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Scientific Reports Jul 2022Strategies aiming to improve the longevity of resin-dentin adhesive interface developed so far have only been able to retard the problem. Different approaches are thus...
Strategies aiming to improve the longevity of resin-dentin adhesive interface developed so far have only been able to retard the problem. Different approaches are thus needed. The objective of this review was to determine whether the use of collagen-depletion strategies after acid-etching procedures may improve the bond strength of resin-based materials to dentin. A systematic review was planned following 2021 PRISMA statement guidelines, with a search strategy performed in five electronic databases: PubMed/Medline, Scopus, EMBASE, SciELO and IADR Abstract Archive (last search: 17/01/2022). Inclusion criteria encompassed studies which evaluated a collagen-depletion strategy in acid-etched human dentin and tensile/shear bond strength tests. Risk of bias assessment was carried out by two reviewers, working independently on an adapted five-domain risk of bias (RoB) checklist for laboratory studies. Results were synthesized qualitatively, as a meta-analysis was not possible due to limited number of studies and their RoB. A total of eight studies were eligible for inclusion in the systematic review after inclusion/exclusion criteria application. Out of these, two evaluated the effect of using NaOCl followed by an antioxidant, and the remaining six evaluated different enzymatic treatments (bromelain, chondroitinase ABC, papain, and trypsin). None of the studies reported a decrease of bond strength when a collagen-depletion strategy was used, in comparison to traditional hybrid layers (control). All enzymatic treatment studies which respected the inclusion criteria improved the bond strength to dentin. Some specific collagen-depletion strategies seem to play a favorable role in improving immediate bond strengths to dentin. Further research with sound methodology is required to consolidate these findings, since limitations in RoB and a low number of studies were found. The assessment of further proteolytic agents and long-term outcomes is also required.
Topics: Collagen; Composite Resins; Dentin; Dentin-Bonding Agents; Humans; Materials Testing; Resin Cements; Tensile Strength
PubMed: 35906302
DOI: 10.1038/s41598-022-17371-0 -
Dental Materials : Official Publication... Jul 2022The conventional radiotherapy protocol to treat head-and-neck cancer is usually followed by tooth-decay onset. Radiation impact on mineralized tooth structures is not... (Review)
Review
OBJECTIVES
The conventional radiotherapy protocol to treat head-and-neck cancer is usually followed by tooth-decay onset. Radiation impact on mineralized tooth structures is not well-understood. This systematic review aimed to collect the recorded effects of therapeutic radiation on tooth chemical, structural and mechanical properties, in relation with their means of investigation.
DATA
Systematic search (January 01 2012 - September 30 2021) terms were "Radiotherapy", "Radiation effects", "Dental enamel", "Dentin", "Human" and "Radiotherapy" NOT "Laser".
SOURCES
PubMed, DOSS and Embase databases were searched.
STUDY SELECTION
Selected studies compared dental enamel, coronal and root dentin properties before and after in vitro or in vivo irradiation up to 80 Gy.
RESULTS
The systematic search identified 353 different articles, with 28 satisfying inclusion criteria. Their reference lists provided two more. Twenty-two studies evaluated dental enamel evolution, nine assessed coronal dentin and eight concerned root dentin. Coronal and root dentin results indicate a major impact of the radiation on their organic matrix. Dental enamel's chemical properties are less modified. Enamel and root dentin's hardness are decreased by therapeutic radiation, but no consensus arises for coronal dentin.
CONCLUSIONS
Our findings revealed some interesting information about enzymatic degradation mechanisms of dentin organic matrix and highlighted that dental hard-tissue characterization requires highly specific expertise in materials science. That scientific knowledge is necessary to design suitable protocols, adequately analyze the obtained data, and, thus, provide relevant conclusions.
CLINICAL SIGNIFICANCE STATEMENT
Better knowledge and understanding of the mechanisms involved in the degradation of enamel and dentin would enable development of new preventive and therapeutic methods for improved medical care of patients undergoing radiotherapy.
Topics: Dental Caries; Dental Enamel; Dentin; Head and Neck Neoplasms; Humans; Radiation Injuries; Tooth
PubMed: 35570008
DOI: 10.1016/j.dental.2022.04.014 -
Efficacy of sonic and ultrasonic activation during endodontic treatment: a Meta-analysis of studies.Acta Odontologica Scandinavica Nov 2022To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To ensure a successful endodontic treatment, it is important to have a proper disinfection of the root canal. The current study compares the root canal cleanliness and smear layer score between sonic and ultrasonic activation.
