A. Rüya Yazici

Surface roughness and bond strengths of glass-infiltrated alumina-ceramics prepared using various surface treatments

OBJECTIVES To compare and evaluate effects of CO(2) laser and conventional surface treatments on surface roughness and shear bond strengths of glass-infiltrated alumina-ceramics to dentin. METHODS One hundred fifty ceramic discs of In-Ceram Spinell, In-Ceram Alumina and In-Ceram Zirconia (n=50) were prepared. Specimens which were divided into 5 groups (n=10) were untreated (control group), sandblasted, airborne particle abraded, etched with 9.6% hydrofluoric acid or irradiated with CO(2) laser. Scanning electron microscope was used at 1000x magnification for qualitative examination. Following surface roughness (Ra) determination by profilometry, discs were cemented on extracted-human-molar teeth. Cemented specimens were stored in distilled water at 37 degrees C for 1 week. Shear bond strength (MPa) test was performed using a universal testing machine at a crosshead speed of 1mm/min. Statistical comparisons were made with Wilcoxon signed ranked test, Kruskall Wallis test and Spearmans correlation coefficient. RESULTS All surface treatments produced rougher surfaces than the untreated groups of all ceramics (P<.05). Sandblasting demonstrated a rougher surface on In-Ceram Spinell than In-Ceram Alumina and In-Ceram Zirconia (P<.05). While CO(2) laser irradiation showed significantly higher bond strength for In-Ceram Spinell (P<.05), both airborne particle abrasion and CO(2) laser irradiation showed higher bond strengths for In-Ceram Zirconia (P<.05). Airborne particle abrasion demonstrated higher bond strength for In-Ceram Alumina and In-Ceram Zirconia (P<.05). No significant relationship was determined between surface roughness (Ra) and shear bond strength values (MPa) among ceramic groups. CONCLUSIONS Sandblasting is an effective surface treatment for roughening surfaces of In-Ceram Spinell. Although CO(2) laser irradiation does not increase surface roughness, it reveals the highest bond strength.

Comparison of different finishing/polishing systems on surface roughness and gloss of resin composites

OBJECTIVES The aim of this study was to compare four finishing/polishing systems (F/P) on surface roughness and gloss of different resin composites. METHODS A total of 40 disc samples (15 mm × 3 mm) were prepared from a nanofill - Filtek Supreme Plus (FS) and a micro-hybrid resin composite - Esthet-X (EX). Following 24h storage in 37°C water, the top surfaces of each sample were roughened using 120-grit sandpaper. Baseline measurements of surface roughness (Ra, μm) and gloss were recorded. Each composite group was divided into four F/P disk groups: Astropol[AP], Enhance/PoGo[EP], Sof-Lex[SL], and an experimental disk system, EXL-695[EXL] (n=5). The same operator finished/polished all samples. One sample from each group was evaluated under SEM. Another blinded-operator conducted postoperative measurements. Results were analysed by two-way ANOVA, two interactive MANOVA and Tukeys t-test (p<0.05). RESULTS In surface roughness, the baseline of two composites differed significantly from each other whereas postoperatively there was no significance. The Sof-Lex F/P system provided the smoothest surface although there were no statistical significance differences between F/P systems (p>0.01). In gloss, FS composite with the EXL-695 system provided a significantly higher gloss (p<0.01). EX treated by Soflex revealed the least gloss (p<0.05). SEM images revealed comparable results for F/P systems but EX surfaces included more air pockets. CONCLUSIONS Four different finishing/polishing systems provided comparable surface smoothness for both composites, whereas EXL with FS provided significantly higher gloss. SEM evaluations revealed that the EX surface contained more air pockets but F/P systems were compatible.

