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Journal of Dental Research Mar 2023There have been significant advances in adhesive dentistry in recent decades, with efforts being made to improve the mechanical and bonding properties of resin-based... (Review)
Review
There have been significant advances in adhesive dentistry in recent decades, with efforts being made to improve the mechanical and bonding properties of resin-based dental adhesive materials. Various attempts have been made to achieve versatility, introducing functional monomers and silanes into the materials' composition to enable the chemical reaction with tooth structure and restorative materials and a multimode use. The novel adhesive materials also tend to be simpler in terms of clinical use, requiring reduced number of steps, making them less technique sensitive. However, these materials must also be reliable and have a long-lasting bond with different substrates. In order to fulfill these arduous tasks, different chemical constituents and different techniques are continuously being developed and introduced into dental adhesive materials. This critical review aims to discuss the concepts behind novel monomers, bioactive molecules, and alternative techniques recently implemented in adhesive dentistry. Incorporating monomers that are more resistant to hydrolytic degradation and functional monomers that enhance the micromechanical retention and improve chemical interactions between adhesive resin materials and various substrates improved the performance of adhesive materials. The current trend is to blend bioactive molecules into adhesive materials to enhance the mechanical properties and prevent endogenous enzymatic degradation of the dental substrate, thus ensuring the longevity of resin-dentin bonds. Moreover, alternative etching materials and techniques have been developed to address the drawbacks of phosphoric acid dentin etching. Altogether, we are witnessing a dynamic era in adhesive dentistry, with advancements aiming to bring us closer to simple and reliable bonding. However, simplification and novelty should not be achieved at the expense of material properties.
Topics: Dental Cements; Dental Bonding; Resin Cements; Acid Etching, Dental; Dental Materials; Materials Testing; Dentin-Bonding Agents; Dentin; Composite Resins
PubMed: 36694473
DOI: 10.1177/00220345221145673 -
International Endodontic Journal Nov 2021Cemental tears are an important condition of relevance to Endodontics but are often overlooked. A cemental tear is the partial or complete detachment of the cementum... (Review)
Review
Cemental tears are an important condition of relevance to Endodontics but are often overlooked. A cemental tear is the partial or complete detachment of the cementum from the cemento-dentinal junction or along the incremental line within the body of cementum. The limited attention received is most likely due to the limited awareness amongst dental professionals and challenges in accurately diagnosing them, resulting in misdiagnosis and erroneous treatment. The aim of this review is to describe the: (i) epidemiology and predisposing factors; (ii) clinical, radiographic and histological features and (iii) the clinical management and treatment outcomes of cemental tear. The review included 37 articles published in English that comprised eight observational studies and 29 case reports. The prevalence of cemental tears was reported to be lower than 2%; whilst the incidence remains unknown. Internal factors due to the inherent structural weakness of cementum and its interface with the dentine, and external factors that are associated with stress have been proposed as the two mechanisms responsible for the development and propagation of cemental tears. Predisposing factors that have been implicated were tooth type, gender, age, previous root canal treatment, history of dental trauma, occlusal trauma and excessive occlusal force; however, evidence is limited. Common clinical and radiographic manifestations of cemental tears resemble the presentations of primary endodontic diseases, primary periodontal diseases and combined endodontic-periodontal lesions. Clinical management tended to focus on complete removal of the torn fragments and periodontal treatment, often combined with regenerative treatment. In this article, a new classification for cemental tears is developed that consists of classes 0 to 6 and stages A, B, C and D based on the: (i) location and accessibility of the torn cemental fragment; (ii) the pattern and extension of the associated bony defect in relation to the root length and (iii) the number of root surface/s affected by the cemental tear/s and the associated bony defect. Recommendations for treatment strategies are also provided and linked to the classification to aid in streamlining the process of treatment decision making.
Topics: Dental Cementum; Endodontics; Humans; Root Canal Therapy; Tooth Fractures; Tooth Injuries
PubMed: 34403513
DOI: 10.1111/iej.13611 -
Journal of Esthetic and Restorative... Oct 2023Currently, a classification of resin cements that includes relatively recently formulated ("universal") cements is lacking. Furthermore, the terminology used to define... (Review)
Review
OBJECTIVES
Currently, 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.
