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Complete removal of the collagen matrix with sodium hypochlorite (NaOCl) as an adjunctive step of restorative and adhesive dentistry is still a subject for debate. This study evaluated the efficacy of a 12 w/v% NaOCl solution for complete removal of exposed collagen matrices from acid-etched dentin surfaces within a maximum clinically possible period of 120 seconds and a longer period of application (10 minutes) using confocal reflection/immuno-fluorescence microscopy and ESEM. An extended period (45 minutes) of NaOCl application was also performed as a negative control. Unstained and immunohistochemically-stained collagen fibrils were imaged using a confocal laser-scanning microscope for the reflection/fluorescence experiment. Fully-hydrated specimens were also examined with an ESEM. Unetched dentin was devoid of exposed collagen fibrils. Conversely, confocal microscopy showed demineralized collagen after acid-etching, which appeared as a hydrogel-like layer during ESEM examination. The application of NaOCl for two minutes left remnants of dentin collagen on intertubular and intratubular surfaces. The ESEM examination confirmed the presence of remnants of a hydrogel-like layer. After 10 minutes of NaOCl application, residual collagen reflection and immuno-fluorescence signals were detected around dentinal tubules, appearing as spike-like projections during the ESEM investigation. Complete dissolution of the collagen presence was achieved after 45 minutes of NaOCl treatment. Complete deproteinization of acid-etched dentin is unachievable in a maximum clinically possible period of 120 seconds.

Air-abrasion is a tooth preparation technology developed in the 1940s that is currently gaining popularity due to its compatibility with adhesive restorations. Variables, including propellant pressure, powder flow rate, nozzle angle and distance to the tooth surface abrasion time, can affect the cutting rate of the air-abrasion unit. A static setup and a more clinically realistic dynamic experimental setup have been used to assess the effect of these parameters of the cutting rate on an enamel analogue. By keeping each parameter fixed, its effect on the cutting rate was examined. The results showed that increasing the propellant pressure (20-100 PSI) caused an almost linear increase in the cutting rate in both setups. Increasing the powder flow rate (0.5 - 3 g/minute) concurrently increased the powder flow and caused an increase in the cutting rate but with a plateau differing for the different propellant pressures. The nozzle angles producing the highest cutting rates were 60 degrees and 75 degrees for static and dynamic cutting, respectively, with smaller and larger angles producing lower rates. Increasing abrasion time in static cutting and the nozzle advancement rate in dynamic cutting both caused an increase in the cutting rate. These findings are relevant for both clinicians, who might wish to alter the cutting rate of their instrument, and researchers, who should always control the numerous parameters in studies involving air-abrasion in order to control the variables, which can influence the end effect of air-abrasion.

We reviewed studies wherein the cutting of dental tissues, simulating interactions that would occur under clinical circumstances in the mouth, have been observed directly-first by real time, video rate, stereoscopic, three-dimensional scanning electron microscopy; and second and more conveniently, by video rate confocal optical microscopy. We have observed, directly, both the interactions of slow-moving cutting instruments emulating "chisels" and high-speed events, including the effects of rotary burs and air-propelled abrasive particles and soft powder slurries. The observational data contribute to our basic understanding of the functional behavior of dental tissues and formed a useful background for the practitioner of operative dentistry.

This study evaluated the long-term durability of three one-step adhesive-composite systems to ground enamel and dentin. Twenty-seven teeth were randomly divided into three groups of nine. The first group had its crowns sectioned to expose superficial dentin, which was then ground with 600 grit SiC paper. One of three one-step adhesives: a trial bonding agent, OBF-2; i Bond or Adper Prompt L-Pop was applied to the dentin of three teeth and built-up with the corresponding resin composite (Estelite sigma, Venus or Filtek Supreme). The second group of nine teeth had their enamel approximal surfaces ground with wet 600-grit SiC paper, then one of the three one-step adhesives was applied and built-up with resin composite. The bonded specimens were sliced into 0.7 mm-thick slabs. After 24 hours and one year of water storage at 37 degrees C, the slabs were sectioned into beams for the microtensile bond strength test. Failure modes were observed using optical and electron scanning microscopy. The third group of nine teeth had approximal wedge-shaped cavities prepared above the CEJ into dentin. Two-to-three grains of rhodamine B were added to each of the three adhesives prior to restoring the cavities with resin composite. After 24 hours storage, the teeth were sectioned and their interfaces examined with a laser scanning confocal microscope. The bond strengths of the three adhesive-composite systems to both enamel and dentin significantly lessened after one year of water storage, however, there was no significant difference between the materials.

SUMMARY The aim of this study was to evaluate the effects of extended light-curing procedures on the microtensile bond strength (μTBS) of one-step self-etch adhesives (1-SEAs) submitted to simulated pulpal pressure. Coronal deep-dentin specimens were bonded using Clearfil S3 Bond (S3), Adper Easy Bond (EB), or G-Bond Plus (GB) following the manufacturers' recommendations and light-cured for 10 seconds or 40 seconds. The dentin-bonded specimens were stored in distilled water for 24 hours without pulpal pressure (control) or submitted to 20 cm H2O simulated pulpal pressure for 24 hours. The specimens were cut into matchsticks and subjected to μTBS testing. The data were statistically analyzed using the three-way analysis of variance and Tukey's tests (p

