Duygu Tuncer

Clinical evaluation of different adhesives used in the restoration of non-carious cervical lesions: 24-month results.

BACKGROUND The aim of this study was to compare after 24 months the clinical performance of cervical restorations placed with the use of an etch-and-rinse and an all-in-one adhesive. METHODS Twenty-four patients with at least one pair of non-carious cervical lesions participated in this study. One hundred and twenty-three cervical lesions were restored (62 etch-and-rinse adhesive, Solobond M; 61 all-in-one adhesive, Futurabond NR). A nanohybrid resin composite, Grandio, was used as the restorative material. Restorations were evaluated according to modified USPHS criteria by two independent examiners. The survival rates of the restorations were calculated by the Kaplan-Meier estimator and log-rank test. The restorations in each category were compared using the Pearson chi-square test, while the performance of restorations at the baseline and at each recall time was evaluated by McNemars test (p < 0.05). RESULTS The recall rate of patients was 100%. The retention rates were 82% and 75% at 6 months and 77% and 62% at 12 months for Solobond M and Futurabond NR, respectively. At the 24-month recall, the retention rate was 69% for Solobond M and 49% for Futurabond NR, and this difference was statistically significant (p < 0.05). No statistically significant difference was found for colour match, marginal staining, or marginal adaptation between the adhesives (p > 0.05). None of the restorations had secondary caries, loss of anatomical form, or surface texture changes. CONCLUSIONS Cervical restorations placed with an etch-and-rinse adhesive showed higher retention than an all-in-one adhesive.

Does the temperature of beverages affect the surface roughness, hardness, and color stability of a composite resin?

Objective: To investigate the effect of beverages′ temperature on the surface roughness, hardness, and color stability of a composite resin. Materials and Methods: Fifty specimens of the Filtek Z250 composite (3M ESPE, Dental Products, St.Paul, MN, USA) were prepared and initial roughness, microhardness, and color were measured. Then the specimens were randomly divided into five groups of 10 specimens each: Coffee at 70°C, coffee at 37°C, cola at 10°C, cola at 37°C, and artificial saliva (control). After the samples were subjected to 15 min × 3 cycles per day of exposure to the solutions for 30 days, the final measurements were recorded. Results: After immersion in beverages, the artificial saliva group showed hardness values higher than those of the other groups (P < 0.001) and the microhardness values were significantly different from the initial values in all groups except for the control group. Both cola groups showed roughness values higher than the baseline values (P < 0.05), while the other groups showed values similar to the baseline measurements. When ΔE measurements were examined, the 70°C coffee group showed the highest color change among all the groups (P < 0.05). Conclusion: High-temperature solutions caused alterations in certain properties of composites, such as increased color change, although they did not affect the hardness or roughness of the composite resin material tested.

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.

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.

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.

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.

Repair of Direct Resin Composite Restorations

“Minimally Invasive Dentistry” approach offers unique solutions to prolong the longevity of a defective resin composite restoration with the adhesive technology. A repair of a defective resin composite restoration is indicated when the clinician can replace the defective part of the restoration leaving the intact part in place. Repairing a restoration the dentist avoids unnecessary removal of healthy tooth tissues and iatrogenic further damage to pulp, reduces cost and shortens chair-time. However, since repair of an existing resin composite restoration is indicated after months or years of service life, obtaining a durable bond between the existing and repair resin composite becomes complicated because of leaching of the constituents, water uptake and enzymatic degradation of restoration surface. The interface between the aged and repair composite material can be considered “the weakest link”. Up-to-date, numerous surface treatment modalities have been introduced but none of them has been accepted as the “golden standard”. This chapter summarizes the repair mechanisms of surface treatment methods of the existing resin composite to achieve long lasting and durable bond between the existing and the repair resin composite.

Efficacy of multi-mode adhesive systems on dentin wettability and microtensile bond strength of resin composite

Abstract Purpose: To evaluate the wetting ability and the microtensile bond strength of adhesive systems in various depths of dentin. Materials and Method: 48 extracted human molars cut in half in buccolingual direction. Buccal and lingual surfaces were used to obtain deep (n = 48) and superficial (n = 48) dentin. Groups were divided into 4 subgroups: Self-etch (CSE), etch&rinse (SB), multi-mode self-etch (SAU) and multimode etch&rinse (EAU) adhesive systems. 3 consecutive contact-angle measurements were obtained: T0- 3 μl drop of distilled water on dentin; T1-Droplet of the adhesive; T2- Distilled water after polymerization of the adhesive. After composite build-ups, microtensile measurements were performed. Contact angle data were analysed with analysis of variance for repeated measures. Bond strength data were analyzed by repeated measures analysis of variance, comparisons were made according to the logarithmic values (p < 0.05). Results: The difference between groups was not significant regardless of dentin depth for all measurements (p < 0.05). All groups except CSE enhanced the wetting ability of the adhesive but reduced the wetting ability of distilled water after application of the adhesive (p < 0.05). Regarding adhesive systems, the groups showed no significant difference between bond strengths to various depths of dentin except SAU (p > 0.05); in SAU, bond strength to deep dentine were significantly higher than superficial dentin (p < 0.05). Regarding adhesives’ bond strength, CSE showed significantly greater values than the other groups (p < 0.05). Conclusion: The cavity depth does not affect the bonding ability for all adhesive systems; self-etch adhesive systems might be a better choice since different adhesives may influence the wetting ability and microtensile bond strength of the dentin substrates.

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.

The influence of blood and/or hemostatic agent contamination on Micro-TBS to dentin

Aim: The purpose of this study was to evaluate the effects of blood contamination and hemostatic agent Ankaferd Blood Stopper (ABS: Ankaferd Drug Inc, Istanbul, Turkey) on the microtensile bond strength of a self-etching adhesive. Material and methods: Flat dentin surfaces were created from 40-M teeth and randomly divided to four groups according to contamination and adhesive procedure. The specimens of Group 1 are contaminated with blood; ABS was applied to the specimens of Group 2 after blood contamination and applied to the specimens of Group 3 without blood contamination. Group 4 is control group and self-etching adhesive was applied to all specimens. Teeth were restored with a nanohybrid composite. The specimens were sectioned to the beams and microtensile testing was carried out and the data were statistically analyzed with analysis of variance test. Tukey’s honestly significant difference post hoc test was also performed for multiple comparisons to compare subgroups. Results: Group 4 had the highest strength value, followed by Group 3, while Group 1, which contacts only with blood, had the lowest strength value. Conclusion: ABS has a negative effect on the bond strength of one-step self-etching adhesive system.