METHODS
An analysis of peer-reviewed literature (PubMed search), as well as market research on definitive resin composite cements were performed.
RESULTS
A 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.
CONCLUSIONS
This 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 SIGNIFICANCE
The 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.
Topics: Resin Cements; Reproducibility of Results; Dental Bonding; Materials Testing; Composite Resins; Dental Cements; Surface Properties
PubMed: 36924395
DOI: 10.1111/jerd.13036 -
International Endodontic Journal Feb 2018Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in... (Review)
Review
Mineral trioxide aggregate (MTA) is a bioactive endodontic cement (BEC) mainly comprised of calcium and silicate elements. The cement was introduced by Torabinejad in the 1990s and has been approved by the Food and Drug Administration to be used in the United States in 1997. A number of new BECs have also been introduced to the market, including BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, NeoMTA Plus, OrthoMTA, Quick-Set, RetroMTA, Tech Biosealer and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA without its drawbacks. In this article, the chemical composition and the application of MTA and other BECs for vital pulp therapy (VPT), including indirect pulp cap, direct pulp cap, partial pulpotomy, pulpotomy and partial pulpectomy, have been reviewed and compared. Based on selected keywords, all papers regarding chemical composition and VPT applications of BECs had been reviewed. Most of the materials had calcium and silicate in their composition. Instead of referring to the cements based on their chemical compositions, we suggest the term 'bioactive endodontic cements (BECs)', which seems more appropriate for these materials because, in spite of differences in their chemical compositions, bioactivity is a common property for all of them. Numerous articles were found regarding use of BECs as VPT agents for indirect and direct pulp capping, partial pulpotomy and cervical pulpotomy. Most of these investigations used MTA for VPT. In most studies, newly introduced materials have been compared to MTA. Some of the BECs have shown promising results; however, the number of their studies compared to investigations on MTA is limited. Most studies had several methodological shortcomings. Future investigations with rigorous methods and materials are needed.
Topics: Aluminum Compounds; Biocompatible Materials; Calcium Compounds; Dental Cements; Dental Pulp Capping; Drug Combinations; Humans; Oxides; Pulpotomy; Silicates
PubMed: 28836288
DOI: 10.1111/iej.12841 -
Dental Materials : Official Publication... Nov 2022A low-shrinkage-stress resin-based cement with antibacterial properties could be beneficial to create a cement with lower stress at the tooth-restoration interface,...
OBJECTIVE
A low-shrinkage-stress resin-based cement with antibacterial properties could be beneficial to create a cement with lower stress at the tooth-restoration interface, which could help to enhance the longevity of the fixed dental restoration by reducing microleakage and recurrent caries. To date, there has been no report on the development of a low-shrinkage-stress and bio-interactive cement. Therefore, the objectives of this study were to develop a novel low-shrinkage-stress resin-based cement containing dimethylaminohexadecyl methacrylate (DMAHDM) and investigate the mechanical and antibacterial properties for the first time.
METHODS
The monomers urethane dimethacrylate (UDMA) and triethylene glycol divinylbenzyl ether (TEG-DVBE) were combined and denoted as UV resin. Three cements were fabricated: (1) UV+ 0%DMAHDM (experimental control); (2) UV+ 3%DMAHDM, (3) UV+ %5DMAHDM. RelyX Ultimate cement was used as commercial control. Mechanical properties and Streptococcus mutans (S. mutans) biofilms growth on cement were evaluated.
RESULTS
The novel bio-interactive cement demonstrated excellent antibacterial and mechanical properties. Compared to commercial and experimental controls, adding DMAHDM into the UV cement significantly reduced colony forming unit (CFU) counts by approximately 7 orders of magnitude, metabolic activities from 0.29 ± 0.03 A/cm to 0.01 ± 0.01 A/cm, and lactic acid production from 22.3 ± 0.74 mmol/L to 1.2 ± 0.27 mmol/L (n = 6) (p < 0.05). The low-shrinkage-stress cement demonstrated a high degree of conversion of around 70 %, while reducing the shrinkage stress by approximately 60%, compared to a commercial control (p < 0.05).
