The effect of chlorhexidine and dimethyl sulfoxide on long-term sealing ability of two calcium silicate cements in root canal

Objectives. To evaluate the long-term effect of chlorhexidine (CHX) and dimethyl sulfoxide (DMSO) on the sealing ability and biomineralization of two different calcium silicate cements (CSC) in root canal. Methods. Sixty human third molar root canals were obturated with ProRoot MTA or Biodentine. Before obturation the canals were irrigated with saline (control), 2% CHX or 5% DMSO. Microleakage was tested after three days and after six months. After additional six months (12 months after root filling) the roots were cut into 2 mm thick dentine discs. The discs were stored in artificial saliva for one year. The bond strength was measured with the push-out method, and the failure mode was evaluated with a stereomicroscope. The most apical disc of each tooth was used for Vickers hardness test. Results. No significant differences between the groups was found in initial microleakage. The leakage increased significantly during the 6-month storage in all groups except in Biodentine-CHX group and Biodentine-DMSO group. CHX and DMSO irrigation significantly increased the leakage with ProRoot MTA with time, but there was no statistically significant difference compared to the ProRoot MTA-control group at six months' time point. CHX significantly reduced the push-out bond strength of ProRoot MTA. With Biodentine irrigation with CHX or DMSO resulted with significantly higher push-out strength compared to the Biodentine control group. Fracture analysis showed statistically significant difference in the distribution of the fractures between the groups, but neither CHX nor DMSO change the fracture pattern statistically significantly. With Vickers hardness test ProRoot MTA with and without DMSO as the final irrigant showed significantly higher dentin hardness than any Biodentine-group. Significance. Considering that aging increased the leakage in all groups except with Biodentine-DMSO and the differences in the push-out strength and surface microhardness data, it appears that the time-related biomineralizing effect of MTA and Biodentine does not improve sealing to dentin. CHX significantly reduced ProRoot MTA bond strength and increased pure adhesive failures with both cements. (C) 2020 Published by Elsevier Inc. on behalf of The Academy of Dental Materials.Peer reviewe

The effect of chlorhexidine and dimethyl sulfoxide on long-term sealing ability of two calcium silicate cements in root canal

Objectives. To evaluate the long-term effect of chlorhexidine (CHX) and dimethyl sulfoxide (DMSO) on the sealing ability and biomineralization of two different calcium silicate cements (CSC) in root canal. Methods. Sixty human third molar root canals were obturated with ProRoot MTA or Biodentine. Before obturation the canals were irrigated with saline (control), 2% CHX or 5% DMSO. Microleakage was tested after three days and after six months. After additional six months (12 months after root filling) the roots were cut into 2 mm thick dentine discs. The discs were stored in artificial saliva for one year. The bond strength was measured with the push-out method, and the failure mode was evaluated with a stereomicroscope. The most apical disc of each tooth was used for Vickers hardness test. Results. No significant differences between the groups was found in initial microleakage. The leakage increased significantly during the 6-month storage in all groups except in Biodentine-CHX group and Biodentine-DMSO group. CHX and DMSO irrigation significantly increased the leakage with ProRoot MTA with time, but there was no statistically significant difference compared to the ProRoot MTA-control group at six months' time point. CHX significantly reduced the push-out bond strength of ProRoot MTA. With Biodentine irrigation with CHX or DMSO resulted with significantly higher push-out strength compared to the Biodentine control group. Fracture analysis showed statistically significant difference in the distribution of the fractures between the groups, but neither CHX nor DMSO change the fracture pattern statistically significantly. With Vickers hardness test ProRoot MTA with and without DMSO as the final irrigant showed significantly higher dentin hardness than any Biodentine-group. Significance. Considering that aging increased the leakage in all groups except with Biodentine-DMSO and the differences in the push-out strength and surface microhardness data, it appears that the time-related biomineralizing effect of MTA and Biodentine does not improve sealing to dentin. CHX significantly reduced ProRoot MTA bond strength and increased pure adhesive failures with both cements. (C) 2020 Published by Elsevier Inc. on behalf of The Academy of Dental Materials.Peer reviewe

Effect of drying time of 3-methacryloxypropyltrimethoxysilane on the shear bond strength of a composite resin to silica-coated base/noble alloys

Objectives. In this in vitro study, the effect of various drying (surface reaction) times of a commercial silane, other than that recommended by the manufacturer (at least 5 min), on the bond strength between the resin composite and silica coated base and noble alloys was evaluated. Methods. A total of 112 disc specimens (9 mm diameter and 0.5 mm thickness) were cast out of two types of alloy designed for ceramic firing, one of which was a noble (Degunorm) (gold– silver–platinum) and the other a base alloy (Wiron 99) (nickel–chromium–molybdenum). The specimens were assigned to two main groups according to each alloy type. These two main groups were further divided into seven subgroups, having eight specimens each. The specimens of both alloy types were airabraded with 30 mm silica (SiO2) coated alumina (Al2O3) (CoJetw-Sand, ESPE, Seefeld, Germany). The conditioned surfaces were coated with 3-thacryloxypropyltrimethoxysilane(MPS) and were allowed to react and dry for 1, 2, 3, 4, 5, 6, and 7 min, respectively, before the opaquer was applied. Immediately after the waiting periods for the silane to dry, first opaquer and then resin composite were applied. After storage in water for 30 days at 37 8C and thermocycling (5000 cycles, 5–55 8C), shear tests were performed using the universal testing machine at a crosshead speed of 0.5 mm/min. Results. Analysis of data showed no significant difference in bond strength for any silane drying and reaction period for both base and noble alloys between 1 and 7 min (ANOVA, P ¼ 0:05) (Degunorm: 5.8–7.4 MPa and Wiron 99: 7.2–10.2 MPa, respectively). Bond strengths of resin composite to base alloys were significantly higher than those to noble alloys at 2, 3 and 5 min (P ¼ 0:0045; P ¼ 0:05; P ¼ 0:002; respectively). Significance. In order to optimize the flow of laboratory work, the silane solution drying time might be reduced to 1 min for both base and noble alloys

