American journal of dentistry最新文献

Purpose: To evaluate different polishing methods' effects on the color stability of recent resin composites.

Methods: 160 samples for color stability evaluation and 40 samples for the degree of conversion evaluation were prepared with four different resin composites [Harmonize (H), Filtek Universal (F), Omnichroma (O), Essentia Universal (E)] and light cured. For color stability evaluation, samples prepared from each resin composite were divided into four groups: three polishing procedures and a control group. The ΔE₀₀ was calculated between initial, and after immersion in coffee solution for 12 days. The degree of conversion was evaluated with Fourier Transform Infrared Spectroscopy. The statistical analysis of ΔE₀₀ values was made with the two-way ANOVA, Tukey HSD, and Tamhane's T2 tests. One-way ANOVA and Tukey HSD tests were used to compare the degree of conversion values (P< 0.05).

Results: In all composite groups, mylar (control) groups had the highest ΔE₀₀, and no differences between other polishing procedures. According to the polishing procedures, Omnichroma showed the highest ΔE₀₀ values (on mylar groups O vs F, P< 0.001; O vs H, P< 0.001; O vs E, P< 0.001). There was a significant difference between the composite groups in terms of the degree of monomer conversion (P< 0.05). Omnichroma showed, significantly, the highest discoloration.

Clinical significance: Different polishing procedures showed effective performance on current composite surfaces. Omnichroma resin composite showed higher color change than composites with similar properties.

Purpose: To evaluate the effect of sandblasting on the microtensile strength between sclerotic dentin and resin composite.

Methods: 32 premolars with noncarious cervical lesions (NCCLs) were collected, and the teeth were randomly assigned to the control group (C group) and the sandblasted group (S group). Teeth in the S group were sandblasted with 110 µm Al₂O₃ particles at a pressure of 75 psi, while those in the C group received no further treatment. The characteristics of the tooth surface were observed by scanning electron microscopy (SEM), and the relative area of open dentin tubules (OTs) was calculated by IPP6.0 software. Surface roughness (Ra) was also assessed. The noncarious cervical lesions of all teeth were restored with a resin composite and subsequently sectioned into sticks to measure the microtensile bond strength (µTBS).

Results: The mean ± SD µTBS (in MPa) of the sandblasted group was 17.9 ± 0.69 and 14.23 ± 0.44 in the control group (P< 0.05). The relative area of OTs at the gingival wall of the sandblasted group was 69.74 ± 5.23%, and 47.24 ± 7.67% in the control group (P< 0.05). The average surface roughness (µm) was 1.01 ± 0.05 in the sandblasted group and 0.16 ± 0.03 in the control group. Sandblasting could increase the bond strength of sclerotic dentin and resin restorations.

Clinical significance: After sandblasting, the microtensile strength of sclerotic dentin on the surface of noncarious cervical lesions increased, prolonging the resin adhesion longevity. Sandblasting could also alleviate the pain of patients during the treatment process and achieve a minimally invasive treatment.

Purpose: To investigate the effect of different chemical compositions of primers on the bond strength between nano-ceramic, polymer-infiltrated ceramic, and zirconia ceramic materials and dual-cure cement.

Methods: Fifty 2 mm-thick specimens were prepared from Vita Enamic, Cerasmart, and Katana Zirconia UTML. The specimens were embedded in acrylic blocks. To standardize the surfaces, 600 grit silicon carbide abrasives were applied underwater for 60 seconds. Then, each section underwent grit-blasting using Al₂O₃ with a particle size of 50 µm at 10 mm and a pressure of 2 bar for 10 seconds. Each prepared sample from the experimental groups received the appropriate primer (Z-PRIME Plus, G-Multi Primer, Alloy Primer, Clearfil Primer Plus) according to the manufacturers' instructions. Subsequently, the prepared CAD-CAM specimens underwent cementation using Duo-Link Universal Adhesive Resin Cement with a cylinder mold of 2.6 mm diameter and 3 mm height. The cement was light-cured for 20 seconds from both sides. The specimens obtained were stored in distilled water at 37°C for 24 hours. The shear bond strength test of the specimens was performed using a Bisco Shear Bond Tester device. The data were statistically analyzed using ANOVA and the Kruskal-Wallis test (P< 0.05).

