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Purpose: To investigate the effects of recycling lithium disilicate (LD), surface treatment, and thermocycling on the bond strength to resin cement. Materials and Methods: A total of 72 tablets (10 × 10 × 3 mm) of LD were made according to the recycling cycle with 24 tablets for each strategy: control (conventional sintering), 1R (1 recycling cycle), and 3R (3 recycling cycles). For the recycling groups, tablets were waxed, mounted in a silicone ring, and poured with investment material, and residues of sintered LD tablets were pressed by the lost wax technique. The residual LD was reused as described until it reached 3R. Afterward, the tablets were embedded in acrylic resin, sanded, and divided (n = 15) according to the factors of "surface treatment" (hydrofluoric acid [HF] for 20 seconds [HF20s] and silane, HF for 120 seconds [HF120s] and silane, and Monobond Etch & Prime [MEP]) and thermocycling (TC; with 10,000 cycles and without). After surface treatment, cylinders (diameter: 2 mm) of resin cement were made and submitted to SBS test (100 kgf, 1 mm/minute). Data (MPa) were analyzed by three-way ANOVA, Tukey test (5%), and Weibull analysis. Failure analysis was performed with a stereomicroscope. Results: ANOVA revealed that all factors were significant (P = .000*). The group 3RMEP (105.09 ± 19.49) presented the highest SBS among the experimental groups. The 1RHF20sTc (7.50 ± 1.97) group had the lowest SBS, similar to CHF20sTc (15.69 ± 3.77), 1RHF20s (15.12 ± 3.03), 1RHF120sTc (14.60 ± 3.43), and 3RHF20sTc (15.65 ± 0.97). The Weibull modulus and characteristic strength varied among the experimental groups (P = .0). Failure analysis revealed adhesive and mixed types. Conclusions: The recycling of DL ceramics increases the SBS to resin cement when the ceramic is treated with HF120s and silane or MEP. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of adhesive type and long-term aging on the shear bond strength (SBS) between silicabased ceramics and composite cement (CC). Materials and Methods: Lithium-silicate (LS), feldspathic (FD) and polymer-infiltrated ceramic (PIC) blocks were sectioned (10 x 12 x 2 mm) and divided into 24 groups considering the factors: "ceramics" (LS, FD, and PIC), "adhesive" (Ctrl: without adhesive; 2SC: 2-step conventional; 3SC: 3-step conventional; 1SU: 1-step universal), and "aging" (non-aged or aged [A]). After the surface treatments, CC cylinders (n = 15, ɸ=2mm; height = 2mm) were made and half of the samples were subjected to thermocycling (10,000) and stored in water at 37°C for 18months. The samples were submitted to SBS testing (100 kgf, 1mm/min) and failure analysis. Extra samples were prepared for microscopic analysis of the adhesive interface. SBS (MPa) data was analyzed by 3-way ANOVA and Tukey's test (5%). Weibull analysis was performed on the SBS data. Results: All factors and interactions were significant for SBS (p<0.05). Before aging, there was no significant difference between the tested groups and the respective control groups. After aging, the LS_1SU (22.18±7.74) and LS_2SC (17.32±5.86) groups exhibited significantly lower SBS than did the LS_Ctrl (30.30±6.11). Only the LS_1SU group showed a significant decrease in SBS after aging vs without aging. The LS_1SU (12.20) group showed the highest Weibull modulus, which was significantly higher than LS_2SC_A (2.82) and LS_1SU_A (3.15) groups. Conclusion: No type of adhesive applied after silane benefitted the long-term adhesion of silica-based ceramics to CC in comparison to the groups without adhesive. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of two surface conditioning methods, namely conventional hydrofluoric acid vs self-etching primer, and the application of adhesive on the bond strength of composite cement to CAD/CAM glass-ceramics. Materials and Methods: Blocks (N = 96) (12 x 10 x 2.5 mm) were manufactured, 24 for each tested ceramic type: lithium silicate ceramic (LS), polymer-infiltrated ceramic (PIC), leucite-reinforced feldspathic ceramic (FD), and lithiumdisilicate glass-ceramic (LD). For bond strength testing, 64 blocks were randomly divided into 16 groups (4 blocks per group) according to the following factors: ceramic: 4 levels; etching: 2 levels (HFS: hydrofluoric acid + silane or Monobond Etch & Prime [MEP]); and adhesive application: 2 levels, with (signified as A) and without. Then for each group, 15 composite cement cylinders (AllCem Dual, FGM) were built up. All specimens were subjected to thermocycling (10,000 cycles) and to shear bonding strength testing (SBS) (100 kgf, 0.5 mm/min). Mean shear stresses (MPa) were statistically analyzed by three-way ANOVA, Tukey's test, and Weibull analysis. Results: The mean bond strength of group PIC-HFS-A (28.45 ± 7.6 MPa) was significantly higher than that of groups LS-HFS-A (12.11 ± 2.7 MPa) and FDHFSA (20.86 ± 2.0 MPa). Group PIC-HFS bond strength (25.02 ± 6.5 MPa) was significantly higher only when compared to group LS-HFS (15.82 ± 4.4 MPa). The LS group presented lower SBS compared to all other groups. No significant differences were found between HFS and MEP surface treatments. Conclusion: Surface treatment with MEP promotes adhesion similar to that of HFS. Additional application of adhesive after the surface treatments did not improve the bond strength. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of surface conditioning methods and aging on the repair bond strength between resin composite and nanoceramic CAD/CAM resin. Materials and Methods: Twenty-four blocks of nanoceramic CAD/CAM resin (NCR) (Lava Ultimate, 3M Oral Care) (10 x 5 x 2 mm3) and resin composite (Filtek Z350, 3M Oral Care) (RC) were made, embedded in acrylic resin, polished (#600, #800, #1200) and randomly divided into 8 groups (n = 12 each) according to surface conditioning methods (air abrasion with 30-μm CoJet [CJ] or air abrasion with 50-μm Al2O3 [AB]) and aging prior to repair (without aging, 24 h in water at 37°C; with aging 6 months in water at 37°C). The blocks were air abraded (20 s, 2.5 bar, 10 mm) using a standardized device. A layer of adhesive resin (Scotchbond Universal) was applied (20 s) and photopolymerized for 20 s. RC cylinders (Ø = 2 mm; h = 2 mm) were then bonded to the NCR substrates using a Teflon matrix and photopolymerized for 40 s. All specimens were thermocycled (10,000 cycles, 5°C-55°C) and submitted to the shear bond test (50 kgf, 0.5 mm/min) to measure repair strength. Data (MPa) were analyzed using 3-way ANOVA and Tukey's test (α = 0.05). Failure analysis was performed using stereomicroscopy (20X). Results: ANOVA revealed a significant effect of only the "material" factor (p = 0.00). The group NCR6mCJ presented bond strengths (29.37 ± 5.41) which were significantly higher than those of the NCR24hCJ (20.88 ± 5.74) and RC groups (p < 0.05). The group RC24hCJ (19.71 ± 4.21) presented the lowest shear bond strength (p < 0.05). Failure analysis revealed predominantly type B mixed failures (adhesive+cohesive in the substrate material) except for the groups NCR24hCJ and NCR6mAB, where mainly type C failure (adhesive+cohesive at the RC) was observed. Conclusion: Air abrasion with Al2O3 particles or silicatization with CoJet followed by adhesive resin application are effective surface conditioning methods for the repair of nanoceramic CAD/CAM resin with resin composite. [ABSTRACT FROM AUTHOR]

Purpose: The air-particle-abrasion on zirconia in the gingival area of connectors and pontics in fixed partial dentures appears to increase fracture resistance. This study evaluated 'in situ' biofilm formation on the zirconia surface after different air-particle-abrasion protocols.Materials and Methods: Ninety sintered blocks (5 × 5 × 2 mm) of yttrium partially stabilised zirconia (Y-TZP) were obtained and randomised among nine groups according to the factors 'type of particle' (Alumina 50 and 110 µm; Cojet and Rocatec) and 'pressure' (2.5 and 3.5 bar) used for sandblasting for 10 s. The surface roughness (Ra/Rz) was measured before and after sandblasting. For the in-situ analyses, custom-made removable intraoral devices n = 10 with one sample of each group attached to the buccal area were used by volunteers for 8 h at