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Objectives: The use of LED light-curing units (LED LCUs) for polymerising resin-based composite restorations has become widespread throughout dentistry. Unfortunately, there is a paucity of clinical longitudinal studies that evaluate the comparative efficacy of LED-based polymerisation in direct posterior composite restorations. The aim of the present study was to investigate the performance of class I and II resin composite restorations for two successful composite restorative materials cured with LED versus halogen LCUs., Methods: One hundred restorations were placed using the nano-filled composites Grandio® or Filtek™ Supremé. The following test groups were established: LED-Grandio® n = 23 (LG), LED-Filtek™ Supremé n = 21 (LS). As controls were used: Halogen-Grandio® n = 28 (HG), Halogen-Filtek™ Supremé n = 28 (HS). All restorations were evaluated according to the clinical criteria of the CPM index (C-criteria) at baseline and after 6, 12 and 36 months., Results: After 12 and 36 months, there were no significant differences between restorations polymerised with LED or halogen light. At the end of the study, 97% of the restorations showed sufficient results regardless of the employed LCU or composite. Globally, after 36 months, 56% of all restorations were assessed with code 0 (excellent) and 41% with code 1 (acceptable). In detail, excellent results (code 0) among the criteria surface quality; marginal integrity and marginal discoloration were assigned in 72, 70 and 69%., Conclusions: For the current limitations in the clinical trial design, the results showed that LED-polymerisation is appropriate to ensure clinical success of direct posterior resin composite restorations in a range of 3 years., Clinical Significance: The choice of LCU has no significant influence on the clinical performance of posterior direct resin composite restorations within 3 years of wear.

This study compared the effectiveness of cure of bulk-fill composites using polywave light-emitting diode (LED; with various curing modes), monowave LED, and conventional halogen curing lights. The bulk-fill composites evaluated were Tetric N-Ceram bulk-fill (TNC), which contained a novel germanium photoinitiator (Ivocerin), and Smart Dentin Replacement (SDR). The composites were placed into black polyvinyl molds with cylindrical recesses of 4-mm height and 3-mm diameter and photopolymerized as follows: Bluephase N Polywave High (NH), 1200 mW/cm 2 (10 seconds); Bluephase N Polywave Low (NL), 650 mW/cm 2 (18.5 seconds); Bluephase N Polywave soft-start (NS), 0-650 mW/cm 2 (5 seconds) → 1200 mW/cm 2 (10 seconds); Bluephase N Monowave (NM), 800 mW/cm 2 (15 seconds); QHL75 (QH), 550 mW/cm 2 (21.8 seconds). Total energy output was fixed at 12,000 mJ/cm 2 for all lights/modes, with the exception of NS. The cured specimens were stored in a light-proof container at 37°C for 24 hours, and hardness (Knoop Hardness Number) of the top and bottom surfaces of the specimens was determined using a Knoop microhardness tester (n=6). Hardness data and bottom-to-top hardness ratios were subjected to statistical analysis using one-way analysis of variance/Scheffe's post hoc test at a significance level of 0.05. Hardness ratios ranged from 38.43% ± 5.19% to 49.25% ± 6.38% for TNC and 50.67% ± 1.54% to 67.62% ± 6.96% for SDR. For both bulk-fill composites, the highest hardness ratios were obtained with NM and lowest hardness ratios with NL. While no significant difference in hardness ratios was observed between curing lights/modes for TNC, the hardness ratio obtained with NM was significantly higher than the hardness ratio obtained for NL for SDR.

Objective: To assess light irradiance (LI) delivered by two light-curing units (LCU's) and to measure the degree of conversion (DC) of three composite cements, when cured through different thicknesses of two novel CAD-CAM block materials., Methods: 100-μm-thick films of a dual-curable composite cement (G-CEM LinkAce, GC), a light-curable flowable resin-based composite (RBC) (G-ænial Universal Flo, GC) and a micro-hybrid RBC (G-ænial Posterior, GC) were investigated as luting agents. Two 'polymer-ceramic' CAD-CAM blocks (Cerasmart, GC; Enamic, Vita Zahnfabrik) were sectioned in slabs with different thicknesses (1, 3 and 5mm). LI at the bottom of the specimens was measured using a calibrated spectrometer, while being light-cured through the CAD-CAM block slabs for 40s with a low- (±500mW/cm 2 ) or high- (±1,600mW/cm 2 ) irradiance LCU (n=5). After light-curing, micro-Raman spectra of the composite films were acquired to determine DC at 5min, 10min, 1h and 24h. LI data were statistically analyzed by Kruskal-Wallis followed by post-hoc comparisons, while a linear mixed-effect model was applied for the DC analysis. In addition, the CAD-CAM blocks ultrastructure was characterized upon argon-ion slicing using scanning transmission electron microscopy (STEM). Finally, light transmission (LT) through each CAD-CAM block material was assessed using a spectrophotometer., Results: Curing-light attenuation and DC were significantly influenced by thickness and type of the overlying material. LCU only had a significant effect on DC of the micro-hybrid RBC. DC significantly increased over time for all composite cements. CAD-CAM block structural analysis revealed a relatively small and homogenous filler configuration (mean filler size of 0.2-0.5μm) for Cerasmart, while Enamic contained ceramic grains varying in shape and size (1-10μm), which were interconnected by the polymer-based network. LT was much higher at a wavelength range of 300-800nm for Cerasmart than for Enamic., Significance: Light-curable composite cements can be cured through a restoration up to 2.7-mm thickness, depending on the kind of CAD-CAM material. A high-irradiance LCU only has a limited effect on the maximum thickness of the polymer-ceramic CAD-CAM material that can be cured through., (Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Statement of Problem: The cementation of ceramic veneers using light-polymerized resin cement is largely dependent on the proper light activation of the cement. Light activation using high irradiance could shorten the time required to lute multiple restorations., Purpose: The purpose of this in vitro study was to evaluate the light transmission of dental light-polymerizing units through ceramic cylinders and its effect on the polymerization kinetics of a resin cement., Material and Methods: Ceramic ingots (IPS Empress Esthetic, shade ET1) were sectioned to produce cylinders 0.5, 1.0, and 2.0 mm thick. Two light-emitting diode units were evaluated: SmartLite Focus and Valo Cordless, the latter used in either Standard or Xtra Power (XP) modes. Light transmission (average of irradiance, total energy, and light-emission profile) through the cylinders was measured (n=3). The polymerization kinetics of a resin cement light polymerized through the ceramic was monitored for 5 minutes (n=3). The degree of conversion was measured again after 72 hours. Data were individually analyzed with 2-way ANOVA and the Tukey HSD test (α=.05)., Results: Valo at XP presented the highest values of irradiance and SmartLite the lowest, irrespective of the ceramic thickness. Regarding the total energy, XP showed the lowest values. The total energy and irradiance lessened with the increase in ceramic thickness. In general, except for Valo at XP, the ceramic thickness did not affect the degree of conversion. Valo at XP and interposing 2.0 mm ceramic resulted in the lowest values of Rp max ., Conclusions: The reduction of total energy and irradiance by ceramic interposition had only a slight effect on polymerization kinetics., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Contemporary dentistry literally cannot be performed without use of resin-based restorative materials. With the success of bonding resin materials to tooth structures, an even wider scope of clinical applications has arisen for these lines of products. Understanding of the basic events occurring in any dental polymerization mechanism, regardless of the mode of activating the process, will allow clinicians to both better appreciate the tremendous improvements that have been made over the years, and will also provide valuable information on differences among strategies manufacturers use to optimize product performance, as well as factors under the control of the clinician, whereby they can influence the long-term outcome of their restorative procedures.

