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Numerous systematic reviews (SRs) have produced conflicting findings on engine‐driven nickel–titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health‐related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high‐quality evidence, future well‐designed studies and reviews considering core outcome measures are needed. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta‐analysis aimed to evaluate the difference in the color stability of light‐cured and dual‐cured resin cements. Materials and Methods: Two separate reviewers used the PubMed, Scopus, Web of Science, Embase, and Scielo databases to execute the systematic review. For the analysis, studies that evaluated the color stability of dual‐cured and light‐cured resin cements over time were used. The random effects model was used in the meta‐analysis. Analyses of subgroups were carried out based on the aging technique. The methodological quality of each in vitro study was evaluated in accordance with the parameters of a prior systematic review. Results: From all databases, a total of 2223 articles were retrieved. Following the screening of titles and abstracts, 44 studies were selected for full text review, and a total of 27 articles were used for the qualitative analysis. Finally, 23 articles remained for the qualitative analysis. The majority of studies were labeled as having a medium risk of bias. The global analysis showed that the dual‐cure resin cements had considerably greater differences in the color change (p = 0.006). A high heterogeneity index (86%) was found in the analysis. Conclusions: The best available in vitro evidence suggests that dual‐polymerizing cement has higher color variation than light‐polymerized materials. To reduce the likelihood of color change after the luting of thin ceramic restorations, clinicians should employ light‐polymerizable resin cements. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the whiteness index (WID) and surface roughness (Ra) of bovine enamel after simulated tooth brushing with different commercial and experimental whitening dentifrices. Materials and Methods: Cylindrical enamel bovine specimens were acid etched, stained, and divided in nine groups (n = 8): Colgate® Optic White®, Crest® Baking Soda and Peroxide, Arm and Hammer® Advanced White™ Extreme Whitening, Rembrandt® Deeply White® + Peroxide, Close up® White Attraction Natural Glow, Hinode Prowhite, and experimental dentifrice containing papain (PP), bromelain (PB), or papain and bromelain (PPB). Ra and WID were obtained initially and after 600, 1200, and 3,600 cycles of simulated tooth brushing. Data were analyzed using two‐way analysis of variance test (α = 0.05). Results: Ra was significantly influenced by both dentifrice (p = 0.043) and period of tooth‐brushing simulation (p < 0.001). Except for PP and PPB, all groups showed a statistically significant increase in Ra after simulated tooth brushing. After staining and brushing, none of the materials tested increased the initial WID. Conclusions: The effect of commercial whitening dentifrices may be related to their high abrasiveness. Experimental formulations tested provided a similar effect without undesired wear of enamel. Whitening dentifrices only act through an abrasive effect rather than bleaching the tooth structures. When used, special care must be taken for avoid undesired wear of enamel. Experimental dentifrices provided similar removal of extrinsic stains without undesired abrasiveness; however, this effect may be due to the use of less aggressive abrasives in their formulations. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the efficacy of natural bleaching agents and the current technological development in this research field. Two reviewers performed a literature search up to July 2019 in 15 databases. Five laboratory studies and 25 patents were included. Data regarding natural bleaching agent used, application protocol, and the main findings of studies were analyzed. Laboratory studies that evaluated natural bleaching agents' peroxide-free or associated to peroxides and patents related to natural bleaching agents were included. The studies evaluated papain, bromelain, chlorine dioxide, sodium chloride plus vinegar and sodium bicarbonate as peroxide-free agents; and sweet potato extract, lactoperoxidase, and peroxidase associated to peroxide used were included. Twenty-five patents were included; among the most cited are the papain and the chlorine. The addition of non-peroxide agents into peroxide showed improvement in bleaching effect with the incorporation of these non-peroxide agents (p < .05). On the other hand, peroxide-free agents did not show an improvement in bleaching effect (p < .05). The evidence in literature suggested that natural bleaching agents incorporated to peroxide may improve the bleaching. Therefore, the current literature does not support the use of natural agents as dental bleaching. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the in vitro bond strength of universal adhesive systems to indirect substrates. Material and Methods: Two reviewers performed a literature search up to March 2018 in seven databases: PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO. The review included studies that compared the bond strength of universal adhesives and well‐established material‐specific primers to indirect substrates: lithium disilicate ceramic, yttrium‐stabilized zirconium dioxide ceramic, leucite‐reinforced ceramic, feldspathic porcelain, polymer infiltrated ceramic material, resin composite or metal alloys. Analyses were carried out using RevMan 5.3.5. A global comparison was performed with the standardized mean difference using a random‐effects models at a significance level of p < 0.05. Results: A total of 45 studies were included in the qualitative analysis, and the meta‐analysis was performed with 42 studies. Bond strength to glass‐based ceramics and alloys was improved with the use of a specific‐primer as separate step before the bonding procedures (lithium disilicate, p < 0.001; alloys, p < 0.001). The bond strength to zirconium substrates was improved with the use of universal adhesives (p < 0.001). For bond strength to composite resin as indirect substrate, universal adhesives performed in a manner similar to that of the material‐specific primer (p = 0.11). Conclusions: The clinical procedure of luting zirconia and resin composite restorations could be simplified by using single‐bottle universal adhesives. However, the ability of universal adhesives to achieve an adequate and durable bond to glass‐based ceramics and alloys appears to be limited. [ABSTRACT FROM AUTHOR]

