This study evaluated the influence of LED curing units and selective enamel etching on the dentin bond strength of self-etch adhesives in class I composite restorations. Two self-etch adhesives were bonded to dentin with or without prior enamel etching and cured with different LED curing lights. The dentin bond strength was measured and the failure modes analyzed. Selective enamel etching decreased the bond strength of one adhesive but not the other. A polywave LED provided stronger bonding than single-peak LEDs for one of the adhesives tested.
This study evaluated the influence of LED curing light type and selective enamel etching on the dentin microtensile bond strength (μTBS) of two self-etch adhesives (Clearfil SE and Clearfil S3) in class I composite restorations. For Clearfil S3, selective enamel etching resulted in lower dentin μTBS values compared to non-etched specimens. However, dentin μTBS of Clearfil SE was not affected by enamel etching. When curing the adhesives, the polywave LED yielded higher dentin μTBS for Clearfil SE than the single-peak LEDs. Enamel etching and LED type influenced dentin bonding of the self-etch ad
The document reviews new resins being developed for dental composites. It discusses the history and composition of composites. Shortcomings of traditional composites like polymerization shrinkage and techniques sensitivity are addressed. New materials aim to reduce shrinkage through modified monomers and fillers. Bulk-fill composites allow thicker placement in less time. Self-adhesive composites bond without separate bonding steps. Bioactive materials incorporate antimicrobial or remineralizing agents. Future areas of research include further reducing stresses during curing and improving resistance to degradation in the oral cavity.
Bioactive effects of a calcium/sodium phosphosilicate on the resin–dentine in...DrMarkHogan
This study evaluated, through microtensile bond strength (μTBS) testing, the bioactive effects of a calcium/sodium phosphosilicate (BAG) at the resin–dentine interface after 6 months of storage in phosphate buffer solution (PBS). Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were also per- formed. Three bonding protocols were evaluated: (i) RES-Ctr (no use of BAG), (ii) BAG containing adhesive (BAG-AD), and (iii) BAG/H3PO4 before adhesive (BAG-PR). The dentin-bonded specimens were prepared for μTBS testing, which was carried out after 24 h or 6 months of storage in PBS. Scanning electron microscopy ultramorphology analysis was performed after debonding. Confocal laser scanning microscopy was used to evaluate the morphological and nanoleakage changes induced by PBS storage. High μTBS values were achieved in all groups after 24 h of storage in PBS. Subsequent to 6 months of storage in PBS the specimens created using the BAG-AD bonding approach still showed no significant reduction in μTBS. Moreover, specimens created using the BAG-AD or the BAG-PR approach showed an evident reduction of nanoleakage after prolonged storage in PBS. The use of BAG-containing adhesive may enhance the durability of the resin–dentine bonds through therapeutic/protective effects associated with mineral deposition within the bonding interface and a possible interference with collagenolytic enzyme activity (matrix metalloproteinases) responsible for the degradation of the hybrid layer.
The study evaluated the Knoop hardness and bond strength of methacrylate- and silorane-based composites when photoactivated by different methods. Bond strength was tested using a push-out test on restored bovine teeth, and Knoop hardness was measured on the top and bottom of restorations. The photoactivation methods did not affect bond strength or hardness within the same composite. The silorane-based composite Filtek P90 showed higher bond strength but lower hardness than the methacrylate-based Filtek Supreme. The photoactivation method did not influence results for either composite.
The study evaluated the influence of curing methods (continuous light, soft-start, pulse delay) and composite volumes (12.6 mm3, 24.5 mm3) on the marginal and internal adaptation of composite restorations. Sixty bovine teeth were prepared with cavities of different volumes and restored with composite using different curing methods. Marginal and internal gaps were measured. The results showed that higher composite volumes led to greater gap formation, and modulated curing methods reduced gap formation, particularly for higher volume restorations and internal adaptation of lower volume restorations. Therefore, composite volume and curing method can impact adaptation, and modulated curing may help reduce gaps.
This study evaluated the effect of using a warm versus cold air stream for solvent evaporation on the properties of two etch-and-rinse adhesive systems. Microtensile bond strength and nanoleakage patterns were compared between the two drying methods. Degree of conversion and solvent evaporation rates were also analyzed. The results showed that using a warm air stream improved bond strength and reduced nanoleakage, without affecting degree of conversion. This suggests that a warm air dry may help form a stronger polymer network within the hybrid layer.
Repair of teeth with cracks in crowns and roots: An observational clinical studyDR.AJAY BABU GUTTI M.D.S
1) An observational clinical study investigated the survival rate of teeth with longitudinal cracks (PRCT and DRCT) that underwent composite restoration.
2) 180 cracked teeth from 99 patients were included, with 26% surviving after 5 years. Survival was better for PRCT (75%) than DRCT (48%).
3) The adhesive composite restoration technique was found to promote bone repair in most cases and reduce risk of further crack progression or extraction.
While time-consuming, it provided a promising long-term prognosis for vertical root cracks.
This study evaluated the influence of LED curing light type and selective enamel etching on the dentin microtensile bond strength (μTBS) of two self-etch adhesives (Clearfil SE and Clearfil S3) in class I composite restorations. For Clearfil S3, selective enamel etching resulted in lower dentin μTBS values compared to non-etched specimens. However, dentin μTBS of Clearfil SE was not affected by enamel etching. When curing the adhesives, the polywave LED yielded higher dentin μTBS for Clearfil SE than the single-peak LEDs. Enamel etching and LED type influenced dentin bonding of the self-etch ad
The document reviews new resins being developed for dental composites. It discusses the history and composition of composites. Shortcomings of traditional composites like polymerization shrinkage and techniques sensitivity are addressed. New materials aim to reduce shrinkage through modified monomers and fillers. Bulk-fill composites allow thicker placement in less time. Self-adhesive composites bond without separate bonding steps. Bioactive materials incorporate antimicrobial or remineralizing agents. Future areas of research include further reducing stresses during curing and improving resistance to degradation in the oral cavity.
Bioactive effects of a calcium/sodium phosphosilicate on the resin–dentine in...DrMarkHogan
This study evaluated, through microtensile bond strength (μTBS) testing, the bioactive effects of a calcium/sodium phosphosilicate (BAG) at the resin–dentine interface after 6 months of storage in phosphate buffer solution (PBS). Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were also per- formed. Three bonding protocols were evaluated: (i) RES-Ctr (no use of BAG), (ii) BAG containing adhesive (BAG-AD), and (iii) BAG/H3PO4 before adhesive (BAG-PR). The dentin-bonded specimens were prepared for μTBS testing, which was carried out after 24 h or 6 months of storage in PBS. Scanning electron microscopy ultramorphology analysis was performed after debonding. Confocal laser scanning microscopy was used to evaluate the morphological and nanoleakage changes induced by PBS storage. High μTBS values were achieved in all groups after 24 h of storage in PBS. Subsequent to 6 months of storage in PBS the specimens created using the BAG-AD bonding approach still showed no significant reduction in μTBS. Moreover, specimens created using the BAG-AD or the BAG-PR approach showed an evident reduction of nanoleakage after prolonged storage in PBS. The use of BAG-containing adhesive may enhance the durability of the resin–dentine bonds through therapeutic/protective effects associated with mineral deposition within the bonding interface and a possible interference with collagenolytic enzyme activity (matrix metalloproteinases) responsible for the degradation of the hybrid layer.
The study evaluated the Knoop hardness and bond strength of methacrylate- and silorane-based composites when photoactivated by different methods. Bond strength was tested using a push-out test on restored bovine teeth, and Knoop hardness was measured on the top and bottom of restorations. The photoactivation methods did not affect bond strength or hardness within the same composite. The silorane-based composite Filtek P90 showed higher bond strength but lower hardness than the methacrylate-based Filtek Supreme. The photoactivation method did not influence results for either composite.
The study evaluated the influence of curing methods (continuous light, soft-start, pulse delay) and composite volumes (12.6 mm3, 24.5 mm3) on the marginal and internal adaptation of composite restorations. Sixty bovine teeth were prepared with cavities of different volumes and restored with composite using different curing methods. Marginal and internal gaps were measured. The results showed that higher composite volumes led to greater gap formation, and modulated curing methods reduced gap formation, particularly for higher volume restorations and internal adaptation of lower volume restorations. Therefore, composite volume and curing method can impact adaptation, and modulated curing may help reduce gaps.
