Effect of a Desensitizing Varnish on Microleakage of Two Self-Etch Adhesives

Objectives: The aim of this in-vitro experimental study was to assess the effect of application of a desensitizing varnish on the enamel and dentin marginal seal. Materials and Methods: Seventy-two freshly extracted, intact human premolar teeth were divided into four groups (n=18). Class V cavities (3mm in length, 2mm in width and 2mm in depth) were prepared on the buccal surface of each tooth. The following sealing materials were applied in the four groups: One-step Clearfil S3 Bond (S3) self-etch adhesive, two-step Clearfil SE Bond (SE) self-etch adhesive, S3 Bond+ VivaSens desensitizing varnish (VS+S3) and Clearfil SE Bond + VivaSens (VS+SE). The cavities on the teeth were then incrementally filled with Z350 light-cure composite. The teeth were stored in distilled water for 24 hours at 37°C, and were then thermocycled for 1000 cycles. Then, all the specimens were prepared for dye penetration test and were immersed in 2% basic fuchsin dye and incubated at 37°C for 24 hours. The teeth were then sectioned buccolingually along the center of restorations with a diamond disk.   Microleakage at the tooth-restoration interface was assessed in the enamel and dentin margins blindly using dye penetration under a stereomicroscope at ×20 magnification. Results: There was significantly greater leakage at the enamel and dentin margins in group VS+SE than in group SE; also, these values were higher in group VS+S3 than in S3. Conclusion: Combined application of desensitizing varnish and self-etch adhesives seems to increase microleakage in composite restorations. Thus, its application is not suggested

Effect of Re-etching of Oxalate-Occluded Dentin on Microleakage of Composite Resin Restorations

Objectives: This study aimed to assess the effect of re-etching of desensitized dentin for five and 10 seconds on marginal microleakage of composite restorations. Materials and Methods: Class V cavities (4x2x2mm) were prepared on the buccal surfaces of 64 third molars and randomly divided into four groups of 16. In the control group, Single Bond (SB) adhesive was applied after etching. In BB+SB group, after application of BisBlock (BB) desensitizer agent (which needs etching), SB adhesive was used. In BB+5E+SB group, re-etching of dentin was done for five seconds after application of desensitizer, and then the adhesive was applied. The process in BB+10E+SB was the same as BB+5E+SB group except for re-etching time, which was 10 seconds. The cavities were restored with composite resin. After 24 hours of storage in distilled water and 10,000 thermal cycles, all samples were subjected to dye penetration test. The teeth were sectioned buccolingually in the middle of restorations. A blind examiner observed the sections under a stereomicroscope. Results: At the occlusal margins, no significant difference in microleakage was observed among the groups (P>0.05). Application of BB in combination with SB had no effect in comparison to the control group (P>0.05); while there were significant differences in microleakage scores between BB+10E+SB and control (P=0.002), BB+10E+SB and BB+SB (P<0.001) and BB+5E+SB and BB+SB groups (P=0.009). Conclusions: Dentin re-etching after application of BB desensitizer increased the gingival microleakage of class V composite restorations. Application of BB desensitizer combined with SB adhesive enhanced marginal seal.

Perception of Laypeople and Dental Professionals of Smile Esthetics

Objectives: This study aimed to assess and compare the perception of laypersons and dental professionals of smile esthetics based on two factors namely gingival display and alignment of teeth. Materials and Methods: A total of 32 females were randomly selected among dental students in the International Campus of School of Dentistry, Tehran University of Medical Sciences (Tehran, Iran) with no previous history of esthetic dental work. Frontal photographs were obtained and cropped from the subnasal to menton areas of subjects to standardize the size of pictures. Three series of slides were prepared of the pictures using Microsoft PowerPoint software. The first series of slides were shown to familiarize the observers with the images. The second and third series were displayed for the observers and they were then asked to fill out a questionnaire. The group of observers included 10 dental specialists and 10 laypersons. Each observer was given a visual analog scale (VAS) chart for scoring (1-10). After completion of the questionnaires, data were transferred to a computer and the differences in judgments of professionals and laypeople were analyzed using the Mann Whitney test. Results: No significant difference was found in the judgments of professionals and laypeople on evaluating overall smile esthetics, gingival display and alignment of teeth except for the slide showing a reverse smile arc. Conclusions: Laypeople and professionals had similar perceptions of smile esthetics. Thus, it appears that clinicians can rely on the judgment of laypersons in esthetic dental treatments. Keywords: Smiling; Perception; Esthetics, Denta

Effect of Chlorhexidine Application Protocol on Durability of Marginal Seal of Class V Restorations

Objectives: This study aimed to evaluate the effect of chlorhexidine (CHX) application protocol on durability of marginal seal of class V composite restorations. Materials and Methods: Class V cavities (4×2×1.5mm) were prepared in the buccal surfaces of 160 human third molars. The teeth were randomly divided into five groups (n=32) of (G1) CHX+rinse+etching, (G2) CHX+etching, (G3) etching+CHX+rinse, (G4) etching+ CHX, and (G5) etching alone as the control group. Adper Single Bond 2 was applied as an etch and rinse (E & R) bonding system. Cavities were filled with Z350 composite. Half of the teeth in each group were stored in distilled water for 24 hours and the other half were thermocycled (10,000 cycles, 5-55˚C). For dye penetration test, the teeth were sectioned buccolingually and assessed at the enamel and dentin margins under a stereomicroscope at ×20 magnification. The Kruskal-Wallis, Dunn and Mann-Whitney tests were used for statistical analyses. Results: There was no significant difference in immediate microleakage among the groups at the enamel and dentin margins (P= 0.894). After thermocycling, there was significantly less microleakage in G4 than the control group at dentin margin. There were significant differences in microleakage between G4 and G1(P=0.002), G4 and G2 (P=0.001) and G4 and G5 (P= 0.001) at dentin margin. Conclusions: Application of CHX after etching without rinsing is effective to decrease microleakage. However, it has no effect if applied before etching in use of this particular type of E & R adhesive after thermocycling.

Shear Bond Strength of Self-Adhesive Composite Containing TiO2 and SiO2 Nanoparticles with an Additional Etching Step for Orthodontic Brackets Bonding to Enamel

Introduction: Recently, nanoparticles such as nano-TiO2 have been added to some dental materials for enhancing dental carries prevention due to their antibacterial activity.Aim: This study aimed to assess the shear bond strength of a self-adhesive composite containing TiO2 and SiO2 nanoparticles for orthodontic bracket bonding.Materials and methods: This in vitro, experimental study was done on 70 extracted human premolars divided into 7 groups. Six groups of Vertise Flow self-adhesive composite samples were prepared: without any nanoparticles, with 0.5% and 1% TiO2 nanoparticles, 0.5% and 1% SiO2 nanoparticles, and 1% mixture of TiO2 and SiO2 nanoparticles so that nano-hybrid composites were prepared. Metal brackets were bonded with these samples as well as Transbond XT as the control group. The shear bond strength of the brackets to enamel was measured using a universal testing machine. The adhesive remnant index (ARI) score was also determined by a stereomicroscope. Data were analyzed by one-way ANOVA, Tukey’s test and Kruskal-Wallis test.Results: The shear bond strength of the groups was significantly different (p=0.000). Pairwise comparisons revealed that the bond strength of Transbond XT group was significantly higher than others (p<0.05), followed by the 1% TiO2 group with significant differences with Vertise Flow and 0.5% TiO2 groups. The lowest value belonged to Vertise Flow with no nanoparticles. The ARI scores was different in the control group (p=0.000).Conclusions: Adding TiO2 and SiO2 nanoparticles to Vertise Flow self-adhesive composite not only did not adversely affect its shear bond strength, but also slightly increased it. Overall, the self-adhesive nano-hybrid composite containing TiO2 and/or SiO2 nanoparticles, following an additional etching step would be acceptable for bracket bonding and can be used clinically to benefit from the antimicrobial activity of these nanoparticles