Aim: The elaboration of an experimental system to obtain reproducible and comparable photographs of the occlusal surface to monitor sealants retention., Materials and Methods: An intraoral camera connected to a computer was used to obtain photos of the occlusal surfaces. A specific software was utilized to perform measurements on archived pictures. An experimental two-part system, consisting of a dental arch support and a camera support, connected to each other through holes and pins, was made to obtain a standardised and reproducible placement of the camera in the mouth. In the first part, to test the degree of reliability of the procedure and the percentage of image distortion, 120 first molars were sealed and for each molar ten photographs were taken, using the intraoral camera connected with the dental arch support, the camera support and the dedicated software. In the second part, 165 first molars were sealed and photographed, as above described, immediately after sealing (T0), 6 months (T1) and 1 year later (T2). With the software, the sealed areas were measured. The comparison of the selected sealed areas between T0 and T1, T0 and T2, T1 and T2 determined the percentage of sealant loss., Results: In the first part, the experimental procedure showed a reliability of 96.85%. In the second part, the difference in the rate of lost sealant between T0-T1 and T1-T2 was statistically significant (p <0.001)., Statistics: ANOVA analysis was made., Conclusions: Photographs, obtained through the experimental two-part system, allowing a reproducible positioning of the intraoral camera in oral cavity, could represent a standardised and useful method to monitor sealants retention over time.

The purpose of this study was to investigate the relationship between hygroscopic expansion and polymerization shrinkage for compensation of polymerization shrinkage stresses in a restored tooth. One resin-modified glass-ionomer (RMGI) (Ketac Nano, 3M ESPE), 2 compomers (Dyract, Dentsply; Compoglass, Ivoclar), and a universal resin-based composite (Esthet•X HD, Dentsply) were tested. Volumetric change after polymerization ("total shrinkage") and during 4 wk of water storage at 37°C was measured using an optical method (n= 10). Post-gel shrinkage was measured during polymerization using a strain gauge method (n= 10). Extracted human molars with large mesio-occluso-distal slot preparations were restored with the tested restorative materials. Tooth surfaces at baseline (preparation), after restoration, and during 4 wk of 37°C water storage were scanned with an optical scanner to determine cuspal flexure (n= 8). Occlusal interface integrity was measured using dye penetration. Data were analyzed using analysis of variance and post hoc tests (significance level 0.05). All tested materials shrunk after polymerization. RMGI had the highest total shrinkage (4.65%) but lowest post-gel shrinkage (0.35%). Shrinkage values dropped significantly during storage in water but had not completely compensated polymerization shrinkage after 4 wk. All restored teeth initially exhibited inward (negative) cuspal flexure due to polymerization shrinkage. Cuspal flexure with the RMGI restoration was significantly less (-6.4 µm) than with the other materials (-12.1 to -14.1 µm). After 1 d, cuspal flexure reversed to +5.0 µm cuspal expansion with the RMGI and increased to +9.3 µm at 4 wk. After 4 wk, hygroscopic expansion compensated cuspal flexure in a compomer (Compoglass) and reduced flexure with Dyract and resin-based composite. Marginal integrity (93.7% intact restoration wall) was best for the Compoglass restorations and lowest (73.1%) for the RMGI restorations. Hygroscopic expansion was more effective in compensating shrinkage stress than would be assumed based on total shrinkage, because only post-gel shrinkage needed compensation. Effective expansion is therefore hygroscopic expansion minus post-gel shrinkage., (© International & American Associations for Dental Research 2016.)

Purposes: (1) To evaluate in vitro the surface roughness of a resin composite covered with three surface sealants and submitted to simulated toothbrushing for different periods; (2) Verify, through scanning electron microscopy (SEM), the presence of surface sealants after simulated toothbrushing; and (3) To evaluate whether the type of dentifrice influences the maintenance of the surface sealant. The study hypothesis was that neither variable would influence the surface roughness of the composite and the maintenance of the surface sealant., Methods: 108 specimens were prepared with the resin Amelogen Plus, and divided into six groups (n = 18) according to the type of surface sealant [Fortify (F), BisCover LV (B) and Permaseal (P)] and toothpaste [Total 12 Clean Mint (CT) and Colgate Total 12 Professional Whitening (PW)]. The samples were subjected to brushing cycles, simulating periods of 6, 12, 18, and 24 months. After each period, the surface roughness of the samples was measured. An additional group of 48 samples was prepared for SEM analysis. The results were analyzed by ANOVA with three fixed variables (sealants, time and toothpaste) and by Tukey's test (α = 0.05)., Results: BisCover had the lowest mean surface roughness (0.06 µm) compared with the sealants Fortify (0.09 µm) and Permaseal (0.08 µm), which were not statistically different. Fortify, at 12 months of brushing, had the highest mean roughness (0.13 µm). The mean roughness for the dentifrice CT was lower (0.07 µm) when compared with PW (0.08 µm) and was statistically different. Roughness increased up to 12 months of simulated brushing (0.04 µm, 0.08 µm and 0.11 µm), decreasing from the 18th month (0.08 µm) to the 24th month of brushing (0.07 µm). None of the sealants was observed (with SEM) to be completely removed from the resin at 24 months of brushing.

Purpose: To examine the effect that a stainless steel (SS) matrix band has on the depth and distribution of cure of a resin-based composite (RBC) in a simulated Class II cavity., Methods: RBC was cured for 20 seconds in a simulated Class II cavity with and without a SS matrix band, and after 24 hours the specimens were scraped back and ground to expose a vertical central plane where Knoop micro-hardness (KHN) mapping was conducted from 0.05-1.5 mm from the band and in 0.5 mm intervals from the top of the specimens. The effect of different angles of the light guide on the distribution of hardness was also examined., Results: KHN values near the SS matrix band were significantly lower (P < 0.05) than within the bulk of the specimen and were lower than those found without the matrix band. Angles of incidence for the curing light-guide produced changes in the distribution of KHN within the specimens, but particularly near the matrix band, and with a 35° angle of incidence, the depth of cure was significantly different from that of normal incidence of the light.