This study evaluated the effect of using a warm versus cold air stream for solvent evaporation on the properties of two etch-and-rinse adhesive systems. Microtensile bond strength and nanoleakage patterns were compared between the two drying methods. Degree of conversion and solvent evaporation rates were also analyzed. The results showed that using a warm air stream improved bond strength and reduced nanoleakage, without affecting degree of conversion. This suggests that a warm air dry may help form a stronger polymer network within the hybrid layer.
Repair of teeth with cracks in crowns and roots: An observational clinical studyDR.AJAY BABU GUTTI M.D.S
1) An observational clinical study investigated the survival rate of teeth with longitudinal cracks (PRCT and DRCT) that underwent composite restoration.
2) 180 cracked teeth from 99 patients were included, with 26% surviving after 5 years. Survival was better for PRCT (75%) than DRCT (48%).
3) The adhesive composite restoration technique was found to promote bone repair in most cases and reduce risk of further crack progression or extraction.
While time-consuming, it provided a promising long-term prognosis for vertical root cracks.
This study evaluated the degree of conversion (DC) and plasticization of a pit and fissure sealant (Fluroshield) and a flowable composite (Permaflo) when cured for either 20 or 60 seconds. The key findings were:
1) Permaflo had a higher DC than Fluroshield at both curing times. Extended curing (60 seconds) increased the DC of Permaflo but not Fluroshield.
2) Fluroshield showed higher plasticization (hardness decrease after ethanol storage) than Permaflo. Extended curing did not decrease plasticization for either material.
3) There was a low negative correlation between DC and plasticization, suggesting DC
This paper aims to submit the report the aesthetic correction in a disharmonious smile and unsatisfactory composite restorations in anterior teeth who were treated with direct aesthetic restorative procedure. The results show the use of this technique to allows an immediate aesthetic quality, directly and inexpensively restoring the natural features of the smile.
Key Words: Composite Resin,Class IV, Aesthetic.
This study evaluated the Knoop hardness of resin composite restorations photoactivated by different methods when different mold materials were used. Resin composite samples were cured using high-intensity continuous, low-intensity continuous, soft-start, or pulse-delay methods and placed in either a bovine tooth or metal mold. Knoop hardness was measured on the top and bottom surfaces. On the top surface, hardness did not differ between curing methods but was higher for the metal mold. On the bottom, high-intensity continuous curing produced higher hardness than low-intensity continuous, and hardness was influenced by the mold material used. The results indicate that photoactivation method and mold can impact hardness values of resin composite restorations.
This study compared the clinical performance of a polyacid modified resin composite (Dyract eXtra) and a nanocomposite (Filtek Supreme) when used with an antibacterial adhesive system (Clearfil Protect Bond) to restore noncarious cervical lesions over 2 years. 100 restorations were placed - 50 of each material - and evaluated at baseline and 6, 12, and 24 months using criteria like color match, marginal adaptation, retention, etc. Both materials showed acceptable clinical performance, though Filtek Supreme had a significantly better retention rate (100% vs 96% for Dyract eXtra). Some Dyract eXtra restorations were lost or fractured. Overall both materials can be suitable options for restoring
The document describes the NobelActive implant system. It has a unique tapered design that provides high initial stability, even in compromised bone. The implant features a back-tapered collar for optimal soft tissue support and a variable thread pitch that gradually condenses bone. Clinical studies show the implants achieve osseointegration and stable bone and soft tissue levels over multiple years. The system allows for minimally invasive insertion and adjustable placement for optimal prosthetic outcomes.
This study evaluated the clinical performance of a self-etching adhesive system (Clearfil SE Bond) and a one-bottle adhesive system (Prime&Bond NT) in non-carious Class V restorations over 2 years. 98 restorations were placed in 32 patients using the two adhesive systems. At 2 years, the retention rates were 93% for Clearfil SE Bond and 91% for Prime&Bond NT, showing very good clinical performance for both systems with no statistically significant differences in failure rates. A few restorations showed slight marginal discoloration or adaptation issues, but no restorations exhibited postoperative sensitivity, recurrent caries or changes in anatomical form.
This article describes the long-term treatment of a case of molar incisor hypomineralization (MIH) involving both anterior and posterior teeth. Initial treatment included calcium-phosphate supplementation, which SEM images showed improved the enamel morphology. Later treatments included orthodontics, bleaching of anterior teeth, and restorative work. An 8-year follow-up found that calcium-phosphate supplementation, bleaching, and restorations effectively addressed the esthetic and functional issues caused by the MIH while minimizing intervention.
This document is a thesis submitted by Anthony Khoo for a Master of Science degree in Restorative Dentistry. The thesis evaluates a self-etch, self-adhesive resin cement for bonding indirect all-ceramic restorations. It includes an introduction discussing different all-ceramic materials and the need for resin bonding. The specific aims are to clinically evaluate the new self-adhesive resin cement based on USPHS criteria at 1 week and 6 months, compare it to a control cement, and evaluate post-cementation sensitivity. The literature review covers self-adhesive cements such as RelyX Unicem, as well as causes of post-cementation sensitivity and strategies to reduce it.
This study evaluated three composite resins (Z100, Clearfil Ray-Posterior, and Prisma TPH) used to restore 120 posterior teeth over 24 months. Clinical evaluations were performed every 6 months using Ryge criteria and stone casts, while direct evaluations assessed color match, margins, anatomy, etc. Results found that all materials were suitable for posterior restorations. Some Z100 and Prisma TPH restorations showed marginal crevices. Clearfil Ray-Posterior alone showed slight surface roughness. Direct and indirect evaluation results differed for Z100 and Prisma TPH, attributed to method sensitivity.
This document summarizes a study that evaluated the bond strength of two root canal filling systems (ActiV GP and gutta-percha with AH Plus sealer) when used with different irrigation protocols. Forty single-rooted teeth were divided into four groups based on the final irrigation used: EDTA, EDTA followed by chlorhexidine, MTAD, or MTAD followed by chlorhexidine. Each group was further divided based on the filling system used. Horizontal sections were taken and subjected to push-out testing to measure bond strength. The results showed that EDTA followed by chlorhexidine yielded the highest bond strength for ActiV GP. MTAD and MTAD followed by chlorhexidine adversely affected the
This document summarizes a study evaluating the use of carbon fiber post systems for restoring teeth defects in children. 106 children with anterior tooth defects from trauma or decay were restored with carbon fiber posts, resin cores, and jacket crowns and observed for 3-5 years on average. The restorations were deemed successful in 121 cases (96.2%), with only 4 crowns lost. The study concluded that carbon fiber post systems can satisfactorily restore anterior teeth in children, with good esthetic and functional outcomes and ease of use for dentists.
This in vitro study evaluated the shear bond strength and adhesive remnant index of two fluoride-releasing sealants (Pro Seal and Opal Seal) compared to a control group using only Transbond XT adhesive. 105 extracted human premolars were bonded with brackets using the three materials and subjected to thermocycling. Shear bond strength testing found no significant differences between groups. Analysis of the adhesive remnant index found the control group was statistically different from the sealant groups, but there was no difference between the two sealants. The study concluded that fluoride-releasing sealants may help reduce white spot lesions associated with orthodontic treatment, but further clinical studies are needed to support the findings.
This document provides an overview of various materials that can be used for root repair, including root-end fillings, perforation repair, and root regeneration. It discusses both traditional materials like amalgam, gutta percha, and zinc oxide eugenol, as well as more recent bioactive materials like mineral trioxide aggregate (MTA) and Biodentine. MTA has become the material of choice for many root repair procedures due to its biocompatibility and ability to stimulate hard tissue formation. The document provides details on the composition and setting reaction of MTA and reviews its advantages and limitations for different clinical applications in root repair.
Bioactive materiasl have played significant role in endodontics since the introduction of MTA. other materials have been introduced into the market in order to achieve better results with good prognosis and improved quality in shorter period of time. hence we need to take a quick look on the common available Bioactive materials in the endodontic market in order to investigate the properties of each and to give the practitioner good idea to know how to select the materials.
Bioceramics are materials which include Alumina, Zirconia, Bioactive glass, Glass ceramics, Hydroxyapatite, resorbable Calcium phosphates.
Used in dentistry for
Filling up bony defects
Root repair materials
Apical fill materials
Aids in regeneration etc.
