Controlled, prospective, randomized, clinical split-mouth evaluation of partial ceramic crowns luted with a new, universal adhesive system/resin cement: results after 18 months.

OBJECTIVES A new universal adhesive with corresponding luting composite was recently marketed which can be used both, in a self-etch or in an etch-and-rinse mode. In this study, the clinical performance of partial ceramic crowns (PCCs) inserted with this adhesive and the corresponding luting material used in a self-etch or selective etch approach was compared with a self-adhesive universal luting material. MATERIAL AND METHODS Three PCCs were placed in a split-mouth design in 50 patients. Two PCCs were luted with a combination of a universal adhesive/resin cement (Scotchbond Universal/RelyX Ultimate, 3M ESPE) with (SB+E)/without (SB-E) selective enamel etching. Another PCC was luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE). Forty-eight patients were evaluated clinically according to FDI criteria at baseline and 6, 12 and 18 months. For statistical analyses, the chi-square test (α = 0.05) and Kaplan-Meier analysis were applied. RESULTS Clinically, no statistically significant differences between groups were detected over time. Within groups, clinically significant increase for criterion "marginal staining" was detected for SB-E over 18 months. Kaplan-Meier analysis revealed significantly higher retention rates for SB+E (97.8 %) and SB-E (95.6 %) in comparison to RXU2 (75.6 %). CONCLUSION The 18-month clinical performance of a new universal adhesive/composite combination showed no differences with respect to bonding strategy and may be recommended for luting PCCs. Longer-term evaluation is needed to confirm superiority of SB+E over SB-E. CLINICAL RELEVANCE At 18 months, the new multi-mode adhesive, Scotchbond Universal, showed clinically reliable results when used for luting PCCs

General diseases and medications in 687 patients reporting on adverse effects from dental materials.

OBJECTIVES Examination of patients claiming adverse effects from dental materials can be very challenging. Particularly, systemic aspects must be considered besides dental and orofacial diseases and allergies. Therefore, the aim of this study was to investigate a cohort of 687 patients reporting on adverse effects from dental materials focusing on findings related to known general diseases or conditions or medication-related findings with relevance to their subjective complaints. METHODS Six hundred eighty-seven patients visiting a specialized consultation on claimed adverse effects from dental materials were retrospectively investigated for their subjective complaints, findings related to known general diseases or conditions, medication-related findings, dental and orofacial findings, or allergies with relevance to their subjective complaints. RESULTS The most frequent subjective complaints were burning mouth (44.1%), taste disorders (28.5%), and dry mouth (23.7%). In 58.4% of the patients, dental and orofacial findings relevant to their complaints could be found. Findings related to known general diseases or conditions or medication-related findings were found in 28.7% or 21.0% of the patients, respectively. Regarding medications, findings related to antihypertensives (10.0%) and psychotropic drugs (5.7%) were found most frequently. Relevant diagnosed allergies toward dental materials were found in 11.9%, hyposalivation in 9.6% of the patients. In 15.1% of the patients, no objectifiable causes for the expressed complaints could be found. CONCLUSIONS For patients complaining of adverse effects from dental materials, findings related to known general diseases or conditions and medications should be given particular consideration, while still in some patients, no objectifiable causes for their complaints can be found. CLINICAL RELEVANCE For patients complaining about adverse effects from dental materials, specialized consultations and close collaboration with experts from other medical fields are eligible

Three-Dimensional Human Cell Cultures for Cytotoxicity Testing of Dental Filling Materials

Cilj: Za uzgoj trodimenzionalnih kultura stanica radi testiranja citotoksičnosti stomatoloških materijala u testu dentinske barijere (DBT) dosad su se rabile “besmrtne” stanice goveđe pulpe. U ovom istraživanju ocijenili smo uporabu stanica dobivenih iz ljudske pulpe koje bi mogle preciznije simulirati kliničku situaciju. Također, testirali smo smolasti kompozitni materijal. Materijali i metode: SV40-transfektirane stanice ljudske pulpe (tHPC) uzgojene su u hidrogelu (fibrin, peptid, kolagen) te su određena mehanička svojstva i vitalnost stanica (MTT I WST-1). Na uzorcima stanica uzgojenih u kolagenu proveden je test proliferacije stanica nakon četiri tjedna (WST-1). Nakon 14 dana na uzgojenim trodimenzionalnim kulturama stanica u kolagenu proveden je DBT test s 200 μm debelim dentinskim diskovima. Nakon inkubacije od 24 sata pod perfuzijom (0.3ml/h) upotrijebljeni su materijali prema uputama proizvođača (1) President (Coltene): negativna (netoksična) kontrola, (2) CaGPG14 (ISO 7405): pozitivna (toksična) kontrola, (3) Tetric EvoCeram (Ivoclar Viadent) s Clearfil SEBond (Kuraray, referentni materijal), (4) N´Durance (Sepodont, testni materijal), (5) N´Durance s Clearfil SEBond. Ocijenjena je vitalnost stanica nakon inkubacije od 24 sata (WST-1). Izračunat je postotak relativne vitalnosti (negativna kontrola = 100%) i provedena je statistička analiza (Kruskal-Wallisov test, p<0.05). Rezultati: Hidrogelovi od fibrina i peptida pokazali su nedostatna mehanička svojstva za DBT. Kolagenski gel pokazao se pogodnim za trodimenzionalnu kulturu stanica tHCP do 21 dan. Nakon toga uzorci su preneseni na DBT analizu te su rezultati bili slični onima iz prijašnjih istraživanja s goveđim stanicama. DBT test, primjenjujući tHPC, u kolagenu nije pokazivao statistički značajne razlike između testiranih materijala s adhezivom i bez njega i referentnih smolastih kompozita. Zaključak: tHCP u kolagenu može nadomjestiti goveđe stanice u DBT testu. Testirani materijal ne uzrokuje oštećenje pulpe ako je prekrivena intaktnim slojem dentina.Objectives: So far, bovine immortalized pulp cells have been used as three dimensional cultures for cytotoxicity testing of filling materials in the dentin barrier test (DBT). In this study, the use of human pulp-derived cells was evaluated, which would better simulate the clinical situation, and a composite material with a new resin base was tested. Materials and Methods: SV40-transfected human pulp cells (tHPC) were cultured in hydrogels (fibrin, peptide, collagen) and mechanical properties and cell viability (MTT or WST-1) were determined. For cell cultures in collagen, a four week - proliferation assay was performed (WST-1). After 14 days of three-dimensional culture in collagen, tHPC were introduced into the DBT with 200 μm dentin disks. After a 24-hour incubation under perfusion (0.3 ml/h), the following materials were applied according to the manufacturers’ instructions (1) President (Coltene): negative (non-toxic) control, (2) CaGPG14 (ISO 7405): positive (toxic) control, (3) Tetric EvoCeram (Ivoclar Vivadent) with Clearfil SEBond (Kuraray, reference material), (4) N´Durance (Sepodont, test material), (5) N´Durance with Clearfil SEBond. Cell viability was determined after 24-hour incubation (WST-1). The percentage of relative viability was calculated (negative control=100%) and statistically analyzed (Kruskal-Wallis-test, p<0.05). Results: Fibrin and peptide gels had insufficient mechanical properties for the DBT. Collagen appeared suitable for three-dimensional cell culture of tHPC for up to 21 days. The cultures could be transferred to the DBT device and results for controls were similar to previous tests with bovine cells. The DBT using tHPC in the collagen showed no statistically significant difference between the test material with and without the adhesive and the reference resin composite. Conclusions: tHPC in collagen can replace bovine cells in the DBT. The tested filling material is not likely to cause pulp damage, if the pulp is covered by an intact dentin layer

Membrane damage as mechanism of photodynamic inactivation using Methylene blue and TMPyP in Escherichia coli and Staphylococcus aureus

The worldwide threat of antibiotic resistance requires alternative strategies to fight bacterial infections. A promising approach to support conventional antibiotic therapy is the antimicrobial photodynamic inactivation (aPDI). The aim of this work was to show further insights into the antimicrobial photodynamic principle using two photosensitizers (PS) of different chemical classes, Methylene Blue (MB) and TMPyP, and the organisms Escherichia coli and Staphylococcus aureus as Gram-negative and Gram-positive representatives. Planktonic cultures of both species were cultured under aerobic conditions for 24 h followed by treatment with MB or TMPyP at various concentrations for an incubation period of 10 min and subsequent irradiation for 10 min. Ability to replicate was evaluated by CFU assay. Accumulation of PS was measured using a spectrophotometer. The cytoplasmic membrane integrity was investigated by flow cytometry using SYBR Green and propidium iodide. In experiments on the replication ability of bacteria after photodynamic treatment with TMPyP or MB, a killing rate of 5 log10 steps of the bacteria was achieved. Concentration-dependent accumulation of both PS was shown by spectrophotometric measurements whereby a higher accumulation of TMPyP and less accumulation of MB was found for S. aureus as compared to E. coli. For the first time, a membrane-damaging effect of TMPyP and MB in both bacterial strains could be shown using flow cytometry analyses. Furthermore, we found that reduction of the replication ability occurs with lower concentrations than needed for membrane damage upon MB suggesting that membrane damage is not the only mechanism of aPDI using MB

Remineralizing amorphous calcium phosphate based composite resins: the influence of inert fillers on monomer conversion, polymerization shrinkage, and microhardness

