The journal of adhesive dentistry最新文献

Several adhesion strategies have been proposed for restoring non-carious cervical lesions (NCCLs). Long-term clinical trials are essential to guide clinicians toward the most effective approach.

Purpose: To evaluate the 5-year clinical performance of NCCLs restored using different adhesion strategies.

Materials and methods: Four strategies were assessed: an adhesive system (Scotchbond Universal; SBU/Filtek Z350XT) applied without (SBU) and with selective enamel conditioning (E-SBU), and a resin-modified glass-ionomer cement (Vitremer; RMGIC) applied without (RMGIC) and with ethylene-diaminetetraacetic acid pretreatment (E-RMGIC). Two hundred restorations were evaluated using United States Public Health Service criteria after 5 years. Kappa test, Wilcoxon Signed-Rank test, Kaplan-Meier analysis, equality tests of two proportions, and multiple logistic regression were applied (α = 0.05).

Results: One hundred and nineteen restorations were re-evaluated after 5 years. No significant differences were observed in restoration survival among groups. E-SBU exhibited more Bravo scores for marginal integrity compared to the ionomer groups and for marginal discoloration compared to RMGIC. Ionomer groups had higher Bravo scores for surface texture. RMGIC showed greater wear than E-SBU, being statistically similar to SBU. No significant differences were found for color and secondary caries over time. Multiple logistic regression analysis revealed that restoration retention was significantly influenced by the type of tooth (premolars), the degree of dentin sclerosis, and the degree of marginal tissue recession.

Conclusions: All four adhesion strategies demonstrated similar 5-year survival. Marginal defects were more frequent in the selective enamel etching group than in ionomeric restorations. Surface luster was reduced in ionomer restorations. The retention of NCCL restorations may be affected by tooth type, degree of dentin sclerosis, and marginal tissue recession. The four adhesion strategies had similar survival after 5 years; however, composite resin restorations applied after selective enamel etching promote more initial marginal defects than ionomer-based restorations following the manufacturer's instructions. Clinical factors such as lesion location, dentin sclerosis, and gingival recession can influence the retention of NCCL restorations.

Purpose: This randomized clinical trial (RCT) aims to evaluate the clinical performance of the two powder-liquid restoratives Cention Forte ('CF'; Ivoclar Vivadent AG, Schaan, Liechtenstein) and Equia Forte HT ('EF'; GC, Tokyo, Japan) in class-I/II restorations. Here, the early 6-month clinical performance is reported.

Materials and methods: Fifty-nine patients were included based on specific exclusion/inclusion criteria. Each patient had two teeth with similar cavities restored using either CF or EF, which were randomly assigned using the Castor EDC system. Baseline (BL) evaluation occurred at 2 weeks followed by a 6-month recall, both conducted by two independent examiners using FDI criteria.

Results: The 6-month recall rate was 96.6%. All restorations were rated as clinically acceptable, except for 1 EF restoration showing a severe but repairable marginal defect. Similar clinical performance was recorded for both restorative materials regarding surface staining, margin discolouration, anatomic form, approximal contact, postoperative hypersensitivity, and tooth integrity. Slight but still clinically acceptable marginal deterioration was observed for both restoratives. Regarding color match, most EF restorations (94.7%) showed a clinically acceptable deviation in color match (opaquer; FDI score 2 and 3), compared to 57.9% CF restorations having an excellent color match rated as FDI score 1. The percentage of EF restorations with a surface luster comparable to that of enamel (FDI score 1) decreased from 50.8% at BL to 14% at 6 months, mainly due to wearing off of the resin-based coating. CF restorations showed more frequently a slightly dull surface (FDI Score 2 for BL: 81.4%; 6 months: 82.5%).

Conclusion: Both powder-liquid restoratives revealed a similarly favorable early clinical performance after 6 months of clinical service.

This comprehensive literature-based review critically examines the physico-chemical properties of functional monomers present in contemporary dental adhesive formulations or dental materials relying on self-adhesive technology. A qualitative synthesis of evidence was conducted through searches in PubMed, Scopus, and LILACS over a 20-year period (2005-2025), without language restrictions. Data on the chemical structure, composition, adhesive performance, pKa, etching efficacy, polymerization, mechanical properties, toxicity, and hydrolytic stability/degradation were analyzed from peer-reviewed studies and manufacturer technical information. Several relevant acidic functional monomers are covered, but key players include 10-MDP, GPDM, and 4-META. Notably, 10-MDP emerged as the most prevalent monomer in commercial adhesives, appearing in nearly 50% of the current adhesives in the market. Its superior adhesive performance and longevity stem from its unique chemical characteristics, whereas other commercial acidic monomers, including GPDM and 4-META, are still present in many adhesive formulations despite their structural limitations and comparatively lower bonding efficacy. Understanding the chemical composition of dental adhesives is essential for achieving improved clinical outcomes and driving material development. This knowledge allows clinicians to select adhesive materials based on performance requirements and informs future innovations to address challenges such as degradation pathways, biocompatibility, and their overall long-term bonding efficacy.

