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Objectives In-vitro evaluation of the influence of preparation design and thickness of ceramic veneers on the interfacial bond using optical coherence tomography (OCT). Methods Sixty-four central incisors were randomly assigned to four preparation designs differing from no to complete dentine exposure (n = 16 each): non-prep (NP), minimal-invasive (MI, no dentine exposure), semi-invasive (SI, 50% dentine) and invasive (I, 100% dentine). Ceramic veneers (IPS InLine Veneer) of two thicknesses (0.2−0.5 mm (T1) and > 0.5–1.2 mm (T2)) were etched, silanized, and adhesively luted (Optibond FL, Variolink Veneer). After water storage (37 °C, 21d), thermocycling (2000 cycles, 5°-55 °C), and mechanical loading (2 + 1 million cycles, 50 + 100 N) specimens were imaged by spectral-domain OCT (Telesto II, Thorlabs). Adhesive defects at the ceramic-composite and tooth-composite interfaces were quantified on 35 equidistantly distributed OCT B-scans (length, %). Statistical differences were verified with Wilcoxon-/Mann-Whitney-U-test (α = 0.05). Results Adhesive defects appeared in all groups at both interfaces, albeit to differing extents (0.1 – 31.7%). NP and MI veneers showed no significant differences at the interfaces (pi > 0.05). In groups, SI and I, significantly more adhesive defects appeared at the tooth-composite compared to the veneer-composite interface (pi ≤ 0.039). The following preparation designs and veneer thicknesses showed differences (pi ≤ 0.021): Veneer-composite: NP-T1 I-T2; Tooth-composite: NP-T1 MI-T2, MI-T1 Significance The interface adhesion of ceramic veneers was influenced by the preparation design and the veneer thickness. A ceramic thickness of at least 0.5 mm and a preparation without exposing dentine is advantageous for the interfacial bond.

To investigate the clinical behavior of two different resin-based restorative systems in extended Class II cavities in a controlled prospective split-mouth study over 12 years and to assess marginal quality under a SEM using epoxy replicas.Thirty patients received 68 resin composite restorations (Solobond M+Grandio: n=36; Syntac+Tetric Ceram: n=32) by one dentist in a private practice. 35% of cavities revealed no enamel at the bottom of the proximal box, 48% of cavities provided0.5mm remaining proximal enamel. Restorations were examined according to modified USPHS criteria at baseline, and after six months, one, two, four, six, eight, 10, and 12 years. Expoxy replicas of 21 restoration pairs were analysed under a SEM at 200× magnification regarding marginal quality.At the 12-years recall, 59 of the original 68 restorations in 27 of 30 patients were available (drop out 13%). Two restorations failed due to cusp fracture (Tetric Ceram) and marginal fracture (Grandio). The overall success rate of all restorations was 97.1% (Kaplan-Meier survival algorithm) with no differences between the two materials (p=0.923). After 144 months of clinical service, restorations in molars performed worse than in premolars regarding the integrity of restoration and tooth (p0.05) being detected as wear, chippings, and cracks. Beyond the 4-year recall, marginal staining significantly increased. SEM evaluation of replicas revealed that perfect margin (49% baseline vs. 10% after 12 years), overhang (13% at baseline vs. 3% after 12 years), negative step formation (34% at baseline vs. 75% after 12 years), and marginal fractures (0% at baseline vs. 6% after 12 years) significantly changed during the evaluation period (p0.001).Extended direct resin composite restorations performed satisfactorily over 12 years of clinical service. SEM analysis delivered qualitative data regarding marginal deterioration over time.