CONCLUSIONS
The new antibacterial low-shrinkage-stress resin-based cement provides strong antibacterial action and maintains excellent mechanical properties with reduced polymerization shrinkage stress.
CLINICAL SIGNIFICANCE
A low-shrinkage-stress resin-based cement containing DMAHDM was developed with potent antibacterial effects and promising mechanical properties. This cement may potentially enhance the longevity of fixed dental restoration such as a dental crown, inlay, onlay, and veneers through its excellent mechanical properties, low shrinkage stress, and strong antibacterial properties.
Topics: Anti-Bacterial Agents; Biofilms; Dental Cements; Dental Materials; Ethers; Lactic Acid; Methacrylates; Methylamines; Resin Cements
PubMed: 36115699
DOI: 10.1016/j.dental.2022.08.005 -
International Endodontic Journal Mar 2018Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures,... (Review)
Review
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
Topics: Aluminum Compounds; Animals; Calcium Compounds; Dental Cements; Drug Combinations; Humans; Oxides; Root Canal Filling Materials; Silicates
PubMed: 28846134
DOI: 10.1111/iej.12843 -
Journal of the Mechanical Behavior of... May 2022A non-leaching antibacterial bone cement has been developed and evaluated. Chlorine- and bromine-containing furanone derivatives were synthesized and covalently coated...
A non-leaching antibacterial bone cement has been developed and evaluated. Chlorine- and bromine-containing furanone derivatives were synthesized and covalently coated onto the surface of zirconia filler particles, followed by mixing into a conventional poly(methyl methacrylate) bone cement. Flexural strength and bacterial viability were used to evaluate the modified cements. Effects of coated antibacterial moiety content, coated zirconia loading and halogen on furanone were investigated. Results showed that the experimental cement showed significant enhanced antibacterial function against bone-associated Gram-positive Staphylococcus aureus as well as Gram-negative Pseudomonas aeruginosa, as compared to commercial PMMA cement. The cement also exhibited a comparable flexural strength to and 3-14% higher flexural modulus than commercial PMMA bone cement. Increasing antibacterial moiety content and filler loading significantly enhanced antibacterial activity. Increasing antibacterial moiety content slightly increased both flexural strength and modulus of the modified cement. Increasing filler loading slightly increased flexural strength up to 7% loading and then decreased. The bromine-containing furanone modified cement showed a higher antibacterial activity than its chlorine counterpart. Antibacterial agent leaching tests exhibited that the modified experimental cement showed no leachable antibacterial components to surroundings. Within the limitations of this study, this experimental poly(methyl methacrylate) cement may find potential applications in orthopedics for reducing in-surgical and post-surgical infection after further investigations are conducted.
Topics: Anti-Bacterial Agents; Bone Cements; Bromine; Chlorine; Glass Ionomer Cements; Materials Testing; Polymethyl Methacrylate; Zirconium
PubMed: 35279449
DOI: 10.1016/j.jmbbm.2022.105135 -
Journal of Esthetic and Restorative... Jun 2022This study aims to evaluate and compare the film thickness obtained with a resin cement and two composite resins, preheated and/or ultrasonically vibrated, as luting...
OBJECTIVE
This study aims to evaluate and compare the film thickness obtained with a resin cement and two composite resins, preheated and/or ultrasonically vibrated, as luting agents.
MATERIALS AND METHODS
One hundred and twenty-six (126) pairs of resin discs were randomly assigned to six experimental groups (n = 21) according to luting agent (Variolink Esthetic LC, IPS Empress Direct or Estelite Omega) and cementation technique (preheating at 68°C and/or ultrasonic vibration). Specimens were luted by applying a controlled force. Following sectioning and film thickness measurement through field emission gun scanning electron microscopy, statistical analysis was carried out considering a 5% significance level.