METHOD
Systematic literature review was implemented, using 12 databases. All studies comparing the efficacy of sonic and ultrasonic activation and reporting at least one outcome of interest were included.
RESULTS
At the apical level, pooling the data in the random-effects model (I=64%, ) revealed a statistically significant lower smear layer score within the sonic activation group (MD-0.48; 95% CI-0.92, -0.04; ). Furthermore, there was a statistically significant lower push-out bond strength value among the sonic group, in contrast to the ultrasonic group at the middle (MD-0.69; 95% CI-1.13, -0.25; ) and at the apical levels (MD-0.78; 95% CI-1.09, -0.46; ) of the root canal.
CONCLUSIONS
Sonic activation accomplished advancement relative to ultrasonic agitation in removing the smear layer, while ultrasonic activation resulted in significant cohesion between the sealers and the dentine tubules, decreasing the vulnerability of apical leakage and tooth fracture.
Topics: Humans; Smear Layer; Root Canal Irrigants; Root Canal Preparation; Dental Pulp Cavity; Ultrasonics; Sodium Hypochlorite; Therapeutic Irrigation; Edetic Acid; Microscopy, Electron, Scanning
PubMed: 35430959
DOI: 10.1080/00016357.2022.2061591 -
JDR Clinical and Translational Research Apr 2023Estimating the risk of dental problems in long-duration space missions to the Moon and Mars is critical for avoiding dental emergencies in an environment that does not... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Estimating the risk of dental problems in long-duration space missions to the Moon and Mars is critical for avoiding dental emergencies in an environment that does not support proper treatment. Previous risk estimates were constructed based on the experience in short-duration space missions and isolated environments on Earth. However, previous estimates did not account for potential changes in dental structures due to space travel, even though bone loss is a known problem for long-duration spaceflights. The objective of this study was to systematically analyze the changes in hard tissues of the craniofacial complex during spaceflights.
METHODS
Comprehensive search of Medline, Embase, Scopus, the NASA Technical Report Server, and other sources identified 1,585 potentially relevant studies. After screening, 32 articles that presented quantitative data for skull in humans (6/32) and for calvariae, mandible, and lower incisors in rats (20/32) and mice (6/32) were selected.
RESULTS
Skull bone mineral density showed a significant increase in spacefaring humans. In spacefaring rodents, calvariae bone volume to tissue volume (BV/TV) demonstrated a trend toward increasing that did not reach statistical significance, while in mandibles, there was a significant decrease in BV/TV. Dentin thickness and incisor volume of rodent incisors were not significantly different between spaceflight and ground controls.
DISCUSSION
Our study demonstrates significant knowledge gaps regarding many structures of the craniofacial complex such as the maxilla, molar, premolar, and canine teeth, as well as small sample sizes for the studies of mandible and incisors. Understanding the effects of microgravity on craniofacial structures is important for estimating risks during long-duration spaceflight and for formulating proper protocols to prevent dental emergencies.
KNOWLEDGE TRANSFER STATEMENT
Avoiding dental emergencies in long-duration spaceflights is critical since this environment does not support proper treatment. Prior risk estimates did not account for changes in dental structures due to space travel. We reviewed and synthesized the literature for changes in craniofacial complex associated with spaceflight. The results of our study will help clinicians and scientists to better prepare to mitigate potential oral health issues in space travelers on long-duration missions.
Topics: Humans; Mice; Rats; Animals; Emergencies; Space Flight; Head; Skull; Incisor
PubMed: 35311413
DOI: 10.1177/23800844221084985 -
Critical Reviews in Biomedical... 2021One aspect of special concern in endodontics is the effect of irrigating solutions on the biomechanical properties of dentine. A systematic review of in vitro studies... (Meta-Analysis)
Meta-Analysis
One aspect of special concern in endodontics is the effect of irrigating solutions on the biomechanical properties of dentine. A systematic review of in vitro studies was conducted to analyze and systematize the effect of endodontic irrigating solutions on biomechanical properties in noninstrumented dentine, according to published in vitro studies. A literature review was conducted on different databases including papers from 2009 to 2019. Two researchers identified in vitro studies on permanent teeth root dentine that reported control group, featured nonmechanical preparation, and sample size ≥ 10. An instrument was designed for bias assessment in three categories (High-Uncertain-Low), applying 17 criteria. Using the PRISMA tool, an electronic search found 9,026 titles. From these, 28 were subjected to full-text analysis and 9 were chosen for qualitative analysis. It was identified that chelates decrease microhardness and stiffness. It was also inferred that the proteolytic effect of NaOCl reduces the elasticity modulus and flexural strength. The heterogeneity analysis, with a value I2:92% for microhardness and I2:81% for roughness, revealed high heterogeneity among the included studies. The random effect model identified with 95% confidence that NaOCl and EDTA significantly decrease microhardness: -3.00[-4.22, -1.78]; EDTA 17% at 15 min being on average the lowest value: -6.66[-8.32, -5.00]. For roughness, all the proposed solutions increased significantly: 2.37[1.67, 3.08]; the highest, 3.94[2.84, 5.04], was recorded by NaOCl2.5%-15 min. In contrast, CLX registered a high roughness value: 3.33[1.88, 4.77]. Dentinal microhardness reduction associated to chelates is a concentration and time- dependent variable. Collagen degradation by NaOCl is a time and concentration-dependent variable.