A morphological and micro-tensile bond strength evaluation of a single-bottle adhesive to caries-affected human dentine after four different caries removal techniques

OBJECTIVES This study evaluated the influence of different caries removal techniques (conventional bur; chemomechanical removal/Carisolv()-MediTeam; a sonic preparation system/SonicsysMicro-Kavo and air abrasion/PrepStar-Danville Engineering) on microtensile bond strength to caries-affected human dentine. METHODS Occlusal surfaces of extracted human permanent third molars with coronal dentine caries extending approximately halfway through the dentine was ground perpendicular to the long axis of the tooth to expose a flat surface of normal dentine surrounding the carious lesion with laser fluorescence values of approximately 30 (DIAGNODent), KaVo). Carious lesions were excavated with one of the four techniques until laser fluorescence values decreased to 15 in the center of the lesions. An ethanol-based dentine adhesive (Single Bond, 3M) was used to bond composite resin (P60, 3M) to the substrate. Vertical slices (n=11/group), approximately 0.8 mm thick were made through the caries-affected portions of each tooth, perpendicular to the bonding surface. Specimens were subjected to tensile stress at a crosshead speed of 1 mm/min. Data were analyzed by Kruskal-Wallis test. SEM investigation was performed for the qualitative evaluation of resin-dentine hybridization. RESULTS The microtensile bond strengths were as follows (mean+/-SD in MPa): 6.4+/-5.3 (bur), 8.4+/-3.3 (Carisolv), 8.5+/-5.9 (Sonicsys Micro), and 8.8+/-8.8 (air abrasion). Statistical analysis did not show significant differences between any of the treatment modalities (p=0.160). Tensile fracture was cohesive within caries-affected dentine in all specimens. CONCLUSIONS The four different caries removal techniques used within this study did not influence the bond strength of the tested dentine adhesive to caries-affected human dentine.

In vitro analysis of the effects of acid or laser etching on microleakage around composite resin restorations.

OBJECTIVES The aim of the present study was to determine the effect of two conditioning methods, phosphoric acid and XeCl laser application on microleakage at composite resin restorations. METHODS Class II MOD (mesio-occluso-distal) cavities were prepared on 90 extracted human wisdom teeth with one proximogingival margin on enamel and the other on dentin. Phosphoric acid (37%) and a XeCl excimer laser system were used for the etching procedure. The prepared teeth were randomly assigned to six groups: In group 1, acid-etching of the enamel margins was followed by application of enamel bonding, in group 2 additionally a dentin bonding system was used. In group 3, acid-etching of the enamel and dentin (total etch) was followed by the application of dentin bonding. In group 4, laser-etching of enamel margins was followed by the application of enamel bonding, in group 5 dentin bonding was used additionally. In group 6, laser-etching of enamel and dentin margins was followed by the application of dentin bonding. All restorations were placed incrementally and polymerized with a halogen light source. After restoration, all samples were thermocycled and stained in 0.5% basic fuchsin and sectioned longitudinally in a mesio-distal plane. Microleakage was scored by means of a stereomicroscope. The margins of the restorations at tooth-resin interface were examined with a scanning electron microscope. RESULTS In all groups, marginal leakage was more extensive at the gingival margin that was in dentin than at the gingival margin in enamel. Microleakage scores and the gap at the tooth-resin interface were significantly lower in all acid-etched groups than in laser-etched groups. CONCLUSION Acid-etch technique is more effective than the investigated laser-etch technique at 308nm concerning the reduction of marginal leakage in composite restorations.

Effect of bleaching on staining susceptibility of resin composite restorative materials.

STATEMENT OF THE PROBLEM Effect of bleaching procedures on staining susceptibility of resin restorative materials is still questionable. PURPOSE The aim of this study was to evaluate the staining susceptibility of restorative materials bleached with 20% carbamide peroxide home bleaching agent and subsequently immersed in coffee and tea. MATERIALS AND METHODS Forty-two disk-shaped specimens were fabricated for each of the resin composites (Filtek Supreme XT [3M ESPE, St. Paul, MN, USA], Ceram-X Mono [Dentsply, Konstanz, Germany], and Aelite All Purpose Body [BISCO, Inc., Shaumburg, IL, USA]). The baseline color values were measured with a spectrophotometer. The specimens of each restorative material were randomly divided into two groups (N = 21). While the first group specimens were stored in distilled water (nonbleaching group-control), bleaching agent (Opalescence PF 20% [Ultradent Poducts, South Jordan, UT, USA]) was applied on the top surface of each specimen of the second group (bleaching group). After color change values were measured, the specimens were randomly divided into three subgroups (N = 7) according to the staining solutions. The color change values (DeltaE*ab) were calculated and the data were subjected to analysis of variance. Statistical significance was declared if the p value was 0.05 or less. RESULTS There was no statistically significant difference within each restorative materials DeltaE*ab values after bleaching (p = 0.714). Also, the staining solutions did not cause a statistically significant difference between DeltaE*ab values of bleaching compared with nonbleaching groups (p = 0.146). Significant interaction was found only between restorative materials and staining solutions (p = 0.000). CONCLUSION Bleaching of the tested resin composites did not increase their susceptibility to extrinsic staining in vitro. CLINICAL SIGNIFICANCE Bleaching did not affect staining susceptibility of the tested resin composite restorative materials. (J Esthet Restor Dent 21:407-415, 2009).