Aim Diode lasers are commonly used for antimicrobial photodynamic therapy (aPDT). This study aimed to assess the feasibility of transgingival laser irradiation during aPDT and evaluate whether the photosensitizer can be activated. Materials and Methods Four diode laser settings were assessed for transgingival irradiation: 120 mW, 80 mW, 60 mW, and 40 mW. Fifteen soft-tissue pieces from a pig’s lower jaw were prepared. The specimens’ thickness was measured and transgingival laser irradiation was performed. A digital power meter measured laser power on the other side of the tissue. The power outcome after staining of the nonbuccal aspect of the tissue with photosensitizer dye was assessed similarly. Results Transgingival laser irradiation (average soft-tissue thickness: 0.84 ± 0.06 mm) resulted in different power transmission depending on the power settings and photosensitizer. The lowest values were observed with the 40 mW setting and photosensitizer (median 3.3 mW, max. 5.0 mW, min. 2.3 mW, interquartile range 1.2), and the highest at 120 mW without photosensitizer (median 41.3 mW, max. 42.7 mW, min. 38.0 mW; interquartile range 1.5). Conclusions This study indicates that transgingival irradiation may be suitable for aPDT, since power transmission through the gingival tissue was observed in all specimens. However, the decrease in laser power caused by both the soft tissue and the photosensitizer has to be taken into account.

Objective To investigate secondary caries inhibition after dentine pre-treatment with 2% CHX, experimental addition of CHX in primer and adhesive of a 3-step adhesive system, and industrial addition od CHX in a 2-step adhesive system. Materials and method Sixty Class-V cavities were restored according to the adhesive protocol (n = 12): 1) control group, Scotchbond Multi-Purpose, 3M (CTRL), 2) 2% CHX dentine pre-treatment (DENT), 3) 0.1% CHX in primer (PRIM), 4) 0.1% CHX in bonding agent (BOND), 5) Peak Universal Bond including 0.2% CHX (PEAK). Specimens were thermocycled (10,000 cycles) and inserted into a Streptococcus mutans biofilm artificial mouth (caries model). The 10-day biological loading protocol consisted of consecutive phases of demineralisation (1 h) and remineralisation (5 h). Evaluation under a fluorescence microscope (demineralisation) and an SEM (marginal gap) followed, at restoration margins, and at 0.3 mm and 0.5 mm distance from the margins, in enamel and in dentine. Total demineralization was calculated as the sum of demineralisation and substance loss due to demineralisation. Results PRIM (p = 0.007, mod. LSD), BOND (p = 0.012, mod. LSD) and PEAK (p = 0.008, mod. LSD) exhibited significantly higher total demineralisation values in enamel margins than CTRL. No significant differences were noted for total demineralisation in dentine. Regarding marginal gaps, DENT exhibited significantly lower enamel gap values compared to all other groups (p = 0.001). Conclusions 2% CHX as dentine pre-treatment, 0.1% or 0.2% CHX added in adhesives did not provide any antibacterial effect regarding secondary caries in dentine. On the other hand, 2% CHX dentine pre-treatment managed to limit marginal gap formation in enamel compared to the other adhesive protocols in the study.

Aim of the present study was to evaluate resin composite adhesion to dental hard tissues affected by molar incisor hypomineralisation (MIH).94 freshly extracted human molars and incisors (53 suffering MIH) were used. 68 teeth (35 with MIH) were used for μ-TBS tests in enamel and dentin, 26 (18 with MIH) for qualitative evaluation. Specimens were bonded with Clearfil SE Bond, Scotchbond Universal, and OptiBond FL. For MIH affected enamel, additional OptiBond FL groups with NaOCl and NaOCl+Icon were investigated. Beside fractographic analysis, also qualitative evaluations were performed using SEM at different magnifications as well as histological sectioning.Highest μ-TBS values were recorded with dentin specimens (ANOVA, mod. LSD, p0.05). Results were independent of adhesive and dentin substrate (p0.05). Pre-test failures did not occur in dentin specimens. Sound enamel specimens exhibited significantly higher μ-TBS values than MIH enamel (p0.05). The two-step self-etch adhesive (Clearfil SE Bond) and the two-step etch-and-rinse adhesive (Scotchbond Universal) showed the lowest values in affected enamel specimens (p0.05) with most pre-test failures (p0.05). OptiBond FL on affected enamel showed better results than Clearfil SE Bond (p0.05). An additional pre-treatment of affected enamel with NaOCl or NaOCl and Icon did not enhance enamel bonding (p0.05), however, it caused less pre-test failures (p0.05). Micromorphological analyses revealed that conventional phosphoric acid etching produces a much less pronounced etching pattern in affected enamel and a porous structure as weak link for the resin-enamel bond was identified.Bonding to porous hypomineralized MIH enamel is the limiting factor in adhesion to MIH teeth. MIH-affected dentin may be bonded conventionally.

