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BMC Oral Health Apr 2023Restoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Restoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical pathosis in such teeth are still unknown. Therefore, this systematic review and meta-analysis aimed to investigate the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations.
METHODS
The search was conducted in five databases, using MEDLINE via PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library. Eligible clinical trials and cohort studies were included. The risk of bias was assessed using Joanna Briggs Institute's critical appraisal tool and Newcastle-Ottawa Scale. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were calculated using a random effects model. Subgroup meta-analyses were also performed to determine the potential influencing factors for pulp necrosis and periapical pathosis. The certainty of the evidence was assessed using the GRADE tool.
RESULTS
A total of 5,814 studies were identified, of which 37 were included in the meta-analysis. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were determined to be 5.02% and 3.63%, respectively. All studies were assessed as having a moderate-low risk of bias. The incidence of pulp necrosis following indirect restorations increased when the pulp status was objectively assessed (thermal/electrical testing). The presence of pre-operative caries or restorations, treatment of anterior teeth, temporization for more than two weeks, and cementation with eugenol-free temporary cement, all increased this incidence. Final impression with polyether and permanent cementation with glass ionomer cement both increased the incidence of pulp necrosis. Longer follow-up periods (> 10 years) and treatment provided by undergraduate students or general practitioners were also factors that increased this incidence. On the other hand, the incidence of periapical pathosis increased when teeth were restored with fixed partial dentures, the bone level was < 35%, and the follow-up was > 10 years. The certainty of the evidence overall was assessed as low.
CONCLUSIONS
Although the incidences of pulp necrosis and periapical pathosis following indirect restorations remain low, many factors affect these incidences that should thus be considered when planning indirect restorations on vital teeth.
DATABASE REGISTRATION
PROSPERO (CRD42020218378).
Topics: Humans; Dental Pulp Necrosis; Incidence; Dental Caries; Dental Cements; Glass Ionomer Cements
PubMed: 37009911
DOI: 10.1186/s12903-023-02826-1 -
BMC Oral Health Jun 2022This study aimed to investigate the effect of enamel-surface modifications on the shear bond strength between ceramic brackets bonded using different adhesive materials...
BACKGROUND
This study aimed to investigate the effect of enamel-surface modifications on the shear bond strength between ceramic brackets bonded using different adhesive materials and the enamel surface and to identify the most suitable clinical adhesive and bonding method. Whether the non-acid-etching treatment met the clinical bond strength was also determined.
METHODS
A total of 108 extracted premolars were divided into nine groups (n = 12) based on the different enamel-surface modification techniques (acid etching, deproteinization, and wetting). Group 1 was bonded with Transbond™ XT adhesive, whereas groups 2-9 were bonded with resin-modified glass ionomer cement (RMGIC). The treatment methods for each group were as follows: groups 1 and 2, acid etching; group 3, acid etching and wetting; group 4, acid etching and deproteinization; group 5, acid etching, deproteinization, and wetting; group 6, deproteinization; group 7, deproteinization and wetting; group 8, without treatment; and group 9, wetting. The samples' shear bond strength was measured using an universal testing machine. Adhesive remnant index (ARI) was examined using a stereomicroscope. The enamel-surface morphology was observed with a scanning electron microscope. One-way ANOVA with Tukey's post-hoc test and chi-square test were used for statistical analysis, and p < 0.05 and α = 0.05 were considered statistically significant.
RESULTS
The ARIs of groups 1-5 and 6-9 were statistically significant (p = 0.000). The enamel surface of groups 1-5 was demineralized, and only a tiny amount of protein remained in groups 7 and 8, whereas a thick layer of protein remained in groups 8 and 9.
CONCLUSIONS
RMGIC adhesive did not damage the enamel surface and achieved the required clinical bond strength. The enamel surface was better treated with 5.25% sodium hypochlorite preferably under non-acid-etching conditions.
Topics: Acid Etching, Dental; Dental Bonding; Dental Cements; Dental Enamel; Dental Stress Analysis; Glass Ionomer Cements; Humans; Materials Testing; Orthodontic Brackets; Resin Cements; Shear Strength; Surface Properties
PubMed: 35672818
DOI: 10.1186/s12903-022-02254-7 -
Journal of Dentistry Jan 2021To evaluate the incorporation of doxycycline (DOX) into a commercial dental adhesive regarding physicochemical properties, microtensile bond strength (μTBS),...
OBJECTIVES
To evaluate the incorporation of doxycycline (DOX) into a commercial dental adhesive regarding physicochemical properties, microtensile bond strength (μTBS), nanoleakage (NL), nanohardness (NH) and Young's modulus (YM), metalloproteinases (MMP) inhibition, and antibiofilm activity.