Bioinert: non-interactive with biological systems (Alumina, zirconia)
Bioactive: durable tissues that can undergo interfacial interactions with surrounding tissue (bioactive glasses, bioactive glass ceramics, hydroxyapatite, calcium silicates)
Biodegradable: soluble or resorbable, eventually replaced or incorporated into tissue (Tricalcium phosphate, Bioactive glasses).
Here is a 3 sentence summary of the key points from the document:
SUMMARY: This study aimed to evaluate the effect of selective enamel etching and different light-emitting diode (LED) curing units on gap formation of two self-etch adhesive systems in Class I composite restorations after thermomechanical aging. One hundred ninety-two human molars received Class I cavities that were restored with either Clearfil SE Bond or Clearfil Tri-S Bond and a microhybrid composite. The restorations were evaluated using scanning electron microscopy to analyze the influence of prior enamel etching and three LED curing lights on marginal adaptation before and after thermomechanical aging.
This study evaluated the effect of selective acid etching of enamel and dentin on the microtensile bond strength of a self-adhesive resin cement. Bovine teeth were used to test three cementation strategies: cement alone, acid etching prior to cement, or a conventional resin cement as a control. Bond strength was measured and found to be higher for enamel than dentin, with no difference between strategies for each substrate. Acid etching did not improve bonding of the self-adhesive cement to enamel or dentin.
This study evaluated the effect of different curing light sources and chemical catalysts on the degree of conversion of two dual-cured resin luting cements, RelyX ARC and Panavia F. Specimens were light cured using an argon ion laser, LED, or halogen light through a composite disk. The degree of conversion was measured using FTIR. For RelyX ARC, satisfactory curing was achieved with any light source with or without chemical catalyst. For Panavia F, the highest degree of conversion was achieved when used with ED Primer and cured with halogen light. The type of curing light and use of chemical catalyst influenced the degree of conversion of the resin luting cements
This study evaluated the degree of conversion (DC) and plasticization of a pit and fissure sealant (Fluroshield) and a flowable composite (Permaflo) when cured for either 20 or 60 seconds. The key findings were:
1) Permaflo had a higher DC than Fluroshield at both curing times. Extended curing (60 seconds) increased the DC of Permaflo but not Fluroshield.
2) Fluroshield showed higher plasticization (hardness decrease after ethanol storage) than Permaflo. Extended curing did not decrease plasticization for either material.
3) There was a low negative correlation between DC and plasticization, suggesting DC
This paper aims to submit the report the aesthetic correction in a disharmonious smile and unsatisfactory composite restorations in anterior teeth who were treated with direct aesthetic restorative procedure. The results show the use of this technique to allows an immediate aesthetic quality, directly and inexpensively restoring the natural features of the smile.
Key Words: Composite Resin,Class IV, Aesthetic.
This study evaluated the Knoop hardness of resin composite restorations photoactivated by different methods when different mold materials were used. Resin composite samples were cured using high-intensity continuous, low-intensity continuous, soft-start, or pulse-delay methods and placed in either a bovine tooth or metal mold. Knoop hardness was measured on the top and bottom surfaces. On the top surface, hardness did not differ between curing methods but was higher for the metal mold. On the bottom, high-intensity continuous curing produced higher hardness than low-intensity continuous, and hardness was influenced by the mold material used. The results indicate that photoactivation method and mold can impact hardness values of resin composite restorations.
This study compared the clinical performance of a polyacid modified resin composite (Dyract eXtra) and a nanocomposite (Filtek Supreme) when used with an antibacterial adhesive system (Clearfil Protect Bond) to restore noncarious cervical lesions over 2 years. 100 restorations were placed - 50 of each material - and evaluated at baseline and 6, 12, and 24 months using criteria like color match, marginal adaptation, retention, etc. Both materials showed acceptable clinical performance, though Filtek Supreme had a significantly better retention rate (100% vs 96% for Dyract eXtra). Some Dyract eXtra restorations were lost or fractured. Overall both materials can be suitable options for restoring
The document describes the NobelActive implant system. It has a unique tapered design that provides high initial stability, even in compromised bone. The implant features a back-tapered collar for optimal soft tissue support and a variable thread pitch that gradually condenses bone. Clinical studies show the implants achieve osseointegration and stable bone and soft tissue levels over multiple years. The system allows for minimally invasive insertion and adjustable placement for optimal prosthetic outcomes.
This study evaluated the clinical performance of a self-etching adhesive system (Clearfil SE Bond) and a one-bottle adhesive system (Prime&Bond NT) in non-carious Class V restorations over 2 years. 98 restorations were placed in 32 patients using the two adhesive systems. At 2 years, the retention rates were 93% for Clearfil SE Bond and 91% for Prime&Bond NT, showing very good clinical performance for both systems with no statistically significant differences in failure rates. A few restorations showed slight marginal discoloration or adaptation issues, but no restorations exhibited postoperative sensitivity, recurrent caries or changes in anatomical form.
This article describes the long-term treatment of a case of molar incisor hypomineralization (MIH) involving both anterior and posterior teeth. Initial treatment included calcium-phosphate supplementation, which SEM images showed improved the enamel morphology. Later treatments included orthodontics, bleaching of anterior teeth, and restorative work. An 8-year follow-up found that calcium-phosphate supplementation, bleaching, and restorations effectively addressed the esthetic and functional issues caused by the MIH while minimizing intervention.
This document is a thesis submitted by Anthony Khoo for a Master of Science degree in Restorative Dentistry. The thesis evaluates a self-etch, self-adhesive resin cement for bonding indirect all-ceramic restorations. It includes an introduction discussing different all-ceramic materials and the need for resin bonding. The specific aims are to clinically evaluate the new self-adhesive resin cement based on USPHS criteria at 1 week and 6 months, compare it to a control cement, and evaluate post-cementation sensitivity. The literature review covers self-adhesive cements such as RelyX Unicem, as well as causes of post-cementation sensitivity and strategies to reduce it.
This study evaluated three composite resins (Z100, Clearfil Ray-Posterior, and Prisma TPH) used to restore 120 posterior teeth over 24 months. Clinical evaluations were performed every 6 months using Ryge criteria and stone casts, while direct evaluations assessed color match, margins, anatomy, etc. Results found that all materials were suitable for posterior restorations. Some Z100 and Prisma TPH restorations showed marginal crevices. Clearfil Ray-Posterior alone showed slight surface roughness. Direct and indirect evaluation results differed for Z100 and Prisma TPH, attributed to method sensitivity.
This document summarizes a study that evaluated the bond strength of two root canal filling systems (ActiV GP and gutta-percha with AH Plus sealer) when used with different irrigation protocols. Forty single-rooted teeth were divided into four groups based on the final irrigation used: EDTA, EDTA followed by chlorhexidine, MTAD, or MTAD followed by chlorhexidine. Each group was further divided based on the filling system used. Horizontal sections were taken and subjected to push-out testing to measure bond strength. The results showed that EDTA followed by chlorhexidine yielded the highest bond strength for ActiV GP. MTAD and MTAD followed by chlorhexidine adversely affected the
This document summarizes a study evaluating the use of carbon fiber post systems for restoring teeth defects in children. 106 children with anterior tooth defects from trauma or decay were restored with carbon fiber posts, resin cores, and jacket crowns and observed for 3-5 years on average. The restorations were deemed successful in 121 cases (96.2%), with only 4 crowns lost. The study concluded that carbon fiber post systems can satisfactorily restore anterior teeth in children, with good esthetic and functional outcomes and ease of use for dentists.
This in vitro study evaluated the shear bond strength and adhesive remnant index of two fluoride-releasing sealants (Pro Seal and Opal Seal) compared to a control group using only Transbond XT adhesive. 105 extracted human premolars were bonded with brackets using the three materials and subjected to thermocycling. Shear bond strength testing found no significant differences between groups. Analysis of the adhesive remnant index found the control group was statistically different from the sealant groups, but there was no difference between the two sealants. The study concluded that fluoride-releasing sealants may help reduce white spot lesions associated with orthodontic treatment, but further clinical studies are needed to support the findings.
This document provides an overview of various materials that can be used for root repair, including root-end fillings, perforation repair, and root regeneration. It discusses both traditional materials like amalgam, gutta percha, and zinc oxide eugenol, as well as more recent bioactive materials like mineral trioxide aggregate (MTA) and Biodentine. MTA has become the material of choice for many root repair procedures due to its biocompatibility and ability to stimulate hard tissue formation. The document provides details on the composition and setting reaction of MTA and reviews its advantages and limitations for different clinical applications in root repair.