Introduction Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration with or without ferrule support was not systematically reviewed so far. It was assumed that the effect of an endodontic post compared with a post-free restoration can be evaluated only when at the same time a ferrule or no-ferrule situation was clinically compared. Methods The specific PICO question was as follows: Patient: adults with sufficient endodontic treatment needing a core or post; Intervention: post-endodontic treatment using posts with or without ferrule; Comparison: post-endodontic treatment without posts with or without ferrule; Outcomes: failure rates of post/core complexes with or without ferrule support. A Medline search was performed via PubMed in June 2017 using relevant electronic databases. Additionally, hand search was performed. Only prospective clinical studies in humans comparing the success/survival of teeth restored with or without posts over a minimum time of observation of 5 years were included. Results In total, 7 randomized controlled trials and 1 prospective clinical trial met inclusion criteria. Cochrane rating showed high risk of bias in 5 studies. Two of 3 studies support the ferrule-effect concept. Seven of 8 show no post effect. Clinical evidence regarding the influence of tooth location on its survival is scarce. Conclusion Ferrule effect and maintaining cavity walls are the predominant factors with regard to tooth and restoration survival of endodontically treated teeth. Most studies do not confirm a positive effect of post placement.

Aim of the present study was to evaluate fracture strength of endodontically treated molars with different preparations/restorations after thermomechanical loading in vitro.264 extracted human third molars were used. Beside the control group, 256 teeth in 32 test groups (n=8) received root canal treatment (MTwo #40/.6) and root canal obturation with AH Plus and Guttapercha. After postendodontic sealing and build-up (Syntac, SDR), specimens were additionally prepared MO or MOD. Postendodontic restorations were: Direct restorations (Tetric EvoCeram Bulk Fill bonded with Syntac; as filling or direct partial crown (PC) after reducing the cusps 3mm; amalgam as filling or direct pin-retained partial crown (PC)), vs. indirect adhesive restorations (I: Inlay vs. PC; IPS Empress I/PC; Celtra Duo I/PC; e.max CAD I/PC; Lava Ultimate I/PC; Enamic I/PC - all inserted with Syntac/Variolink) vs. cemented cast gold I/PC. After 300,000 thermocycles (5/55°C) and 1.2 Mio. 100N load cycles, specimens were loaded until fracture.Whereas IPS Empress showed no difference between I and PC (p0.05), in all other groups PC were significantly more stable than fillings/inlays (p0.05), this effect was more pronounced after MOD preparations. Cast gold PC exhibited the highest fracture strengths (p0.05), inlays the lowest (p0.05). IPS Empress was generally inferior to the other bonded materials under investigation (p0.05) which as PC almost reached the level of control specimens. Amalgam fillings showed the worst outcome (p0.05).Less invasive preparation designs were not beneficial for the stability of postendodontic restorations. Except for IPS Empress, PC were generally more successful in restabilization of weakened cusps after endodontic treatment and preparation. Cast gold PC remain the ultimate stabilization tool for ETT in terms of fracture resistance.