Results: The highest bond strength was observed in Z-Prime Plus applied specimens, regardless of material differences (Cerasmart 11.60±4.61; Vita Enamic 12.93±3.86; Katana Zirconia 13.85±4.00). The lowest bond strength, showing differences according to materials (P< 0.05), was found for Clearfil Ceramic Primer Plus-Cerasmart (7.88±3.90), Alloy Primer-Vita Enamic (7.90±2.14), and G Multi Primer-Katana Zirconia UTML (4.98±3.67).

Clinical significance: Failure of the restoration usually occurs at the weakest point in this three-element structure, thus correct primer selection according to material type is important. Additionally, for all CAD-CAM materials used in the study, Z-Prime Plus showed significantly greater adhesion strength than other systems so it may be more appropriate for use in clinics.

Purpose: To investigate the discoloration, line roughness and gloss of conventional and universal shade resin-based composites.

Methods: Clearfil AP-X (AP-X) and Estelite Sigma Quick (EQ) samples were prepared. Discoloration, roughness, and gloss were measured on mirror-polished, alkaline-degraded, and repolished surfaces. The superficial layer degraded by alkaline immersion (degraded layer) was ground off from the sample surface. After removing the degraded layer, the surface was polished with aluminum oxide powder (1.0 µm and 0.3 µm), to create a repolished specimen. Scanning electron microscopy observations were made of the specimens.

Results: The results were compared with those for Omnichroma (OC) from a previous study. All the materials showed different responses to degradation and repolishing, but repolishing of AP-X, for surface roughness and gloss, was more effective at restoring pre-degradation properties. Repolishing effectively removed discoloration in all materials.

Clinical significance: The materials tested showed different responses to degradation and repolishing, but repolishing of AP-X, for surface roughness and gloss, was more effective at restoring pre-degradation properties. Repolishing effectively removed discoloration in all materials.

Purpose: To evaluate the effect of two resin composites (with different viscosities) and the elevation amount on fracture strength and fracture behavior of molars with and without deep margin elevations (DME).

Methods: 70 extracted, caries-free human molars were selected. All teeth were prepared as MOD onlay cavities with a margin 2 mm below the cemento-enamel junction (CEJ) on the mesial and buccal sides and 2 mm above the CEJ on the distal side. The teeth were divided into two groups according to the type of resin composite used in margin elevation, elevated with flowable composite (Universal Flo) or condensable composite (G-Aenial Posterior). These two groups were further subdivided into subgroups in which the elevation was 2, 3, or 4 mm, and a control group in which the non-elevated indirect restoration was directly bonded to the subgingival margin, making a total of seven groups (n= 10). After elevations, the restorations were completed using a nanoceramic CAD-CAM block (Cerasmart A3 HT) and as adhesive cement, G-Cem Link Force. Static force was applied to the restored teeth using a universal testing machine at an angle of 15° until fracture occurred. Fracture strength values were recorded, and fracture types were examined under 6x magnification. One-way ANOVA was carried out to determine the effect of DME on the fracture strength. A two-way ANOVA was conducted to investigate main and interaction effects of the material type used in the elevation and the amount of elevation made on the fracture strength (P< 0.05).

Results: Using flowable or condensable composite as elevation material did not affect the fracture strength of CAD-CAM restorations. Flowable and condensable composites of 2, 3, or 4 mm did not significantly affect fracture strength values for either material. Specimen margins with and without elevation exhibited similar fracture strength values. The type of material used in the elevation and the amount did not affect the fracture strength of teeth.

Clinical significance: The deep margin elevation technique for teeth with carious lesions extending subgingivally, may be useful in routine practice.