METHODS
DOX was incorporated into the adhesive at 0.05, 0.1, 0.5, and 1 wt%. Restored teeth were evaluated for μTBS, NL, NH, and YM after 24 -hs and 1-year of water storage. Biofilms of Streptococcus mutans were grown on top of these adhesives and determined for bacterial viability and amount of biomass. The inhibitory effect on MMP was analyzed by in situ zymography under confocal microscopy.
RESULTS
Adhesives with 0.5 and 1 wt% of DOX presented reduced pH and degree of conversion. The incorporation of DOX did not affect μTBS and hybrid layer YM. The control group (no DOX) had a decrease in μTBS and the densest silver nitrate areas after 1-year storage. Hybrid layer NH values increased with 0.1 wt% DOX compared to control and 1 wt% DOX groups, at 24 -hs. After 1-year storage, NH of 1 wt% DOX adhesive decreased compared to the control group. The 0.5 and 1 wt% concentrations of DOX decreased the bacterial viability and the biofilm biomass. Confocal images suggest an increased MMP inhibition proportional to the percentage of DOX.
CONCLUSION
At any concentration, DOX-doped dental adhesives were able to inhibit MMP activity, diminish nanoleakage, and maintain the resin-dentin bond-strength after 1 year of artificial aging.
CLINICAL SIGNIFICANCE
Doxycycline-doped dental adhesive inhibited metalloproteinases activity and preserved interface bond strength. This formulation has a potential to improve adhesive restorations clinical longevity.
Topics: Biofilms; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Doxycycline; Humans; In Vitro Techniques; Materials Testing; Metalloproteases; Molar; Resin Cements; Tensile Strength
PubMed: 33276081
DOI: 10.1016/j.jdent.2020.103550 -
Journal of Oral Science Jul 2022Recently in Japan, due to the increased prices of palladium and gold, cast titanium restorations have been included in the Japanese national health insurance system. The... (Review)
Review
Recently in Japan, due to the increased prices of palladium and gold, cast titanium restorations have been included in the Japanese national health insurance system. The purpose of this review was to survey the available literature on titanium bonding systems, focusing on the adhesive monomer in the luting agent in order to expand the application of resin-bonded fixed prostheses made of titanium or titanium alloys. It was found that adhesive monomers are effective for bonding to titanium, and provide results equal to the procedures of silanization and tribochemical silica coating. A primer or a luting agent, including 10-methacryloyloxydecyl dihydrogen phosphate (MDP), methacryloyloxyalkyl thiophosphate derivative (MEPS), 6-methacryloxyhexyl phosphonoacetate (6-MHPA), and 4-methacryloyloxyethl trimellitate anhydride (4-META) promotes bonding characteristics between titanium and the resin material.
Topics: Alloys; Dental Bonding; Dental Cements; Materials Testing; Methacrylates; Resin Cements; Surface Properties; Titanium
PubMed: 35584941
DOI: 10.2334/josnusd.22-0036 -
Dental Traumatology : Official... Dec 2022Opportunities for dental students to obtain clinical experience in the management of traumatic dental injuries are scarce, and most dentists encounter difficulties with...
BACKGROUND/AIM
Opportunities for dental students to obtain clinical experience in the management of traumatic dental injuries are scarce, and most dentists encounter difficulties with their first trauma patients after graduation. The aim of this study was to question students on the ease of handling of four types of flexible splints, with two common methods of bonding to the tooth.
MATERIAL AND METHODS
A total of 161 fourth year dental students completed a simulated treatment of an avulsed tooth using orthodontic wire, Twistflex wire, nylon fishing line, and Powermesh as splints. The bonding materials were composite resin (Spectra ST LV) or glass ionomer cement (GC Fuji LC Ortho). The students then answered 16 questions on a 5-point Likert scale, or with an open answer field.
RESULTS
Most students agreed (48.8%) or strongly agreed (31.3%) that the simulated trauma exercise assisted their learning. There was strong agreement (68.8%) and agreement (28.7%) that the simulation added value to their dental training compared to didactic training only. Similarly, 52.3% of participants strongly agreed and 40% agreed that they felt engaged in the learning activity. Only 53.8% of the participants agreed and 7.5% strongly agreed that the simulation felt realistic. Most students (56.2%) found a Powermesh/composite splint was the easiest to place, and nylon fishing line/GC Fuji LC Ortho splints was the least difficult to remove (35%).
CONCLUSION
Wire-free splints with composite bonding were judged as the easiest to place by students, while glass ionomer cement was the easiest to remove.
Topics: Humans; Cross-Sectional Studies; Nylons; Glass Ionomer Cements; Orthodontic Wires; Composite Resins; Simulation Training; Dental Bonding; Resin Cements
PubMed: 35753070
DOI: 10.1111/edt.12772 -
Indian Journal of Dental Research :... 2020In-vitro studies of microleakage are an initial screening method to assess the maximum theoretical loss of sealing ability in-vivo.