Introduction: The purpose of this study was to compare the clinical failure rates and the in-vitro bond strengths of metal brackets bonded with different light-emitting diode (LED) devices and curing times., Methods: Forty patients were included in the clinical part of this study. A split-mouth design was used, with the adhesive in group 1 cured for 10 seconds with an LED unit (Elipar S10; 3M Unitek, Monrovia, Calif), and the adhesive in group 2 cured for 3 seconds with another LED unit (VALO Ortho; Ultradent Products, South Jordan, Utah). Bond failures during 12 months of orthodontic treatment were recorded. In-vitro performance of the brackets was also compared by bonding brackets to extracted premolars and using the same light units and curing times (n = 20 for each group). The adhesive remnant index was used to determine the bond failure interface., Results: Clinical bond failure rates were 2.90% for the Elipar and 3.16% for the VALO curing units. The difference in bracket failure rates between the 2 LED devices was not statistically significant. No statistically significant difference was found between the in-vitro bond strengths of the groups., Conclusions: Our findings regarding long-term clinical survival rates and in-vitro bond strengths indicate that bracket bonding can be safely accomplished in 10 seconds of light-curing with an Elipar LED and 3 seconds of light-curing with a VALO LED., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To measure the Knoop microhardness at the bottom of four posterior resin-based composites (RBCs): Tetric EvoCeram Bulk Fill (Ivoclar Vivadent), SureFil SDR flow (DENTSPLY), SonicFill (Kerr), and x-tra fil (Voco)., Methods: The RBCs were expressed into metal rings that were 2, 4, or 6-mm thick with a 4-mm internal diameter at 30°C. The uncured specimens were covered by a Mylar strip and a Bluephase 20i (Ivoclar Vivadent) polywave(®) LED light-curing unit was used in high power setting for 20s. The specimens were then removed and placed immediately on a Knoop microhardness-testing device and the microhardness was measured at 9 points across top and bottom surfaces of each specimen. Five specimens were made for each condition., Results: As expected, for each RBC there was no significant difference in the microhardness values at the top of the 2, 4 and 6-mm thick specimens. SureFil SDR Flow was the softest resin, but was the only resin that had no significant difference between the KHN values at the bottom of the 2 and 4-mm (Mixed Model ANOVA p<0.05). Although the KHN of SureFil SDR Flow was only marginally significantly different between the 2 and 6-mm thickness, the bottom at 6-mm was only 59% of the hardness measured at the top., Clinical Significance: This study highlights that clinicians need to consider how the depth of cure was evaluated when determining the depth of cure. SureFil SDR Flow was the softest material and, in accordance with manufacturer's instructions, this RBC should be overlaid with a conventional resin., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Purpose: To assess the light irradiance (LI) delivered by two light-curing units and to measure the degree of conversion (DC) of three composite cements and one flowable composite when cured through zirconia or ceramic-veneered zirconia plates with different thicknesses., Materials and Methods: Three dual-curing composite cements (Clearfil Esthetic Cement, Panavia F2.0, G-CEM LinkAce) and one light-curing flowable composite (G-aenial Universal Flo) were investigated. Nine different kinds of zirconia plates were prepared from three zirconia grades (YSZ: Aadva and KATANA; Ce-TZP/Al2O3: NANOZR) in three different thicknesses (0.5- and 1.5-mm-thick zirconia, and 0.5-mm-thick zirconia veneered with a 1.0-mm-thick veneering ceramic). Portions of the mixed composite cements and the flowable composite were placed on a light spectrometer to measure LI while being light cured through the zirconia plates for 40 s using two light-curing units (n = 5). After light curing, micro-Raman spectra of the composite films were acquired to determine DC at 5 and 10 min, 1 and 24 h, and at 1 week., Results: The zirconia grade and the thickness of the zirconia/veneered zirconia plates significantly decreased LI. Increased LI did not increase DC. Only the Ce-TZP/Al2O3 (NANOZR) zirconia was too opaque to allow sufficient light transmission and resulted in significantly lower DC., Conclusion: Although zirconia-based restorations attenuate the LI of light-curing units, the composite cements and the flowable composite could be light cured through the YSZ zirconia. LI is too low through Ce-TZP/Al2O3 zirconia, necessitating the use of self-/dual-curing composite cements.

Purpose: To clinically evaluate the performance of indirect composite resin restorations cemented with conventional and self-adhesive resin cements over a 12-month period., Materials and Methods: Ten patients fulfilled all the inclusion criteria. Twenty-four composite resin restorations were performed using an indirect technique and cemented with a resin cement (RelyX ARC) or a self-adhesive resin cement (RelyX U100). Two independent evaluators analyzed the restorations using modified USPHS criteria after periods of two weeks and 6 and 12 months. Statistical significance between the cements at each timepoint was evaluated with the Wilcoxon test and between timepoints with the Mann-Whitney test, both at a significance level of 5%. Fisher's exact test was used to assess the occurrence of absolute failures., Results: No statistically significant differences were found between the groups at the same timepoint nor between groups at different timepoints. The only significant difference was found for color match for both groups after 12 months., Conclusion: After 12 months, indirect composite resin restorations cemented with self-adhesive resin cement performed similarly to those cemented with conventional resin cement.

Purpose: To measure and compare the depth of cure (DOC) of two bulk fill resin composites using a monowave and polywave light curing unit (LCU) according to ISO 4049 and using custom tooth molds., Methods: The DOC of Tetric Evoceram Bulk Fill and Filtek Bulk Fill Posterior were measured using a monowave LED LCU (Elipar S10) and a polywave LED LCU (Bluephase G2). Metal molds were used to fabricate 10 mm long DOC specimens (n = 10) according to ISO 4049. Uncured composite material was scraped away with a plastic instrument and half the length of remaining composite was measured as the DOC. Custom tooth molds were fabricated by preparing > 10 mm long square- shaped (4 x 4 mm) holes into the mesial/distal surfaces of extracted human molars. Resin composite was placed into one end of the prepared tooth and light polymerized. Uncured resin composite was removed from the opposite side from which the tooth was irradiated and the tooth was sectioned mesio-distally. Half the length of remaining cured composite was measured as the DOC. Data were analyzed by three-way ANOVA (α = 0.05) for factors material, LCU, and mold., Results: The main effect LCU was not significant (P = 0.58). The interaction effect between material x mold was significant (P = 0.0001). The DOC of the composites differed significantly only with the stainless steel mold in which Tetric Evoceram Bulk Fill showed a deeper DOC than Filtek Bulk Fill Posterior (4.03 ± 0.14 vs 3.56 ± 0.38 mm, P < 0.0001).

Purpose: To assess the resin microtensile bond strength (MTBS) and the degree of conversion (DC) of indirect composite resin restorations polymerized with light and heat., Materials and Methods: Two direct (Filtek Z100 and Premise) and one indirect (Premise Indirect) composite resins were polymerized with a combination of light and heat (138°C for 20 min). For MTBS, 42 cylinders were fabricated (n = 7). After the surface treatment, cylinders were bonded to each other using adhesive resin (Optibond FL). Specimens were stored in water for 24 h. Another 15 cylinders (n = 5) were fabricated for determining degree of conversion using Fourier Transform Infrared Spectrometry immediately and at 24 h. The MTBS and the DC was submitted to two-way ANOVA. The interaction with existing data was explored with univariate ANOVA and two-way ANOVA. Tukey's HSD post-hoc test was used to detect pairwise differences (α = 0.05)., Results: The MTBS to light and heat polymerized Z100 was 75.7 MPa, significantly higher than that to Premise (58.6 MPa) and Premise Indirect (63.9 MPa). The immediate DC for Z100, Premise, and Premise Indirect were 51.0%, 68.7%, and 61.8%, respectively. The DC at 24 h ranged from 53.4% (Z100) to 72.8% (Premise Indirect) and significantly increased for Premise Indirect only. Comparison with previously published data revealed that the heat treatment increased both MTBS and DC of Premise and Premise Indirect., Conclusion: Z100 showed better bond strength but lower DC. Heat treatment and a 24-h delay before delivery can benefit DC of Premise Indirect. The increase in DC of Premise and Premise Indirect did not affect their bond strength.