AIM: To determine if the addition of inert fillers to a bioactive dental restorative composite material affects its degree of conversion (DC), polymerization shrinkage (PS), and microhardness (HV). METHODS: Three amorphous calcium phosphate (ACP)-based composite resins: without added fillers (0-ACP), with 10% of barium-glass fillers (Ba-ACP), and with 10% of silica fillers (Si-ACP), as well as commercial control (Ceram•X, Dentsply DeTrey) were tested in laboratory conditions. The amount of ACP (40%) and the composition of the resin mixture (based on ethoxylated bisphenol A dimethacrylate) was the same for all ACP materials. Fourier transform infrared spectroscopy was used to determine the DC (n = 40), 20 min and 72 h after polymerization. Linear PS and Vickers microhardness (n = 40) were also evaluated. The results were analyzed by paired samples t test, ANOVA, and one-way repeated measures ANOVA with Student-Newman-Keuls or Tukey’s post-hoc test (P = 0.05). RESULTS: The addition of barium fillers significantly increased the DC (20 min) (75.84 ± 0.62%) in comparison to 0-ACP (73.92 ± 3.08%), but the addition of silica fillers lowered the DC (71.00 ± 0.57%). Ceram•X had the lowest DC (54.93 ± 1.00%) and linear PS (1.01 ± 0.24%) but the highest HV (20.73 ± 2.09). PS was significantly reduced (P < 0.010) in both Ba-ACP (1.13 ± 0.25%) and Si-ACP (1.17 ± 0.19%) compared to 0-ACP (1.43 ± 0.21%). HV was significantly higher in Si-ACP (12.82 ± 1.30) than in 0-ACP (10.54 ± 0.86) and Ba-ACP (10.75 ± 0.62) (P < 0.010). CONCLUSION: Incorporation of inert fillers to bioactive remineralizing composites enhanced their physical-mechanical performance in laboratory conditions. Both added fillers reduced the PS while maintaining high levels of the DC. Silica fillers additionally moderately improved the HV of ACP composites

Randomized clinical split-mouth study on a novel self-adhesive bulk-fill restorative vs. a conventional bulk-fill composite for restoration of class II cavities – results after three years

Objectives This randomized prospective split-mouth study evaluated the clinical performance of a novel, tooth-colored, self-adhesive bulk-fill restorative (SABF, 3M) for restoration of class II cavities as compared to a conventional bulk-fill composite (Filtek One, 3M; FOBF) over 36 months. The null-hypothesis was that both materials perform equally regarding clinical success and performance according to the FDI clinical criteria and scoring system. Methods 30 patients received one SABF and one FOBF restoration each. For FOBF, Scotchbond Universal (3M) was used as adhesive (self-etch mode), whereas SABF was applied without adhesive. Two blinded examiners evaluated the restorations at baseline, 24 and 36 months using FDI criteria. Data were analyzed non-parametrically (χ2-tests; α=0.05). Results 29 patients were available for the 24- and 36-month examinations. Clinical success rate was 96.6% for both materials at 36-mo (one restoration failure due to secondary caries each). All other restorations revealed clinically acceptable FDI scores at all recalls. FOBF performed significantly better than SABF at all time points regarding surface lustre (p<0.001) and color match and translucency (p<0.001) and regarding marginal staining at 36-months (p=0.008). Marginal staining and marginal adaptation deteriorated significantly over time for both materials (both p<0.001). Conclusions The null-hypothesis could only partially be rejected. Both materials performed similarly regarding clinical success and performance within 36 months of clinical service, but SABF exhibited significantly inferior, but clinically fully acceptable esthetic properties as compared to FOBF. Both restorative materials showed clinically fully acceptable results over 36 months of clinical service and thus may be recommended for clinical use. Clinical significance The novel tooth-colored self-adhesive bulk-fill restorative exhibited clinically fully acceptable results over 36 months of clinical service, similarly to a conventional bulk-fill restorative used with a universal adhesive, but with slight shortcomings in esthetic properties. Therefore, both restorative materials may be recommended for clinical use

The Optimal Effective Concentration Combination (OPECC) as a Novel Method for Evaluating the Effects of Binary Application of Antibacterial Compounds

