthodontic patients (142) aged between 14 and 28 years were recruited in this study. The polyethylene woven ribbon (Ribbond, Seattle, WA, USA) retainer was compared with a 0.0175-in flexible spiral wire (Respond, Ormco, Glendora, CA, USA) retainer. When treatment was completed, the retainers were bonded from canine to canine in the maxillary and the mandibular arches of the participants. In the follow-up visits, the patients were re-evaluated every 3 months over a period of 18 months. The time taken for the retainers to remain without any fracture was appraised. Kaplan-Meier analysis and the logrank test were employed to identify significant differences in the survival functions between the groups. The rates of the retainers' failure between the groups were analyzed using Chi-square test. Results It was revealed that the mean survival of the flexible spiral wire retainer was 15.34 ± 0.47 and 15.60 ± 0.42 months in the maxillary and mandibular arches, respectively. The mean survival of the ribbon retainer was 13.95 ± 0.55 and 14.26 ± 0.57 months in the maxillary and mandibular arches, respectively. Ribbon retainers showed a failure rate of 50% in the maxillary and 42.6% in the mandibular arches. Flexible spiral retainers showed a failure rate of 36.5% in the maxillary and 37.8% in the mandibular arches. The differences were not statistically significant. Regarding the evaluation period, the differences had limited clinical significance. Conclusion The mean survival time and the failure rates of the polyethylene woven ribbon retainer were comparable to the flexible spiral wire retainer during the 18 months after orthodontic treatment.

This study examined the effects of a widely used (Delton Pit & Fissure Sealant - Light Cure Opaque, DENTSPLY Professional, York, PA) pit and fissure sealant material on bisphenol A (BPA) levels in blood and saliva, among both low and high-dose groups over time. A convenience sample of 30 adults from the Old Dominion University population were randomly and evenly divided into 2 independent variable groups: a low-dose group (1 occlusal sealant application) and high-dose group (4 occlusal sealant applications). A 2 group, time series design was used to examine the presence and concentration of BPA in serum and saliva after sealant placement. Differences comparing low-dose and high-dose groups were examined 1 hour prior (baseline), 1 hour post, 3 hours post and 24 hours after sealant placement, as measured by a direct-competitive BPA Enzyme Linked ImmunoSorbent Assay (ELISA). Hypothesized outcomes were evaluated by applying a parametric, 2 way ANOVA for repeated measures technique to data on the 30 participants ranging in age from 18 to 40 years, and were of mixed gender and ethnicity. BPA was detected in the saliva of all participants prior to sealant placement and ranged from 0.07 to 6.00 ng/ml at baseline. Salivary BPA concentration levels peaked over a 3 hour period following sealant placement and returned to baseline levels within 24 hours. BPA was significantly elevated at all post-sealant placement time periods for both the low-dose (1 occlusal sealant application) and high-dose (4 occlusal sealant applications) groups with peak levels of 3.98 ng/ml and 9.08 ng/ml, respectively. The blood serum did not contain BPA at any point in this investigation. Exposure to BPA from sources other than dental resins contributes to salivary baseline concentration levels and indicates environmental exposure and use of products containing BPA. Use of specific molecular formulations of dental sealant material determines the release of BPA, therefore, dental sealant materials should be reviewed independently when questioning the release of BPA from dental sealants. In addition, dosage amounts of the dental sealant material used in this study do not influence the serum concentration levels of BPA. Further research is needed to examine the cumulative estrogenic effects of BPA from dental sealants.