Bioactive materiasl have played significant role in endodontics since the introduction of MTA. other materials have been introduced into the market in order to achieve better results with good prognosis and improved quality in shorter period of time. hence we need to take a quick look on the common available Bioactive materials in the endodontic market in order to investigate the properties of each and to give the practitioner good idea to know how to select the materials.
Bioceramics are materials which include Alumina, Zirconia, Bioactive glass, Glass ceramics, Hydroxyapatite, resorbable Calcium phosphates.
Used in dentistry for
Filling up bony defects
Root repair materials
Apical fill materials
Aids in regeneration etc.
Bioinert: non-interactive with biological systems (Alumina, zirconia)
Bioactive: durable tissues that can undergo interfacial interactions with surrounding tissue (bioactive glasses, bioactive glass ceramics, hydroxyapatite, calcium silicates)
Biodegradable: soluble or resorbable, eventually replaced or incorporated into tissue (Tricalcium phosphate, Bioactive glasses).
Here is a 3 sentence summary of the key points from the document:
SUMMARY: This study aimed to evaluate the effect of selective enamel etching and different light-emitting diode (LED) curing units on gap formation of two self-etch adhesive systems in Class I composite restorations after thermomechanical aging. One hundred ninety-two human molars received Class I cavities that were restored with either Clearfil SE Bond or Clearfil Tri-S Bond and a microhybrid composite. The restorations were evaluated using scanning electron microscopy to analyze the influence of prior enamel etching and three LED curing lights on marginal adaptation before and after thermomechanical aging.
This study evaluated the effect of selective acid etching of enamel and dentin on the microtensile bond strength of a self-adhesive resin cement. Bovine teeth were used to test three cementation strategies: cement alone, acid etching prior to cement, or a conventional resin cement as a control. Bond strength was measured and found to be higher for enamel than dentin, with no difference between strategies for each substrate. Acid etching did not improve bonding of the self-adhesive cement to enamel or dentin.
This study evaluated the effect of different curing light sources and chemical catalysts on the degree of conversion of two dual-cured resin luting cements, RelyX ARC and Panavia F. Specimens were light cured using an argon ion laser, LED, or halogen light through a composite disk. The degree of conversion was measured using FTIR. For RelyX ARC, satisfactory curing was achieved with any light source with or without chemical catalyst. For Panavia F, the highest degree of conversion was achieved when used with ED Primer and cured with halogen light. The type of curing light and use of chemical catalyst influenced the degree of conversion of the resin luting cements
This study evaluated the bond durability of dentin restorations bonded with light-cured or dual-cured etch-and-rinse adhesive systems, finding that dual-cured adhesive systems produced higher immediate bond strength and durability compared to light-cured systems, and that a three-step adhesive system resulted in the highest bond values while an acetone-based two-step system produced the lowest.
This study evaluated the degree of conversion (DC) of nine one-bottle adhesive systems when photo-activated under different conditions of solvent volatilization. The adhesives were tested with five evaporation methods: without solvent volatilization, left undisturbed for 10 or 60 seconds, or air-dried for 10 or 60 seconds before curing. Fourier transform infrared spectroscopy results showed that the DC of most adhesives increased with extended (60 second) passive or active air-drying before curing. However, the DC of two adhesives was not affected by the evaporation conditions. In general, allowing more time for solvent evaporation enhanced the DC of the one-bottle simplified adhesive systems tested
The document summarizes a study that evaluated the adhesion of a 7th generation dental adhesive (Futurabond M) to normal and sclerotic dentin. When applied to normal dentin, the adhesive formed a hybrid layer 20-25 μm deep and penetrated 6-8 μm into dentin tubules. When applied to sclerotic dentin, the hybrid layer was shallower at 10-15 μm and the adhesive did not penetrate tubules. To improve adhesion to sclerotic dentin, the hypermineralized surface layer must be removed and the dentin pre-demineralized with phosphoric acid. The study used various microscopy techniques to examine the hybrid layer formation on different types of
Comparison of Different Dentin Pretreatment Protocols on the Bond Strength of...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Recent advances in orthodontic materials 8th ios-pgsc /certified fixed orth...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Recent advances in orthodontic materials /certified fixed orthodontic cours...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This study evaluated nanoleakage at the interface between dental enamel, leucite-reinforced ceramic, and four different resin luting systems. Bovine teeth were divided into four groups based on the luting procedure used: Excite adhesive with Variolink II cement, Clearfil SE Bond with Panavia F cement, Scotchbond Multi-Purpose Plus with RelyX ARC cement, or Single Bond 2 with Filtek Z350 Flow composite. Specimens were immersed in silver nitrate and examined under SEM. The Single Bond 2/Filtek Z350 Flow group showed no nanoleakage at the enamel interface. The Excite/Variolink II group had the highest nanoleakage
Grau de Conversão de cimento resinoso - Degree of Conversion - resin cementEduardo Souza-Junior
This study evaluated the effect of different light curing units and use of chemical catalysts on the degree of conversion of two dual-cured resin luting cements, RelyX ARC and Panavia F. Sixty disk-shaped specimens of each cement were cured with an argon ion laser, LED, or halogen light through a composite disk. The degree of conversion was measured using FTIR spectroscopy. Panavia F without catalyst cured with LED or laser showed significantly lower conversion than other groups. RelyX ARC showed similar high conversion with all light sources and use of catalyst. To achieve satisfactory conversion, Panavia F requires use of chemical catalyst and halogen light.
The document discusses the role and importance of adhesive dentistry. It describes the different generations of dentine bonding agents from the early phosphoric acid-based systems to newer self-etch adhesives. Key challenges in dentine adhesion are the structural differences between enamel and dentine such as dentine's high water content and presence of a smear layer. Conditioning with acid or chelators is needed to remove the smear layer and expose collagen fibers for bonding to occur. Current adhesive systems are classified as etch-and-rinse or self-etch and involve either two or three step application processes.
The document discusses the role and development of dentine bonding agents. It describes the challenges of bonding to dentine due to its structure and composition compared to enamel. Various generations of bonding agents are classified, from early phosphoric acid-based systems to modern multi-step etch-and-rinse and self-etch adhesives. Conditioning of the dentine surface and the role of priming agents are explained. Factors affecting the bonding process such as smear layer removal and acid etching duration are also covered.
This study evaluated and compared the shear bond strength of orthodontic brackets that were rebonded using three different techniques: sandblasting, direct flaming, and grinding with a green stone bur. Sixty extracted premolars were bonded with brackets and divided into groups for each rebonding technique. A universal testing machine measured the shear bond strength of the rebonded brackets. Scanning electron microscopy examined the surface characteristics of new and rebonded bracket bases. Sandblasting yielded the highest bond strength and well-defined retentive areas, while flaming and grinding filled retentive areas and reduced bond strength. Sandblasting is the best technique for rebonding brackets to achieve high bond strength.
This study evaluated the effect of dentin pre-treatment with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on the push-out bond strength of dimethacrylate-based and silorane-based restorative systems. Bovine teeth were treated with or without CPP-ACP paste prior to application of Clearfil SE Bond/Filtek Z250, Adper SE Plus/Filtek Z250, or Filtek P90 adhesive system/Filtek P90 composite. Dentin pre-treatment did not affect bond strength for Clearfil SE Bond/Filtek Z250 or Filtek P90 adhesive system/Filtek P90. For Adper SE
This document summarizes a study that evaluated the wear resistance of nine different dental cements when tested against human enamel. The cements included self-adhesive resins, self-etch resins, total-etch resins, resin modified glass ionomers, and zinc-phosphate. Specimens of each cement were prepared and cured via light or chemical modes. The specimens and enamel cusps were then used in a wear test to compare the wear resistance of the different cements and curing methods. Statistical analysis was conducted on the results to determine any significant differences in wear between the cement types and curing methods.
