Çiğdem Çelik

Effect of laser irradiation and cavity disinfectant application on the microtensile bond strength of different adhesive systems.

OBJECTIVE The aim of this study was to evaluate the effect of two different cavity disinfection procedures (chlorhexidine gluconate-based cavity disinfectant and Er,Cr:YSGG laser irradiation) on the bond strength of two different types of adhesive systems (Adper Single Bond 2 [SB] and Clearfil SE Bond [SE]). MATERIALS AND METHODS Thirty human third molars were ground flat to expose midcoronal dentin. After the dentin surfaces were polished with 600-grit silicon carbide paper, the teeth were randomly assigned to six groups (n = 5) according to the cavity disinfection procedure and the adhesive resin: Group I, etch and rinse adhesive (SB); Group II, self-etch adhesive (SE); Group III, cavity disinfectant application (cavity cleanser) + SB; Group IV, cavity disinfectant application + SE; Group V, laser irradiation (Er,Cr:YSGG laser, 20 Hz; 0.75 W; 15% water, 15% air) + SB; Group VI, laser irradiation + SE. For each group, the composite crown was incrementally fabricated with a composite resin. Following storage in distilled water at 37 degrees C for 24 h, the bonded specimens were serially sectioned into rectangular beams (n = 32). Bond strengths were determined using a microtensile tester at a crosshead speed of 0.5 mm/min. Data were analyzed using two-way ANOVA, and multiple comparisons were performed using post hoc Duncans test (p < 0.05). RESULTS Cavity disinfectant application and laser irradiation produced significantly higher bond strength values compared to the control group for SB. For SE, only laser irradiation improved the bond strength values compared to the control. There was a statistically significant decrease in the bond strength values of the specimens that were subjected to cavity disinfectant before SE application. The failure mode was mainly adhesive in all groups. CONCLUSION Cavity disinfectant application and laser irradiation may influence bond strength, depending on the adhesive system used. As a cavity-disinfecting procedure, laser irradiation might enhance the bond strength of etch and rinse and self-etch adhesive systems.

Effect of sodium ascorbate on bond strength of different adhesive systems to NaOCl-treated dentin

The aim of this study was to evaluate the effects of sodium ascorbate on bond strength of different adhesive systems to NaOCl-treated dentin. Eighty extracted molar teeth were used in the study. The buccal enamel surfaces were removed to obtain a flat dentin surface. The teeth were mounted in self-curing resin and dentin surfaces were irrigated with NaOCl for 10 min. Half of the specimens were treated with sodium ascorbate for 10 min. The teeth were randomly assigned to four subgroups according to the adhesive systems used (Clearfil SE Bond, Clearfil Tri-S Bond, Adper Prompt-L-Pop, Adper Single Bond 2). Bond strengths were determined with a Universal Testing Machine, at a crosshead speed of 0.5 mm/min. Data were statistically analysed using anova at a significance level of 0.05. Two-way ANOVA revealed that the effect of sodium ascorbate application on bond strength of adhesive systems to NaOCl-treated dentin was statistically significant (P < 0.05). The bond strength results were significantly influenced by the application of sodium ascorbate (P < 0.05) and there was a significant difference between the adhesive systems (P < 0.05). Although statistically significant differences were not demonstrated in all adhesive resin groups, sodium ascorbate application after NaOCl treatment improved the bond strength values.

Clinical Evaluation of Resin-Based Composites in Posterior Restorations: A 3-Year Study

Objectives: The aim of this study was to evaluate the clinical performance of a nanohybrid and a microhybrid composite in class I and II restorations after 3 years. Subjects and Methods: A total of 82 class I and class II restorations were performed in 31 patients (10 males and 21 females) using Grandio and QuiXfil with self-etch adhesives (Futurabond and Xeno III). The restorations were clinically evaluated by 2 operators 1 week after placement (baseline) and at 6 months and 1, 2, and 3 years using modified United States Public Health Service (USPHS) criteria. At the 3-year follow-up, 62 class I and class II cavities were reevaluated in 23 patients (7 males and 16 females). Statistical analysis was performed using Pearsons χ2 and Fishers exact tests (p < 0.05). Results: At the 6-month follow-up, all restorations received Alfa scores with respect to each evaluation criterion. At the 1-year follow-up, 2 QuiXfil restorations had to be replaced and Grandio restorations started to deteriorate in terms of marginal adaptation. At the end of 2 years, 9 Grandio restorations showed significant deterioration of the surface properties, demonstrating Bravo scores. At the end of 3 years, no significant differences were observed regarding color match, marginal adaptation, secondary caries, marginal discoloration, and anatomic form loss between the evaluated materials in 25 class I and 37 class II restorations. At the 3-year follow-up, Grandio restorations had 21% Bravo scores and showed significant deterioration of the surface properties, which were still clinically acceptable according to USPHS criteria. Three QuiXfil and 1 Grandio restorations were replaced because of secondary caries and loss of retention. Conclusions: Both the nanohybrid (Grandio) and the microhybrid (QuiXfil) composites were clinically functional after 3 years.

Resin composite repair: Quantitative microleakage evaluation of resin-resin and resin-tooth interfaces with different surface treatments.