Comparison of the Er,Cr:YSGG laser with a chemical vapour deposition bur and conventional techniques for cavity preparation: a microleakage study

The aim of this study was to compare the effects of the Er,Cr:YSGG laser using chemical vapour deposition (CVD) bur cavity preparation with conventional preparation methods including a diamond bur and a carbide bur on the microleakage with two different adhesive systems. A total of 40 extracted human premolars were randomly assigned to four experimental groups according to the cavity preparation technique: group I diamond bur (Diatech); group II carbide bur (Diatech); group III Er,Cr:YSGG laser (Biolase Millennium II); and group IV CVD bur (CVDentUS). Using the different preparation techniques, Class V standardized preparations were performed on the buccal and lingual surfaces with gingival margins on the dentin and occlusal margins on the enamel. Each preparation group was randomly assigned to two subgroups (five teeth, ten preparations) according to the type of adhesive: an etch-and-rinse adhesive (Adper Single Bond), and a single-step self-etch adhesive (AdheSE One). All preparations were restored with a nanohybrid composite resin in a single increment. Following thermocycling (×500; 5–55°C), the teeth were immersed in basic fuchsin and sectioned in the orovestibular direction. Dye penetration was evaluated under a light microscope by two blinded examiners. Data were statistically analysed with the Kruskal-Wallis and Wilcoxon tests (p<0.05). There were no statistically significant differences between the preparation techniques with either of the two adhesive systems (p>0.05). Comparing the enamel and dentin leakage scores within each group, no statistically significant differences were found (p>0.05). The Er,Cr:YSGG laser cavity preparation did not differ from preparation with CVD, diamond or carbide bur in terms of microleakage with the different adhesive systems.

Effect of operator variability on microleakage with different adhesive systems

Objective: The objective of this study was to evaluate the effect of operator variability on microleakage with different adhesive systems. Materials and Methods: A total of 180 standardized Class V cavities were prepared on facial and lingual of 90 extracted human premolar teeth and randomly assigned to five groups according to the adhesive systems used (n = 36): Prime and Bond NT (PB), Single Bond (SB), Futura Bond NR, Xeno III (XE) and Adper Prompt-L-Pop (LP). The adhesive groups were then further subdivided into three operator groups according to level of clinical experience (n = 12): An undergraduate student, a research assistant and a faculty member. All cavities were restored with same composite resin. The restored teeth were thermocycled (500 cycles, 5-55°C) then immersed in 0.5% basic fuchsin and measured for leakage under a stereomicroscope. Statistical analyses were performed with the Kruskal-Wallis and Mann-Whitney U tests. Results: Significant inter-operator variation was found in the enamel margins in the XE group with significantly higher microleakage when used by the undergraduate student (P < 0.05). Although no significant differences in microleakage were found between adhesive systems for the research assistant and faculty member (P > 0.05), significant differences were observed between PB and LP, PB and XE, SB and LP and SB and XE in the enamel margins for the undergraduate student (P < 0.05). Conclusion: Microleakage of adhesive systems is more dependent on interactions between the operator and adhesive material than on the choice of adhesive material.

