Clinical performance of an alkasite-based bioactive restorative in class II cavities: a randomized clinical trial

Objective: This clinical study aimed to evaluate the clinical performance of an alkasite-based bioactive material by comparing it with a resin composite (RC) in the restoration of Class II cavities over a year. Methodology: A hundred Class II cavities were restored at 31 participants. Groups were as follows: Cention N (CN) (Ivoclar Vivadent, Schaan, Liechtenstein) and G-ænial Posterior (GP) (GC, Tokyo, Japan) in combination with G-Premio Bond (etch&rinse). Restorative systems were applied following manufacturers’ instructions. They were finished and polished immediately after placement and scored based on retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified USPHS criteria after 1 week (baseline), 6 months, and 12 months. Statistical analyses were performed using chi-square, McNemar’s, and Kaplan Meier tests. Results: After 12 months, the recall rate was 87%. Survival rates of CN and GP restorations were 92.5% and 97.7%, respectively. Three CN and one GP restorations lost retention. Seven CN (17.9%) and five (11.6%) GP restorations were scored as bravo for marginal adaptation and no significant difference was seen between groups (p=0.363). One (2.7%) CN and two GP (4.7%) restorations were scored as bravo for marginal discoloration, but no significant difference was observed between groups(p=1.00). For surface texture, three (8.1%) CN and three (7%) GP restorations were scored as bravo (p=1.00). None of the restorations demonstrated post-operative sensitivity or secondary caries at any examinations. Conclusion: The tested restorative materials performed similar successful clinical performances after 12 months. ClinicalTrials.gov (NTC04825379)

One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial

Objective: This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months. Methodology: 134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer’s instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar’s tests were used to detect differences over time. Results: After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months. Conclusion: Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year. Clinical relevance: Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases

Comparison of different universal adhesives’ bond strength to laser-assisted bleached enamel

Objective: The aim of this in vitro study was to evaluate the bond strength of several universal adhesives used in different application modes to laser-assisted bleached enamel.Materials and Methods: Freshly extracted 72 sound bovine incisors were used for the study. The teeth were bleached with 38% of hydrogen peroxide gel that was activated with a diode laser (Epic). The diode laser with a 949nm wavelength was used at 7 W in continuous mode for 30 s. After bleaching procedure, the teeth were kept in artificial saliva for 2 weeks. The bleached teeth were randomly assigned into three groups according to different universal adhesive systems (n=24); Single Bond Universal-SU, All-Bond Universal-ABU and Adhese Universal-ADU. All adhesives were applied in two modes: a- etch&rinse (ER); and b- self etch (SE). A cylinder-shaped resin composite was placed on treated surfaces and cured. After storage of specimen in distilled water for 24 h, they were subjected to shear bond strength test. Data were analyzed using two-way ANOVA followed by Bonferroni test (α = 0.05) Results: The highest mean shear bond strength values were obtained in Single Bond Universal group used in self-etch mode (p<0.05). No difference was observed between All-Bond Universal and Adhese Universal. In etch&rinse application mode, Adhese Universal resulted in significantly lower bond strength values (p<0.05) than Single Bond Universal and All-Bond Universal. For all groups, etch&rinse application mode caused significantly higher bond strength values. Conclusion: The bonding performance of tested universal adhesives was enhanced with the etch&rinse mode application  to diode laser- assisted bleached enamel. Key Words: Diode laser, universal adhesives, bleachin

Clinical Evaluation of a Self-Adhering Flowable Resin Composite in Minimally Invasive Class I Cavities: 5-year Results of a Double Blind Randomized, Controlled Clinical Trial

