Esra Yildiz

Evaluation of microhardness, surface roughness, and wear behavior of different types of resin composites polymerized with two different light sources

The microhardness, surface roughness and wear resistance of different types of resin composites, polymerized by a Quartz Tungsten Halogen (QTH) or Light Emitting Diode (LED) light curing units (LCU) were evaluated in this in vitro study. Cylindrical blocks were prepared from composites (8 mm in diameter, and 2 mm in thickness) and polymerized by a LED or a QTH LCU. Vickers hardness was measured on the top and bottom surfaces of the specimens. Surface roughness was measured with a surface profilometer on the top of the specimens. For the wear test, specimens were tested in a conventional pin-on-disc tribology machine under 15 N loads. The statistical analyses were performed by one-way analysis of variance (ANOVA) and t-tests, including the Bonferroni correction. Nanocomposite material Clearfil Majesty Posterior showed the highest hardness values in all polymerization types at the top and bottom surfaces (p < 0.05). Microhybrid Clearfil APX and hybrid Quixfil composites demonstrated the greatest surface roughness. Wear resistance of Clearfil Majesty Posterior was found to be the highest among the other tested resin composites. The results indicated that Clearfil Majesty Posterior demonstrated higher microhardness, less surface roughness, and higher wear resistance when compared with the other tested materials for both polymerization types.

Effects of sports drinks on color stability of nanofilled and microhybrid composites after long-term immersion

OBJECTIVES This study assessed the effects of three sports drinks on the color stability of two nanofilled and two microhybrid composite materials after 1-month and 6-month periods. MATERIALS AND METHODS Twenty-eight disc-shaped specimens (diameter: 10mm and thickness: 2mm) each were made from four resin composites (Clearfil Majesty Posterior, Filtek Supreme, Clearfil APX, and Filtek Z250). All the specimens were stored in distilled water for 24h at 37°C. Then, the baseline color values (L*a*b*) of each specimen were measured using a spectrophotometer according to the CIEL*a*b* color scale. Seven randomly selected specimens from each composite material were then immersed in one of the three sports drinks (Powerade, Red Bull, and Burn) or distilled water (control) for 1 and 6 months. After each immersion, the color values of each specimen were remeasured, and the color change value (ΔE) was calculated. The data were evaluated using the Kruskal-Wallis and Mann-Whitney U-tests. RESULTS The tested resin composites showed color changes over the 6-month evaluation periods. At 1 month, highest level of color changes was observed in the Clearfil APX specimens immersed in Burn (p<0.01). Clearfil Majesty Posterior showed less discoloration in all the composite materials tested after 6 months (p<0.001). Independent of the composite materials tested, Burn resulted in the highest level of discoloration after both immersion periods (p<0.01). CONCLUSION All the test solutions used in the present study caused greater discoloration than the clinically acceptable level of threshold (ΔE<3.3) over the 6-month evaluation period except for Clearfil Majesty Posterior immersed in distilled water (2.91±0.28). The effect of each solution on the color stability of the composite materials depended on the type of solution, exposure time, and composition of the composite material. CLINICAL SIGNIFICANCE The effect of a solution on color stability of composite materials depends on the type of solution, exposure time, and composition of the material. In clinical practice, patients should be aware of the staining effects and erosive potential of sports drinks if consumed a longer period of time.

Micro push-out bond strengths of 2 fiber post types luted using different adhesive strategies

OBJECTIVE The objective of this study was to evaluate the push-out bond strengths of carbon and glass fiber posts adhesively luted with Panavia F 2.0 and RelyX Unicem luting cements, as well as a modified application procedure using RelyX Unicem cement in combination with a single-bottle total-etch adhesive in 3 segments of teeth. STUDY DESIGN Sixty single-rooted human maxillary central incisors and canines were sectioned below the cementoenamel junction, and the roots were endodontically treated. The roots were divided into 2 fiber-post groups, and then divided into 3 subgroups of 10 specimens each to test different luting strategies. Bonded specimens were cut (1-mm-thick sections) and push-out tests were performed (crosshead-speed, 0.5 mm/min). Failure modes were evaluated using a stereomicroscope at original magnification ×40. RESULTS Micro push-out bond strengths were significantly affected by the type of luting agent and the type of post (P < .05). In all root sections, the push-out bond strength values of glass fiber posts were significantly higher than that of carbon fiber posts (P < .05). Moreover, the highest push-out bond strengths were measured for Panavia F 2.0 and RelyX Unicem cements. These values were significantly higher than that of modified application procedure in the medium section for both glass- and carbon-fiber posts, and in the apical root sections only for glass-fiber post (P < .05). In each region, the modified application procedure showed the lowest bond strength values. Adhesive failure between dentin and cement was the most frequent type of failure. CONCLUSIONS In all root segments, the glass fiber post provided significantly increased post retention compared with the carbon fiber post, regardless of the luting strategy used.