Introduction This ex vivo pilot study tested the influence of defect extension and quartz-fiber post placement (QFP) on the ex vivo survival rate and fracture resistance of root-treated upper central incisors served as abutments for zirconia 2-unit cantilever fixed partial dentures (2U-FPDs) exposed to 10 years of simulated clinical function. Methods Human maxillary central incisors were endodontically treated and divided into the following 5 groups (n = 8): (1) access cavity filled with core build-up composite, (2) biproximal class III cavities filled as in group 1, (3) specimens restored as in group 2 with QFP placed, (4) specimens decoronated and core buildup as in group 1, and (5) specimens restored as in group 4 but with QFP as in group 3. On all specimens, 2U-FPDs were placed with dual-curing resin cement. In order to simulate 10 years of clinical function, specimens were exposed to thermal cycling and mechanical loading with subsequent loading to failure. Kaplan-Meier curves were constructed, and log-rank tests were performed. Fracture force and patterns were compared by means of Kruskal-Wallis, Mann-Whitney U (post hoc), and Fisher exact tests, respectively (P = .05). Results For specimens only with an access cavity, it was observed that 25% had catastrophic tooth fractures and the lowest load-to-fracture values. In all other groups, chipping combined with or without debonding occurred. Groups did not differ significantly regarding the survival rate (P = .603) and fracture patterns (P = .633), but they did for fracture load including technical failures (P = .017). Conclusions After 10 years of simulated clinical function, both defect extension and placement of QFP had no significant influence on survival of root-treated upper central incisors as abutments restored with zirconia-based 2U-FPDs.

Objective This study evaluated marginal integrity of bonded posterior resin composite fillings to enamel and dentine with and without 4 mm flowable base, before and after thermo-mechanical loading (TML). Methods 80 MOD cavities with one proximal box beneath the CEJ were prepared in extracted human third molars. Direct resin composite restorations (SDR with CeramX mono, Tetric EvoCeram, Filtek Supreme XT, and Venus Diamond or the respective resin composites alone) were bonded with system immanent adhesives XP Bond, Xeno V, Syntac, Adper Prompt L-Pop, and iBond self-etch. Before and after thermomechanical loading (100,000 × 50 N, 2500 thermocycles between 5 and 55 °C), marginal gaps were analysed using SEM of epoxy resin replicas. Results were analysed with Kruskal–Wallis and Mann–Whitney U-tests (p Results In enamel, high percentages of gap-free margins were initially identified for all adhesives. After TML, etch-and-rinse adhesives performed better than self-etch adhesives (p 0.05). Conclusions SDR as 4 mm bulk fill dentine replacement showed an good performance with the material combinations under investigation.

The aim of this investigation was to test the in vitro performance of a self-adhesive resin composite core build-up in comparison with two typical conventional etch-and-rinse composite core build-up materials, before and after 1year of storage in 0.5% chloramine solution (LTS). Sixty human maxillary central incisors were divided into three groups. Teeth were root filled and decoronated. Specimens were restored using glass fiber posts cemented with a self-adhesive resin cement. Core build-ups were made with a self-adhesive (U) and two core build-up materials (C and L) applied with their corresponding bonding systems. All specimens received adhesively luted lithium disilicate crowns. Ten specimens of each group were exposed to LTS and examined monthly for cracks or other alterations. All specimens were thermocycled, mechanically loaded (TCML) and finally loaded until failure occurred. There was no statistical significant difference in regard to the number of failures during TCML without and with LTS (log rank: p = 0.225 and 0.609, respectively). The median fracture load values after static loading without LTS and with LTS did not differ significantly (Kruskal-Wallis test: p = 0.057 and 0.106, respectively), though the fracture patterns between the groups without (p = 0.024) and with LTS (p = 0.027) did. Self-adhesive cements used for core build-up have no significantly higher risk of failure compared to conventional core build-up materials in both LTS and TCML test scenarios.

Introduction: The aim of this study was to evaluate the bond strength of different adhesive sealers on Resilon and gutta-percha. Methods: Pellets of gutta-percha and Resilon were embedded into test tubes. Small eyelets were attached to those surfaces with a 0.5-mm film of different root canal sealers. Real Seal, Real Seal SE, Hybrid Root Seal (also known as Meta Seal), and AH Plus were used. AH Plus as a nonadhesive sealer served as a control group. In all groups (n = 10) shear bond strength was measured. Results: Shear bond strength was relatively low (0.1–3 MPa) and significantly higher in the groups with a single component adhesive sealer. No substantial bond strength was found in the control group. Overall bond strength to Resilon was higher than to gutta-percha but not significant compared with the Hybrid Root Seal group. Conclusions: With single component self-adhesive sealers, an adhesive connection might be formed to gutta-percha as well as to Resilon.