Objective: To investigate clinical effect of individual light-curing resin tray as edge plastic material in complete denture modulo.
, Methods: A total of 30 patients with poor condition for alveolar ridge of mandible were chosen individual tray with individual light-curing resin tray for material edge shaping or traditional individual impression tray for edge shaping cream to produce complete denture. The operability, questionnaire about denture retention, comfort, mucosal cases and chewing function in the process of shaping the edge were investigated three months later after wearing dentures.
, Results: There was no significant difference in retention, comfort, mucosa and the chewing function between the two mandibular denture impression methods. However, the patients with individual light-curing resin tray as edge shaping material felt better in the process than that in the patients with die-cream as the edge shaping material (P<0.05). Furthermore, the manipulation with individual light-curing resin tray as edge shaping material is easy for doctor.
, Conclusion: Although the clinical effect of Individual light-curing resin tray material as the edge shaping material is equal to that of impression cream, it saves time and human resource. Moreover, it is more acceptable for the patients and thus it can be spread in clinics.

Objectives: The aim of the present study was to assess and compare the shear bond strength (SBS) of metal pre-coated orthodontic brackets bonded to fluorotic and non-fluorotic teeth treated with three different etching techniques. A second aim was to determine the volume of adhesive remaining on the tooth at debond using micro-computed tomography (μCT)., Methods: Ninety extracted premolars were selected to include 45 fluorotic (test group) and 45 non-fluorotic (control group) teeth. Each group was divided into three subgroups of 15 each, which were treated as follows: 1) micro-etched; 2) acid-etched; and 3) both micro-etched and acid-etched. A bonding agent was applied to the prepared surfaces; pre-coated and light-cured brackets were attached to all teeth. An Instron universal testing machine was used to record the debonding force. Specimens were then scanned using a microCT to evaluate the amount of adhesive remaining on the teeth. The significance of the statistical tests was pre-determined at p < 0.05., Results: Two-way ANOVA showed that fluorosis of teeth had no influence on the SBS (p = 0.165) whereas the volume of adhesive remnants was significantly higher in the control group compared with the test group (p < 0.001)., Conclusions: Fluorosis had no influence on the SBS of brackets, whereas it had a negative influence on retaining adhesives onto the tooth surfaces.

Under clinical conditions, conventional glass-ionomer dental cements can be cured by application of heat from dental cure lamps, which causes acceleration in the setting. In order for this to be successful, such heat must be able to spread sufficiently through the cement to enhance cure, but not transmit heat so effectively that the underlying dental pulp of the tooth is damaged. The current study was aimed at measuring heat transfer properties of modern restorative glass-ionomers to determine the extent to which they meet these twin requirements. Three commercial glass ionomer cements (Ionofil Molar, Ketac Molar and Equia™ Fill) were used in association with three different light emitting diode cure lamps designed for clinical use. In addition, for each cement, one set of specimens was allowed to cure without application of a lamp. Temperature changes were measured at three different depths (2, 3 and 4 mm) after cure times of 20, 40 and 60 s. The difference among the tested groups was evaluated by ANOVA (P < 0.05) and post hoc Newman-Keuls test. All brands of glass-ionomer showed a small inherent setting exotherm in the absence of heat irradiation, but much greater temperature increases when exposed to the cure lamp. However, temperature rises did not exceed 12.9 °C. Application of the cure lamp led to the establishment of a temperature gradient throughout each specimen. Differences were typically significant (P < 0.05) and did not reflect the nominal power of the lamps, because those lamps have variable cooling systems, and are designed to optimize light output, not heating effect. Because the thermal conductivity of glass-ionomers is low, temperature rises at 4 mm depths were much lower than at 2 mm. At no time did the temperature rise sufficiently to cause concern about potential damage to the pulp.

Objectives: To quantify the depth of cure (DOC) of a composite resin system using two different testing criteria., Method and Materials: The DOC testing employed two different experimental protocol: 1) Forty-eight previously extracted human molars were randomly assigned to four groups of twelve each (n = 12): Group 1 SonicFill composite resin system, shade A1; Group 2 SonicFill, shade A3; Group 3 Herculite Ultra composite resin, shade A1; Group 4 Herculite Ultra, shade A3. Cylindrical cavities (4.0 mm diameter and 10 mm depth) were prepared at the tooth CEJ, in a mesiodistal direction. The preparations were filled with each composite resin material in one bulk increment and polymerized with a LED light for 20 seconds. After 5 minutes, the occlusal surfaces of the teeth (specimens) were ground flat until the composite was exposed in a transverse plane. The uncured (soft) composite was scraped away, using a "modified" ISO 4049 DOC specification, and the remaining cured (hard) material was measured. Three measurements, at different positions of the specimen, were performed, for a total of thirty-six measurements per specimen group. The measurements were averaged and divided by fifty percent, arriving at the final DOC for each specimen. 2) A DOC testing protocol was performed using a two-piece (4.0 mm x 10.0 mm) custom-made Teflon device (mold). The groupings duplicated the previous experimental protocol. The mold was filled with each composite resin material in one bulk increment to a 10 mm length (depth). Excess composite material was removed, followed by placement of a Mylar strip over the external orifice. The composite resin specimen was light-polymerized for 20 seconds. Again, the uncured (soft) composite was scraped away, with the same measurement protocol followed as in method 1. Statistical analyses were conducted using ANOVA tests at a p < .05 level of significance., Results: Statistical differences were exhibited between the two different DOC methodologies, extracted teeth versus the Teflon device. Considering each method, the SonicFilTM composite revealed significantly greater DOC compared to the Herculite Ultra composite resin. Also, significant differences were displayed between the Al compared to the A3 shades, with the A1 (lighter) shades exhibiting greater DOC., Conclusion: The prepped teeth seemed a more realistic DOC testing approach due to the variables of light interaction of the composite resin to either tooth substance (enamel/dentin) versus using the Tefion mold, although greater DOCs were recorded using the manufactured device. The SonicFill composite system did reveal greater DOC compared to the Herculite Ultra composite regardless of experimental method or material shade.

The UT College of Dentistry has been one of the leaders in the introduction of the CAD/CAM delivery of dentistry to the dental students. The integration of technology into a dental school curriculum requires a change in thinking and a modification of the curriculum in order to introduce it to the present day students This article updates the integration of the CEREC system into the UT Dental School curriculum, discussing the changes in equipment and teaching techniques since the last article in 2012.