Svrha istraživanja: Cilj ovog istraživanja bio je procijeniti dugoročne kliničke rezultate samoadhezivnog tekućeg kompozita u usporedbi s konvencionalnim tekućim kompozitom u kombinaciji s jetkajuće-ispirućim adhezivom u minimalno invazivnim kavitetima I. razreda. Materijali i metode: Na zubima dvadeset i pet pacijenata izrađena su barem po dva ispuna I. razreda (n = 65). Nakon što su preparirani kaviteti I. razreda, nasumično su restaurirani ili samoadhezivnim tekućim kompozitom (Vertise-Flow/Kerr-VR) [skupina 1 (n = 33)], ili konvencionalnim tekućim kompozitom (Luxaflow/DMG-LX) u kombinaciji s jetkajuće-ispirućim adhezivnim sustavom (Teco/DMG) [skupina 2 (n = 32)] prema uputama proizvođača. Dva istraživača procijenila su početne vrijednosti restauracija prema kriterijima FDI-a i nakon toga u petogodišnjem razdoblju jedanput na godinu. Statistička analiza provedena je Pearsonovim Chi-kvadrat testom i Cochranovim Q-testom, a zatim McNemarovim testom (p = 0,05). Rezultati: Nakon pet godina ukupno je izrađeno 47 restauracija sa stopom odaziva na kontrolne preglede od 68 %. U razdoblju od četiri godine, na trima (11,5 %) restauracijama u skupini VR i dvjema u skupini LX (7,6 %) dogodio se kumulativni gubitak retencije. Sedamnaest restauracija (73,9 %) VR i 14 LX (58,3 %) ocijenjeno je klinički dobrima (2) za parametar rubne prilagodbe. Pri procjeni nakon pet godina u skupinama VR i LX zabilježeni su slični rezultati za sve procijenjene parametre (p > 0,05). Kumulativne stope gubitka retencije u skupinama VR i LX iznosile su 15,3 %, odnosno 7,6 %. Ni kod jedne restauracije nije zabilježen rekurentni karijes ili postoperativna osjetljivost. Za oba materijala zabilježena je značajna promjena nakon četiri i pet godina, kad je riječ o rubnom obojenju, u odnosu prema početnoj vrijednosti (p < 0,001). Nadalje, opažene su značajne promjene za parametar rubne prilagodbe u skupinama VR i LX nakon jedne, dvije, tri, četiri i pet godina u usporedbi s početnom vrijednosti (p < 0,001). Zaključak: Oba materijala za restauraciju kaviteta I. razreda pokazala su klinički prihvatljive rezultate nakon pet godina. Samoadhezivni tekući kompozit imao je slične kliničke performanse kao i konvencionalni tekući kompozit u kombinaciji s jetkajuće-ispirućim adhezivnim sustavom.Objective: The aim of this study was to evaluate the long-term clinical performance of a self-adhering flowable resin composite compared to a conventional flowable resin composite used with an etch&rinse adhesive system in minimally invasive Class I cavities. Materials and Methods: Twenty-five patients received at least one pair of Class I restorations (n=65). After Class I cavities had been prepared, they were randomly restored either with a self-adhering flowable resin composite (Vertise-Flow/Kerr-VR) [Group-1 (n=33)], or with a flowable resin composite (Luxaflow/DMG-LX) in combination with an etch&rinse adhesive (Teco/DMG) [Group-2 (n=32)] according to the manufacturers’ instructions. The restorations were evaluated at baseline and yearly during 5 years according to the FDI criteria by two evaluators. A statistical analysis was carried out using the Pearson Chi-Square test and the Cochran Q-test followed by the Mc Nemar’s test (p=0.05). Results: After 5 years a total of 47 restorations were evaluated with a recall rate of 68%. At 4-year, 3 (11.5%) VR and 2 LX (7.6%) restorations exhibited a cumulative retention loss. Seventeen (73.9%) VR and 14 LX (58.3%) restorations exhibited clinically acceptable (2) scores for marginal adaptation. At 5-year evaluations VR and LX showed similar results regarding all evaluated criteria (p > 0.05). The cumulative retention loss rates of VR and LX were 15.3% and 7.6%, respectively. None of the restorations demonstrated a recurrence of caries and post operative sensitivity. Both materials showed significant changes at 4 and 5 years regarding marginal staining when compared to baseline (p<0.001). Furthermore, significant changes were observed for VR and LX at 1, 2, 3, 4 and 5 years for marginal adaptation according to baseline (p<0.001). Conclusion: The use of both materials for the restoration of Class-I cavities demonstrated clinically acceptable performance at the end of 5-year. The self-adhering flowable composite exhibited a clinical performance similar to the conventional flowable applied with an etch&rinse adhesive

AŞAMALI ÇÜRÜK TEDAVİSİ

Günümüzde diş dokusunun sağlıklı olarak kalmasında pulpanın önemi daha iyi anlaşıldıkça, diş hekimleri çürük temizlenmesi sırasında pulpa ekspoz olsa bile pulpanın canlılığının korunması için daha çok çaba sarf etmeye başlamışlardır. Çünkü pulpasız dişlerde dişin kırılması gibi kritik komplikasyonlar ortaya çıkabilmektedir. Diş hekimliği uygulamalarında diş hekimleri, eğer çürük tamamen uzaklaştırılacaksa pulpa ekspozu ile sonuçlanabilecek derin çürüklerle çok sık karşılaşırlar. Pulpanın doğal rejenerasyon yeteneğinin çok yüksek olduğu araştırmacılar tarafından gözlenmektedir. Direk pulpa kaplaması tipik olarak pulpanın korunması için uygulanır. Bununla birlikte çürük kaldırılmasına bağlı olarak ekspoz olan pulpaya direk pulpa kaplaması uygulamasına alternatif olarak çürük dokunun tamamı kaldırılmadan ilk randevude yumuşak dentinin sadece bir kısmı kaldırılarak kavite  geçici restore edilir ve bir süre sonra tekrar açılır. İleri ekskavasyon bu randevuda yapılır ve kavite kalıcı olarak restore edilir. Bu uygulamanın amacı lezyonun ilerlemesini durdurmaktır ve pulpal ekspoz olmadan tersiyer dentin oluşumuna izin vermektir. Bu tedavi yöntemi ile ilgili literatürde bulunan pek çok çalışma incelenerek tedavinin prognozu hakkında bilgi edinilmiştir

Effect Of Various Bleaching Treatments On Shear Bond Strength Of Different Universal Adhesives And Application Modes

Objectives The aim of this in vitro study was to evaluate the bond strength of 2 universal adhesives used in different application modes to bleached enamel. Materials and Methods Extracted 160 sound human incisors were used for the study. Teeth were divided into 4 treatment groups: No treatment, 35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide. After bleaching treatments, groups were divided into subgroups according to the adhesive systems used and application modes (n = 10): 1) Single Bond Universal, etch and rinse mode; 2) Single Bond Universal, self-etch mode; 3) Gluma Universal, etch and rinse mode; 4) Gluma Universal, self-etch mode. After adhesive procedures nanohybrid composite resin cylinders were bonded to the enamel surfaces. All specimens were subjected to shear bond strength (SBS) test after thermocycling. Data were analyzed using a 3-way analysis of variance (ANOVA) and Tukey post hoc test. Results No significant difference were found among bleaching groups (35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide, and no treatment groups) in the mean SBS values. There was also no difference in SBS values between Single Bond Universal and Gluma Universal at same application modes, whereas self-etch mode showed significantly lower SBS values than etch and rinse mode (p < 0.05). Conclusions The bonding performance of the universal adhesives was enhanced with the etch and rinse mode application to bleached enamel and non-bleached enamel.PubMe

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL – a randomized controlled clinical trial

Abstract Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL – a randomized controlled clinical trial

Objective: The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods: Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etchand-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results: The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p&lt;0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p&gt;0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion: GLUMA Universal and AllBond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation