Benchmarking of pluck lesions at slaughter as a health monitoring tool for pigs slaughtered at 170 kg (heavy pigs)

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The effect of chlorhexidine primer application on the clinical performance of composite restorations: a literature review

AbstractTo discuss the effectiveness of chlorhexidine (CHX) used as therapeutic dentin primer in adhesively bonded composite restorations.OverviewAn electronic search in MEDLINE database, accessed through PubMed was conducted. No restrictions of languages and date of publication were made. The following key words were used: "chlorhexidine", "composite" and "composite resins." Clinical studies in which CHX was used during bonding procedures were included in this review. Six studies met the inclusion criteria. Of these, five studies were carried out on noncarious cervical lesions (NCCL). Only one study was carried out on class II preparation of permanent molars. In all studies, either etch‐and‐rinse and self‐etch adhesive systems were used during bonding procedures. On the basis of the reviewed clinical trials, it can be concluded that CHX primer application does not seem to influence clinical outcome of composite restorations.Clinical significanceCurrent scientific evidence cannot neither strongly recommend nor discourage the application of CHX as therapeutic primer in composite restorations. Studies with longer follow‐up periods with adhesive restorations placed on dentin after caries removal, rather than only on NCCL, are desirable to further investigate the therapeutic effect of CHX during bonding procedures

Structurally compromised teeth. Part II: A novel approach to peripheral build up procedures

ObjectiveTo introduce the "Peripheral Build-Up technique - PBUt" as a foundation restoration strategy for structurally compromised teeth (SCT). Clinical ConsiderationsSeveral strategies have been proposed over time (cervical marginal relocation, doughnut, and preformed ring techniques) to enable the management of restorative procedures in challenging situations such as the presence of deep subgingival defects. The PBUt is a versatile, completely additive direct technique that share some strategical concepts with these techniques to approach critical clinical situations while supplying a wider field of application thanks to distinct operative expedients. The clamp insertion modality, the extension of the proximal wall and the matrix customization/stabilization strategies adopted in PBUt endorse the possibility to manage the most apical and peripheral border of the residual tooth structure when located up to >1.5 mm above the bone crest. The periodontal response has to be then monitored over time. Moreover, thanks to the peripheral and apically-extended addictive approach, it allows a massive preservation of residual sound tooth structure and improves the resistance and retentive physical/geometrical features of the abutment tooth. The PBUt operative workflow is herein explained. Clinical SignificanceThe Peripheral-Build-Up technique (PBUt) advocates some innovative clinical restorative steps for the management of SCT with coronal and deep subgingival defects

Effect of shelf-life of a universal adhesive to dentin

The microtensile bond strength (\u3bcTBS), nanoleakage expression (NL), and endogenous enzymatic activity of a simplified universal adhesive system used in combination with a dual-cure resin cement for luting indirect restorations were evaluated considering its shelf-life (as-received vs expired). The universal adhesive was used asreceived (AS-R) by manufacturer or after three months after being expired (EXP). Resin composite overlays (n \ubc 10) were luted to flat deep coronal dentin surfaces with a universal bonding system (iBond universal, used in the self-etch mode) in combination with a dual-cure resin cement (RelyX Ultimate; 20s of light-cure followed by 15 min of self-cure at 37 \ufffdC). After 24 h, the specimens were cut into microtensile sticks (1 mm2) and stressed to failure under tension, in accordance with ISO/TS 11.405. The fracture pattern was evaluated with optical microscopy. The significance level of p \ubc 0.05 was used for the statistical analysis. Additional specimens (n \ubc 4) were processed for quantitative interfacial nanoleakage expression using ammoniacal silver nitrate. To investigate the endogenous enzymatic activity within the hybrid layer in situ zymography was performed. The EXP group obtained significantly lower \u3bcTBS values than those recorded in the AS-R group (p < 0.05). NL resulted in higher deposition of AgNO3 granules when the adhesive was used in the EXP group compared to the AS-R bonding system. In situ zymography assay revealed increased level of fluorescence when the universal bonding system was used at the end of shelf-life compared to the AS-R group. The use of the universal adhesive system beyond the expiry limit resulted in decreased bonding performances. Furthermore, the higher endogenous enzymatic activity recorded after the end of the shelf life of the universal adhesive would portend for a shortened durability of the restorations

Effect of Endodontic Irrigating Solutions on Radicular Dentine Structure and Matrix Metalloproteinases-A Comprehensive Review