Objectives: The photoinitiator diphenyl-(2,4,6-trimethylbenzoyl)phosphine oxide (TPO) is more reactive than a camphorquinone/amine (CQ) system, and TPO-based adhesives obtained a higher degree of conversion (DC) with fewer leached monomers. The hypothesis tested here is that a TPO-based adhesive is less toxic than a CQ-based adhesive., Methods: A CQ-based adhesive (SBU-CQ) (Scotchbond Universal, 3M ESPE) and its experimental counterpart with TPO (SBU-TPO) were tested for cytotoxicity in human pulp-derived cells (tHPC). Oxidative stress was analyzed by the generation of reactive oxygen species (ROS) and by the expression of antioxidant enzymes. A dentin barrier test (DBT) was used to evaluate cell viability in simulated clinical circumstances., Results: Unpolymerized SBU-TPO was significantly more toxic than SBU-CQ after a 24h exposure, and TPO alone (EC50=0.06mM) was more cytotoxic than CQ (EC50=0.88mM), EDMAB (EC50=0.68mM) or CQ/EDMAB (EC50=0.50mM). Cultures preincubated with BSO (l-buthionine sulfoximine), an inhibitor of glutathione synthesis, indicated a minor role of glutathione in cytotoxic responses toward the adhesives. Although the generation of ROS was not detected, a differential expression of enzymatic antioxidants revealed that cells exposed to unpolymerized SBU-TPO or SBU-CQ are subject to oxidative stress. Polymerized SBU-TPO was more cytotoxic than SBU-CQ under specific experimental conditions only, but no cytotoxicity was detected in a DBT with a 200μm dentin barrier., Significance: Not only DC and monomer-release determine the biocompatibility of adhesives, but also the cytotoxicity of the (photo-)initiator should be taken into account. Addition of TPO rendered a universal adhesive more toxic compared to CQ; however, this effect could be annulled by a thin dentin barrier., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Statement of Problem: The type of resin-based luting agent might influence the color stability of ceramic veneers., Purpose: The purpose of this study was to investigate the effects of resin-based agents and aging on the color stability of ceramic veneers bonded to enamel., Material and Methods: Ceramic disks were cemented to bovine enamel disks with 4 resin-based luting agents (n=10): dual-polymerizing cement (RelyX ARC), light-polymerizing cement (RelyX Veneer), flowable composite resin (Filtek Z350 Flow), or composite resin preheated for 30 minutes at 60°C (Filtek Z350 XT). CIE L*, a*, and b* color coordinates were measured 24 hours after cementation (baseline) with a color spectrophotometer and reevaluated after 10,000 and 20,000 thermal cycles. Color variation was calculated by using CIELab (ΔE*(ab)) and CIEDE2000 (ΔE00) methods. Then 95% confidence intervals were calculated for color variation means between baseline and 10,000 thermal cycles and between 10,000 and 20,000 thermal cycles. The 95% confidence intervals were also calculated for the means of individual color coordinates (L*, a*, and b*)., Results: The dual-polymerizing cement had the highest color variation among all luting agents. No significant differences were found in color variation among the light-polymerizing materials. All agents showed ΔE*(ab)>3.46 and ΔE00>2.25 after 20,000 thermal cycles. Variations in L*, a*, and b* coordinates were material dependent. The dual-polymerizing agent was yellowish and reddish after aging., Conclusions: The dual-polymerizing cement had higher color variation than the light-polymerized materials when used for bonding ceramic veneers to enamel. Flowable and preheated composite resins had similar color stability to that of light-polymerizing resin-based cement., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to evaluate the influence of accelerated artificial aging (AAA) on color stability (AE) and surface roughness of composite submitted to different systems and periods of finishing/polishing., Materials and Methods: A Teflon matrix was used to fabricate 60 specimens that were separated into four groups, according to the finishing/polishing system: G1: no polishing; G2: abrasive papers; G3: rubber polishing disks; and G4: G2 + G3. Polishing was performed at three different time intervals (n = 6): immediately (Im), 24 hours (24 hours) and 7 days (7 day) after specimen fabrication. Initial color and surface roughness readouts were taken. Afterwards, specimens were submitted to AAA (480 hours) and new readouts were taken., Results: Results demonstrated that G2 (7 day) presented lower AE, statistically different from G1 and G4 (7 days) (two-way analysis of variance (ANOVA), Bonferroni, p < 0.05)., Conclusion: Regarding roughness, there was no difference among groups and periods. Polishing performed with abrasive papers, 7 days after performing the restoration, promoted less color alteration., Clinical Significance: Most of composite restorations are replaced within a period shorter than 5 years due to esthetic failure, and correct finishing and polishing procedures are fundamental to avoid these problems.

Purpose: To investigate sealant depth of cure after increasing the curing times of high-intensity light-emitting diode units (LEDs)., Methods: Three sealants (opaque-unfilled, opaque-filled, and clear-filled) were light cured in a covered-slot mold with: (a) three LEDs (VALO, SmartLite, Fusion) for six to 15 seconds; and (b) a quartz-tungsten halogen (QTH) light for 40 seconds as a control (N=10). Twenty-four hours after light curing, microhardness was measured at the sealant surface and through the depth at 0.5 mm increments. Results were analyzed via analysis of variance followed by the Student-Newman-Keuls test (significance level 0.05)., Results: The opaque-filled and clear-filled sealants cured with VALO for six or nine seconds had hardness values that were statistically equivalent to or better than the QTH to a depth of 1.5 mm. Using Fusion for 10 seconds (exposure limit) did not adequately cure the three sealants beyond one mm. SmartLite at 15 seconds (maximum exposure period without overheating) did not adequately cure the sealants beyond 0.5 mm., Conclusions: Among the tested high-intensity LEDs, only VALO at double or triple the manufacturers' shortest curing time (six or nine seconds) provided adequate curing of opaque-filled and clear-filled sealants at 1.5 mm depth compared to the 40-second QTH light.

Objective: The aim of this study was to evaluate clinical success of primary teeth class II lesions restored with different restorative materials [Hybrid Composite Resin (HCR), Resin Modified Glass Ionomer Cement (RMGIC), compomer, and Giomer Composite Resin (GCR)] followed up for 24 months., Study Design: This study was carried out on 146 primary molars of 41 children in the age range of 5-7 years. The class II lesions in primary molars of a patient were restored using different restorative materials. Restorations were evaluated according to FDI-criteria and their survival rates were determined. Data were analysed with Pearson chi-square, Kaplan-Meier and Wilcoxon (Breslow) tests (α = 0.05)., Results: The failure rates of restorative materials were as follows: compomer 33.3%, RMGIC 28.1%, HCR 22.5% and GCR 21.1%., Conclusions: While the functional failure was the most important factor in restorative material failure, RMGIC was the most successful material in terms of biological evaluation criterion and GCR had the longest survival rate.

Objective: To evaluate the curing profile of bulk-fill resin-based composites (RBC) using micro-Raman spectroscopy (μRaman)., Methods: Four bulk-fill RBCs were compared to a conventional RBC. RBC blocks were light-cured using a polywave LED light-curing unit. The 24-h degree of conversion (DC) was mapped along a longitudinal cross-section using μRaman. Curing profiles were constructed and 'effective' (>90% of maximum DC) curing parameters were calculated. A statistical linear mixed effects model was constructed to analyze the relative effect of the different curing parameters., Results: Curing efficiency differed widely with the flowable bulk-fill RBCs presenting a significantly larger 'effective' curing area than the fibre-reinforced RBC, which on its turn revealed a significantly larger 'effective' curing area than the full-depth bulk-fill and conventional (control) RBC. A decrease in 'effective' curing depth within the light beam was found in the same order. Only the flowable bulk-fill RBCs were able to cure 'effectively' at a 4-mm depth for the whole specimen width (up to 4mm outside the light beam). All curing parameters were found to statistically influence the statistical model and thus the curing profile, except for the beam inhomogeneity (regarding the position of the 410-nm versus that of 470-nm LEDs) that did not significantly affect the model for all RBCs tested., Conclusions: Most of the bulk-fill RBCs could be cured up to at least a 4-mm depth, thereby validating the respective manufacturer's recommendations., Clinical Significance: According to the curing profiles, the orientation and position of the light guide is less critical for the bulk-fill RBCs than for the conventional RBC., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The aim of this study was to determine the effects of different storage media and bleaching treatments on the flexural strength of two resin cements (Panavia and BisCem). One hundred rectangular-shaped specimens were prepared with two resin cements and were stored in five media types (n = 10): distilled water (DW), lactic acid (LA), sodium hydroxide (NH), in-office bleaching (OB) and home bleaching (HB). There was significant interaction between the solutions and cements (p < 0.05). The lowest three-point flexural strength was found in sodium hydroxide for both cements (p < 0.05). Both cements exhibited significant increase in flexural strength following home and in-office bleaching (except Panavia in OB) (p < 0.05) compared with immersion in distilled water. Panavia recorded significantly higher flexural strength compared with BisCem in all media (p < 0.002), with the exception of in-office bleaching.