This study assessed the effect of 2% chlorhexidine digluconate (CHX) pretreatment on the immediate and six-month microshear bond strength (μSBS) of an etch-and-rinse adhesive to sound and eroded dentin. Bovine teeth were subjected to either a control treatment or erosive challenge to create sound and eroded dentin substrates. Specimens received adhesive with or without prior CHX application. μSBS was measured initially and after six months. CHX pretreatment minimized but did not prevent the reduction in μSBS over time, especially for eroded dentin. While CHX helped maintain higher bond strengths after aging, the effectiveness of bonding to
This document summarizes a study that compares the bond strength of orthodontic brackets bonded to enamel surfaces prepared by different methods: phosphoric acid etching, Er:YAG laser etching, a combination of acid etching and laser etching, and laser etching followed by acid etching. Sixty human premolars were divided into four groups based on the enamel preparation method used. Brackets were bonded to the prepared enamel surfaces using a standard protocol. The bond strength of each sample was then tested using a universal testing machine. The study aims to investigate methods that provide maximum bond strength and analyze the fracture mode for each preparation method.
This study evaluated the Knoop microhardness and microshear bond strength of different dual-cured resin luting systems and a flowable resin when bonding leucite-reinforced ceramic to enamel. The results showed that the Scotchbond/RelyX ARC system had the highest bond strengths while the Single Bond/Filtek Z350 Flow showed the lowest. Thermocycling reduced bond strengths for all groups. Panavia F showed the highest hardness values and the flowable resin showed the lowest. Dual-cured resin luting systems provided more reliable bonding and hardness than the flowable resin.
1) The study evaluated and compared the adhesion of two self-etch adhesive systems (OptiBond XTR and Bond Force) on normal and sclerotic dentin using scanning electron microscopy (SEM) and transmission electron microscopy (TEM).
2) SEM examination showed that on normal dentin, both adhesives formed hybrid layers of varying thickness, with OptiBond XTR penetrating dentinal tubules and Bond Force not penetrating. On sclerotic dentin, hybrid layers were thinner but OptiBond XTR still penetrated tubules.
3) TEM examination revealed that on normal dentin, Bond Force penetrated tubules as well, but not on sclerotic dentin. Hybrid
Similar to Tração lasers in medical science in press (20)
O documento discute técnicas de reanatomização estética de dentes anteriores com resina composta. Inclui etapas como planejamento com fotografias e modelos, confecção de mock-ups, condicionamento ácido, aplicação de adesivos e resinas de diferentes cores e translucidez, fotoativação, acabamento e polimento. O objetivo é melhorar a autoestima do paciente por meio de um tratamento minimamente invasivo e previsível.
[1] O artigo descreve um caso clínico de remodelação do sorriso com resina composta direta, com acompanhamento de dois anos. [2] O tratamento envolveu análises facial, dentolabial e cromática detalhadas, confecção de enceramento diagnóstico e mock-up para planejamento e aprovação da paciente. [3] Após a etapa restauradora, o resultado estético mostrou-se satisfatório e natural ao longo do tempo.
Este documento descreve um caso clínico de resolução estética do sorriso de uma paciente através da confecção de coroas cerâmicas reforçadas com dissilicato de lítio nos dentes superiores. O tratamento teve como objetivo devolver cor, forma e harmonia ao sorriso, corrigindo problemas como alteração de cor, diastemas e restaurações deficientes.
1. O documento apresenta um relato de caso sobre um procedimento de contorno cosmético realizado para melhorar a estética do sorriso de uma paciente sem a necessidade de restaurações.
2. Inicialmente, observou-se desarmonia no tamanho, formato e áreas de reflexão de luz dos dentes anteriores superiores da paciente.
3. Em seguida, foram simulados desgastes nos modelos de estudo para planejar o procedimento. Pequenos desgastes seletivos foram então realizados nos dentes da paciente
The document summarizes a study that evaluated the effects of cigarette smoke exposure on the microhardness and color of dental enamel. Fifteen bovine enamel fragments were exposed to the equivalent of 50 cigarettes over five days using a smoking machine. Testing found that exposed enamel fragments had a significant decrease in microhardness and an unacceptable increase in color change compared to pre-exposure measurements. The study concludes that cigarette smoke exposure can negatively impact the microhardness and coloring of dental enamel.
The document is a proof cover sheet for a journal article on the influence of preheating bonding agents on the degree of conversion and bond durability in dental cavities. It requests that the author carefully check the proofs, limit changes to corrections of errors, and confirm that the author list is correct. It also includes two queries asking the author to provide an institutional email address and history date for the article.
Este documento descreve o planejamento e execução de laminados cerâmicos para restaurar o sorriso de uma paciente. Inclui fotos do antes e depois do tratamento, detalhes do planejamento digital do sorriso, preparo dos dentes, confecção dos laminados e resultados finais.
[1] O documento descreve a técnica de estratificação natural com resinas compostas para restaurar dentes anteriores fraturados. [2] A técnica envolve aplicar camadas incrementais de resinas de diferentes cores e opacidades para reproduzir a aparência natural do esmalte e dentina. [3] Imagens ilustram cada etapa do procedimento, desde a preparação do dente até o acabamento final, demonstrando como a técnica pode restaurar com sucesso a forma, cor e função do dente danificado.
O documento fornece diretrizes sobre a fotoativação de materiais resinosos utilizados em odontologia restauradora. É importante selecionar uma fonte de luz adequada e seguir as instruções do fabricante para cada material, realizando a fotoativação por tempo suficiente para garantir a polimerização completa. A técnica correta de fotoativação promove maior durabilidade dos tratamentos e satisfação do paciente.
Este documento descreve um caso clínico no qual laminados cerâmicos foram utilizados para melhorar a estética do sorriso de uma paciente. Laminados de cerâmica feldspática foram preparados e cimentados nos dois incisivos centrais superiores para restaurar a cor, forma e tamanho originais dos dentes e proporcionar harmonia ao sorriso. O resultado final mostrou uma reabilitação estética satisfatória com boa adaptação marginal e detalhes semelhantes aos dentes naturais.
Este documento descreve dois casos clínicos de restaurações cerâmicas:
1) Foram confeccionadas coroas cerâmicas para os dentes 11 e 12, que necessitavam de preparo dental devido ao escurecimento.
2) Uma lente de contato cerâmica sem preparo dental foi confeccionada para o dente 21 para melhorar a estética. Ambas as restaurações utilizaram cerâmica reforçada com dissilicato de lítio para restaurar a harmonia do sorriso.
As etapas de moldagem e cimentação de laminados cerâmicos são cruciais para o resultado final do tratamento. A moldagem deve ser realizada com silicones para garantir precisão, enquanto a cimentação requer condicionamento das superfícies dentais e cerâmicas, aplicação de sistema adesivo e cimento resinoso fotoativado. Um protocolo correto nestas etapas é essencial para proporcionar estabilidade estética e funcional de longo prazo às restaurações cerâmicas.
This study evaluated the accuracy of the Joypex 5 multifrequency electronic apex locator (EAL) in determining working length in primary teeth. The working lengths of 25 root canals in 14 primary molars were measured directly using a file and microscope and electronically using the EAL. There was no statistically significant difference between the two measurement methods. The intraclass correlation coefficient showed almost perfect agreement between the direct and EAL measurements. The study concluded that the Joypex 5 EAL showed adequate accuracy in determining root length in primary teeth.
This document summarizes a study that evaluated the influence of different curing methods on the post-polymerization shrinkage stress of a composite resin. Specifically, it:
1) Compared stress levels immediately after curing and after 5 minutes using different curing methods (continuous QTH light, soft-start QTH light, intermittent QTH light, and xenon plasma arc light).
2) Found that all curing methods resulted in significantly higher stress levels after 5 minutes compared to immediately after curing.
3) Determined that xenon plasma arc light resulted in the greatest increase in stress over 5 minutes, while continuous QTH light produced the smallest increase.
The study evaluated the influence of eugenol-containing endodontic sealers and resin luting strategies on the pull-out bond strength of glass fiber posts to dentin. Sixty-four bovine teeth were treated with either gutta-percha alone or with a eugenol-based sealer, then fiber posts were cemented using different adhesive systems and resin cements. The eugenol sealer did not affect bond strength regardless of the luting strategy. Resin cements from the same manufacturer resulted in similar bond strengths, while a dual-cured cement paired with a two-step adhesive yielded higher strength than a self-cured cement. The eugenol sealer did
Este documento relata um caso clínico de restauração estética direta de um dente anterior fraturado utilizando a técnica de estratificação de resina composta. O paciente sofreu fratura no dente 11 e optou-se por reconstruir a morfologia do dente com resina composta ao invés de tentar colar o fragmento, que não foi recuperado. A restauração foi realizada em camadas mimetizando a estrutura dentária natural para um resultado estético.