RESULTS
Statistically significant lower film thickness was observed in Variolink Esthetic LC group when compared to all composite resin groups (p < 0.001), except IPS Empress Direct preheated and ultrasonically vibrated group (p = 0.073). IPS Empress Direct with ultrasonic vibration yielded statistically lower film thickness values than Estelite Omega groups, regardless of luting technique (p < 0.05). Ultrasonically vibrated Estelite Omega groups showed statistically lower film thickness values than solely preheated groups (p < 0.05).
CONCLUSIONS
Both Variolink Esthetic LC and IPS Empress Direct preheated and ultrasonically vibrated provided the lowest film thickness. The addition of ultrasonic vibration during cementation proved to be effective in reducing film thickness of both tested composite resins.
CLINICAL SIGNIFICANCE
The cementation technique will have variable results depending on the luting material. Adhesive cementation protocols with composite resins should mainly consider ultrasonic vibration, but also preheating, as strategies for reducing film thickness. The tested resin cement, alongside with IPS Empress Direct composite resin preheated and ultrasonically vibrated, provided the lowest film thickness among the tested materials and techniques.
Topics: Cementation; Composite Resins; Dental Bonding; Dental Cements; Dental Porcelain; Materials Testing; Resin Cements; Surface Properties; Random Allocation
PubMed: 34897958
DOI: 10.1111/jerd.12851 -
Dental Materials : Official Publication... Jan 2019Adhesive systems are resin-based materials that reach their final mechanical properties through a polymerization process. Previous literature correlated the failure of... (Review)
Review
Adhesive systems are resin-based materials that reach their final mechanical properties through a polymerization process. Previous literature correlated the failure of the adhesive interface to low polymer setting. Adhesives systems are elaborate mixtures of different molecules of both hydrophilic and hydrophobic nature, included in the formulation to adequately infiltrate the complex dental substrate or added to prolong the stability of the adhesive layer over time. Each adhesive component may influence the polymerization reaction of the material. Photopolymerization is a complex reaction that has several clinical implications, and besides the material composition, it is influenced by multiple factors, including the substrate characteristics, the operator technique, and the light cure unit properties. This review is focused on the analysis of factors that have a potential role in the setting of adhesive materials and thus the ultimate characteristics of the adhesive layer and the stability of the resin-dentin interface.
Topics: Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Light-Curing of Dental Adhesives; Materials Testing; Polymerization; Resin Cements
PubMed: 30554830
DOI: 10.1016/j.dental.2018.11.012 -
Materials Science & Engineering. C,... Apr 2019Metal oxide nanoparticles are a new class of important materials used in a wide variety of biomedical applications. Bulk zinc oxide (ZnO) particles have been used for...
Metal oxide nanoparticles are a new class of important materials used in a wide variety of biomedical applications. Bulk zinc oxide (ZnO) particles have been used for temporal or permanent luting cement because of their excellent mechanical strength and biocompatibility. ZnO nanoparticles have distinct optical and antibacterial properties and a high surface-to-volume ratio. We investigated the mechanical and antibacterial properties of luting cement with different ratios of ZnO nanospheres. We showed that luting cement with 5% and 10% ZnO nanospheres was less soluble in low-pH (pH 3) artificial saliva. Antibacterial activity was 40% higher for Streptococcus mutans and 90% higher for Porphyromonas gingivalis when >10% (w/v) of the bulk particles were replaced with ZnO nanospheres in ZnO polycarboxylate cement. ZnO nanospheres were also biocompatible with mammalian cells. Additionally, the compressive strength was 1.2 times greater and the diametral tensile strength was 1.5 times greater for cements with 10% ZnO nanospheres than for conventional ZnO polycarboxylate cement. We propose a new method for improving dental luting cement by integrating it with ZnO nanospheres. This method simultaneously adds their greater antibacterial, mechanical, and acid resistance properties and retains an outstanding degree of biocompatibility.
Topics: Animals; Anti-Bacterial Agents; Dental Cements; Dental Implants; Dose-Response Relationship, Drug; Hydrogen-Ion Concentration; Materials Testing; Mice; Nanospheres; Polycarboxylate Cement; Porphyromonas gingivalis; Saliva; Streptococcus mutans; Tensile Strength; Zinc Oxide
PubMed: 30678896
DOI: 10.1016/j.msec.2018.12.007