Objectives: This study investigated the curing efficiency, the extent of atmospheric oxygen inhibition to the polymerization reaction and the mechanical properties of a new resin-infiltration system for caries treatment., Methods: The curing efficiency was estimated by measuring the percentage degree of cure (%DC) of thin resin films (h: 150μm, Ø: 5mm, n=3), 10min after 40s exposure to a quartz halogen bulb (750mW/cm2) light curing unit (Optilux 501, Demetron/Kerr, USA), in the absence of O2, by micro ATR-FTIR spectroscopy. The extent of O2 inhibition on resin film setting (width in μm) was assessed by transmission optical microscopy on thin films (h: 150μm, Ø: ∼7mm, n=5) placed between two transparent cover slips and exposed to air from lateral sites. For each sample the extent of inhibition was measured at 5 different locations. The mechanical properties were tested employing Instrumented Indentation Testing according to ISO 14577:2002. Resin specimens (h: 2mm, Ø: 10mm, n=5) were prepared employing cylindrical teflon moulds enclosed in transparent matrix strips and glass slides as before. The measurements were performed employing a Vickers indenter attached to a universal hardness testing machine (ZHU2.5/Z2.5 plus test Xpert software, Zwick/Roell, Ulm, Germany). The parameters tested were Martens Hardness (MH), Vickers Hardness (VHN), Indentation Elastic Modulus (EIT) and elastic to total ratio of indentation work (ηIT). For all these tests, specimens of a conventional light-curing bonding resin (HB-Heliobond, Ivoclar-Vivadent, FL) prepared as above were used as control. Student t-test was used to identify statistically significant differences between the two materials in the parameters tested (a: 0.05)., Results: The results of the materials tested were: (a) [% DC]; IC: 57.4±1.5, HB: 59.8±2.4, (b) [Width of O2 inhibition/μm]; IC: 33.1±6.5, HB: 23.6±4.4, (c) [MH/N/mm(2)] IC; 116±16, HB: 261±35, (d) [VHN]; IC; 15.4±2.5, HB: 22.1±1.8, (e) [EIT/(GPa)]; IC; 2.3±0.4, HB: 7.5±0.5, and (g) [ηIT (%)] IC; 50.3±3.4, HB: 35.1±1.9. The IC presented no significant difference in terms of % DC, higher thickness of the inhibited layer, lower MH, VHN, EIT and greater ηIT values than HB., Conclusions and Clinical Significant: The resin-infiltrating system for incipient caries treatment demonstrated the same curing efficiency with a conventional unfilled bonding resin, but exhibited higher extent of oxygen inhibition, lower hardness, lower elastic modulus and higher plastic to elastic indentation energy., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aim: Polymerization shrinkage is one of the important factors in creation of gap between dental structure and composite resin restorations. The aim of this study was to evaluate the effect of configuration factor (C-factor) on gap formation in a hybrid composite resin, a low shrinkage composite resin and a resin modified glass ionomer restorative material., Methods: Cylindrical dentin cavities with 5.0 mm diameter and three different depths (1.0, 2.0 and 3.0 mm) were prepared on the occlusal surface of 99 human molars and the cavities assigned into three groups (each of 33). Each group contained three subgroups depend on the different depths and then cavities restored using resin modified glass ionomer (Fuji II LC Improved) and two type composite resins (Filtek P90 and Filtek Z250). Then the restorations were cut into two sections in a mesiodistal direction in the middle of restorations. Gaps were measured on mesial, distal and pulpal floor of the cavities, using a stereomicroscope., Results: Data analyses using Kruskal-Wallist and Mann-Whitney tests. Increasing C-factor from 1.8 to 3.4 had no effect on the gap formation in two type composite resins, but Fuji II LC Improved showed significant effect of increasing C-factor on gap formation. Taken together, when C-factor increased from 1.8 up to 3.4 had no significant effect on gap formation in two tested resin composites. Although, Filtek P90 restorations showed smaller gap formation in cavities walls compared to Filtek Z250 restorations., Conclusions: High C-factor values generated the largest gap formation. Silorane-based composite was more efficient for cavity sealing than methacrylate-based composites and resin modified glass ionomer., (© 2014 Wiley Publishing Asia Pty Ltd.)

Objective: To evaluate and compare intrapulpal temperature rise with three different light-curing units by using a study model simulating pulpal blood microcirculation., Materials and Methods: The roots of 10 extracted intact maxillary central incisors were separated approximately 2 mm below the cement-enamel junction. The crowns of these teeth were fixed on an apparatus for the simulation of blood microcirculation in pulp. A J-type thermocouple wire was inserted into the pulp chamber through a drilled access on the palatal surfaces of the teeth. Four measurements were made using each tooth for four different modes: group 1, 1000 mW/cm(2) for 15 seconds; group 2, 1200 mW/cm(2) for 10 seconds; group 3, 1400 mW/cm(2) for 8 seconds; and group 4, 3200 mW/cm(2) for 3 seconds. The tip of the light source was positioned at 2 mm to the incisor's labial surface., Results: The highest temperature rise was recorded in group 1 (2.6°C ± 0.54°C), followed by group 2 (2.57°C ± 0.62°C) and group 3 (2.35°C ± 0.61°C). The lowest temperature rise value was found in group 4 (1.74°C ± 0.52°C); this value represented significantly lower ΔT values when compared to group 1 and group 2 (P  =  .01 and P  =  .013, respectively)., Conclusions: The lowest intrapulpal temperature rise was induced by 3200 mW/cm(2) for 3 seconds of irradiation. Despite the significant differences among the groups, the temperature increases recorded for all groups were below the critical value of 5.6°C.

Objective: This study evaluated the impact of the distance between the light guide tip of the curing unit and material surface on the degree of conversion and Knoop microhardness of a composite resin., Materials and Methods: Circular samples were carried out of a methacrylate micro-hybrid resin-based composite and light cured at 0, 2 and 4 mm distance. Monomer conversion rate was measured using a Fourier-transform Raman spectrometer and Knoop hardness number was obtained using a microhardness tester on the top and bottom surfaces. Data were statistically analyzed by analysis of variance and Tukey's test (α=0.05)., Results: Overall, the increase of curing distance reduced the microhardness (p≤0.05), but did not influence the carbon double bond conversion rate (p>0.05) of the composite resin tested; and the top surface showed better properties compared to the bottom (p≤0.05)., Conclusions: The light curing at distance can reduce mechanical properties and could affect long-term durability of the composite restorations. Thus, the use of a curing device with high irradiance is recommended.

The distribution of light intensity of three light-curing units (LCUs) to cure the resin-based composite for dental fillings was analyzed, and a homogeneity index [flat-top factor (FTF)] was calculated. The index is based on the M2 index, which is used for laser beams. An optical spectrum analyzer was used with an optical fiber to produce an x-y power profile of each LCU light guide. The FTF-calculated values were 0.51 for LCU1 and 0.55 for LCU2, which was the best FTF, although it still differed greatly from the perfect FTF = 1, and 0.27 for LCU3, which was the poorest value and even lower than the Gaussian FTF = 0.5. All LCUs presented notably heterogeneous light distribution, which can lead professionals and researchers to produce samples with irregular polymerization and poor mechanical properties.