CONTEXT
In-vitro studies of microleakage are an initial screening method to assess the maximum theoretical loss of sealing ability in-vivo.
AIMS
Our objective was to determine and compare microleakage patterns of conventional glass ionomer cement (GIC) and resin-modified GIC (RMGIC) for band cementation.
METHODS
Forty caries-free second primary molars were randomly divided into two groups of 20 teeth each. Preformed molar bands in the two groups were cemented to enamel with one of two types of cement: Conventional GIC (Fuji I, GC Corporation; Tokyo, Japan) and RMGIC (Fuji Plus, GC Corporation; Tokyo, Japan). A dye penetration method was used for microleakage evaluation. Microleakage was determined by a stereomicroscope for the cement-band and cement-enamel interfaces.
STATISTICAL ANALYSIS USED
Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney U tests.
RESULTS
The mean microleakage value for conventional GIC (Fuji I) at cement-band and cement-enamel interfaces was 2.41 mm and 2.15 mm, respectively. The mean microleakage value for RMGIC (Fuji Plus) at cement-band and cement-enamel interfaces was 0.44 mm and 0.46 mm, respectively. Compared to conventional GIC, RMGIC showed less microleakage at both cement-band and cement-enamel interfaces. P < 0.001 and it was statistically highly significant.
CONCLUSIONS
Bands cemented with RMGIC had significantly less microleakage between the cement-band and cement-enamel interfaces than conventional GIC.
Topics: Dental Cements; Dental Enamel; Dental Leakage; Glass Ionomer Cements; Humans; Resin Cements; Tooth, Deciduous
PubMed: 32436911
DOI: 10.4103/ijdr.IJDR_850_19 -
BMC Oral Health Dec 2022Adhesive tooth-colored restorations are strongly dependent on the substrate surface cleanliness to allow intimate contact between resin cement and dentin surface, so...
BACKGROUND
Adhesive tooth-colored restorations are strongly dependent on the substrate surface cleanliness to allow intimate contact between resin cement and dentin surface, so several methods were adopted for the total cleaning of temporary cement residues. This study aimed to assess the effect of mechanical and chemo-mechanical cleaning methods of temporary cement on the immediate shear bond strength of self-adhesive resin cement to dentin surface.
METHODS
Forty freshly extracted lower first premolars were cut to expose a flat dentin surface. Discs of temporary crown composite resin material were constructed and cemented to the flat dentin surface using resin-based and non-eugenol temporary cement then stored at room temperature in distilled water. Dividing of samples into two groups according to the method of temporary cement cleaning. Group I (n = 20) mechanical cleaning using the rotary instrument, and group II (n = 20) chemo-mechanical cleaning using chlorhexidine-containing scrub. CAD/CAM reinforced Composite discs were bonded to the dentin surface using self-adhesive composite resin cement, then measurement of shear bond strength was done using a universal testing machine. Further analysis of failure mode after debonding was performed by Scanning electron microscope.
RESULTS
No statistically significant difference was found between the mean shear bond strength of the two cleaning methods (P-value = 0.636). Regardless of the cleaning method, the group cemented with resin-based temporary cement showed statistically significantly higher mean shear bond strength than non-eugenol temporary cement (P-value = 0.048).
CONCLUSION
Both cleaning methods (mechanical and chemo-mechanical) applied in this study were effective in cleaning temporary cement remnants from the dentin substrate surface with statistically significant differences between results of shear bond strength with significantly higher values recorded with resin-based temporary cement.
Topics: Humans; Dental Cements; Resin Cements; Zinc Oxide-Eugenol Cement; Dentin-Bonding Agents; Dental Bonding; Glass Ionomer Cements; Composite Resins; Dentin; Materials Testing; Shear Strength; Surface Properties; Dental Stress Analysis
PubMed: 36578003
DOI: 10.1186/s12903-022-02672-7 -
Journal of Applied Oral Science :... 2020Tricalcium silicate-based cement are materials used in reparative and regenerative procedures in endodontics. A recently proposed formulation aimed to enhance handling...