: Irrigating solutions play an important role in the eradication of intracanal microbes and debris dissolution during endodontic treatment. Different combinations of solutions and protocols have been advocated, with sodium hypochlorite (NaOCl), ethylenediamine tetra acetic acid (EDTA), and chlorhexidine (CHX) remaining the most widely used ones by many clinicians. Although these solutions provide efficient inorganic dissolution and antimicrobial capacity, their use has also been reported to cause undesired effects on root dentin composition and mechanical and biomechanical properties, such as microhardness, surface roughness, bond strength, and matrix metalloproteinase (MMP) activity. Several corroborating studies attribute these changes in mechanical properties of dentine to the use of irrigating solutions, and there are limited reports on how the solutions affect the expression of MMPs, which may be a correlating link to understanding the role of these enzymes in dentin collagen and changes in the mechanical properties of dentin. Hence, using the basis of several studies from the literature, the objective is to comprehensively review the influence of individual and combined irrigating solutions on root dentine structure and the activity of the MMPs

Resin composite cements: Current status and a novel classification proposal

ObjectivesCurrently, a classification of resin cements that includes relatively recently formulated ("universal") cements is lacking. Furthermore, the terminology used to define different resin cements in the scientific reports is inconsistent. Accordingly, this work aims to: (i) propose a novel classification of resin composite cements; (ii) disambiguate the term "universal cements" and (iii) present an overview of the properties of these cements. MethodsAn analysis of peer-reviewed literature (PubMed search), as well as market research on definitive resin composite cements were performed. ResultsA tendency toward simplified and versatile luting materials was observed both in the scientific literature and on the dental market with the advent of self-adhesive/one-step resin cements. However, additional priming procedures were necessary to improve their bonding performance in certain clinical situations. Hence, several cements that can be applied both in adhesive and self-adhesive mode were introduced. These cements are associated with a universal adhesive resin, that can be used as a tooth and/or restorative material primer, without the need for other priming systems, regardless of the substrate. These systems should be considered truly universal. Therefore, we hereby suggested a new classification of resin-based cements: (1) adhesive/multi-step; (2) self-adhesive/one-step; (3) universal cements (one- or multi-step). Despite promising in vitro results, clinical trials and long-track laboratory studies are necessary to confirm the reliability of the universal cements. ConclusionsThis review presented the current advances in the field of resin-based cements, which are reflected in the proposed classification. The term "universal cement" was disambiguated, which will help standardize the terminology used in published research. Clinical SignificanceThe classification of resin-based cements and a better understanding of the proper terminology will help standardize the terminology in published research, as well as improve the understanding of the clinical practitioners of the different indications and possible modalities of use of the available cements

Selective adhesive luting: A novel technique for improving adhesion achieved by universal resin cements

Objective: We aimed to introduce the concept of "Selective adhesive luting-SAL" which is explained through clinical steps and supported by preliminary laboratory evidence. Clinical considerations: Cementation with rubber dam is difficult to perform in case of short abutment teeth and/or subgingival crown margins. By means of universal resin cements/universal adhesive systems, which can be employed in self-adhesive as well as adhesive luting procedures, this paper presents a novel technique allowing clinicians to perform reliable cementation where rubber dam isolation is difficult. The SAL technique entails the application of a universal adhesive system only on easily accessible abutment surfaces, enabling simultaneous adhesive and self-adhesive luting in different portions of the abutment. The SAL clinical workflow is explained through prosthodontic rehabilitation of maxillary right central incisor affected by microdontia and restored with a lithium-disilicate crown. Furthermore, our laboratory microshear bond strength study supports the rationale behind SAL application demonstrating higher bond strength even when the adhesive resin is placed only on one portion of the cementation substrate. Clinical significance: This article advocates the application of SAL technique in clinical situations where effective adhesive luting is uncertain, since it can improve the adhesion between the tooth and universal resin cements

Does immediate dentin sealing influence postoperative sensitivity in teeth restored with indirect restorations?:A systematic review and meta-analysis

OBJECTIVE: This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and clinical performance of indirect restorations. MATERIALS AND METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta‐analyses statement, and was guided by the PICOS strategy. Clinical trials in which adult patients received at least one indirect restoration cemented with IDS approach and one restoration cemented following the delayed dentin sealing (DDS) were considered. RESULTS: Following title screening and full‐text reading, four studies met the inclusion criteria and were included for qualitative synthesis, while two studies were selected for quantitative synthesis. According to Risk of bias‐2 tool, two studies were classified as “some concerns” for the outcome POS. No statistically significant differences were found between teeth restored with indirect restorations using the IDS and DDS approach for POS (p > 0.05), neither at the baseline (very low certainty of evidence according to GRADE) nor after 2 years of follow‐up (low certainty of evidence according to GRADE). CONCLUSION: There is low‐certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations. CLINICAL SIGNIFICANCE: There is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations

The effect of carbodiimide on push-out bond strength of fiber posts and endogenous enzymatic activity

BackgroundTo investigate the effect of 0.3 M 1-ethyl-3(3-dimethylaminopropyl) carbodiimide (EDC) aqueous solution pretreatment on push-out bond strength (PBS) and matrix-metalloproteinases (MMPs) activity within radicular dentin when different post cementation strategies were employed.MethodsOne hundred and twenty monoradicular human teeth were endodontically treated and randomly divided into six groups, depending on the cementation strategy and root dentin pretreatment (n = 20): EAR: cementation with an etch-and-rinse adhesive (LuxaBond Total Etch, DMG) and resin cement (LuxaCore Z Dual, DMG); EAR/EDC: 1 min EDC pretreatment after etching + EAR; SE: cementation with a self-etch primer (Multilink Primer, Ivoclar Vivadent) and corresponding cement (Multilink Automix, Ivoclar Vivadent); SE/EDC: self-etch primer + EDC pretreatment + SE; SA: cementation with a universal self-adhesive cement (RelyX Universal, 3 M); SA/EDC: EDC pretreatment + SA. Slices were submitted to PBS test and interfacial nanoleakage evaluation 24 h after cementation or after thermocycling (40.000 cycles, 5-55 & DEG;C). To investigate the effect of EDC on MMPs activity, 4 additional first maxillary premolars per group were processed for in situ zymography analysis. Multivariate ANOVA and post hoc Tukey tests were used to analyze PBS values. The data from in situ zymography were analyzed with Kruskal-Wallis test and Dunn's pairwise multiple comparison procedures (& alpha; = 0.05).ResultsThe variables "EDC pretreatment", "root region" and "thermocycling" significantly influenced PBS (p < 0.05), while the variable "cementation strategy" had no influence (p > 0.05). Thermocycling significantly reduced PBS in SE and SA groups (p < 0.05). EDC was effective in preserving PBS after artificial aging. EDC pretreatment significantly reduced enzymatic activity at baseline in EAR and SE groups, and in SA group after thermocycling (p < 0.05).ConclusionsThe use of EDC prevents the reduction of bond-strength values after artificial aging and silences endogenous enzymatic activity within radicular dentin when different cementation strategies were employed

Glutaraldehyde-based desensitizers' influence on bonding performances and dentin enzymatic activity of universal adhesives

Objectives: To evaluate the influence of two glutaraldehyde-based desensitizers (L: GLUMA Desensitizer, Heraeus Kulzer and G: GLUMA Desensitizer PowerGel) prior to the adhesive procedures on microtensile bond strength (& mu;TBS) to dentin and endogenous enzymatic activity. Methods: Noncarious human third molars (N = 48) were cut to expose middle coronal dentin. Six experimental groups were formed according to the dentin pre-treatment (L or G) and the universal adhesives (IBU -iBond universal, Kulzer or AU -Adhese Universal, Ivoclar Vivadent) used in the self-etch mode (n = 8): 1) L/IBU; 2) G/ IBU; 3) IBU; 4) L/AU; 5) G/AU; 6) AU. Specimens were cut into sticks and stressed until failure after 24 h (T0) or 1 yr of aging (T12). Additional 4 teeth were used for in situ zymography evaluation and data were statistically analyzed (& alpha; = 0.05). Results: Dentin pre-treatment, adhesive and aging statistically influenced bond strength and enzymatic activity (P<0.001). AU demonstrated higher bond strength values than IBU (P<0.001). The L resulted in higher bond strength compared to the G and control groups (P<0.001). aging statistically influenced bonding performance, especially when no dentin pre-treatment was performed (P<0.001). In situ zymography revealed that at baseline the control groups exhibited lower interfacial fluorescence compared to the experimental groups, irrespective of the adhesive used (P<0,001). However, after 1 yr of artificial storage, no differences were found among the groups (P>0.05). Conclusions: : Glutharldeadeyde-based products increased bond strength and determined a stabilization of the adhesive interface over time apparently not related to the MMPs inhibition. Clinical Significance: The results of this in vitro study suggest that the application of glutaraldehyde-based de-sensitizers prior to the adhesive procedures when associated with universal adhesives could result in increased bond strength and stabilization of the adhesive interface over time