Clinical comparison of a flowable composite and fissure sealant: A 24-month split-mouth, randomized, and controlled study

OBJECTIVES The aim of this clinical study was to evaluate the retention rate and caries-prevention effect of a flowable composite compared to a conventional resin-based sealant in a young population over a 24-month period. METHODS Thirty-four patients, ranging in age from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were selected for this randomized split-mouth design trial. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. The teeth were sealed with a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F). Each restoration was independently evaluated in terms of retention and the presence of caries at baseline and at 1, 6, 12, and 24 months. Data were analyzed using non-parametric Mann-Whitney U and Friedman 1-way ANOVA tests at p<0.05. RESULTS Tetric Evo Flow showed complete retention with 100%, 95.5%, 93.8%, and 88.5% at 1, 6, 12, and 24-month evaluations, respectively, while Helioseal F retention rates were 98.1%, 95.5%, 94.8%, and 85.4%, respectively, for the same evaluation periods. At the 24-month recall, 4 (4.2%) total losses were observed in subjects treated with Tetric Evo Flow and 2 total losses (2.1%) for Helioseal F, respectively. No significant differences were observed between the materials in retention rates or caries incidence for each evaluation period (p>0.05). CONCLUSION Placement of flowable composite as fissure sealants in the younger population seems to be as effective as conventional fluoride containing fissure sealants for the prevention of fissure caries. CLINICAL RELEVANCE The use of a flowable composite as a fissure sealant material, in conjunction with a total-etch, single bottle adhesive, yielded better retention than did the conventional fluoride containing resin-based fissure sealant over a 24-month period in young patients.

Retracted: Push-out bond strengths of two fiber post types bonded with different dentin bonding agents

The aim of this study was to evaluate the regional push-out bond strengths for two fiber-reinforced post types using three different dentin bonding agents. Sixty single-rooted extracted human first premolar teeth were sectioned below the cemento-enamel junction, and the roots were endodontically treated. Following standardized post space preparations, the roots were divided into two fiber-post groups (Glassix and Carbopost), and further divided into three subgroups of 10 specimens each for the bonding systems self-etching dentin bonding agents (Clearfil SE Bond and Optibond all-in-one), and total-etching dentin bonding agent (XP Bond). A dual-cure resin luting cement (Maxcem) was then placed in the post spaces and posts were then seated into the root canals polymerized through the cervical portion. The roots were then cut into 3-mm thick sections. Push-out tests were performed at a crosshead speed of 0.5 mm/min. The data were analyzed with multivariate ANOVA (alpha = 0.05). The morphology of interface between different dentin bonding agents from the cervical sections were analyzed with SEM. Glass fiber-reinforced posts demonstrated significantly higher push-out bond strengths than carbon fiber-reinforced posts (p < 0.001). Bond strength values decreased significantly from the cervical to the apical root canal regions (p < 0.001). Self-etching dentin adhesive Clearfil SE Bond and total-etching dentin adhesive XP Bond demonstrated similar bond strengths values and this was significantly higher compared with the Optibond all-in-one in cervical root canal region. In conclusion, in all root segments, the glass fiber-reinforced posts provided significantly increased post retention than the carbon fiber-reinforced posts, regardless of the adhesive used.

Surface hardness evaluation of different composite resin materials: influence of sports and energy drinks immersion after a short-term period

Objectives: This study evaluated the effect of sports and energy drinks on the surface hardness of different composite resin restorative materials over a 1-month period. Material and Methods: A total of 168 specimens: Compoglass F, Filtek Z250, Filtek Supreme, and Premise were prepared using a customized cylindrical metal mould and they were divided into six groups (N=42; n=7 per group). For the control groups, the specimens were stored in distilled water for 24 hours at 37º C and the water was renewed daily. For the experimental groups, the specimens were immersed in 5 mL of one of the following test solutions: Powerade, Gatorade, X-IR, Burn, and Red Bull, for two minutes daily for up to a 1-month test period and all the solutions were refreshed daily. Surface hardness was measured using a Vickers hardness measuring instrument at baseline, after 1-week and 1-month. Data were statistically analyzed using Multivariate repeated measure ANOVA and Bonferronis multiple comparison tests (α=0.05). Results: Multivariate repeated measures ANOVA revealed that there were statistically significant differences in the hardness of the restorative materials in different immersion times (p<0.001) in different solutions (p<0.001). The effect of different solutions on the surface hardness values of the restorative materials was tested using Bonferronis multiple comparison tests, and it was observed that specimens stored in distilled water demonstrated statistically significant lower mean surface hardness reductions when compared to the specimens immersed in sports and energy drinks after a 1-month evaluation period (p<0.001). The compomer was the most affected by an acidic environment, whereas the composite resin materials were the least affected materials. Conclusions: The effect of sports and energy drinks on the surface hardness of a restorative material depends on the duration of exposure time, and the composition of the material.

Shear bond strength of a new self-adhering flowable composite resin for lithium disilicate- reinforced CAD/CAM ceramic material

PURPOSE The purpose of this study was to evaluate and compare the effects of different surface pretreatment techniques on the surface roughness and shear bond strength of a new self-adhering flowable composite resin for use with lithium disilicate-reinforced CAD/CAM ceramic material. MATERIALS AND METHODS A total of one hundred thirty lithium disilicate CAD/CAM ceramic plates with dimensions of 6 mm × 4 mm and 3 mm thick were prepared. Specimens were then assigned into five groups (n=26) as follows: untreated control, coating with 30 µm silica oxide particles (Cojet™ Sand), 9.6% hydrofluoric acid etching, Er:YAG laser irradiation, and grinding with a high-speed fine diamond bur. A self-adhering flowable composite resin (Vertise Flow) was applied onto the pre-treated ceramic plates using the Ultradent shear bond Teflon mold system. Surface roughness was measured by atomic force microscopy. Shear bond strength test were performed using a universal testing machine at a crosshead speed of 1 mm/min. Surface roughness data were analyzed by one-way ANOVA and the Tukey HSD tests. Shear bond strength test values were analyzed by Kruskal-Wallis and Mann-Whitney U tests at α=.05. RESULTS Hydrofluoric acid etching and grinding with high-speed fine diamond bur produced significantly higher surface roughness than the other pretreatment groups (P<.05). Hydrofluoric acid etching and silica coating yielded the highest shear bond strength values (P<.001). CONCLUSION Self-adhering flowable composite resin used as repair composite resin exhibited very low bond strength irrespective of the surface pretreatments used.

Effect of different adhesive strategies on the post-operative sensitivity of class I composite restorations

Objective: To evaluate the post-operative sensitivity of occlusal restorations using different dentin adhesives performed by an undergraduate and a post-doctorate dentist. Materials and Methods: One hundred and eighty-eight molar occlusal restorations were placed in 39 patients (ages between 18 and 30) using 3 different kind of adhesive systems; Optibond FL (OBF), Clearfil Protect Bond (CPB), and iBond (IB) by a post-doctorate dentist or a fifth-year dental student according to the manufacturers′ instructions. Post-operative sensitivity to cold and air was evaluated using a Visual Analog Scale (VAS) after 24 hours, 30, 90, and 180 days. Data were analyzed using the Mann-Whitney U and Friedman tests (P < 0.05). Results: Post-operative sensitivity scores for OBF and CPB were higher for the dental student (P < 0.05), while IB scores did not differ statistical significantly according to the operator (P > 0.05). Conclusion: Operator skill and experience appears to play a role in determining the outcome of post-operative sensitivity of multi-step adhesive systems although the post-operative sensitivity was low. It is suggested that the less experienced clinicians (rather than experienced clinicians) should better use the self-etching dentin bonding systems with reduced application steps to minimize the potential risk of post-operative sensitivity of dental adhesives.

Influence of bleaching regimen and time elapsed on microtensile bond strength of resin composite to enamel

Objectives: The aim of this study was to evaluate the effects of time elapsed since bleaching and different bleaching regimens on the microtensile bond strength of resin composite to enamel. Methodology: Forty flattened buccal enamel surfaces were divided into four groups: An unbleached (control) group and three bleaching groups. Control group specimens were not subjected to a bleaching regimen (Group 1), while those in the bleaching groups were bleached as follows: opalescence 10% (Group 2), whiteness perfect 16% (Group 3), and whiteness hydrogen peroxide 35% (Group 4). Thereafter, the bleached specimens were divided into three subgroups (n = 4 teeth each) for restoration according to predetermined posttreatment time intervals (immediately, 1 week, and 2 weeks). Bonded specimens were then sectioned and subjected to μTBS testing. The data were analyzed using Kruskal–Wallis and Mann–Whitney U-tests at α = 0.05. Results: There was a significant difference in the μTBS of the resin composite to enamel in groups that were bonded immediately after bleaching and in the control group (P < 0.05). Compared to the control group, the μTBS in Groups 2, 3, and 4 decreased significantly 1-week postbleaching (P < 0.05). No significant difference in μTBS was observed between the bleached and unbleached groups 2 weeks after treatment (P > 0.05). Conclusions: Adhesive restorative procedures could not be performed immediately or after 1 week irrespective of the type or concentration of bleaching system used. Composite restorations on bleached enamel surfaces should be performed after an interval of at least 2 weeks.

Initial Consultation and/or Clinical Considerations (Patient History)

Initial consultation is important for both patient and clinician for a joint evaluation of an esthetic treatment plan. Multiple appointments are necessary to create optimal results and satisfactory outcomes for both patient and clinician; hence, a comprehensive evaluation of the patient before initiation of any therapy is mandatory. Sufficient time should be allotted for initial consultation to gather necessary information and response the specific questions related to the case. Thereafter, a detailed medical history of the patient should be gathered to identify the conditions that could contraindicate, complicate, or alter the treatment procedure. In addition, extraoral, muscle, intraoral, periodontal, radiographic, and occlusion examinations should be performed meticulously, with attention also devoted to esthetic considerations.