Purpose: Orthodontic treatment often requires anatomical tooth reconstruction for esthetic and functional reasons. Direct resin composite (RC) restorations, which preserve tooth structure while providing high bond strength, are widely used. Recently, orthodontic treatment plans increasingly incorporate RC restorations for correction of tooth form. This report presents a case in which RC injection, aided by a digital workflow, successfully restored lost canine morphology.

Materials and methods: An intraoral scanner was used to obtain optical impressions and occlusal records, which were then imported into a computer-aided design (CAD) system for analysis using a virtual articulator. Lateral movements were simulated in the virtual articulator to replicate occlusal contacts. Subsequently, a digital wax-up was used to fabricate a 3D-printed model, and a transparent silicone index with designated openings for RC injection was created. A flowable RC (Filtek™ Supreme Ultra Flowable Restorative, Solventum) was injected through the incisal access opening of the index.

Results: By utilizing a clear index designed through the digital workflow, the wear of the canine teeth was efficiently restored using the injection technique. Evaluation of occlusal guidance with a digital articulator revealed that minimal morphological adjustment was required, resulting in a significant reduction in chair time. At the two-year follow-up, the clinical outcomes remained highly favorable.

Conclusions: Preoperative occlusal simulations enable precise transfer of tooth form, enhancing clinician-technician communication and reducing chair time. Despite requiring additional visits for index fabrication and specialized equipment, digital workflow-assisted RC injection guarantees esthetic and functional outcomes.

Purpose: Evaluation of radicular bond strength and dentinal matrix metalloproteinases (MMPs) activity with different endodontic sealers (traditional vs bioceramic), filling techniques (warm vs cold), and adhesive protocols (self-etch vs etch-and-rinse), after 24 hours and after one year (T0 vs T1).

Materials and methods: 96 extracted, caries-free, single-rooted teeth were selected and shaped with Proglider, ProTaper Next X1-X2. Samples were randomly divided into four groups: warm filling with ZOE sealer; cold filling with resin-based sealer; cold filling with bioceramic sealer; warm filling with bioceramic sealer. After 7 days, a 10 mm post space was prepared using dedicated drills, and each group was divided into two subgroups according to the adhesive procedure (self-etch vs etch-and-rinse, SE vs ER) employed for fiber post cementation with dual resin cement. Samples were analyzed with push-out tests at T0 and T1. 16 additional non-carious multirooted teeth were prepared following the described groups and subgroups for in-situ zymography analysis at T0 and T1. A four-way ANOVA, post-hoc Tukey was used to test the four factors and one-way ANOVA to evaluate the differences within each variable (α = 0.05).

Results: Bioceramic sealer showed significantly higher bond strength than traditional sealer (P 0.05), especially when associated with the warm filling technique. SE adhesive protocol performed significantly better (P 0.05) independently of the sealer used, the filling technique, and the aging time. Greater endogenous collagenolytic activity was identified within the hybrid layer of ER-treated samples compared to SE independently from the other variables tested. In addition, warm technique proved to significantly reduce MMPs activity compared to the cold technique.

Conclusion: The results showed that bioceramic sealers should guarantee better results in radicular dentin bond strength, without altering the endogenous enzymatic activity. The heat produced during the root canal obturation might reduce the internal enzymatic activity but, in association with bioceramic sealers, after 12 months, it produces higher bond strength. Heat reduces the difference between the two adhesive systems. ER technique and aging increase enzymatic activity. Aging tends to increase bond strength, especially in traditional sealers groups associated with ER protocol.

Purpose: The aim of this in-vitro study was to evaluate the effect of different indirect pulp capping (IPC) materials on bond strength to surrounding dentin.

Materials and methods: Fifty-six human third molars were used in this study. Occlusal dentin of 42 teeth was exposed. Dentin surfaces (n = 6) were left uncovered (control) or received a 1 × 1 mm central IPC (KL: Kerr life, DY: Dycal, TC: Theracal LC, CL: Calcimol LC, BD: Biodentine, and PR: ProRoot MTA) and were then bonded with Scotchbond Universal adhesive and restored with a composite resin build-up (Filtek™ Z250). After 24 h of water storage, the specimens were cut into sticks, which were marked red (1 mm distance from IPC spot), green (2 mm distance), and blue (3 mm distance). Consequently, µ-TBS tests were performed and analyzed using one-way ANOVA (P 0.05) for normal distributions and Mann-Whitney U-test (P 0.05) for non-normal distributions. Pretesting failures were recorded as 0 MPa. Fracture modes were analyzed under a fluorescence microscope, and interfaces and surfaces of 14 additional specimens were visualized under a scanning electron microscope (SEM).

Results: A significant reduction in peripheral seal was only observed for KL (Mann-Whitney U-test, P 0.05). All groups showed increasing bond strengths from the IPC area to the periphery, indicating a certain contamination potential of IPC materials.

