The journal of adhesive dentistry最新文献

Purpose: This study aims to assess whether orthodontic bonding systems prevent orthodontic-induced white spot lesions (OIWSLs), exploring efficacy and identifying associated factors through a comprehensive systematic review of existing evidence.

Materials and methods: The study complied to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two evaluators screened records, and data were extracted on orthodontic bonding systems, outcomes, and participant characteristics from PubMed/MEDLINE, Cochrane Library, and EM Premium. The search equation focused on white spot lesions and orthodontic bonding. Only in-vivo studies and clinical trials on humans were included, while in-vitro studies were excluded. The risk of bias was assessed using Cochrane's RoB2 tool for RCTs and ROBINS-I tool for non-randomized studies, evaluating key domains related to bias.

Results: The systematic review, including 12 articles with 550 participants and 2,000 teeth, revealed that bonding with nanoparticles of nCaF2-primer and amorphous calcium phosphate-containing adhesives effectively reduced WSLs. In contrast, one-step adhesive without primer (GC Ortho Connect™) was associated with higher and more severe WSLs. Fluoride-releasing primers (Opal Seal™ and Clearfil™) did not exhibit an advantage in demineralization reduction. The inclusion of TiO2 nanoparticles in two studies yielded conflicting results on antibacterial effects.

Discussion: Various nanoparticles incorporated into adhesives or primers exhibit promise in preventing white spot lesions in fixed orthodontic treatment. However, the used evaluation methods, such as clinical examinations or advanced imaging, significantly impact result interpretation. The effectiveness of orthodontic adhesives in preventing WSLs should balance between biocompatibility, bond strength and demineralization control tailored to patient-specific needs.

Purpose: To assess the bond strength and the hybrid layer (HL) micro-morphological characteristics at the cement-dentin interface (CD-i) between root canal walls and two adhesive resin cements [self-etch (SERc) and self-adhesive (SARc)] in root-canal-treated (RCT) and naturally aged retreated teeth (RCR-T).

Materials and methods: Vital (n = 16) and RCT (n = 16) teeth were, respectively, endodontically treated or retreated. Fiber posts were luted either with SERc (Clearfil Universal Bond Quick + DC Core Plus) or SARc (iCEM). Samples were then sectioned into 1 mm thick slices perpendicular to the fiber post and submitted to push-out bond strength test. Vital (n = 4) and RCT (n = 4) first maxillary molars were also selected and prepared to evaluate CD-i morphology through confocal laser scanning microscopy (CLSM). Three-way analysis of variance (ANOVA) and Tukey post-hoc tests were assessed to statistically analyze the obtained data (p 0.05).

Results: Bond strength was significantly jeopardized in retreated teeth and in the root apical half, while the cements had no significant influence. Most failures occurred between dentin and resin cement. HL thickness was also hindered in retreated teeth. iCEM produced a thinner HL compared to SERc. Resin tag formation was significantly hampered in the root apical half.

Conclusions: SARc performed as well as SERc on aged RCT radicular dentin. Clinicians can rely on simplified one-step luting systems when adhesion is required in unfavorable substrates such as the root canal post space of aged RCT teeth.

Purpose: This German S3 clinical practice guideline offers evidence-based recommendations for the use of composite materials in direct restorations of permanent teeth. Outcomes considered were the survival rates and restoration quality and process quality of the manufacturing process. Part 1 of this two-part presentation deals with the indication classes.

Materials and methods: A systematic literature search was conducted by two methodologists using MEDLINE and the Cochrane Library via the OVID platform, including studies up to December 2021. Six PICO questions were developed to guide the search. Recommendations were formulated by a panel of dental professionals from 20 national societies and organizations based on the collected evidence.

Results: Composite materials are a viable option for the direct restoration of cavity Classes I-V and may also be used for restorations with cusp replacement, and tooth shape corrections. In the posterior region, direct composite restorations should be preferred over indirect composite inlays. For Class V restorations, composite materials can be used if adequate contamination control and adhesive technique are ensured.