This study investigated the impact of extended curing time on the polymerization depth of fluoride-containing pit and fissure sealant materials. Specifically, it evaluated the Knoop hardness number (KHN) of the top and bottom surfaces of a conventional pit and fissure sealant and a flowable composite cured for the manufacturers' recommended time of 20 seconds as well as an extended time of 60 seconds. The flowable composite exhibited higher KHN values than the pit and fissure sealant under all curing conditions. An extended curing time of 60 seconds increased the KHN of the bottom surface and bottom/top hardness ratio of the composite but did not significantly impact the sealant. The flowable composite demonstrated
Este documento descreve um caso clínico de reabilitação estética anterior com coroas totais de cerâmica reforçada por dissilicato de lítio. O paciente apresentava desgaste excessivo nos dentes anteriores, comprometendo a estética e função. As etapas do tratamento incluíram preparo dental, moldagem, confecção das coroas de cerâmica reforçada por dissilicato de lítio e cimentação adesiva. O resultado final proporcionou estética e função satisfatórias.
This document summarizes a study that evaluated the surface roughness and color stability of two resin composites (Z250 and 4 Seasons) after polishing with two systems (Sof-Lex and Jiffy). Specimens were polished and their surface roughness and color changes after staining in coffee solution were measured. The results showed that 4 Seasons composite polished with Jiffy had the lowest surface roughness and color variation. Z250 presented higher roughness values compared to 4 Seasons. The study concluded that polishing affected surface roughness and staining susceptibility of the composites.
1. Influence of the LED curing source and
selective enamel etching on dentin bond
strength of self-etch adhesives in class I
composite restorations
Eduardo José Souza-Junior, Cíntia
Tereza Pimenta Araújo, Lúcia Trazzi
Prieto & Luís Alexandre Maffei Sartini
Paulillo
Lasers in Medical Science
ISSN 0268-8921
Lasers Med Sci
DOI 10.1007/s10103-011-1030-y
1 23
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available until 12 months after publication.
1 23
3. Author's personal copy
Lasers Med Sci
DOI 10.1007/s10103-011-1030-y
ORIGINAL ARTICLE
Influence of the LED curing source and selective enamel
etching on dentin bond strength of self-etch adhesives
in class I composite restorations
Eduardo José Souza-Junior &
Cíntia Tereza Pimenta Araújo & Lúcia Trazzi Prieto &
Luís Alexandre Maffei Sartini Paulillo
Received: 18 July 2011 / Accepted: 7 November 2011
# Springer-Verlag London Ltd 2011
Abstract The aim of this study was to evaluate the compared to the non-etched specimens (26.7±2.2). UL
influence of the LED curing unit and selective enamel yielded higher μTBS values (24.1±3.2) in comparison to
etching on dentin microtensile bond strength (μTBS) for the photoactivation approach with FL (18.8 ±3.9) and RD
self-etch adhesives in class I composite restorations. On 96 (19.9 ±1.8) for CSE. The two-step CSE was not influenced
human molars, box-shaped class I cavities were made by the enamel etching (p≥0.05). Enamel acid etching in
maintaining enamel margins. Self-etch adhesives (Clearfil class I composite restorations affects the dentin μTBS of
SE – CSE and Clearfil S3 – S3) were used to bond a the one-step self-etch adhesive Clearfil S3, with no
microhybrid composite. Before adhesive application, half alterations for Clearfil SE bond strength. The polywave
of the teeth were enamel acid-etched and the other half was LED promoted better bond strength for the two-step
not. Adhesives and composites were cured with the adhesive compared to the single-peak ones.
following light curing units (LCUs): one polywave (Ultra-
Lume 5 - UL) and two single-peak (FlashLite 1401 - FL Keywords Acid etching . Enamel . Self-etch adhesives .
and Radii Cal - RD) LEDs. The specimens were then Light curing units . Bond strength
submitted to thermomechanical aging and longitudinally
sectioned to obtain bonded sticks (0.9 mm2) to be tested in
tension at 0.5 mm/min. The failure mode was then Introduction
recorded. The μTBS data were submitted to a three-way
ANOVA and Tukey’s (α=0.05). For S3, the selective Resin composites have been widely used in direct aesthetic
enamel-etching provided lower μTBS values (20.7±2.7) restorative procedures. Self-etching bond systems were
introduced in order to reduce the sensitivity of techniques
that affect the bonding ability of adhesive systems; they
E. J. Souza-Junior also decrease the number of steps in the bonding approach
Department of Restorative Dentistry, Dental Materials Area, because they include acidic monomers that simultaneously
Piracicaba Dental School, University of Campinas (UNICAMP),
etch and prime both enamel and dentin [1, 2]. The absence
Areião, SP, Brazil
of the rinsing approach and partial removal of the smear
C. T. P. Araújo : L. T. Prieto layer and smear plugs with these adhesives lead to less
Department of Restorative Dentistry, Operative Dentistry Area, technique-sensitive, time-consuming procedures, and con-
Piracicaba Dental School, University of Campinas (UNICAMP),
sequently, a possible reduction of postoperative sensitivity
Areião, SP, Brazil
results [2–5].
E. J. Souza-Junior (*) : L. A. M. S. Paulillo Moreover, a recent study has shown that enamel smear
Department of Restorative Dentistry, Piracicaba Dental School, layer compromises bonding by mild self-etch adhesives [6].
University of Campinas (UNICAMP),
Separate preliminary etching is known to remove the smear
Avenida Limeira, 901,
Areião 13414-903 52 SP, Brazil layer created by instrumentation and to demineralize the
e-mail: edujcsj@gmail.com dental substrate. The prior enamel phosphoric acid etching
4. Author's personal copy
Lasers Med Sci
as an additional step for self-etch adhesives has been units on dentin microtensile bond strength (μTBS) of self-
proposed to improve the durability of the enamel bond [7– etching bond systems in class I composite restorations. The
10]. Hence, the selective enamel etching increases marginal first hypothesis tested was that the previous enamel etching
adaptation of self-etch adhesives as evidenced by numerous would not affect microtensile bond strength values of the
studies [4, 5, 11–14]. tested adhesive systems. The second hypothesis was that
While it is clear that selective enamel etching may have the third-generation polywave LED would present higher
some beneficial effects on marginal integrity in class V dentin bond strength values for the tested bond systems.
cervical lesions [5, 11, 13], the literature provides no
evidence for the bonding performance of self-etching
adhesives in class I cavities for direct composite restora- Materials and methods
tions in vitro. Since class V cervical lesions restorations
present smaller amounts of dental enamel, it may not be the LED curing units
best model for understanding the real effects of enamel
etching on dentin substrate and the stress development on Three light-emitting diodes (LEDs) were tested: FlashLite
the tooth/adhesive interface, like class I restorations [13, 1401 (FL) (Discus Dental, Culver City, CA, USA), Radii-
15]. In this sense, the literature gives no evidence about the Cal (RD) (SDI Limited, Victoria, Australia) and UltraLume
role of prior enamel acid etching on the bond strength of LED 5 (UL) (Ultradent, South Jordan, Utah, USA).
self-etch adhesives to dentin in class I cavities in vitro. Characteristics of the LCUs used in this work are presented
It is important to consider when restoring class I cavities in Table 1. Irradiance (mW/cm2) was measured dividing the
with self-etch bond systems is the selection of an efficient output power (measured by a calibrated power meter -
light curing unit (LCU). The LCU should guarantee a Ophir Optronics, Har – Hotzvim, Jerusalem, Israel) by the
satisfactory monomer conversion of the adhesive and resin tip end area of the LCUs. The spectra of the LED units was
composite. Consequently, it may improve the material’s measured with a calibrated spectrometer (USB2000, Ocean
physical and mechanical properties, such as ultimate tensile Optics, Dunedin, FL, USA), as shown in Fig. 1. The energy
strength and bond strength to dental substrate [16–20]. dose was standardized to approximately 11 J/cm2 for the
Light emitting diodes (LEDs) have been shown to bonding systems curing approach and 22 J/cm2 for the cure
effectively cure composites and dental adhesives, emitting of each composite increment. Because the RD light source
unfiltered blues light [17, 21]. These LCUs generate a mandatorily operates in ramp mode for 5s, these initial
narrow spectral range that targets the absorption wave- seconds were discarded and further application was realized
length of camphorquinone, yielding low amounts of wasted in order to maintain the standardized irradiance, conse-
energy and minimum heat generation [22, 23]. quently equaling the energy density obtained for each of the
Previous studies have shown that current LED curing LCUs.