SUMMARY This study investigated the effect of loading on the bond strength to dentin and microleakage of MOD indirect composite restorations bonded with self-adhesive and self-etching resin cements with or without acid etching of the proximal enamel margins. Class II MOD cavities were prepared in 48 molar teeth into dentin and divided into three groups of 16 teeth. Impressions were taken and indirect composite inlays fabricated (Estenia C & B). The enamel margins of the proximal boxes of half the specimens were phosphoric acid etched, and the inlays were cemented with one of three cements (Panavia F 2.0, SA Cement, or Rely X Unicem). After luting, eight teeth in each cement group were mechanically loaded at 2.5 cycles/s for 250,000 cycles. Unloaded teeth acted as controls. Teeth were stored in Rhodamine B solution for 24 hours, sectioned buccolingually at the proximal boxes to examine microleakage using confocal microscopy, and further sectioned for μTBS testing of the resin-dentin interface. Analysis of variance was performed to assess the effect of loading and acid etching on microleakage and bond strength. Acid etching had no effect on microleakage. No significant difference in the dentin bond strengths between the three cements existed after loading. Panavia F 2.0 exhibited a significant reduction in bond strength. With regard to microleakage at the proximal boxes, loading had no effect on dye penetration at the cavity floor. However, at the axial walls, loading had a significant deleterious effect on Panavia F 2.0. No difference in microleakage existed between the three cements at both sites before and after loading. In conclusion, the two tested self-adhesive cements exhibited similar bond strengths before and after loading to the self-etching resin cement. Loading reduced dentin bond strengths and increased microleakage at the resin-dentin interface. However, acid etching of the enamel margins had no significant effect on microleakage in the approximal regions of the bonded inlays.

This study evaluated the influence of surface treatments and metal primers on the bond strength of resin cements to a yttrium-stabilized tetragonal zirconia (Y-TZP) ceramic. Two-hundred and forty plates of Y-TZP ceramic were randomly assigned to 24 groups (n = 10) according to the combination of surface treatment (none, air abrasion with Al2O3 particles, Er:YAG laser irradiation), metal primer (none, Alloy Primer, Metal Primer II or Metaltite) and resin cement (Calibra [Bis-GMA-based] or Panavia F2.0 [MDP-based]). Fragments of dentin with a cylindrical edge (0.8 mm in diameter) were fixed to ceramic surfaces with the resin cements. The micro-shear bond test was carried out at a 1 mm/minute speed until failure, and the ceramic surfaces were examined after debonding. Bond strengths were analyzed through three-way ANOVA/Tukey test with a 5% significance level. Changes in topography after surface treatments were evaluated with scanning electron microscopy. Surface treatments significantly modified the topography of the Y-TZP ceramic. Air abrasion resulted in increased bond strength for both resin cements. However, air abraded and laser irradiated specimens presented higher bond strength with the Bis-GMA-based resin cement than with the MDP-based cement. Both cements presented similar behavior on untreated surfaces. The three metal primers yielded a significant increase in bond strength, regardless of the surface treatment and resin cement. Adhesive failures were the most prevalent. Air abrasion with Al2O3 particles and the application of metal primers increased bond strength to Y-TZP surfaces for both resin cements.

Compared to conventional ceramic systems, Yttrium-stabilized tetragonal zirconia (Y-TZP) ceramics have some superior mechanical properties, ensuring a broad application in dentistry. The current study aimed to present relevant information about Y-TZP ceramics gathered from peer-reviewed papers. A search of the English language peer-reviewed literature was conducted using the PubMed database between 1998 and 2008. Articles that did not focus exclusively on the clinical application of Y-TZP ceramic restorations were excluded from further evaluation. Selected papers describe the chief characteristics of zirconia ceramics and important clinical features, especially those related to cementation procedures. The literature shows that, although new substances and equipment for the surface preparation of zirconia ceramics are in development, the most promising luting protocol seems to be the use of air abrasion with aluminum oxide particles (silanated or not), followed by the application of resin cements or surface primers containing special reactive monomers. However, because zirconia ceramics have only recently been developed for dental applications, there is not enough clinical evidence to support any definitive cementation protocol.

This study investigated the hypothesis that coating eroded teeth with a resin-based dentin bonding agent gave protection from tooth wear. Nineteen adults with palatal tooth wear exposing dentin were recruited, following referral by their general dental practitioner. Alternate teeth were coated with the resin adhesive, while the uncoated teeth acted as controls. Accurate impressions of the eroded teeth, onto which were cemented machined stainless steel discs to act as reference areas, were scanned with a non-contacting laser profilometer at 3, 6, 12 and 24 months. The mean thickness of resin at baseline application was 0.15 mm and, from 0 to 6 months, the rate of wear of the control teeth was higher than those covered with Seal & Protect. There was a statistically significant difference in "wear" measured between resin covered and control teeth at three months. The Inter Class Correlations (repeated measurements) for the step heights obtained for the original and repeat impressions was excellent at 0.99. This study shows that coating eroded teeth with a resin-based adhesive has the potential to prevent further tooth wear.

Prospective clinical studies comparing the results of different types of restorations of endodontically treated teeth are lacking. This study compared the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite to the restorations of premolars using amalgam. Premolars with Class II carious lesions were selected and randomly assigned to one of two experimental groups: (1) restoration with amalgam or (2) restoration with fiber posts and composite. One hundred and nine teeth were included in Group 1 and 110 in Group 2. Patients were recalled after 1, 3 and 5 years. No statistically significant difference was found between the proportion of failed teeth in the two experimental groups. Significant differences were observed between the proportion of root fractures (p=0.029) and caries (p=0.047), with more root fractures and less caries observed in the teeth restored with amalgam at the five-year recall. Within the limits of this study, it can be concluded that restorations with fiber posts and composite were found to be more effective than amalgam in preventing root fractures but less effective in preventing secondary caries.