The aim of the present study was to evaluate the ormocer Definite (Degudent, Hanau, Germany) as resin luting cement.In a controlled prospective clinical study, 57 Cergogold (Degudent) all-ceramic inlays were placed in 24 patients by four dentists. The restorations were luted with two different systems (MD=Definite Multibond+Definite; SV=Syntac+Variolink Ultra, Ivoclar Vivadent, Liechtenstein) without lining. At baseline, after 12, 24, and 48 months, restorations were examined according to modified USPHS scores and criteria.One patient including three restorations missed the 4 years recall (dropout). After 48 months of clinical service, four restorations in four patients (three luted with Definite, one with Variolink) failed due to inlay fracture (n=3) and tooth fracture (n=1), all other fillings were clinically acceptable (survival rate 93.3% for Definite vs. 95.2% for Variolink; Kaplan-Meier algorithm). Except for the rate of hypersensitivity at baseline (MD: 27%; SV 0%; p0.05), no differences were evident between the luting cements at any recalls (Mann-Whitney U-test; p0.05). Between the four recalls, a statistically significant deterioration was detected for both groups regarding the criteria marginal adaptation, filling integrity (cracks/chippings/fractures), and tooth integrity (Friedman test; p0.001). After 4 years, mainly distinct deterioration with marginal fractures or chippings in proximal and marginal areas of the inlays were observed. No differences were found for surface roughness, color matching, and proximal contact (p0.05).For luting of ceramic inlays, only slight differences between the two luting systems were detectable.

Objectives To calculate the probability of interface imperfections within SEM cross-sections of adhesively luted GFP depending on the level of analysis and the cement application method by means of LOM (light-optical microscopic evaluation method). Material and methods Four groups of artificial root canals received GFPs ( n = 5) under following experimental conditions: I = RelyX™ Unicem, applied with application aid, II = RelyX™ Unicem, III = Panavia F 2.0 and IV = Variolink II. In groups II–IV only posts were loaded with cement (i.e. conventional post cementation). After GFP cementation, standardized photographs were taken perpendicularly to post surface under light-optical microscope from two opposite sides. The length of homogenous cement interface areas were measured using surface-analyzing software. The homogenous areas were related to length of apical, middle, cervical post section and to complete post length to generate the probabilities (%) of hitting imperfections when using SEM cross-section analysis. Results The probabilities (%) of hitting imperfections within SEM cross-sections for cervical, middle, and apical level of analysis were: I = 78, 64, 82; II = 89, 98, 99; III = 72, 91, 99; and IV = 85, 91, 97, respectively. For complete post length median values of probabilities (%) were: I = 75; II = 95; III = 87; and IV = 91. Significance The probabilities show, that SEM cross-section evaluation concerning detection of cement interface imperfections of adhesively luted GFPs depends on the cement application method and the level of analysis and seeming therefore not always unrestricted representative for the whole specimen.

Resin composite materials tend to accumulate microorganisms and dental plaque, which in turn may induce secondary caries around adhesive restorations. The aim of the present in vitro study was to evaluate the antibacterial activity of a resin composite material loaded with silver microparticles against Streptococcus mutans.Circular specimens (10.0mm in diameter) of a resin composite matrix loaded with two different concentrations of a silver additive (Comp0.3: 0.3%; Comp0.6: 0.6%) and one unloaded reference composite matrix (Comp0: 0%) were made. Surface roughness R(a) was assessed by perthometer measurements and hydrophobicity according to water contact angles was determined by computerized image analysis. The specimens were incubated in a S. mutans suspension (1h, 37 degrees C) and adhering streptococci were quantified by using a biofluorescence assay (Alamar blue/Resazurin). Additionally, the viability of adhering bacteria was assessed by live/dead cell labelling in combination with fluorescence microscopy.Statistically significant differences between the median water contact angles of Comp0 (66.3 degrees ), Comp0.3 (76.7 degrees ), and Comp0.6 (89.4 degrees ) were observed (p0.001). A three- to fourfold higher amount of adhering S. mutans was found on reference Comp0 (12,093relative fluorescence units) than on Comp0.3 (4258rfu) and Comp0.6 (3292) (p0.001 for both). Significantly higher percentages of dead cells than on Comp0 (0.5%) were found on Comp0.3 (6.1%) and on Comp0.6 (10.1%) (p0.001 for both).The addition of microparticulate silver to a resin composite material increased the surface hydrophobicity and reduced the number of adhering streptococci. Simultaneously it increased the percentage of dead and inactive cells on the composite surface. Thus, silver additives seem to demonstrate anti-adherence activity as well as a bactericidal effect.

To evaluate marginal integrity of IPS Empress inlays luted with different adhesives and cements before and after thermo-mechanical loading (TML).MOD cavities with one proximal box beneath the cementoenamel junction were prepared in 72 extracted human third molars. IPS Empress inlays were luted with nine combinations of adhesive and luting composite or self-etch cement alone (n=8): PrimeBond NT Dual-Cure+Calibra (PC), XP BOND/SCA+Calibra (XC), XP BOND/SCA light-cured+Calibra (XL), Syntac+Variolink II (SV), Multilink Primer+Multilink (ML), AdhesSE DC+Variolink II (AV), ED Primer+Panavia F 2.0 (EP), RelyX Unicem (RU), and Maxcem (MC). Marginal quality was analyzed under an SEM using epoxy resin replicas before and after thermo-mechanical loading (100,000x50N and 2500 thermocylces between +5 and +55 degrees C).All systems involving the etch-and-rinse approach resulted in significantly higher percentages of gap-free margins in enamel than all other luting systems (p0.05). ML and AV achieved higher percentages of gap-free margins in enamel than EP and RU (p0.05), with EP and RU being significantly above MC (p0.05). For dentine margins, XP Bond resulted in significantly higher percentages of gap-free margins than PrimeBond NT, independent of a separate light-curing step (p0.05). Between the luting systems XC, XL, SV, ML, AV, ED, EP, and RU, no significant differences were computed (p0.05). MC ranged at the end of the statistical subsets with 62% gap-free margins (p0.05; Mann-Whitney U-test).Etch-and-rinse adhesives combined with conventional luting resin composites reveal still the best prognosis for adhesive luting of glass ceramic inlays.

Objective The aim of the present study was to investigate the influence of the rigidity of different post materials (titanium versus glass fiber reinforced composite [FRC]) on the fracture resistance of endodontically treated teeth (ETT). Method Forty-eight caries-free maxillary central incisors were randomly assigned to six groups (n = 8). After endodontic treatment, teeth of four groups were flattened 2 mm above and two groups at the cemento-enamel junction (CEJ). As control, specimens of one group received neither composite build-up nor post, and teeth were left empty (E). In another group only a resin composite build-up was placed (C). In two groups, both titanium and FRC posts were inserted. One group with titanium (2/T) and FRC (2/FRC) post received a 2 mm deep ferrule preparation. For one group with titanium (0/T) and FRC (0/FRC) post no ferrule design was provided. All-ceramic crowns were adhesively luted on all specimens. Specimens were exposed to thermomechanical loading and finally statically loaded until failure. Results The median fracture load values (min–max) were: E = 317 (242–404); C = 387 (335–475); 0/FRC = 352 (0–440); 2/FRC = 502 (326–561); 0/T = 420 (0–548), 2/T = 517 (416–653). Statistically significant differences were computed between E, C, 2/FRC, 0/T and 2/T; between C, 2/FRC and 2/T; between 0/FRC, 2/FRC and 2/T; between 0/T and 2/T regarding maximum fracture load. Significance Fracture resistance of ETT is not influenced by the rigidity of the post material. The combination of ferrule preparation and endodontic post results in higher load resistance after TML than any other build-up design.

Glass ceramics;Dentin bondingagents;Etch-and-rinse;Self-etch;Clinical trialSummary Objective. The aim of the present study was to clinically evaluate theeffect of two different adhesive/resin composite combinations for luting of IPSEmpress inlays.Methods. Ninety-four IPS Empress restorations were placed in 31 patients in acontrolled prospective clinical split-mouth study. The restorations were luted withEBS Multi/Compolute (3M Espe) or with Syntac/Variolink II low (Ivoclar Vivadent)without lining. At baseline and after 0.5, 1, 2, and 4 years, the ceramic restorationswere examined according to modified USPHS codes and criteria.Results. Two patients including four restorations missed the 4 years recall (dropout). After 4 years of clinical service, four restorations in two patients (three lutedwith Compolute, one with Variolink II) had to be replaced due to hypersensitivities,90 inlays and onlays were acceptable (failure rate 4%; Kaplan–Meier survivalanalysis). Between the five recalls, a statistically significant deterioration wasfound for the criteria marginal adaptation and inlay fracture (Friedman 2-wayANOVA; p!0.05). Between the adhesives no statistical difference was found. Atbaseline, 95% of the restorations revealed luting composite overhangs. After 4 years,55% of cases had overhangs and 38% showed marginal ditching. No differences werefound for surface roughness, color matching, integrity tooth, proximal contact,hypersensitivity, and satisfaction (pO0.05).Conclusion. For luting of ceramic inlays, no difference between the two lutingsystems was detectable. The overall failure rate after 4 years was 4%.Q 2005 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

This study evaluated the marginal integrity of dentine adhesives bonded to enamel and dentine, before and after thermo-mechanical loading (TML).MO cavities with proximal boxes beneath the CEJ were prepared in extracted human third molars. Direct resin composite restorations (Tetric Ceram) were bonded with 3-step etch-and-rinse (Syntac Classic, Solobond Plus, OptiBond FL), 2-step etch-and-rinse (Admira Bond, Single Bond), 2-step self-etch (AdheSE, Clearfil SE Bond), and 1-step self-etch (all-in-one) adhesives (Adper Prompt, Xeno III, iBond). Marginal gaps were analyzed using SEM of epoxy resin replicas. Bonded interfaces before TML were examined with TEM to identify pre-existing attributes for subsequent marginal disintegration.In enamel, high percentages of gap-free margins were initially identified for all adhesives. After TML, etch-and-rinse adhesives exhibited significantly higher percentages of gap-free margins (approximately 90%) compared with two-step self-etch (approximately 75%) and all-in-one (approximately 55%) adhesives (p0.05). iBond did not completely etch through the enamel smear layer. In dentine, 89-100% gap-free margins were initially observed. After TML, there were no statistical differences among etch-and-rinse (62-70%) and two-step self-etch (62-63%) adhesives (p0.05). The all-in-one adhesives exhibited significantly less gap-free margins (40%) in dentine (p0.05), with iBond showing the worst marginal integrity (15%). The presence of pre-existing water channels within the adhesives probably expedited water sorption when restorations were under functional stresses.Enamel bonding was more effective with phosphoric acid-etching. Etch-and-rinse and 2-step self-etch adhesives showed promising marginal adaptation to dentine and may have a better clinical prognosis than the all-in-one bonding approach.