units can replace, in most situations, the conventional QTH
light units [24–26]. Some adhesive systems are not well Specimen preparation
cured with single-peak LEDs [21] due to alterative photo-
initiators content; to overcome this problem, polywave Ninety-six freshly extracted, sound human molars were
third-generation LEDs were introduced to the market [24– selected. This study had the approval of the Ethical
26]. These LEDs emit light wavelengths targeting the Committee of the State University of Campinas, Piracicaba
absorption peak of camphorquinone. However, they deliver Dental School. The teeth were cleaned, their roots inserted
additional light output at the UV-Vis region of the in polystyrene resin and the occlusal surfaces wet polished
electromagnetic spectrum (400–415 nm). The second peak with 320-grit SiC paper under running water (Politriz,
in the UV-VIS region may promote a satisfactory cure of AROTEC – São Paulo, SP) in order to expose a flat enamel
these adhesives, containing alternative photoinitiators sys- surface without exposing dentin. Box-shaped class I
tems, such as phenyl propanedione (PPD), bis-alquyl cavities were prepared using #56L diamond burs (KG
phosphinic oxide (BAPO) and trimethylbenzoyl-diphenyl- Sorensen, Barueri, SP, Brazil) at high-speed, under air–
phosphine oxide (TPO) [26]. This point is crucial because water cooling. A custom-made preparation device allowed
some manufacturers do not state all of the photoinitiator the standardization of the cavity dimensions to 5-mm
systems used in their proprietary products, [25, 27] and the mesio-distal length, 5-mm bucco-lingual width, and 3-mm
selection of an adequate LCU is primordial to yielding an depth, all cavity margins on enamel substrate. The used bur
adequate adhesive polymerization and resin/dentin bond was replaced after four-cavity preparation.
strength. After cavity preparation, the teeth were assigned to 12
Thus, this study aimed to investigate the influence of groups (n=8) according to the three studied factors:
selective enamel acid etching and different LED curing selective enamel etching, bond system and curing light (2
5. Author's personal copy
Lasers Med Sci
Table 1 Characteristics of the LCUs used in this study
LCU Manufacturer Type Tip diameter Irradiance Radiant exposure
(mm) (mW/cm2) (J/cm2)
FlashLite 1401 Discus Dental, Culver City, CA, USA Single-peak 7 1077 22
Radii Cal SDI Limited, Victoria, Australia Single-peak 7 731 22
UltraLume LED 5 Ultradent products Inc, South Jourdan, Utah, USA Polywave 11 x 7 800 22
conditioning protocols x 2 adhesives x 3 LEDs). Two self- interface. This sectioning was done with a diamond saw
etch adhesive systems (two-step and one-step) were used (Isomet 1000, Buehler Ltd, Lake Bluff, IL, USA) at 300
for the bonding procedure: Clearfil Tri-S Bond (pH=2.7; rpm to obtain sticks with a cross-sectional area of
Kuraray Medical Inc., Tokyo Japan) or Clearfil SE Bond approximately 0.9 mm2. The cross-sectional area of each
(pH = 2.0; Kuraray Medical Inc., Tokyo Japan). The stick thus was measured with the digital caliper to the
composition, application mode, and batch number of the nearest 0.01 mm and recorded for the bond strength
adhesive systems are presented in Table 2. All groups were calculation. The bonded sticks originated from the same
restored with B1-shade Charisma microhybrid composite teeth were assigned to the tested groups. Sticks were
(Heraeus Kulzer, Hanau, Germany) using an incremental individually attached to a jig for microtensile testing with
oblique technique with increments approximately 2 mm cyanoacrylate resin (Super Bond gel, Loctite, Henkel,
thick. Then, the finishing and polishing procedures were Brazil) and subjected to a tensile force in a universal
performed with medium-, fine-, and extra fine-grit alumi- testing machine (EMIC DL500, São José dos Pinhais,
num oxide disks (Sof-Lex – 3M/ESPE), respectively. After Brazil) at a crosshead speed of 0.5 mm/min until failure.
polishing, the specimens were submitted to 200,000 Bond failure modes were evaluated with a scanning
mechanical loading (2 Hz) and 500 thermal cycles (ranging electron microscope (JEOL, JSM-5600LV, scanning elec-
from 5 to 55°C with a dwell time of 60 s in each bath with tron microscope, Japan) and classified as: (1) cohesive
an interval of 5 s) at a thermo-mechanical device ER-11000 (failure exclusive within dentin or resin composite, (2)
(ERIOS, São Paulo, Brazil) in order to simulate similar adhesive (failure at resin/dentin interface or cohesive in
ageing of the composite restorations in oral environment adhesive resin) or (3) mixed (mixed with cohesive failure of
conditions. the neighboring substrates). The obtained data were
subjected to a three-way ANOVA and Tukey’s test at a
Microtensile bond strength pre-set alpha of 0.05.
After storage in distilled water at 37ºC for 24 h, specimens
assigned to the MTBS test were longitudinally sectioned in Results
both “x” and “y” directions across the pulpal wall bonded
Microtensile bond strength
Approximately 16 sticks could be obtained per tooth,
including those with premature debonding. Pre-test failures
were included in the statistical analysis as half of the
minimum bond strength measured for each tooth [27]. The
results of μTBS are shown in Tables 3 and 4. The double
interactions between the factors adhesive x selective
etching (p≤0.05) and adhesive x LED light (p≤0.05) were
statistically significant.
Phosphoric acid-etching pre-treatment of enamel prior to
application of S3 led to lower dentin μTBS values (p≤
0.05). However, for CSE, the pre-etched enamel yielded a
similar dentin μTBS mean compared to the non-etched
specimens. Dentin bond strength of CSE did not statisti-
cally differ from S3 when prior etching was used before the
adhesive application. Moreover, when these adhesives were
Fig. 1 The spectrum range distribution of each LCU used in this study applied following the conventional approach, S3 presented
6. Author's personal copy
Lasers Med Sci
Table 2 Composition, application mode, and manufacturer’s information for the adhesive systems tested
Adhesive systems Composition Application mode
Clearfil SE Bond Primer (Batch #00896A): water, MDP, HEMA, Selective H3PO4 conditioning for 15 s. Rinse with water
(Kuraray Medical camphorquinone, hydrophilic dimethacrylate. spray for 10 s, leaving the tooth dry. Apply primer for
Inc., Tokyo, Japan) Adhesive (Batch #01320A): MDP, bis-GMA, HEMA, 20 s. Mild air stream. Apply bond. Gentle air stream.
camphorquinone, hydrophobic dimethacrylate, N,N- Light cure at an energy density of 11 J
diethanol p-toluidine bond, colloidal silica
Clearfil S3 Bond Adhesive (Batch #00116A): MDP, Bis-GMA, HEMA Selective H3PO4 conditioning for 15 s. Rinse with water
(Kuraray Medical hydrophobic dimethacrylate, dl-camphorquinone, spray for 10 s, leaving the tooth dry. Apply the bond
Inc., Tokyo, Japan) silanated colloidal silica, ethyl alcohol, and water system for 20 s. Gentle air stream for 10 s. Light cure
at a energy density of 11 J.
higher bond strength mean in comparison to the two-step step on the bond strength approach to pulpal dentin in
self-etch adhesive. class I composite restoration has not been clarified. In
All LED curing units promoted similar dentin μTBS for this sense, the selective etching increases the free surface
the one-step self-etch bond system S3 (p≥0.05). In contrast, energy of the enamel substrate and favors mechanical
the two-step CSE showed higher dentin μTBS (24.1±3.2) interlocking with the bonding resin [28]. In this study, the
when UL was used in comparison to the single-peak LEDs bonding ability of self-etch adhesives to pulpal dentin with
FL (18.8±3.9) and RD (19.9±1.8). different application approaches was evaluated in class I
The descriptive analysis of the failure mode for each restorations. These class I preparations frequently present a
adhesive is shown in Table 5 and 6. SEM evaluation of the thick enamel layer on the cavosurface angle surrounding all
fractured surfaces showed predominant adhesive failures the restoration margins, compared to a class V or a class III
for CSE when the enamel prior acid etching was used for cavity. In contrast, there are many studies evaluating the
the bonding approach (Fig. 2). A similar failure mode was bonding performance of self-etch adhesives and prior acid
found for S3 in the same condition. However, when the etching on flat enamel surfaces [29–31]. These circum-
self-etch adhesives were conventionally used, mixed fail- stances do not simulate clinical situations for direct compos-
ures were present (Fig. 3), and one cohesive failure was ite application because the bond performance of dental
shown on composite for CSE when photocured with FL. adhesives occurs with the shrinkage stress influenced by the
Figure 4 shows osmosis-induced droplets due to the cavity configuration and the restoration is surrounded by
adhesive hydrophilicity for Clearfil S3. different dental substrates [32, 33].