Purpose: To evaluate the effect of air abrasion and polishing procedures on roughness and color stability of ceramic and composite materials after artificial accelerated aging.

Methods: In this study, six restorative materials were tested: feldspathic ceramic (CEREC Blocks), glass ceramic (IPS e.max CAD), resin-based hybrid ceramic (Cerasmart), microhybrid composite (Charisma Classic), nanohybrid composite (Charisma Diamond) and nanoceramic composite (CeramXOne). Forty square-shaped composite specimens were fabricated from each composite and CAD-CAM ceramic material. Initial surface roughness measurements were performed using a profilometer and color measurements of each specimen with a spectrophotometer. Ten control specimens for each group did not receive air abrasion. The other specimens were treated by an air abrasion device and then were randomly divided into three subgroups of 10 specimens (n= 10). After air abrasion, 10 specimens of each group did not receive polishing (Air abrasion group) and others were repolished with Sof-Lex kit (Sof-Lex group) or a rubber kit (Rubber group). Surface roughness and color measurements were repeated before and after 300 hours of artificial accelerated aging (AAA). The univariate test and then three-way ANOVA and two-way ANOVA were performed for comparison of groups (α= 0.05).

Results: The univariate statistical analysis revealed that the restorative materials were differently affected after air abrasion, polishing methods and AAA (P< 0.001). Three-way ANOVA showed that the surface roughness of the restorative materials increased after air abrasion and AAA (P< 0.001). Two-way ANOVA showed statistically significant differences between color changes of ceramic (CEREC and IPS e.max CAD) and composite based restorative materials (P< 0.001).

Clinical significance: Clinicians should be aware that air abrasion at a specified power and time significantly changes the surface roughness of the materials except for CEREC. Additionally, polishing procedures (Sof-Lex, Rubber) did not significantly reduce the surface roughness of the ceramic groups. After air abrasion, depending on the material type used clinically, restorations should be repolished to reduce roughness and ensure color stability.

Purpose: To explore the function of miR-221-3p in the development and course of chronic periodontitis (CP) and offer a fresh avenue for CP diagnosis and management.

Methods: miR-221-3p expression was detected by RT-qPCR. The clinical diagnostic value of miR-221-3p in CP patients was analyzed by receiver operating characteristic (ROC). ELISA was used to determine the IL-1β and IL-6 in CP subjects and healthy controls. Pearson correlation analysis was performed with miR-221-3p. PDLCs were induced by LPS, transfected with miR-221-3p mimics, and their expression was analyzed for the effects of IL-1β, and IL-6.

Results: The miR-221-3p expression was lower in the gingival sulcus fluid GCF of CP subjects compared to healthy controls. miR-221-3p showed high potential for clinical diagnosis in CP patients by ROC analysis, with high specificity and sensitivity. miR-221-3p was negatively correlated with Probing pocket depth (PD), Attachment loss (AL), Plaque index (PI), and Bleeding index (BI), and negatively correlated with inflammatory factors IL-1β and IL-6. In LPS-induced PDLCs, IL-1β and IL-6 were significantly increased, whereas miR-221-3p was significantly downregulated. Overexpression of miR-221-3p inhibited the production of inflammatory factors IL-1β and IL-6 in LPS-induced PDLCs.

Clinical significance: miR-221-3p expression may be a potential biological marker for the diagnosis of chronic periodontitis and provide a new direction for its treatment of chronic periodontitis.

Purpose: To evaluate the effect of filled and unfilled modeler liquids on the cohesive strength and color stability when applied in between the resin composite layers in the stratification technique and on the uppermost surface layer.