Objective: This study aimed to investigate the surface roughness of composite resins subjected to thermal cycles procedure., Materials and Methods: Two microfill, four microhybrid and four nanofill composites were used. The surface roughness (Ra) was initially measured in a profilometer using a cut-off 0f 0.25 mm, after 3000 and 10,000 thermal cycles. Data were subjected to ANOVA and Fischer's test (α = 0.05)., Results: Overall, 3000 thermal cycles increased the surface roughness values for all materials and there was a trend in all groups to decrease the roughness after 10,000 thermal cycles., Conclusions: The composition of material, including the type of organic matrix, could be more relevant to roughness maintenance over time than the general behavior of composites based on particles fillers. The maintenance of smooth surface in resin-based composite restorations is totally dependent of organic composition of the material.

Statement of Problem: Clinicians continue to search for ways to simplify bonding procedures without compromising clinical efficacy., Purpose: The purpose of this study was to evaluate the shear strength of self-adhesive cements RelyX U100 and RelyX U200, and conventional resin cement RelyX ARC to enamel and dentin after different surface treatments., Material and Methods: The crowns of 120 bovine incisor teeth were separated from the roots and embedded in epoxy resin in polyvinyl chloride tubes. In each tooth, the area to be cemented was delimited with central holed adhesive tape. The teeth were distributed into 12 groups (n=10) according to the substrate; etched or not with 37% phosphoric acid; and cement type of enamel-U100, enamel-phosphoric acid-U100, enamel-U200, enamel-phosphoric acid-U200, enamel-ARC, enamel-phosphoric acid-ARC, dentin-U100, dentin-phosphoric acid-U100, dentin-U200, dentin-phosphoric acid-U200, dentin-ARC, and dentin-phosphoric acid-ARC. After 7 days of storage in artificial saliva, shear strength tests were performed by using a universal testing machine (0.5 mm/min). The data were analyzed with 3-way ANOVA and the Tukey test (α=.05). Fracture analysis was performed with a light microscope. Two specimens from each group were analyzed with a scanning electron microscope., Results: In enamel, ARC (9.96 MPa) had higher shear strength (P=.038) than U100 (5.14 MPa); however, after surface etching, U100 (17.81 MPa) and U200 (17.52 MPa) had higher shear strength (P<.001). With dentin, no significant differences were observed (P=.999), except for dentin-ARC (0.34 MPa) (P=.001). Most fractures were of the adhesive type., Conclusions: U200 self-adhesive cement had similar bond strength to the ARC in enamel, but the combination with phosphoric acid had the best bond strength. For dentin, self-adhesive resin cements are equally effective alternatives to conventional resin cement., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: This study evaluated the influence of punch and base orifice diameters on push-out test results by means of finite element analysis (FEA)., Materials and Methods: FEA was performed using 3D models of the push-out test with 3 base orifice diameters (2.5, 3.0, and 3.5 mm) and 3 punch diameters (0.5, 1.0, and 1.5 mm) using MARC/MENTAT (MSC.Software). The image of a cervical slice from a root restored with a fiberglass post was used to construct the models. The mechanical properties of dentin, post, and resin cement were obtained from the literature. Bases and punches were constructed as rigid bodies. A 10-N force was applied by the punch in the center of the post in a nonlinear contact analysis. Modified von Mises stress, maximum principal stress, as well as shear and normal stress components were calculated., Results: Both punch and base orifice sizes influenced the stress distribution of the push-out test. Bases with larger diameters and punches with smaller diameters caused higher stress in dentin and at the dentin/cement interface., Conclusion: FEA showed that the diameter of the orifice base had a more significant influence on the stress distribution than did the punch diameter. For this reason, both factors should be taken into account during push-out experimental tests.

Purpose: To evaluate the influence of light-activation of second, third and fourth increments on degree of conversion (DC) and microhardness (KHN) of the top (T) and bottom (B) surface of the first increment., Materials and Methods: Forty samples (n = 5) were prepared. In groups 1-4, after each increment light-activation (multiple irradiation), T and B of the first increment were measured in DC and KHN. In groups 5-8, only the first increment was made (single irradiation) and measurements of DC and KHN were taken at 15 min intervals. The light-activation modes were (XL) 500 mW/cm(2) × 38 s (G1/G5); (S) 1000 mW/cm(2) × 19 s (G2/G6), (HP) 1400 mW/cm(2) × 14 s (G3/G7); (PE) 3200 mW/cm(2) × 6 s (G4/G8). Data for DC and KHN were analyzed separately by using PROC MIXED for repeated measures and Tukey-Kramer test (α = 0.05)., Results: For KHN, B showed lower values than T. PE resulted in lower values of KHN in B surface. For single and multiple irradiations, T and B of first measurement showed the lowest KHN and the fourth measurement showed the highest, with significant difference between them. For single irradiation, first and second increments presented similar KHN, different from the third and fourth increment, which did not differ between them. For multiple irradiations, the second light-activation resulted in KHN similar to first, third and fourth increments. For DC, except QTH, T presented higher DC than B., Conclusion: The light-activation of successive increments was not able to influence the KHN and DC of the first increment.

Purpose: To evaluate the marginal microleakage and the infiltration ability of pit-and-fissure sealants by applying the conventional sealing technique in comparison to using an additional bonding agent., Materials and Methods: Extracted non-carious permanent molars (n = 60) were first stored in sterile saline solution and then assigned to one of two groups: group C (control) was sealed (Helioseal F) by using the conventional technique, while in group BA (bonding agent), a bonding agent (OptiBond FL) was additionally applied prior to sealing. The teeth were thermocycled (1000 cycles, 5°C to 55°C, dwell time 30 s), then varnished and immersed in 5% methylene blue solution for 24 h. After embedding and sectioning each tooth into 6-12 slices, the presence of microleakage, unfilled areas, and air bubbles trapped in the sealant were assessed with a stereomicroscope., Results: A higher proportion of microleakage was found under sealants applied without the additional use of the bonding agent. A statistically significant difference in microleakage was noted between the groups (p = 0.045). Regarding the presence of unfilled areas, a statistically significant difference between the groups was observed (p < 0.001), especially since no unfilled areas were found at all in the samples of the group using the bonding agent. Regarding the amount of air bubbles trapped in the sealant, no statistically significant difference was observed between the two groups (p = 0.829)., Conclusion: Under these in vitro conditions, sealant procedures using an additional bonding agent applied beforehand significantly improved fissure infiltration and microleakage prevention significantly.

The present study aimed to assess the influence of curing distance on the loss of irradiance and power density of four curing light devices. The behavior in terms of power density of four different dental curing devices was analyzed (Valo, Elipar 2, Radii-Cal, and Optilux-401) using three different distances of photopolymerization (0 mm, 4 mm, and 8 mm). All devices had their power density measured using a MARC simulator. Ten measurements were made per device at each distance. The total amount of energy delivered and the required curing time to achieve 16 J/cm(2) of energy was also calculated. Data were statistically analyzed with one-way analysis of variance and Tukey's tests (p < 0.05). The curing distance significantly interfered with the loss of power density for all curing light devices, with the farthest distance generating the lowest power density and consequently the longer time to achieve an energy density of 16 J/cm(2) (p < 0.01). Comparison of devices showed that Valo, in extra power mode, showed the best results at all distances, followed by Valo in high power mode, Valo in standard mode, Elipar 2, Radii-Cal, and Optilux-401 halogen lamp (p < 0.01). These findings indicate that all curing lights induced a significant loss of irradiance and total energy when the light was emitted farther from the probe. The Valo device in extra power mode showed the highest power density and the shortest time to achieve an energy density of 16 J/cm(2) at all curing distances.