night. The specimens were analysed under confocal microscopy to quantify both biovolume and thickness of the initial biofilm formed. One-way analysis of variance (ANOVA) and Dunnett's tests were performed (5%).Results: The roughness values ranged from 0.05 to 0.39 µm for Ra and from 0.35 to 2.11 µm for Rz, p = 0.00. Mean biofilm thickness ranged from 0.06 and 0.54 µm (p = 0.005), while the biovolume values were between 0.02 and 0.61 µm3/µm2 (p = 0.002). Values statistically significant for biofilm thickness and biovolume were found in groups sandblasted with Rocatec using 3.5 bar.Conclusion: In order to increase the fracture resistance of zirconia fixed partial dentures (FPDs), the air particle abrasion of zirconia with SiO2 (110 μm/3.5 bar), in the gingival area of connectors and pontics, should be avoided. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effect of the hydrofluoridric acid (HF) concentration and time of acid conditioning on bond strength of three glass ceramics to a resin cement. Thus, fifty blocks (10 mm x 5 mm x 2 mm) of each ceramic (LDCAD: IPS e.max CAD; LCAD: IPS Empress CAD and LDHP: IPS e.max Press) were made and embedded in acrylic resin. The surfaces were polished with sandpaper (#600, 800, 1000, and 1200 grits) and blocks were randomly divided into 15 groups (n = 10) according to the following factors: Concentration of HF (10% and 5%), conditioning time (20 s and 60 s) and ceramic (LDCAD, LDHP, and L). After conditioning, silane (Prosil / FGM) was applied and after 2 min, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block using a Teflon strip as matrix and light cured for 40 s (1,200 mW/cm²). Then, the samples were thermocycled (10,000 cycles, 5/55°C, 30s) and submitted to the shear bond test (50 KgF, 0.5 mm/min). The data (MPa) were analyzed with 3-way ANOVA and Tukey's test (5%). Failure analysis was performed using a stereomicroscope (20x) and a scanning electron microscope (SEM). ANOVA revealed that the "concentration" factor (p = 0.01) and the interaction "acid concentration X ceramic" (p = 0.009) had a significant effect, however, the "ceramic" (p = 0.897) and "conditioning time" (p = 0.260) factors did not influence the results. The LDHP10%60s (10.98 MPa)aA* group presented significantly higher bond strength than LDHP10%20s (6.57 MPa)bA, LCAD5%20s (6,90 ±3,5)aB and LDHP5%60s (5.66 ± 2,9MPa)aA* groups (Tukey). Failure analysis revealed that 100% of specimens had mixed failure. In conclusion, etching with 5% HF for 20 seconds is recommended for lithium disilicate and leucite-reinforced CAD/CAM ceramics. However, for pressed lithium disilicate ceramic, 10% HF for 60 s showed significantly higher bond strength to resin cement. [ABSTRACT FROM AUTHOR]

Aims: To carry out a systematic review of clinical trials published up to 2015 to determine the effectiveness of acupuncture in treating myofascial pain in temporomandibular disorder (TMD) patients., Methods: The databases used were the Cochrane Library, PubMed, Scopus, and Web of Science; the dates of the articles surveyed ranged from 1990 to May 2015. The inclusion criteria were: (1) publications in English, Portuguese, or Spanish; (2) controlled clinical trials; (3) patients with TMD of muscular origin; and (4) studies that used acupuncture or laser acupuncture only for treatment. Reference lists of the included articles were hand searched., Results: A total of four randomized clinical trials using acupuncture (traditional, trigger point, and laser) for TMD treatment met the eligibility criteria and were included. Although the studies featured small sample sizes and short-term follow-up periods, acupuncture yielded results similar to those observed in groups treated with occlusal splints and were significantly superior than those obtained from placebo acupuncture-treated groups., Conclusion: Despite the weak scientific evidence supporting its efficacy, acupuncture treatment appears to relieve the signs and symptoms of pain in myofascial TMD. More controlled and randomized clinical trials with larger sample sizes are needed in this field of research to verify these initial findings.