Tricalcium silicate-based cement are materials used in reparative and regenerative procedures in endodontics. A recently proposed formulation aimed to enhance handling during clinical use with a versatile material applicable by syringe. Although, the use of bismuth oxide as radiopacifier and grey raw powder are drawbacks considering aesthetics. Objectives Evaluate physicochemical, biological, and antimicrobial properties of Grey-MTAFlow (Ultradent) and assess whether the addition of zinc oxide (ZnO) prevents dentinal discoloration caused by bismuth oxide. Methodology Grey-MTAFlow was manipulated in 'thin' consistency for all tests. Luminosity, color change, ion migration to dentine, radiopacity, setting time, ISO 6876:2012 linear flow, volumetric lateral flow and central filling of simulated grooves scanned using micro-computed tomography (μCT), pH, calcium release, volumetric change using μCT, chemical characterisation, cytotoxicity, and antimicrobial activity were assessed. Addition of 5% ZnO to Grey-MTAFlow and a bismuth-containing experimental composition were comparatively tested. Statistical analyses used Shapiro-Wilk, T-test, ANOVA, and Kolmogorov-Smirnov (p<0.05). Results The addition of ZnO to Grey-MTAFlow prevented dentine darkening after 90 days due to bismuth migration reduction, although no statistical difference was found (p=0.863). ZnO addition significantly enhanced Grey-MTAFlow radiopacity without differences in initial setting time. Grey-MTAFlow presented an ISO linear flow of 10.9 mm and a balanced volumetric lateral flow with central filling in μCT evaluation. All compositions presented an alkaline pH after immersion. Grey-MTAFlow had a significantly higher calcium ion release after 28 days in comparison to 24 hours (p=0.011) and volumetric expansion of 0.4±1.8% after immersion. ZnO addition altered the hydrated cement matrix once calcium hydroxide (portlandite) could not be detected in characterisation. Neither of the materials produced inhibition halos nor reduced bacterial turbidity, but all presented cytocompatibility above 100%. Conclusion Grey-MTAFlow expanded after immersion and exhibited higher luminosity values after the evaluation period when ZnO was added, but chemical modifications after this addition occurred.
Topics: Anti-Infective Agents; Bismuth; Calcium Compounds; Dental Cements; Drug Combinations; Materials Testing; Oxides; Root Canal Filling Materials; Silicates; X-Ray Microtomography
PubMed: 32785521
DOI: 10.1590/1678-7757-2020-0269 -
Dental Materials : Official Publication... Apr 2024Although the introduction of self-adhesive composites in restorative dentistry is very promising, the innovation of new materials also presents challenges and unknowns....
OBJECTIVES
Although the introduction of self-adhesive composites in restorative dentistry is very promising, the innovation of new materials also presents challenges and unknowns. Therefore, the aim of this study was to investigate the cytotoxicity of four different self-adhesive composites (SAC) in vitro and to compare them with resin-modified glass ionomer cements (RM-GIC), a more established group of materials.
METHODS
Samples of the following materials were prepared according to ISO 7405/10993-12 and eluted in cell culture medium for 24 h at 37 °C: Vertise Flow, Fusio Liquid Dentin, Constic, Surefil One, Photac Fil and Fuji II LC. Primary human pulp cells were obtained from extracted wisdom teeth and cultured for 24 h with the extracts in serial dilutions. Cell viability was evaluated by MTT assay, membrane disruption was quantified by LDH assay and apoptosis was assessed by flow cytometry after annexin/PI staining.
RESULTS
Two SAC (Constic and Vertise Flow) and one RM-GIC (Photac Fil) significantly reduced cell viability by more than 30% compared to the untreated control (p < 0.001). Disruptive cell morphological changes were observed and the cells showed signs of late apoptosis and necrosis in flow cytometry. Membrane disruption was not observed with any of the investigated materials.
CONCLUSION
Toxic effects occurred independently of the substance group and need to be considered in the development of materials with regard to clinical implications.
CLINICAL SIGNIFICANCE
SAC have many beneficial qualities, however, the cytotoxic effects of certain products should be considered when applied in close proximity to the dental pulp, as is often required.
Topics: Humans; Resin Cements; Dental Cements; Composite Resins; Glass Ionomer Cements; Materials Testing; Dental Materials
PubMed: 38403539
DOI: 10.1016/j.dental.2024.02.015 -
Medical Science Monitor Basic Research Nov 2022BACKGROUND The aim of this study was to evaluate the antimicrobial effectiveness of dental cement materials for the prevention of bacterial growth, which can cause...
BACKGROUND The aim of this study was to evaluate the antimicrobial effectiveness of dental cement materials for the prevention of bacterial growth, which can cause failure of fixed cementation. MATERIAL AND METHODS We developed an agar diffusion disk test in-house to evaluate the antibacterial properties of 3 commercially available dental cement materials (Ketac, Harvard FLB, and Panavia SA Universal Dual Resin cements) compared with a negative control. The materials were tested for the inhibition against Streptococcus mutans (ATCC 10449), Streptoccocus salivarius (ATCC 25975), Enterococcus faecalis (ATCC 29212), and Lactobacilus acidophilus (ATCC 4356). The antimicrobial effectiveness of materials was expressed as the diameters of the inhibition zones around the disk. RESULTS Overall, 240 specimens were tested. All cement materials showed antimicrobial effectiveness. Different microbial strains reacted differently to the different dental cements (all P.
Topics: Anti-Infective Agents; Anti-Bacterial Agents; Streptococcus mutans; Resin Cements
PubMed: 36394828
DOI: 10.12659/MSMBR.937893