The effect of different in-office bleaching techniques and etching procedures on bond strength of orthodontic brackets

Abstract The aim of this study was to compare the effects of different in-office bleaching techniques and acid/laser etching on bond strength of orthodontic brackets. Ninety-six extracted human premolar teeth were used in the study. The teeth were randomly divided into four groups according to different in-office bleaching techniques (n = 24); Group I: Diode laser-assisted bleaching, Group II: Er:YAG laser-assisted bleaching, Group III: In-office bleaching with LED, Group IV: Unbleached (control). After the samples were kept in artificial saliva for 2 weeks, each group were randomly divided into 2 subgroups according to etching methods; a–acid etching; b–laser etching. For laser etching Er,Cr:YSGG laser was used at 1.5 W, 15 Hz with 140 μs pulse duration for 20 s. For acid etching, 37% phosphoric acid was used for 30 s. The shear bond strength testing was performed using Instron Testing Machine with a crosshead speed of 1mm/min. Adhesive Remnant Index (ARI) scores were also measured. Data was analyzed using two-way ANOVA, Bonferroni, Kruskal Wallis and Mann Whitney U tests (p < 0.05). No statistically significant differences were found between bleaching groups and control (p > 0.05). There were statistically significant differences between acid and laser etching within each group (p < 0.05). Acid etching caused significantly higher bond strength values (p < 0.05). While no statistically significant differences were observed between the ARI scores of bleaching and control groups (p > 0.05), acid etching caused statistically higher ARI scores than laser etching groups (p < 0.05). In conclusion in-office bleaching either with LED or laser before bracket bonding did not affect bond strength. Prior to bracket bonding, acid etching of enamel caused higher shear bond strength values than laser etching.

Effect of an Er,Cr:YSGG laser preparation on dentin bond strength of a universal adhesive

Abstract The aim of this study was to evaluate the bond strength of a universal adhesive system to dentin prepared with SiC paper or an Er,Cr:YSGG laser using different bonding strategies (etch-and-rinse versus self-etch mode). Ninety-six extracted caries-free, sound human molars were used. The teeth were longitudinally sectioned in the mesiodistal direction and were wet polished with 600-grit SiC paper to obtain a standardized flat dentin surface. All prepared teeth were randomly divided into two groups, according to the surface preparation method: GroupI:an erbium, chromium:yttrium,scandium, gallium, garnet laser; Group II: silicon carbide paper[SiC] (n = 48). Each group was then assigned into three subgroups according to the universal adhesive’s (Single Bond Universal) bonding strategies: (a) etch-and-rinse mode with phosphoric acid, (b) etch-and-rinse mode with a laser, (c) self-etch mode (n = 16). For surface preparation, the Er,Cr:YSGG laser was used at 3 W, 30 Hz with 140 μs pulse duration for 25 s. For etching mode, the laser was used at 1.5 W (60% air, 70% water). Cylinders of composite were fabricated on the bonding area and shear bond strength was determined using a universal testing machine. Failure modes were evaluated using a stereomicroscope. The data were analyzed using two-way ANOVA followed by the Bonferroni test (p < 0.05). Bonding strategies showed statistically significant differences in both the SiC-and laser-prepared groups (p < 0.05).Universal adhesive used in etch-and-rinse mode with acid showed significantly higher bond strength values than in self-etch mode (p < 0.05). The bond strength values did not differ according to the surface preparation method (p > 0.05). Irrespective of preparation method, using universal adhesive in etch-and-rinse mode with acid might improve dentin bond strength. Laser preparation did not affect the bond strength of the universal adhesive tested.

Antimicrobial Effect of Ozone on Cariogenic Microorganisms In Vitro

The aim of this study was to examine the antibacterial effect of ozone on cariogenic microorganisms. Streptococcus salivarius, Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus casei and Actinomyces viscosus were used to test the antimicrobial activity of ozone. The microorganisms were exposed to power levels 2, 3, or 4 of an ozone device for 20, 40, 60, or 120 s. CFU numbers of bacteria were counted after the ozone application; as a result, the number of bacterial cells was decreased. The bacterial cells were also evaluated with a fluorescence microscope. This analysis revealed that some bacterial cells were killed instantaneously in ozone. The electron microscopic analysis showed no difference in surface morphology between bacteria to which ozone had been applied and those to which it had not.