Based on the results, the first hypothesis tested was
partially validated, since for CSE, the previous acid etching
Discussion did not influence the μTBS results. In contrast, S3 adhesive
showed lower dentin μTBS when this additional etching
The selective enamel etching is related to increased step was performed. The conventional application of the
bond performance of self-etch adhesives to ground self-etch adhesive generally ensure good retention perfor-
enamel [8, 9]. However, the influence of this additional mance for dentin and a poor bonding approach for enamel
Table 3 Means and standard deviation of the microtensile bond Table 4 Means and standard deviation of the microtensile bond
strength for the interaction between adhesive system and selective strength for the interaction between adhesive system and light curing
etching unit
Adhesive system Selective acid etching Adhesive system Light curing unit
Etching No etching FlashLite 1401 Radii Cal UltraLume 5
Clearfil SE bond 20.3 (3.3) Bb 21.6 (3.2) Bb Clearfil SE bond 18.8 (3.9) Bb 19.9 (1.8) Bb 24.1 (3.2) Aa
Clearfil S3 20.7 (2.7) Bb 26.7 (2.2) Aa Clearfil S3 24.1 (2.8) Aa 23.2 (3.4) Aa 23.5 (3.8) Aa
Mean values followed by different small letters in the column and Mean values followed by different small letters in the column and
capital letters in the row differ statistically among themselves for the capital letters in the row differ statistically among themselves for the
Tukey test at the level of 5% Tukey test at the level of 5%
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Table 5 Percentage of specimens (%) from Clearfil SE bond adhesive distributed according to the failure mode
LCU Prior phosphoric acid etching Without prior phosphoric acid etching
A M C A M C
FlashLite 1401 75 25 0 64 24 1
Radii Cal 100 0 0 100 0 0
UltraLume LED 5 60 40 0 70 30 0
A adhesive failure and cohesive failure within the adhesive; M mixed failure; C cohesive failure within dentin or composite resin
[5, 28, 31]. Thus, the slightly inferior enamel bonding therefore an important bonding behavior since gap forma-
performance may yield minor stress at the margins, tion represents the first sign of restoration failure, which
resulting in fewer gaps and paramarginal enamel fractures can be clinically evidenced by marginal staining [5, 8, 11,
[15]. However, when enamel is pre-etched before the self- 34, 35]. However, the S3 can promote a small decrease in
etch adhesive application, higher bond strength between the bonding ability of this single-step adhesive to the
enamel/adhesive and resulting stress may occur and retention on the pulpal dentin. Therefore, for a gold-
consequently affect dentin bond performance. The enamel standard CSE, it is assumed that prior acid etching can
selective etching for the S3 application may have caused promote better marginal sealing without compromising the
higher stress and bond strength for the enamel substrate, dentin μTBS.
especially due to its ultra-mild pH characteristic, while the The impact of the adhesive bonds to the dental substrate
adhesive layer bonded to dentin might have disrupted and of composite restorations is strongly related to LCU
decreased the dentin μTBS. efficacy, which will promote satisfactory materials poly-
In addition, the stress might have been enhanced due to merization [21]. LED technology has been used for
the thermal and mechanical ageing promoted to the class I resinous materials polymerization as a substitute for
restorations, favoring the decrease in the retention values. conventional QTH curing lights [36, 37]. However, the
The failure mode was mainly adhesive when the previous conventional single-peak second-generation LEDs still
acid etching was performed for S3; therefore, mixed harm the cure of dental resins due to the narrower spectra
failures were more present when this adhesive was used emitted to the camphorquinone initiator [38–40]. They do
in the conventional way. For the CSE, the application of the not allow an optimal cure for other photosensitizes, like
hydrophobic resin layer may have supported the stress phenyl propanedione and TPO, present in some dental
promoted by enamel selective etching, but did not affect the materials [26]. Polywave LEDs were introduced in order to
dentin μTBS when compared to the unique layer applied overcome these concerns, promoting the conversion of this
for the S3. It is suggested that previous enamel etching UV–Vis photoinitiator content [24–26].
needs to be considered for S3 in restorations whose In the present work, the second hypothesis was partially
retention primarily depends on a strong bond to the enamel validated, since for CSE, the polywave third-generation
surface, such as large class III and IV or veneer restorations. LED UL promoted higher dentin μTBS values compared to
In recent studies [5, 11, 14, 31], selective enamel etching the single-peak second-generation ones. However, S3
was shown to improve marginal integrity of composite presented similar dentin bond strength regardless of the
restorations using either a two-step or a one-step self- LCU used. For CSE, the results are in accordance with
etching adhesive. The decrease in marginal gaps is some authors [21, 41] who observed that single-peak LEDs
Table 6 Percentage of specimens (%) from Clearfil S3 adhesive distributed according to the failure mode
LCU Prior phosphoric acid etching Without prior phosphoric acid etching
A M C A M C
FlashLite 1401 80 20 0 50 50 0
Radii Cal 70 30 0 66 34 0
UltraLume LED 5 85 15 0 60 40 0
A adhesive failure and cohesive failure within the adhesive; M mixed failure; C cohesive failure within dentin or composite resin
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Lasers Med Sci
Fig. 4 SEM observation of Clearfil S3 - osmosis induced droplets due
to the adhesive hydrophilicity, especially because of the presence of
Fig. 2 SEM of the fractured specimen showing a pure adhesive HEMA. It is not a phase separation droplets, because this adhesive do
failure within the bonding interface not present phase separation – Clearfil S3
promoted a lower degree of cure for CSE compared to a
LCU with a large spectrum range distribution, comprising curing light may have excited the material’s photoinitiator
the UV–Vis wavelength. This finding may be attributed to content. Nevertheless, the energy dose for all LEDs was
the photoinitiator content of CSE; the manufacturer may standardized at approximately 11 J/cm2 for the bonding
omit the presence of other photosensitizers that may have system, which may have delivered the same quantity of
larger spectrum ranges that comprise the UV–Vis region. photons to allow the satisfactory cure of S3. Consequently,
Another possible explanation is that the absorption peak of similar dentin bond strength values were achieved, regard-
camphorquinone can be moved to lower wavelengths. The less of the spectrum range and irradiance of the LCUs.
LED unit continues to deliver shining light because the Although the etching approach for self-etch adhesives is
structural part of this initiator, responsible for the short- recommended by many authors [4, 5, 11–14], the inclusion
wavelength absorption, remains unchanged while the of an additional step for these bond systems may be
photoreaction at the initial maximum absorption peak controversial, since these adhesives intend to represent a
(468 nm) ends [42]. It may contribute to better bond clear simplification of the clinical application of bond
strength values with the polywave LED UL, which have systems. In this sense, the adverse points of this selective
broader emission spectra, and it may have promoted a approach include the increase of the bonding steps and the
better monomer conversion compared to the single-peak technique sensitivity [13].
ones. However, it is questionable whether 10–20 s of light Although some in vitro studies exist, final conclusions
activation is sufficient to enable this effect. regarding the role of the enamel selective acid etching for
The dentin bond strength of S3 was not affected by the self-etch adhesives in class I composite restorations will
LCU used. A thin adhesive layer was applied onto the depend on the outcomes of clinical trials. Clinical long-term
enamel and dentin surface of the class I preparation, and the studies and investigations of this approach’s retention
ability for bond systems in the oral environment can best
evaluate the quality and durability of these restorations.
Conclusions
The additional selective enamel acid etching in class I
composite restorations does affect the dentin bond strength
of the ultra-mild one-step self-etch adhesive Clearfil S3.
However, this selective step does not affect the bond
performance of the two-step self-etch bond systems Clearfil
SE. The polywave LED promoted better bond strength for
the two-step adhesive when compared to the single-peak
Fig. 3 SEM of the fractured specimen showing mixed failure within ones. Moreover, all LCUs presented similar cure potential
cohesive in adhesive layer and hybrid layer adhesive failure for the one-step self-etch adhesive.
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