Conclusion: The guideline is the first to provide comprehensive evidence on the use of direct composite materials. However, further long-term clinical studies with comparators such as (modified) glass-ionomer cements are necessary. Regular updates will detail the future scope and limitations of direct composite restorations.

Purpose: To evaluate the long-term microtensile bond strength (µTBS) to dentin, water sorption (WSP) and solubility (WSL), and degree of conversion (DC) of self-adhesive resin composites (SACs).

Materials and methods: The mid-coronal dentin of human molars was exposed, and teeth were randomly assigned to five groups according to the SACs (n = 10): 1. FIT SA F03 (FIT); 2. Experimental (EXP); 3. Fusio Liquid Dentin (FLD); 4. Vertise Flow (VER); 5. Constic (CON). The µTBS was evaluated after 24 hours (24 h) and 6 months (6 m) storage. A scanning electron microscope examined failure modes and resin-dentin interfaces. The WSP and WSL (n = 5) were evaluated following ISO 4049:2019 specifications, and DC (n = 3) was measured using Raman spectroscopy. The statistical analyses were performed accepting a significance level of p = 0.05.

Results: FIT, EXP, and FLD produced significantly higher µTBS median values than VER and CON after 24 h and 6 m (p 0.05). After 6m, the µTBS median of FIT and EXP significantly decreased (p 0.05), while FLD, VER, and CON showed no significant difference (p > 0.05). FLD and CON exhibited lower WSP than FIT, EXP, and VER (p 0.05). FLD presented the lowest (p 0.05), and VER revealed the highest WSL (p 0.05). FIT and EXP showed the highest (p 0.05), and VER demonstrated the lowest DC (p 0.05).

Conclusions: Following the present study's design, SACs' bonding performance and physical properties remained restricted. Therefore, the application should be considered cautiously, and further clinical trials are necessary to evaluate their long-term performance.

Purpose: Part 2 of this German S3 clinical practice guideline provides recommendations for the process of manufacturing composite restorations. It covers key aspects like caries removal, field isolation, matrix and adhesive techniques, as well as light curing and polishing. The outcomes of interest include survival rates and restoration quality.

Materials and methods: A systematic literature search was conducted by two methodologists using MEDLINE and the Cochrane Library via the OVID platform, including studies up to December 2021. Additionally, the reference lists of relevant manuscripts were manually reviewed. Six PICO questions were developed to guide the search. Consensus-based recommendations were for- mulated by a panel of dental professionals from 20 national societies and organizations based on the collected evidence and ex- pert opinion.

Results: The guideline advocates for one-stage selective caries removal near the pulp and underscores the effectiveness of various isolation techniques, adhesive systems, and the crucial role of light polymerization. The use of anatomically pre- formed sectional matrices and phosphoric acid etching is recommended to enhance restoration quality. Additionally, polish- ing composite restorations is advised to improve surface finish.

Conclusion: This guideline provides comprehensive recommendations that inform clinicians on optimizing the composite restor- ation manufacturing processes. The adoption of these best practices can improve the quality and longevity of dental restorations.

Purpose: Numerous studies report on the outcome performance of posterior composite restorations. However, there are fewer studies providing data for anterior restorations. The aim of this study was to evaluate the clinical outcome performance of anterior permanent restorations by analyzing a large dataset from a German national health insurance company.

Materials and methods: Routine claims data from a major German national health insurance company were assessed. Fee codes were used for tracing restoration careers on a day-count basis. The treatment was defined as a placed restoration (Class III and IV) on a mesial or distal tooth surface, irrespective of the extension. The restorations were placed between January 1, 2010 and December 31, 2013. Statistical analyses were conducted using Kaplan-Meier survival analysis to determine cumulative 4-year survival rates. The primary outcome was re-intervention on the same surface. Secondary outcomes were crowning and extraction which were analyzed separately.