To compare the adhesive capability of the new adhesive Prompt L-Pop (ESPE) with that of two total-etch adhesive systems-EBS Multi (ESPE) and PrimeBond NT (Dentsply).Extracted human molars were bonded and prepared for microtensile dentin bond strength (microTBS) testing using Prompt L-Pop, EBS Multi, and PrimeBond NT combined with Pertac II (composite) or Hytac Aplitip (compomer). Prompt L-Pop was applied using five different protocols: (1) as an "all-in-one" self-conditioning adhesive, as per manufacturer's instructions (LP); (2) as a self-etching primer combined with a separate bonding resin (LP/self-etch 2-step); (3) as a classical primer used upon etching dentin with phosphoric acid, followed by a bonding resin (LP/total-etch 3-step); (4) as a multi-application "all-in-one" self-conditioning adhesive (LP/multi-coat) to leave a visibly glossy dentin surface; and (5) as a filled adhesive, upon adding quartz fillers to its composition (LP/filled). After 24h of storage in water at 37 degrees C the microTBS were measured in an Instron machine. Corresponding interfaces of the same specimens were micromorphologically analyzed using SEM and TEM.When used with a composite resin, LP/filled and LP/multi-coat resulted in significantly higher microTBS than LP. The addition of an extra adhesive bonding resin (LP/self-etch 2-step) had no effect on bond strength. The use of Prompt L-Pop as a primer of a fourth-generation adhesive (LP/total-etch 3-step) replacing the EBS Multi primer, resulted in lower bond strengths than those of the original EBS Multi. LP/multi-coat showed similar microTBS to PrimeBond NT (PBNT). When used with a compomer, LP exhibited higher bond strengths than when used with the resin composite and was as effective as the experimental groups LP/filled and LP/multi-coat and the control group PBNT. The SEM evaluation showed an inconsistent hybrid layer for the LP specimens, whereas in both the LP/filled and LP/multi-coat specimens a hybrid layer was clearly evident. Under the TEM all groups displayed dentin hybridization with dissolved smear plugs in the specimens that had been conditioned with Prompt L-Pop without a separate etching step. In many tubules of specimens conditioned with LP (as per manufacturer's instructions), fillers of the resin composite were present within the dentinal tubules.When combined with a resin composite, Prompt L-Pop resulted in statistically lower bond strengths when applied in one layer than when applied in multiple layers. Prompt L-Pop also resulted in higher bond strengths when used with a polyacid-modified composite resin than with a composite resin. When applied in multiple coats, Prompt L-Pop results in bond strengths that are not statistically different from those of PrimeBond NT, a total-etch adhesive.

Objective: Ceramic inlays are used as esthetic alternatives to amalgam and other metallic materials for the restoration of badly damaged teeth. However, only limited clinical data are available regarding adhesive inlays and onlays with proximal margins located in dentine. In a prospective, controlled clinical study, the performance of IPS Empress inlays and onlays with cuspal replacements and margins below the amelocemental junction was examined. Materials and methods: Ninety-six IPS Empress fillings were placed in 34 patients by six clinicians. The restorations were luted with four different composite systems. The dentin bonding system Syntac Classic was used in addition to the acid-etch-technique. At baseline and after 6 months, one, two and four years after placement the restorations were assessed by two calibrated investigators using modified USPHS codes and criteria. A representative sample of the restorations was investigated by scanning electron microscopy to evaluate wear. Results: Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier). Four inlays had suffered cohesive bulk fractures and three teeth required endodontic treatment. After four years in clinical service, significant deterioration (Friedman 2-way Anova; p

The aim of this study was to evaluate the influence of moisture on apical leakage using five different types of sealer. There were 120 single-rooted teeth instrumented to .02/#60 and randomly assigned to 10 experimental groups, one control group (AH Plus, lateral condensation) (n = 10) or positive/negative controls (n = 5). Before obturation teeth were dried thoroughly, followed by recontamination with moisture in a wet chamber (moist groups; 37 degrees C for 7 days). The teeth of the experimental groups (a, dry; b, moist) were obturated with sealer (groups 1, AH Plus; 2, Apexit; 3, Ketac-Endo; 4, RoekoSeal; 5, Tubli-Seal) and a single gutta-percha cone .02/#55. Teeth were centrifuged (30 x g for 3 minutes) in 5% methylene blue. Linear dye penetration was measured under a stereomicroscope. Moisture led to less microleakage for Apexit, RoekoSeal, and Tubli-Seal and higher values for AH Plus and Ketac-Endo. Multifactorial ANOVA displayed a significant dependence of leakage on sealer (p < 0.001) and the combination sealer or moisture (p < 0.01). It depends on the sealer type in which way moisture affects the apical seal.