Objective: The aim was to evaluate the effect of different adhesive systems and surface treatments on the integrity of resin-resin and resin-tooth interfaces after partial removal of preexisting resin composites using quantitative image analysis for microleakage testing protocol. Materials and Methods: A total of 80 human molar teeth were restored with either of the resin composites (Filtek Z250/GrandioSO) occlusally. The teeth were thermocycled (1000×). Mesial and distal 1/3 parts of the restorations were removed out leaving only middle part. One side of the cavity was finished with course diamond bur and the other was air-abraded with 50 μm Al 2 O 3 . They were randomly divided into four groups (n = 10) to receive: Group 1: Adper Single Bond 2; Group 2: All Bond 3; Group 3: ClearfilSE; Group 4: BeautiBond, before being repaired with the same resin composite (Filtek Z250). The specimens were re-thermocycled (1000×), sealed with nail varnish, stained with 0.5% basic fuchsin, sectioned mesiodistally and photographed digitally. The extent of dye penetration was measured by image analysis software (ImageJ) for both bur-finished and air-abraded surfaces at resin-tooth and resin-resin interfaces. The data were analyzed statistically. Results: BeautiBond exhibited the most microleakage at every site. Irrespective of adhesive and initial composite type, air-abrasion showed less microleakage except for BeautiBond. The type of initial repaired restorative material did not affect the microleakage. BeautiBond adhesive may not be preferred in resin composite repair in terms of microleakage prevention. Conclusions: Surface treatment with air-abrasion produced the lowest microleakage scores, independent of the adhesive systems and the pre-existing resin composite type. Pre-existing composite type does not affect the microleakage issue. All-in-one adhesive resin (BeautiBond) may not be preferred in resin composite repair in terms of microleakage prevention.

Dental Anxiety and Fear: : Relationship with Oral Health Behavior in a Turkish Population

The aim of this study was to assess fear and anxiety in dental patients. Five hundred patients were evaluated using the Modified Dental Anxiety Scale and the Dental Fear Scale, along with a questionnaire. Oral health status was assessed using the Decayed, Missing, and Filled Teeth (DMFT)/Decayed, Missing, and Filled Surfaces (DMFS) index. Statistic al analysis was performed (P < .05). Sex significantly affected dental anxiety (P < .05), and sex, marital status, having children, and time elapsed since last visit to clinician affected dental fear (P < .05). DMFT/DMFS scores were not related to dental anxiety or fear (P > .05). Female sex alone was a significant predictor of dental anxiety; female sex, adulthood, marriage, having children, and time passed since last visit to a clinician are significant predictors of fear.

Effects of staining and bleaching on a nanohybrid composite with or without surface sealant

Objective: The effect of different staining solutions and a bleaching procedure on color stability and surface roughness of a nanohybrid resin composite were evaluated with or without liquid resin polishing (RP). Materials and Methods: Ninety-six disc-shaped resin composite specimens (A1 Shade, Z550 Filtek 3M ESPE, St. Paul, MN, USA) were prepared and divided randomly into two groups (n = 48). Liquid RP (BisCover LV, Bisco Inc., Schaumburg, IL, USA) was applied in one group (RP) and not in the other (P). Specimen color and surface roughness were determined using a colorimeter and profilometer, respectively. After baseline measurements, each group was divided into four subgroups (n = 12) for immersion in a control (distilled water) or three different staining solutions (ice tea, red wine, and cola) for 1 week. Color and surface roughness were then reevaluated. After measurements, all specimens were bleached using a 35% hydrogen peroxide gel. The color and surface roughness of the specimens were reevaluated. Statistical Analysis: Data were subjected to an analysis of variance for repeated measurements among the groups (P < 0.05). Results: Staining and bleaching did not change the surface roughness of the RP and P groups (P > 0.05). Discoloration in the red wine group was higher than for the other staining solutions for the RP (P < 0.001) and P groups (P = 0.018). Conclusion: Application of liquid RP did not enhance the color stability and surface roughness of the composite resin restoration.

Microtensile bond strength of composite-to-composite repair with different surface treatments and adhesive systems

Objectives: The purpose was to investigate the effect of different surface treatments and bonding agents on the repair bond strength of different resin-based restorative materials by microtensile bond strength (μTBS) testing protocol. Materials and Methods: 24 Grandio SO(VOCO) and 24 Filtek Z250(3 M) resin composite blocks were prepared. Half of the samples (N = 12) were diamond bur-roughened and the other half (N = 12) were sandblasted by 50 μm aluminum oxide particles. They were further divided into four sub-groups (n = 3) and received the following: Sub-Group1: Adper Single Bond2 (Etch&Rinse) (3 M); Sub-Group2: Clearfil SE (Self-etch) (Kuraray); Sub-Group3: Beauty Bond (HEMA-free all-in-one) (Shofu); Sub-Group4: All Bond3 (HEMA-free, hydrophobic, etch&rinse) (Bisco). The samples were repaired by Filtek Z250 to form a block. All of the resultant sub-groups combinations consisted of one of the composite type, surface treatment type, and adhesive systems. A total of 18 groups were prepared including 2 homogeneous blocks. They were thermocycled and μTBS measurements were performed. Data were statistically analyzed with Kruskall–Wallis and Mann–Whitney U tests. Results: The experimental regroups’ μTBS reached to 34.67–66.36% and 43.44–95.52% of the cohesive bond strength for Grandio SO and Z250, respectively. The pre-existing composite type is found to be statistically important. When the surface is bur-finished Grandio performed better; when air-abrasion is considered Z250 showed higher bond strength. All-in-one adhesive system produced the weakest bond strength at all parameters. Conclusion: It may be suggested that when the pre-existing composite is unknown, air-abrasion may be performed with etch&rinse or two-step self-etch adhesives.

The Effect of Different Polishing Sequences on the Adhesion of Streptococcus mutans to Feldspathic Porcelain

The aim of this research was to determine whether extra-oral surface treatments on feldspathic porcelain surfaces influence initial adhesion of Streptococcus mutans. Ninety-six porcelain specimen discs were fabricated and divided into six equal groups according to surface treatment: fine-grit diamond polishing (Group 1); self-glazing (Group 2); overglazing (Group 3); overglazing followed by a finishing procedure and then overglazing (Group 4); Pearl Surface polishing (Group 5); and Diamond Twist SCLTM polishing (Group 6). Surface roughness and hydrophobicity were assessed. An S. mutans suspension was incubated on each specimen group and evaluated. A one-way analysis of variance, post-hoc Tukey honestly significantly different test, Friedman test, and t-test were used for statistical analysis. Group 1 showed the highest surface roughness (p < 0.001) and bacterial adhesion (p < 0.05). Groups 5 and 6 specimen surfaces presented significantly higher contact angles (p < 0.05). Group 1 had the highest S. mutans adhesion, followed by Groups 3, 5, 6, 2, and 4 (p < 0.05). Reglazing after grinding may therefore decrease bacterial adhesion beneficially.

Comparison of microleakage of a multi-mode adhesive system with contemporary adhesives in class II resin restorations

Aim: The aim was to compare the microleakage of resin composite bonded with different adhesive systems in class-II cavities at enamel or dentine margins. Material and methods: 60 extracted human molar teeth received slot cavity preparations on mesial and distal surfaces (mesial cervical margin was prepared in enamel and distal in dentine). They were randomly divided into five groups (n = 12) according to the adhesive system: Group-A: Silorane Bond (S), Group-B: Adper Single Bond 2 (SB), Group-C: Clearfil SE Bond (CSE), Group-D: Single Bond Universal (USel) (selective etch-and-rinse), Group-E: Single Bond Universal (USE) (all-in-one). The preparations were restored using the same resin composite (Filtek Ultimate) except Group A which was restored by Silorane composite. The teeth were thermocycled, immersed in dye, sectioned, and dye penetration was evaluated quantitatively using image analysis. The data were analyzed using the two-way analysis of variance and Bonferroni test. Results: In all groups, there was no statistically significant difference between enamel margins at occlusal and gingival sites (p > 0.05). The statistical difference between Group-A (S) and Group-B (SB) was significant at all margins. Group-B (SB) presented the greatest microleakage amounts at all margins and the highest scores were obtained in the dentine. Likewise, SB demonstrated statistically significant differences between dentine and enamel margins (occlusal and gingival)(p < 0.05). Conclusion: All adhesive systems showed similar microleakage values between enamel margins in occlusal and gingival regions. However, when the gingival margin is located in the dentine, etch&rinse adhesive systems may not be a choice in terms of microleakage prevention.

Clinical evaluation of microhybrid composites in noncarious cervical lesions: 24-month results

Objective: To evaluate the clinical performance of two different microhybrid resin composites in noncarious cervical lesions (NCCLs) after 24 months. Subjects and Methods: Ninety-seven NCCLs were restored with either TPH Spectrum (n = 48) or Filtek Z250 (n = 49) using an etch-and-rinse adhesive in 20 patients. The restorations were clinically evaluated using modified United States Public Health Service criteria for retention, color match, marginal discoloration, marginal adaptation, surface texture, anatomic form, postoperative sensitivity, and secondary caries. The restorations were assessed 1 week after placement (baseline) and after 6, 12, and 24 months. Restoration survival rates were calculated using the Kaplan–Meier procedure estimator, and a log-rank test was used to compare the survival distributions (P < 0.05). Statistical analysis was undertaken using Pearsons Chi-square test and Fishers exact test to assess differences among the restorative materials (P < 0.05). Cochrans Q-test was employed for evaluating differences in the same restorative material between recall periods. Results: The retention rates were 100% at 6 months, 89.6% and 91.8% at 12 months, and 85.4% and 89.8% at 24 months for TPH and Z250, respectively. TPH showed a statistically significant difference in marginal discoloration between the baseline and 24 months results (P < 0.05). Both TPH and Z250 showed statistically significant differences in marginal adaptation between the baseline and 24 months results (P < 0.05). Conclusion: Over the 24-month period, both microhybrid resin composites demonstrated acceptable clinical results in NCCLs.