Results: A total of 2,417,791 restorations involving mesial surfaces and a number of 2,409,031 restorations involving distal surfaces were observed. At 4 years, the cumulative survival rates concerning the primary outcome 're-intervention' were 79.9% for mesial and 80.9% for distal restorations. The respective annual failure rates (AFR) were 5.5% and 5.2%. Four-year survival rates for the secondary outcome 'crown' were 93.8% for mesial and 94.1% for distal anterior restorations. The respective AFRs were 1.6% and 1.5%. For the secondary outcome 'extraction,' the respective rates were 94.6% for mesial and 93.9% for distal restorations. The respective AFRs were 1.4% and 1.6%.

Conclusion: The performance of permanent anterior restorations which were placed in general dental practices in Germany can be rated as acceptable.

Purpose: To evaluate the effect of urethane methacrylate precursor (UMP) on the enzymatic resistance of demineralized dentin (DD) matrices.

Materials and methods: Experimental treatments containing 0 (control), 1, and 5 mmol/L UMP dissolved in an acetone (Ace) solution were formulated. Dentin matrix specimens were demineralized in vitro and immersed in the experimental treatments for 1 h. The treated specimens were then stored in 0.1 mg/mL collagenase solution for 24 h, after which their dry mass loss and hydroxyproline (HYP) release were assessed. The swelling ratios of specimens in each group were also evaluated. The interaction between UMP and the dentin matrix was observed using field-emission scanning electron microscopy (FE-SEM). Endogenous enzyme activity in dentin was evaluated using confocal laser scanning microscopy (CLSM).

Results: Compared with the other treatment groups, treatment with 1 mM and 5 mM UMP-Ace significantly decreased the dry mass loss, HYP release and swelling ratio of the DD matrix (p < 0.05). FE-SEM and CLSM observations showed that treatment with UMP-Ace protected the structure of the dentin matrix and decreased porosity within the dentin-collagen network.

Conclusion: Treatment with 1 mM and 5 mM UMP-Ace protects DD matrix against collagenase degradation and may be clinically useful for improving the durability of the hybrid layer.

Purpose: To systematically review in-vitro studies that evaluated the influence of erbium laser pretreatment on dentin shear bond strength (SBS) and bond failure modes.

Materials and methods: Electronic databases (PubMed, Cochrane Central, Embase, and Web of Science) were searched. Only in-vitro studies involving erbium laser irradiation of the dentin surface and SBS testing of the bonded resin block were included. The three common modes of bond failure (1. adhesive, 2. cohesive, and 3. mixed) were observed and analyzed. The network meta-analysis (NMA) was performed by Stata 15.0 software, the risk of bias was evaluated, and the certainty of the evidence was assessed by the Confidence in Network Meta-analysis (CINeMA).

Results: Forty studies with nine pretreatments (1. blank group: BL; 2. phosphoric acid etch-and-rinse: ER; 3. self-etch adhesive: SE; 4. Er:YAG laser: EL; 5. Er,Cr:YSGG laser: ECL; 6. ER+EL; 7. ER+ECL; 8. SE+EL; 9. SE+ECL) were included in this analysis. The NMA of SBS showed that ER+EL [SMD = 0.32, 95% CI (0.11, 0.98)] had the highest SBS next to ER, especially when using one of the 3M ESPE adhesives, followed by EL, ECL, SE and SE+EL. The Ivoclar Vivadent adhesives significantly increased the SBS of the ECL [SMD = 0.37, 95% CI (0.16,0.90)] and was higher than ER+EL [SMD = 0.25,95% CI (0.07,0.85)]. Finally, the surface under the cumulative ranking curve (SUCRA) value indicated that ER+EL (SUCRA = 71.0%) and EL (SUCRA = 62.9%) were the best treatments for enhancing dentin SBS besides ER. ER+EL (SUCRA = 85.3%), ER (SUCRA = 83.7%) and ER (SUCRA = 84.3%) had the highest probability of occurring in adhesive, cohesive and mixed failure modes, respectively.

Conclusion: Er:YAG and Er,Cr:YSGG lasers improved dentin SBS compared to the blank group, especially when the acid etch-and-rinse pretreatment was combined with Er:YAG laser. Shear bond strength and failure mode do not appear to be directly related.

Purpose: To investigate the effect of adhesive type and long-term aging on the shear bond strength (SBS) between silica-based ceramics and composite cement (CC).

Materials and methods: Lithium-silicate (LS), feldspathic (FD) and polymer-infiltrated ceramic (PIC) blocks were sectioned (10 x 12 x 2 mm) and divided into 24 groups considering the factors: "ceramics" (LS, FD, and PIC), "adhesive" (Ctrl: without adhesive; 2SC: 2-step conventional; 3SC: 3-step conventional; 1SU: 1-step universal), and "aging" (non-aged or aged [A]). After the surface treatments, CC cylinders (n = 15, Ø = 2 mm; height = 2 mm) were made and half of the samples were subjected to thermocycling (10,000) and stored in water at 37°C for 18 months. The samples were submitted to SBS testing (100 kgf, 1 mm/min) and failure analysis. Extra samples were prepared for microscopic analysis of the adhesive interface. SBS (MPa) data was analyzed by 3-way ANOVA and Tukey's test (5%). Weibull analysis was performed on the SBS data.

Results: All factors and interactions were significant for SBS (p<0.05). Before aging, there was no significant difference between the tested groups and the respective control groups. After aging, the LS_1SU (22.18 ± 7.74) and LS_2SC (17.32 ± 5.86) groups exhibited significantly lower SBS than did the LS_Ctrl (30.30 ± 6.11). Only the LS_1SU group showed a significant decrease in SBS after aging vs without aging. The LS_1SU (12.20) group showed the highest Weibull modulus, which was significantly higher than LS_2SC_A (2.82) and LS_1SU_A (3.15) groups.

Conclusion: No type of adhesive applied after silane benefitted the long-term adhesion of silica-based ceramics to CC in comparison to the groups without adhesive.

Purpose: To measure zirconia-to-zirconia microtensile bond strength (µTBS) using composite cements with and without primer.

Materials and methods: Two Initial Zirconia UHT (GC) sticks (1.8x1.8x5.0 mm) were bonded using four cements with and without their respective manufacturer's primer/adhesive (G-CEM ONE [GOne] and G-Multi Primer, GC; Panavia V5 [Pv5]), and Panavia SA Cement Universal [PSAu], and Clearfil Ceramic Plus, Kuraray Noritake; RelyX Universal (RXu) and Scotchbond Universal Plus [SBUp], 3M Oral Care). Specimens were trimmed to an hour-glass shaped specimen whose isthmus is circular in cross-section. After 1-week water storage, the specimens were either tested immediately (1-week μTBS) or first subjected to 50,000 thermocycles (50kTC-aged μTBS). The fracture mode was categorized as either adhesive interfacial failure, cohesive failure in composite cement, or mixed failure, followed by SEM fracture analysis of selected specimens. Data were analyzed using linear mixed-effects statistics (α = 0.05; variables: composite cement, primer/adhesive application, aging).

Results: The statistical analysis revealed no significant differences with aging (p = 0.3662). No significant difference in µTBS with/without primer and aging was recorded for GOne and PSAu. A significantly higher µTBS was recorded for Pv5 and RXu when applied with their respective primer/adhesive. Comparing the four composite cements when they were applied in the manner that resulted in their best performance, a significant difference in 50kTC-aged μTBS was found for PSAu compared to Pv5 and RXu. A significant decrease in µTBS upon 50kTC aging was only recorded for RXu in combination with SBUp.

Conclusion: Adequate bonding to zirconia requires the functional monomer 10-MDP either contained in the composite cement, in which case a separate 10-MDP primer is no longer needed, or in the separately applied primer/adhesive.