Influence of short-fiber composite base on fracture behavior of direct and indirect restorations

Objectives: The aim was to examine the influence of short-fiber composite (SFC) core on the fracture-behavior of different types of indirect posterior restorations. In addition, the effect of thickness ratio of SFC-core to the thickness of the veneering conventional composite (PFC) on fracture-behavior of bi-structured composite restorations was evaluated.Materials and methods: MOD cavities with removed palatal cusps were prepared on 90 intact molars. Five groups of direct overlay restorations (n = 10/group) were fabricated having a SFC-core (everX Flow) with various thicknesses (0, 1, 2, 3, 4 mm) and layer of surface PFC (G-aenial Anterior), remaining the thickness of the bi-structure restoration to be 5 mm. Four groups of CAD/CAM-made restorations (Cerasmart 270 and e-max CAD) were fabricated either with 2-mm layer of SFC-core or without fiber reinforcement. Intact teeth (n = 10) were used as control group. Restorations were statically loaded until fracture. Fracture patterns were evaluated visually. Data were analyzed using ANOVA (p = 0.05).Results: With indirect overlay restorations, no statistically significant differences (p > 0.05) were observed in the load-bearing capacities between restorations reinforced by 2-mm SFC-core (bi-structured) and those fabricated from plain restorative materials. ANOVA displayed that direct overlay restorations made from 4-mm layer thickness of SFC-core had significantly higher load-bearing capacities (3050 ± 574 N) (p Conclusions: Restorations (direct/indirect) combining SFC-core and a surface layer of conventional material demonstrated encouraging achievement in reference to fracture behavior.Clinical relevance: The use of flowable short-fiber composite as reinforcing base with large direct and indirect restorations may result in more repairable failure.</p

Cranioplasty After Severe Traumatic Brain Injury: Effects of Trauma and Patient Recovery on Cranioplasty Outcome

Background: In patients with severe traumatic brain injury (sTBI) treated with decompressive craniectomy (DC), factors affecting the success of later cranioplasty are poorly known.Objective: We sought to investigate if injury- and treatment-related factors, and state of recovery could predict the risk of major complications in cranioplasty requiring implant removal, and how these complications affect the outcome.Methods: A retrospective cohort of 40 patients with DC following sTBI and subsequent cranioplasty was studied. Non-injury-related factors were compared with a reference population of 115 patients with DC due to other conditions.Results: Outcome assessed 1 day before cranioplasty did not predict major complications leading to implant removal. Successful cranioplasty was associated with better outcome, whereas a major complication attenuates patient recovery: in patients with favorable outcome assessed 1 year after cranioplasty, major complication rate was 7%, while in patients with unfavorable outcome the rate was 42% (p = 0.003). Of patients with traumatic subarachnoid hemorrhage (tSAH) on admission imaging 30% developed a major complication, while none of patients without tSAH had a major complication (p = 0.014). Other imaging findings, age, admission Glasgow Coma Scale, extracranial injuries, length of stay at intensive care unit, cranioplasty materials, and timing of cranioplasty were not associated with major complications.Conclusion: A successful cranioplasty after sTBI and DC predicts favorable outcome 1 year after cranioplasty, while stage of recovery before cranioplasty does not predict cranioplasty success or failure. tSAH on admission imaging is a major risk factor for a major complication leading to implant removal

Grit blasted aggregates of hydroxyl apatite functionalized calcium carbonate in occluding dentinal tubules

ObjectivesThis study aimed to investigate the effects of using hydroxyl apatite functionalized calcium carbonate (FCC) particles on occluding dentinal tubules.MethodsDentine specimens extracted from eighteen human molars with exposed dentinal tubules were divided into three groups (n = 6/group): a) Cut surface with smear layer; b) EDTA (smear layer removed with 17% EDTA for 1 min); and c) Grit blasted functionalized calcium carbonate (FCC) with and air pressure of 280 kPa. Microscopic dentinal tubule occlusion, tubule diameter and tubule area were evaluated using scanning electron microscopy (SEM) before and after grit blasting. Biomineralization of specimens was carried out in a simulated body fluid (SBF). Elemental analysis of occluding materials was carried out using energy-dispersive X-ray spectroscopy (EDX). X-ray diffraction (XRD) analysis was performed to demonstrate the crystal structure of the biomineralized layer on dentine.ResultsFCC particles showed penetration into the dentinal tubules by breakage of their original particle shape and size. EDTA treated surface had higher number and larger size tubules than those with smear layer or grit blasted (p ConclusionsGrit blasted FCC particles initially occluded effectively the opened dentinal tubules and biomineralization occurred in tubules primarily occluded by the FCC particles. However, in the optimal in vitro conditions in SBF, no difference between biomineralization was found between the grit blasted surface and the control surface.Clinical significanceSeveral materials and methods have been established for treatment of dentinal hypersensitivity although a golden standard treatment has not been discovered. Grit blasted functionalized calcium carbonate has a potential to occlude and remineralize exposed dentinal tubules. This could offer a more biological approach on treatment of dentin hypersensitivity.<br /