Combination therapies appear to be beneficial for preventing bacterial resistance to antibacterial approaches. The aim of this study was to define and determine an optimal effective concentration combination (OPECC) for binary application of antibacterial compounds. The antiseptics chlorhexidine (CHX), benzalkonium chloride (BAC), and cetylpyridinium chloride (CPC), as well as the antibiotic ciprofloxacin (CIP), were tested against planktonic Escherichia coli in binary combinations by applying a checkerboard assay, and then evaluated according to the established synergism principles. Extending the checkerboard method, the optical density (OD) of the wells was measured photometrically. On the borderline between effective (OD = 0) and non-effective (OD > 0) eradication of the bacterial cultures, the OPECC was determined. Binary combinations of CPC or CHX with BAC were assessed as either synergistic or indifferent, respectively, while there was no OPECC to calculate. For all other binary combinations, an OPECC was derivable, and these were assessed as either synergistic or indifferent. In conclusion, the evaluation of the binary combination application of antibacterial compounds based on the checkerboard method was refined to such an extent that it was possible to determine at least one concentration pair that could be defined and considered as an OPECC, independently of the evaluation of the system according to the different synergy principles. In general, the method presented herein for determining an OPECC can be applied to any conceivable method or system aimed at the eradication of a pathogen

Antibacterial efficacy of cold atmospheric plasma against Enterococcus faecalis planktonic cultures and biofilms in vitro

Nosocomial infections have become a serious threat in our times and are getting more difficult to handle due to increasing development of resistances in bacteria. In this light, cold atmospheric plasma (CAP), which is known to effectively inactivate microorganisms, may be a promising alternative for application in the fields of dentistry and dermatology. CAPs are partly ionised gases, which operate at low temperature and are composed of electrons, ions, excited atoms and molecules, reactive oxygen and nitrogen species. In this study, the effect of CAP generated from ambient air was investigated against Enterococcus faecalis, grown on agar plates or as biofilms cultured for up to 72 h. CAP reduced the colony forming units (CFU) on agar plates by > 7 log10 steps. Treatment of 24 h old biofilms of E. faecalis resulted in CFU-reductions by ≥ 3 log10 steps after CAP treatment for 5 min and by ≥ 5 log10 steps after CAP treatment for 10 min. In biofilm experiments, chlorhexidine (CHX) and UVC radiation served as positive controls and were only slightly more effective than CAP. There was no damage of cytoplasmic membranes upon CAP treatment as shown by spectrometric measurements for release of nucleic acids. Thus, membrane damage seems not to be the primary mechanism of action for CAP towards E. faecalis. Overall, CAP showed pronounced antimicrobial efficacy against E. faecalis on agar plates as well as in biofilms similar to positive controls CHX or UVC

Antimicrobial efficacy of irradiation with visible light on oral bacteria in vitro: a systematic review

AIM: Resistances to antibiotics employed for treatment of infectious diseases have increased to alarming numbers making it more and more difficult to treat diseases caused by microorganisms resistant to common antibiotics. Consequently, novel methods for successful inactivation of pathogens are required. In this instance, one alternative could be application of light for treatment of topical infections. Antimicrobial properties of UV light are well documented, but due to its DNA-damaging properties use for medical purposes is limited. In contrast, irradiation with visible light may be more promising. METHODS: Literature was systematically screened for research concerning inactivation of main oral bacterial species by means of visible light. RESULTS: Inactivation of bacterial species, especially pigmented ones, in planktonic state showed promising results. There is a lack of research examining the situation when organized as biofilms. CONCLUSION: More research concerning situation in a biofilm state is required

General diseases and medications in 687 patients reporting on adverse effects from dental materials

Objectives Examination of patients claiming adverse effects from dental materials can be very challenging. Particularly, systemic aspects must be considered besides dental and orofacial diseases and allergies. Therefore, the aim of this study was to investigate a cohort of 687 patients reporting on adverse effects from dental materials focusing on findings related to known general diseases or conditions or medication-related findings with relevance to their subjective complaints. Methods Six hundred eighty-seven patients visiting a specialized consultation on claimed adverse effects from dental materials were retrospectively investigated for their subjective complaints, findings related to known general diseases or conditions, medication-related findings, dental and orofacial findings, or allergies with relevance to their subjective complaints. Results The most frequent subjective complaints were burning mouth (44.1%), taste disorders (28.5%), and dry mouth (23.7%). In 58.4% of the patients, dental and orofacial findings relevant to their complaints could be found. Findings related to known general diseases or conditions or medication-related findings were found in 28.7% or 21.0% of the patients, respectively. Regarding medications, findings related to antihypertensives (10.0%) and psychotropic drugs (5.7%) were found most frequently. Relevant diagnosed allergies toward dental materials were found in 11.9%, hyposalivation in 9.6% of the patients. In 15.1% of the patients, no objectifiable causes for the expressed complaints could be found. Conclusions For patients complaining of adverse effects from dental materials, findings related to known general diseases or conditions and medications should be given particular consideration, while still in some patients, no objectifiable causes for their complaints can be found. Clinical relevance For patients complaining about adverse effects from dental materials, specialized consultations and close collaboration with experts from other medical fields are eligible