Topics: Dentin; Humans; Root Canal Irrigants; Sodium Hypochlorite
PubMed: 34936315
DOI: 10.1615/CritRevBiomedEng.2021038065 -
Dental Materials Journal Feb 2022This review aims to evaluate whether the etch-and-rinse or self-etch mode is the better protocol for dentin adhesion by universal adhesives. A total of 15 articles were... (Meta-Analysis)
Meta-Analysis
This review aims to evaluate whether the etch-and-rinse or self-etch mode is the better protocol for dentin adhesion by universal adhesives. A total of 15 articles were included in the meta-analysis. Two reviewers performed a literature search up to October 2020in four databases: PubMed, Web of Science, Embase, and the Cochrane Library. Without considering the difference in aging mode, the analysis of the immediate and long-term bond strength of dentin showed that there was no statistical significance between the etch-and-rinse and self-etch mode of universal adhesive, and the long-term bond strength decreased relative to the immediate. In vitro studies suggest that prior acid etching did not improve bond performance. Whether from the perspective of long-term bonding performance or simplifying operating procedures, the self-etch mode is preferred.
Topics: Adhesives; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Materials Testing; Resin Cements
PubMed: 34471040
DOI: 10.4012/dmj.2021-111 -
Scientific Reports Aug 2021To analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot... (Meta-Analysis)
Meta-Analysis
To analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot lesions (WSL) during orthodontic treatment with fixed appliances. Electronic databases (Pubmed, CENTRAL, EMBASE) were screened for studies. No language restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Primary outcome included assessment of WSL with visual-tactile assessment and/or laser fluorescence measurements. Twenty-four studies with 1117 patients (age: 11-40 years) and 12,809 teeth were included. Overall, 34 different sealants or bonding materials were analysed. Fourteen studies analysed fluoride and 14 studies non-fluoride releasing materials. Meta-analysis for visual tactile assessment revealed that sealants significantly decreased the initiation of WSL compared to untreated control (RR [95%CI] = 0.70 [0.53; 0.93]; very low level of evidence). Materials releasing fluoride did not decrease initiation of WSL compared to those with no fluoride release (RR [95%CI] = 0.84 [0.70; 1.01]; very low level of evidence). For laser fluorescence measurements no meta-analysis could be performed. The use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL. Furthermore, there is no evidence supporting that fluoride-releasing sealants or bonding materials are more effective than those without fluoride release. No gold standard prevention strategy to prevent WSL during treatment with fixed orthodontic appliances has been established yet. However, based on only a limited number of studies the use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL.
Topics: Adolescent; Adult; Child; Dental Caries; Dental Enamel; Dentin-Bonding Agents; Fluorides; Humans; Orthodontic Brackets; Pit and Fissure Sealants; Resins, Synthetic; Tooth Demineralization; Treatment Outcome; Young Adult
PubMed: 34400668
DOI: 10.1038/s41598-021-95888-6 -
Microorganisms Jun 2021() is a group of viridans mostly located in oral flora among the wide and biodiverse biofilm. It plays a significant role not only in caries formation but also... (Review)
Review
() is a group of viridans mostly located in oral flora among the wide and biodiverse biofilm. It plays a significant role not only in caries formation but also triggering intracerebral haemorrhage. The durable and stable bond interface, besides bacteria elimination, is one of the crucial factors influencing the resin composite restoration performance. This study aimed to evaluate universal adhesives (UAs) with regard to in vitro bond strength to dentin, and the inhibition of the growth and compare them with UAs modified with antimicrobial agents through a systematic review and meta-analysis. Two reviewers performed a literature search up to April 2021 in 5 electronic databases: PubMed MedLine, Scielo, ISI Web of Science, Scopus, and EMBASE. Only in vitro studies reporting the effect of modifying UAs with antimicrobial agents on the bond strength to dentin and/or on the inhibition of the were included. Analyses were carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). The methodological quality of each in vitro study was evaluated following the parameters of a previous systematic review. A total of 1716 potentially relevant publications were recognized. After reviewing the title and abstract, 16 studies remained in the systematic review. From these, a total of 3 studies were included in the meta-analysis. Since data from the studies included in the antimicrobial outcome included zero values, they could not be meta-analysed. Including 0 values in the analysis will lead to several biases in the analysis, so these data were discarded. The antibacterial effect against of UAs modified with antimicrobial agents was higher than the non-modified adhesive systems. Within the limitations of the present study, the bond strength of UAs to dentin could be improved by using antimicrobial agents. The UAs modified with antibacterial agents showed a decrease in the viability of biofilm, among the adhesives tested. However, there are not enough valid data on antibacterial properties of modified UAs; therefore, more well-designed research on these materials is needed.