To evaluate the properties of experimental mineral trioxide aggregate (MTA) resin‐modified materials for root‐end filling procedures, varying their compositions regarding the addition of hydroxiapatite (HA) or dicalcium phosphate dihydrate, with or without chlorhexidine digluconate. White MTA (Angelus, Londrina, Brazil) was used as a reference material. Degree of conversion (DC) was evaluated by Fourier transformed infrared (FTIr) spectroscopy (n = 5). Flowability (n = 3) and radiopacity (n = 3) were evaluated following ISO 6876:2001 methods. For splitting tensile strength analysis, cylindrical samples (n = 10) were subjected to compressive load using a universal testing machine (Instron Corporation, Norwood, MA). Water sorption and solubility tests were performed according to ISO 4049:2009 methods. Calcium ion release and pH analysis (n = 10) were evaluated using a pH meter (Orion, Watsonville, CA). Cytotoxicity (n = 8) of materials extracts was evaluated as cell viability percentage. Statistical analysis was performed using Kolmogorov–Smirnov for normal distribution and data was subjected to one‐way ANOVA and Tukey test (α = 0.05). Addition of chlorhexidine digluconate reduced DC mean values for experimental materials (<50%). White MTA demonstrated lower flowability (5.3 mm) and higher radiopacity (9.8 mm Al), splitting tensile strength (9.1 MPa), solubility (8.2 μg/mm3), calcium ion release (~26.5 ppm), cytotoxicity (55.2%), and pH mean values (10.8), when compared to experimental materials. All groups demonstrated a decrease in calcium release (<85%) and pH (<13%). Formulation containing HA demonstrated similar pH values after 28 days when compared to white MTA. Evaluated experimental resin‐modified MTA based materials without chlorhexidine digluconate showed satisfactory results for all physico‐chemical properties tested and cytotoxicity. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2195–2201, 2019. [ABSTRACT FROM AUTHOR]

Abstract: Background: The use of bioactive proteins, such as rhBMP‐2, may improve bone regeneration in oral and maxillofacial surgery. Purpose: Analyze the effect of using bioactive proteins for bone regeneration in implant‐based rehabilitation. Materials and Methods: Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant‐based rehabilitation were included. Statistical analyses were carried out using a random‐effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05). Results: Seventeen studies were included in the qualitative analysis, and 16 in the meta‐analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow‐up, no statistically significant differences were observed for implant survival (P > .05). Conclusions: Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long‐term effect of using bioactive treatments for implant‐based rehabilitation. [ABSTRACT FROM AUTHOR]

Abstract: To systematically review the literature to analyze the current trends and future perspectives of dental pulp capping materials through an analysis of scientific and technological data. This study is reported in accordance with the PRISMA Statement. Nine databases were screened: PubMed (MedLine), Lilacs, IBECS, BBO, Web of Science, Scopus, SciELO, Google Scholar, and The Cochrane Library. Additionally, the following patent applications were searched online in Questel Orbit (Paris, France), USPTO, EPO, JPO, INPI, and Patentscope databases. A total of 716 papers and 83 patents were included. Calcium hydroxide was the main type of material studied, especially for direct pulp capping, followed by MTA. Patents related to adhesives or resins increased from 1998 e 2008, while in the last years, a major increase was observed in bioactive materials (containing bioactive proteins), materials derived from MTA (calcium silicate, calcium phosphate and calcium aluminate‐based cements) and MTA. It was possible to obtain a scientific and technological overview of pulp capping materials. MTA has shown favorable results in vital pulp therapy that seem to surpass the disadvantages of calcium hydroxide. Recent advances in bioactive materials and those derived from MTA have shown promising results that could improve biomaterials used in vital pulp treatments. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1358–1368, 2018. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review the literature of animal studies to evaluate whether bioactive dentin proteins could improve vital pulp therapy success. The review is reported in accordance with the PRISMA Statement. Two reviewers independently conducted a literature search of seven databases: PubMed (Medline), Lilacs, IBECS, BBO, Web of Science, Scopus, and SciELO. Animal experiments in which bioactive dentin proteins were applied directly or indirectly to the pulp tissue were included. Data regarding the characteristics of the proteins evaluated, the delivery systems used and the main findings from each study were tabulated to assess the outcomes of interest (tertiary dentin formation, inflammatory response, intratubular mineralization). After screening, 32 papers were subjected to qualitative analysis. In 75% of the studies, direct pulp capping was performed. Additionally, the most studied proteins were BMP-7, TGF-β1, and extracted soluble dentin matrix proteins. In conclusion, there is evidence in the literature suggesting that bioactive dentin molecules could enhance tertiary dentin formation with fewer initial inflammatory responses in direct and indirect pulp therapy in animal models. There are potential areas to be explored for novel therapeutic approaches for dental tissue repair and regeneration with bioactive materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 941-956, 2017. [ABSTRACT FROM AUTHOR]

The ethyl-4-dimethylaminobenzoate (EDAB) is widely used as a coinitiator of the camphorquinone (CQ), but in acidic circumstances it might present some instability, reducing the polymerization efficiency of the material. Considering this, new coinitiators are being evaluated. Hence, this study evaluated the kinetic of polymerization (KP), the degree of conversion (DC), and the rate of polymerization ( RP) of experimental resin adhesives containing 1,3-diethyl-2-thiobarbituric acid (TBA) as a coinitiator of the CQ. The experimental monomeric blend was prepared with bisphenol A glycidyl dimethacrylate, 2-hydroxyethyl methacrylate, and acidic monomers. CQ was added at 1 mol % as photoinitiator. Six groups were formulated: four containing concentrations of 0.1, 0.5, 1, and 2 mol % of TBA, one without coinitiator, and the last one containing 1 mol % of EDAB (control group). The KP and the RP were performed using real-time Fourier Transform infrared spectroscopy. The group without coinitiator has not formed a polymer, whereas the addition of TBA resulted in the conversion of monomers in polymer. The DC of the adhesives was as higher as the increase in the TBA content. The group with 2 mol % of TBA presented improved DC and reactivity ( RP) than the other groups and the control one. Hence, the TBA has performed as a coinitiator of the CQ for the radical polymerization of methacrylate resin adhesives and it has improved the DC and the reactivity of the materials. Thus, it is a potential coinitiator for the photopolymerization of dental materials. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 101B: 1217-1221, 2013. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of benzodioxole derivatives as coinitiators of radical polymerization in a model-dental adhesive resin. To compose the adhesive resin, a monomer mixture based on 50 wt % of Bis-GMA, 25 wt % of TEGDMA, and 25 wt % of HEMA was used. Camphorquinone (CQ) 1 mol % was used as a photoinitiator to initiate polymerization. 1,3-Benzodioxole (BDO) and piperonyl alcohol (PA) were used as coinitiators at 0.25, 0.5, 1, 2, 4, 8, and 16 mol % level. In addition, tertiary amine, ethyl 4-dimethylamino benzoate (EDAB) was used as coinitiator in the control group. Some physical, chemical, and mechanical properties of the polymer formed in the experimental adhesives were evaluated using the kinetics of polymerization, sorption and solubility, flexural strength, and elastic modulus tests. The results indicated that BDO and PA were effective coinitiators in the photoinitiator system based on CQ. Comparisons between the benzodioxoles derivative coinitiators and EDAB showed similar performance in the kinetics of polymerization and flexural strength. For water sorption and solubility evaluation, BDO and PA demonstrated significantly more sorption of water and less solubility than the EDAB control group. The findings suggest that BDO and PA were feasible alternatives to conventional amine as coinitiator. © 2012 Wiley Periodicals, Inc. J. Appl. Polym. Sci., 2013 [ABSTRACT FROM AUTHOR]

This study investigated properties of resin-luting agents using silane [3-(trimethoxysilyl)propyl methacrylate (TSPM)], phosphoric acid methacrylate (PAM) [mono/ bis(methacryloyloxyethyl (di)hydrogen phosphate)], or carboxylic acid methacrylate (CAM) [mono-2-(methacryloyloxy)ethyl maleate] as coupling agents between the inorganic and organic phases. Ba-B-Al-Si microparticles (3 μm) and SiO2 nanoparticles (7 nm) were coated with TSPM, PAM, or CAM (control = no filler coating). A Bis-GMA/triethyleneglycol dimethacrylate comonomer was loaded with 60% mass of inorganic fillers. The properties evaluated were degree of CC conversion (DC), flexural strength (σ), and modulus ( E f), Knoop hardness number (KHN), and film thickness (FT). Dispersion/interaction of the particles with the resin phase was assessed by scanning electron microscopy (SEM). No significant differences in DC were observed. For σ and E f, TSPM > CAM > Control > PAM. For KHN, TSPM > CAM > PAM = Control. For FT, TSPM < Control < CAM < PAM. The SEM analysis revealed clustering of nanoparticles for all groups and better organic-inorganic phases interaction for TSPM and CAM. The use of TSPM generated agents with improved properties as compared with the acidic methacrylates, with CAM showing better performance than PAM. The use of PAM generated agents with properties usually poorer compared with the material with no coupling agent. © 2012 Wiley Periodicals, Inc. J. Appl. Polym. Sci., 2013 [ABSTRACT FROM AUTHOR]

Alginate hydrogel (AH) has intrinsic physical and biological limitations that hinder its broader application in tissue engineering. We hypothesized that the inclusion of nanofibers in the hydrogel and the use of a biotemplate that mimics nature would enhance the translational potential of alginate hydrogels. In this study, we have shown a method to obtain nano-/microfibers of titanium (nfTD) and hydroxyapatite (nfHY) using cotton as a biotemplate. These fibers were incorporated in the alginate hydrogel and the mechanical characteristics and biological response to these reinforced materials were evaluated. We observed that these nanofibers resembled the structure of natural collagen and did not mediate cell toxicity. The incorporation of nfTD or nfHY to the AH has not increased the viscosity of the hydrogel. Therefore, this is a feasible method to produce a scaffold with improved physical characteristics, while at the same time generating an enhanced environment for cell adhesion and proliferation. © 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 100A:3051-3058, 2012. [ABSTRACT FROM AUTHOR]

This study evaluated the influence of surfactant dimethacrylates (SD) on the resin-to-dentin microtensile bond strength (μTBS) and characterized the interfacial micromorphology of the hybrid layer of the experimental HEMA-free self-etching systems. Five experimental HEMA-free two-step self-etching systems containing different SD (Bis-EMA 10, Bis-EMA 30, PEG 400, PEG 1000, and PEG 400 UDMA) and a HEMA-containing system (control) were compared. Each experimental adhesive system was applied and resin composite restorations were incrementally built up in bovine incisors. After 24 h, restored teeth were sectioned to obtain 24 sticks per group. Thereafter, the specimens were subjected to the μTBS test. Data (MPa) were analyzed by One-way ANOVA and Tukey's test. Adhesive-dentin interfaces were analyzed through Scanning Electron Microscopy (SEM). The adhesive system formulated with PEG 400 UDMA produced μTBS similar to the HEMA-containing group and statistically higher than the HEMA-free groups. Similar failure percentages were observed in the PEG 400 UDMA and the control group. In the SEM analysis, all the adhesive systems presented similar partially demineralized hybrid layer (1.5-3.0 μm thickness) with well-formed resin tags. All SD presented reasonable initial μTBS, with the PEG 400 UDMA being a promising monomer to be considered as a HEMA substitute in adhesive systems compositions. © 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2011. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of different concentrations of 2-hydroxyethyl methacrylate (HEMA) on the inhibition of matrix metalloproteinase-2 (MMP-2) in vitro. Mouse gingival explants were cultured overnight in Dulbecco’s modified Eagle’s minimal essential medium, following which the expression of secreted enzymes was analyzed by gelatin zymography and the effects of different amounts of HEMA on enzyme activity were investigated. The gelatinolytic proteinases present in the conditioned media were characterized as being matrix metalloproteinases (MMPs) by means of specific chemical inhibition. The MMPs present in the conditioned media were identified, using immunoprecipitation, as MMP-2. Three major bands were detected in the zymographic assays and were characterized, according to their respective molecular weights, into the following forms of MMP-2: zymogene (72 kDa), intermediate (66 kDa), and active (62 kDa). All forms of MMP-2 were inhibited by HEMA in a dose-dependent manner, implying that MMP-2 may be inhibited by HEMA in vivo. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of organic solvent concentration on the polymerization kinetics for a model dental adhesive resin containing a ternary photoinitiator system. A monomer blend based on the bis‐GMA, TEGDMA, and HEMA was used as a model dental adhesive resin, which was polymerized using a binary system [camphorquinone (CQ) and ethyl 4‐dimethylamine benzoate (EDAB)] and a ternary system [CQ, EDAB, and diphenyliodonium hexafluorphosphate (DPIHFP)]. Additionally, these blends had 0, 10, 20, 30, and 40 wt % ethanol added. Real‐time Fourier transform infrared spectroscopy was used to investigate the polymerization reaction over photoactivation time. Data were plotted, and Hill's three‐parameter nonlinear regression was performed for curve fitting. The addition of a solvent to the monomer blends decreased the polymerization kinetics, directly affecting the rate of polymerization, delaying vitrification, and attenuating the Trommsdorf effect. The introduction of DPIHFP displayed a strong increase in reaction kinetics, reducing the solvent inhibition effect. After 10 s of photoactivation, the binary system obtained in 0, 10, 20, 30, and 40% of ethanol, a degree of conversion of 44.6, 26.3, 13.4, 1.15, and 0.0%, respectively, whereas when a ternary system was used, the values were 54.6, 40.5, 27.4, 14.5, and 3.4%. An improvement was observed in the polymerization kinetics of a model dental adhesive resin when using a ternary photoinitiation system, making the material less sensitive to the residual presence of a solvent before photoactivation. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008 [ABSTRACT FROM AUTHOR]

This study investigated the relationship between the irradiance transmitted through ceramic and the bond strength of a resin cement to dentin. After application of an adhesive system, elastomer molds with cylindrical orifices (1.2 mm in diameter) were placed onto bovine dentin surfaces and filled with a photoactivated luting agent (Enforce; Dentsply Caulk). Light‐activation was performed through a 0.6‐mm‐thick ceramic disc using different intensities: 250, 400, 550, 700, or 850 mW/cm2. Control specimens were irradiated without ceramic (1050 mW/cm2). The radiant exposure was kept at 30 J/cm2. Light spectral distribution was analyzed with a spectrometer. Microshear test was conducted and modes of failure were classified under SEM. Bond strength data were analyzed with ANOVA and Student–Newman–Keuls' test (α ≤ 0.05), and failure scores with the Kruskal–Wallis test (α ≤ 0.05). A linear regression model assessed the relationship between irradiance and bond strength. Groups light‐cured at 250 and 400 mW/cm2 presented lower bond strengths than groups activated at 850 and 1050 mW/cm2. The linear regression showed that a decrease in light irradiance predicts a decrease in bond strength (r2 = 0.955; p = 0.004). A predominance of mixed failures was observed. No significant alteration in the spectral wavelengths was observed. Despite the constant energy dose, the bond strength was dependent upon the irradiance level. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008 [ABSTRACT FROM AUTHOR]

The objective of this work was to synthesize two bio‐based monomers, using the resorcinol as raw material, and its effect as bisphenol A glycidyl dimethacrylate (Bis‐GMA) eluents on different chemical–physical and biological properties of experimental photopolymerizable composite resins. The acrylic 1,3‐phenylen diacrylic (1,3‐FDA) and methacrylic 1,3‐phenylen dimethacrylic (1,3‐FDMA) monomers were synthesized and fully characterized through FTIR and 1H‐NMR spectroscopies. Experimental photopolimerizable composites were formulated using Bis‐GMA/1,3‐FDA or Bis‐GMA/1,3‐FDMA as organic matrix. The materials were compared with a Bis‐GMA/TEGDMA resin‐based composite used as control. Polymerization kinetics was evaluated by means of FTIR spectroscopy. Polymerization stress was directly measured through a polymerization stress tester. The cell viability of the composites was evaluated using the MTT assay. One‐way analysis of variance and Tukey's test were used for statistical analysis. The materials formulated with the 1,3‐FDA monomer showed higher Rpmax values and lower polymerization stress values (p < 0.05), while the flexural strength, water sorption, and solubility remained similar to the TEGDMA composite. Conversely, the materials formulated with the 1,3‐FDMA monomer showed a lower degree of conversion and statistically lower flexural strength (p < 0.05). All materials exhibited a cellular viability close to 100%. Concerning the study conditions, the acrylic 1,3‐FDA monomer could be considered an alternative to TEGDMA in the formulation of photopolymerizable dental composite resins. © 2019 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2020, 137, 48576. [ABSTRACT FROM AUTHOR]