Conclusion: IPC materials being applied in very deep cavity areas except Kerr Life do not harm peripheral seal to dentin. Especially, hydraulic cements can be used without a negative effect on the peripheral dentin seal.

Purpose: To investigate, via questionnaire, how protocols for adhesive luting workflows of dental restorations are applied in three German-speaking countries.

Material and methods: A 47-item questionnaire gathered data on airborne particle abrasion (APA) unit characteristics, parameters, operating procedures, pretreatments in adhesive luting workflows for restorations, and participant demographics. The survey was distributed via trade journals, expert associations, universities, technical schools, and social media. Marginal absolute and relative frequencies were analyzed (95% confidence intervals), with Chi-squared tests comparing observed and expected frequencies (P0.05). Twenty-three experts voted on 23 recommendations regarding APA parameters and other pretreatments for bonding restorations.

Results: A total of 267 participants completed the survey. Access to an APA unit was linked to a higher likelihood of performing APA before placement. Approximately half of the participants used APA in their practice. For zirconia restorations, 47.2% applied alumina APA at 50 µm/0.1 MPa, while 36.7% used the same settings for polymer-based restorations. For alloys, 37.5% employed 110 µm/0.2 MPa. These preferences correlated with age (≥30 years), experience (≥10 years), profession (dental technician/dentist), prior instruction/training, and daily APA use. Adhesives with MDP were used for zirconia (63.8%) and those with silane for silicate-based ceramics (55.9%). Agreement on recommendations ranged between 52% and 100%, with 21/23 reaching an average of 93%.

Conclusion: Access to APA influenced clinical decisions and the feasibility of adhesive luting workflows. Adequate APA equipment in dental facilities is essential for quality care. Standardized protocols, training, and education across dental professions are necessary to enhance understanding and proper use of APA.

Purpose: To evaluate the effect of a self-etching primer on the long-term bond strength stability between a leucite-based glass-ceramic and resin cement, compared to the conventional treatment involving hydrofluoric acid (HF) etching followed by silane application.

Materials and methods: Blocks of a leucite-based glass-ceramic (IPS Empress CAD) were cut into plates and embedded in acrylic resin. Half of the specimens were treated with 5% HF for 60 s and silane application, and the other half was treated with a self-etching primer (Monobond Etch and Prime, MEP). Resin cement cylinders (n = 24) were built onto their surfaces, and the specimens of each group were divided into three subgroups according to the microshear bond strength (µSBS) testing time: baseline, after 10,000 thermocycles, or after 10,000 thermocycles followed by 180 days of immersion in water. Statistical analysis was performed with two-way analysis of variance and Tukey's tests. Complementary failure mode, contact angle, and scanning electron microscopy analyses were carried out.

Results: MEP groups showed higher bond strength results than HF. HF-treated specimens exhibited a decrease in bond strength after thermocycling and water storage, while MEP-treated specimens maintained similar bond strength values across all aging conditions. Only cohesive failures within the ceramic were observed at baseline. After aging, most HF specimens exhibited adhesive failures. HF etching created more irregularities with apparent deeper defects on the ceramic surface compared to MEP. HF etching produced a lower contact angle between the ceramic surface and the water drop compared to the self-etching primer.

Conclusion: Applying the self-etching primer resulted in higher bond strength stability between leucite-based glass-ceramic and resin cement compared to conventional treatment.

Purpose: This study aims to develop and characterize copper-doped bioactive glass nanoparticles (BG/CuNp), and to evaluate the effects of their addition into a resin composite on antimicrobial activity (AMA), cytotoxicity (CTX), ultimate tensile strength (UTS), Knoop microhardness (KHN), as well as immediate resin-dentin microtensile bond strength (μTBS), nanoleakage (NL) and in-situ degree of conversion (DC).

Materials and methods: BG/CuNp were added to a resin composite at different concentrations (0% [control]; 5, 10 and 20 wt%). The AMA was evaluated against Streptococcus mutans. For CTX, the Gingival mesenchymal stem cells (GMSC) cell line was used. For UTS and KHN, specimens were tested after 24 h and 28 days. For bonding evaluation, a universal adhesive was applied on flat dentin surfaces, experimental resin composite build-ups were prepared, and specimens were sectioned to obtain resin-dentin sticks. These were evaluated for μTBS, NL and DC after water storage. Data were submitted to statistical analyses (α = 0.05).

Results: The addition of 5% and 10% of BG/CuNp increases AMA (P 0.05), while the CTX remained unchanged with resin-containing BG/CuNp (P > 0.05). UTS and KHN remained stable with the addition of 5% and 10% of BG/CuNp at 24 h, but showed significantly higher values compared to the control after 28 d (P 0.05). μTBS and in-situ DC remained unchanged with BG/CuNp addition, regardless of the concentration added. However, significantly lower NL was observed for BG/CuNp groups (P 0.05).

Conclusion: The addition of BG/CuNp in the tested concentrations into a resin composite may be an alternative to provide antimicrobial activity and improve the integrity of the hybrid layer, without compromising biological, adhesives and mechanical properties.