PubMed: 34204100
DOI: 10.3390/microorganisms9061230 -
International Journal of Dentistry 2021Resin-dentin bond strength decreases over time. This reduction is related to the loss of hybrid layer integrity. Collagenolytic enzymes, especially matrix... (Review)
Review
OBJECTIVES
Resin-dentin bond strength decreases over time. This reduction is related to the loss of hybrid layer integrity. Collagenolytic enzymes, especially matrix metalloproteinases (MMPs), are responsible for the degradation of the collagen matrix of the hybrid layer. Various MMP inhibitors with the ability to prevent enzymatic degradation have been identified. This study aimed to systematically review the literature for studies which evaluated the effect of MMP inhibitors on the immediate and aged dentin bond strengths. Screening and analysis were carried out by two reviewers. Two databases were searched, and from a total of 740 articles, 43 were accepted for full review. 21 articles with 0.2%-2% chlorhexidine (CHX) treatments were included for meta-analysis. A risk of bias assessment was performed on all studies chosen for meta-analysis. A variety of MMP inhibitors have been studied, CHX being the most widely used.
CONCLUSIONS
A clear trend for a lower loss of dentin bond strength was observed with different MMP inhibitors. In meta-analysis, no significant difference was seen between the CHX and control in the immediate bond strengths. Bond strengths in the CHX group were significantly higher than the control group after aging ( < 0.001). The percentage of fractures occurring at the adhesive interface increased after aging. Five out of 21 studies included in the meta-analysis had high and the rest medium risk of bias. More long-term studies with lower risks of bias should be carried out to increase the reliability of results. The use of MMP inhibition with chlorhexidine can be recommended to increase the longevity of resin-dentin bond strength.
PubMed: 34135969
DOI: 10.1155/2021/9949699 -
Iranian Endodontic Journal 2021The aim of our systematic review was to assess the impact of gutta-percha solvents on the bond strength of endodontic sealers to intraradicular dentin using the push-out... (Review)
Review
INTRODUCTION
The aim of our systematic review was to assess the impact of gutta-percha solvents on the bond strength of endodontic sealers to intraradicular dentin using the push-out bond test.
METHODS AND MATERIALS
The literature was searched in databases (PubMed, Web of Science and Scopus) up to September 2020, using the following search terms: (bond strength AND solvent* AND sealer* AND (tooth root OR dentin OR retreatment OR root canal). No date limits were implemented, and English languages were included. The question research was constructed based on the PICO () strategy: "Does gutta-percha solvents effect the bond strength of sealers to intraradicular dentin?". The studies were analyzed by two reviewers and were included if they utilized extracted permanent human teeth with completely formed apices, as well as assessed the influence of gutta-percha solvents on the bond strength of sealers to intraradicular dentin using push-out bond test. Review articles, case reports and studies that included immature, bovine or artificial teeth were excluded. The risk of bias was evaluated based on the Cochrane criteria adopted to studies.
RESULTS
Thirty-two papers were analyzed, seven accomplished the eligibility criteria and were selected for our systematic review. The global risk of bias was high. Due to variations in the methodological variables, a meta-analysis could not be performed.
CONCLUSION
Our systematic review highlighted the adverse effect of chloroform, which decreased the bond strength of different sealers, and the generally higher bond strength of epoxy resin-based sealers, detected with the push-out bond test. We recommend the standardization of methods in future studies to obtain a more definitive conclusion about the influence of solvents on the bond strength of sealers to intraradicular dentin.
PubMed: 36704416
DOI: 10.22037/iej.v16i1.29297