Methods: For the cohesive strength test (n= 10), 30 cylindrical samples were packed into a Teflon mold (6x2 mm) in 2 mm increments. Firstly, a dentin-shade resin composite (Empress Direct) was placed, followed by the accommodation of a body-shade resin composite (Filtek Z350 XT) and an enamel-shade resin composite (Estelite Omega). Before photoactivation of each increment, an unfilled (Signum Liquid) or filled (Modeling Resin) modeler liquid was applied between the first and second layers and on the uppermost surface layer. The control group (n= 10) did not receive modeler liquid. Cohesive strength was measured in a universal testing machine. For the color test (n= 10), the other 30 samples were fabricated for the cohesive strength test, except for the difference in the diameter (6x6 mm). Before and after the staining of the samples, color was measured using the CIEL*a*b* system with a spectrophotometer (EasyShade). Data were submitted to ANOVA, Kruskal-Wallis test, or Mann-Whitney test (α= 5%).

Results: Modeler liquids significantly increased cohesive strength (P= 0.008), while ΔEab (P= 0.003) and ΔE₀₀ (P= 0.005) values presented significantly lower changes for the groups that received modeler liquids, with no significant difference between unfilled and filled modeler liquids.

Clinical significance: Apart from increasing the interfacial strength of stratified restorations, modeler liquids minimized staining.

Purpose: To evaluate how fluoride- or chitosan-based toothpaste used during at-home bleaching affects enamel roughness, tooth color, and staining susceptibility.

Methods: Bovine enamel blocks were submitted to a 14-day cycling regime considering a factorial design (bleaching agent x toothpaste, 2 x 3), with n=10: (1) bleaching with 16% carbamide peroxide (CP) or 6% hydrogen peroxide (HP), and (2) daily exposure of a fluoride (1,450 ppm F-NaF) toothpaste (FT), chitosan-based toothpaste (CBT), or distilled water (control). Then, 24 hours after the last day of bleaching procedure the samples were exposed to a coffee solution. Color (ΔEab, ΔE₀₀, L*, a*, b*) and roughness (Ra, µm) analyses were performed to compare the samples initially (baseline), after bleaching, and after coffee staining. The results were evaluated by linear models for repeated measures (L*, a*, b*, and Ra), 2-way ANOVA (ΔEab, ΔE₀₀) and Tukey's test (α= 0.05).

Results: After the at-home bleaching procedure (toothpaste vs. time, P< 0.0001), the toothpaste groups presented a statistically lower Ra than the control (CBT 0.05). After coffee exposure, CBT presented lower ΔEab and ΔE₀₀ values in the HP groups (toothpaste, P< 0.0001), and lower b* and a* values in the CP groups (toothpaste vs. time, P= 0.004).

Clinical significance: Fluoride or chitosan delivered by toothpaste can reduce surface alterations of the enamel during at-home bleaching, without affecting bleaching efficacy.

Purpose: To evaluate clinical performances of two lithium disilicate systems (Initial LiSi press vs Initial LiSi Block, GC Co.) using modified United States Public Health Service (USPHS) evaluation criteria and survival rates after 4 years of clinical service.

Methods: Partial adhesive crowns on natural abutment posterior teeth were made on 60 subjects who were randomly divided into two groups: Group 1: Initial LiSi press and Group 2: Initial LiSi Block. Fabrication of partial crowns was made with full analog and digital procedure in Groups 1 and 2 respectively. The restorations were followed-up for 1 and 4 years, and the modified USPHS evaluation was performed at baseline and each recall together with periodontal evaluation. Contingency tables to assess for significant differences of success over time in each group and time-dependent Cox regression to test for differences between the two groups were used and the level of significance was set at P< 0.05.

Results: Regarding modified USPHS scores, all evaluated parameters showed Alpha or Bravo and no Charlie was recorded. No statistically significant difference emerged between the two groups in any of the assessed variables (P> 0.05). No statistically significant difference between scores recorded at the baseline and each recall. All modified USPHS scores were compatible with the outcome of clinical success and no one restoration was replaced or repaired, and the survival rate was 100% after 4 years of clinical service. No difference was found between traditional and digital procedure to fabricate the crowns. The two lithium disilicate materials showed similar results after 4 years of clinical service.

Clinical significance: The crowns made with the two tested lithium disilicate materials with analog and digital procedures showed 100% survival after 4 years of clinical service with no statistically significant difference using the modified USPHS scores.