Objective: The aim of this study was to evaluate the micro-mechanical properties of a light-cured resin cement in four different shades when polymerized through a leucite-reinforced glass-ceramic in different shades and thicknesses., Materials and Methods: A light-cured resin cement in four different shades (HV+1, HV+3, LV-1 and LV-3) was selected for this study. The specimens were cured by using a LED-unit (Bluephase®, IvoclarVivadent) for 20 s under a leucite-reinforced glass-ceramic (IPS Empress® CAD, IvoclarVivadent) in two different shades (A1 and A3) of different thicknesses (1 and 2 mm). Specimens cured directly, without an intermediate ceramic, served as control. The specimens were stored after curing for 24 h at 37°C by maintaining moisture conditions with distilled water. Micro-mechanical properties (indentation modulus, E; Hardness, HV; creep, Cr) of the resin cements were measured with an automatic microhardness indenter (Fisherscope H100C, Germany). Twenty groups were included (n = 3), while 10 measurements were performed on each specimen. Data were statistically analyzed by using one-way ANOVA and Tukey's post-hoc test, as well as a multivariate analysis to test the influence of the study parameters., Results: Significant differences were observed between the micromechanical properties of the tested resin cements (p < 0.05). The resin cement shade showed the highest effect on the micromechanical properties (Partial-eta squared (ηP(2))-E = 0.45, ηP(2)-HV = 0.59, ηP(2)-Cr = 0.29) of the resin cement, followed by ceramic thickness (ηP(2)-E = 0.38, ηP(2)-HV = 0.3, ηP(2)-Cr = 0.04) and ceramic shade (ηP(2)-E = 0.2, ηP(2)-HV = 0.26)., Conclusions: Resin cement shade is an important factor influencing the mechanical properties of the material. Light shades of a resin cement express higher E and HV as well as lower Cr values compared with the darker ones.

Objectives: To investigate the variation in water sorption and solubility across a range of different core build-up materials., Methods: Five materials were tested, four of which are resin-based materials (Grandio Core, Core.X Flow, Bright Flow Core, Speedee) and one resin-modified glass ionomer (Fuji II LC). All specimens (n=10) were immersed in 10ml distilled water in individual glass containers and weighed at one week, 14 and 28 days. After a total immersion time of 28 days, 7 specimens were dried to a constant mass, in a desiccator for 28 days. Three samples of each material were not dried, but were left in distilled water for 1 year, to determine the long-term water sorption properties. Specimens were weighed at monthly intervals until 6 months and then at the 9th and 12th months. Each specimen was measured using a digital electronic caliper (Mitutoyo Corporation, Japan)., Results: After 28 days immersion, the change in water sorption and solubility of the materials ranged from 12.9 to 67.1μg/mm(3) (P<0.001) and 0.9-6.4μg/mm(3) respectively (P<0.001). Except for Fuji II LC, an independent T-test showed significantly higher water sorption and solubility for the other materials after 1-year total immersion in water compared to 1 month (P<0.05). Using repeated measures ANOVA, all materials showed mass changes over time (1 month) (P<0.001)., Significance: Grandio Core had the lowest water sorption and solubility among the tested materials. According to the ISO 4049 standards, all the tested materials showed acceptable water sorption and solubility, apart from the water sorption behavior of Fuji II LC., (Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Aim: To evaluate the degree of conversion (DC) of orthodontic adhesives (RBOAs) cured with dual peak or single peak light-emitting diode (LED) light-curing units (LCUs)., Materials and Methods: Standardized samples of RBOAs, APCPlus, Opal® Bond® and LightBond(TM) were prepared (n = 3) and cured with one of two dual peak LCUs (bluephase® G2-Ivoclar-Vivadent or Valo-Ultradent) or a single peak control (bluephase® Ivoclar-Vivadent). The DC was determined using micro-Raman spectroscopy. The presence or absence of initiators other than camphorquinone was confirmed by high-performance liquid chromatography and nuclear magnetic resonance spectroscopy. Data were analysed using general linear model in Minitab 15 (Minitab Inc., State College, PA, USA)., Results: There was no significant difference in DC between APCPlus, and Opal® Bond (confidence interval: -3.89- to 2.48); significant difference between APCPlus and LightBond(TM) (-18.55 to -12.18) and Opal® Bond and Lightbond(TM) (-17.85 to -11.48); no significant difference between bluephase (single peak) and dual peak LCUs, bluephase G2 (-4.896 to 1.476) and Valo (-3.935 to 2.437) and between bluephase G2 and Valo (-2.225 to 4.147). APCPlus and Opal® Bond showed higher DC values than LightBond(TM) (P<0.05). Lucirin® TPO was found only in Vit-l-escence., Conclusion: Lucirin® TPO was not identified in the three orthodontic adhesives. All three LCUs performed similarly with the orthodontic adhesives: orthodontic adhesive make had a greater effect on DC than the LCUs. It is strongly suggested that manufacturers of resin-based orthodontic materials test report whether or not dual peak LCUs should be used with their materials. Dual peak LED LCUs, though suitable in the majority of cases, may not be recommended for certain non Lucirin® TPO-containing materials., (© 2014 British Orthodontic Society.)

Objective: To evaluate the degree of conversion (DC) of two light-cured composites with different protocols of light curing., Materials and Methods: One hundred and ninety two specimens (n = 8) were prepared (5 mm × 2 mm) according to experimental groups: two composite resins (Filtek Supreme and four seasons); three light curing protocols [20 s with the tip of the light curing unit (LCU) device touching composite surface (C); 20 s with the tip of the LCU at 8 mm distant from composite surface (D); and tip of the LCU at 8 mm distant from composite surface and polymerization time required to obtain a radiant exposure of 16 J/cm(2) (DS)]. Four LCUs (Bluephase 16i, Ultralume LED 5, XL 3000 and Optilux 501C) were used. DC of the bottom and top surface of specimens were measured using a FTIR spectrometer. Data were statistically analyzed by 3-way split splot ANOVA and Tukey's test (alpha = 0.05)., Results: The results showed that DC of the top surface was higher than the bottom at all experimental conditions (p < 0.0001). Overall, the curing at 8 mm of distance did not affect conversion rate on the top surface (p > 0.05), but bottom surfaces showed DC reduction (p < 0.05). The highest monomer conversion values were observed for C and DS situations., Conclusion: The distance between the LCU and material surface and radiant exposure can affect the DC. Polymerization at distance should be performed with curing units with higher light power and/or extended exposure time.

Objective: To evaluate quantitatively the marginal microleakage of restorations carried out with self-etching adhesives with or without prior phosphoric enamel acid etching of silorane or methacrylate resin-based composite restorations subjected to thermal cycling., Materials and Methods: Forty cavities were prepared at the proximal surface of bovine incisors and randomly divided according to the etching of the enamel and restorative system used. The groups were restored with methacrylate [Adper SE Plus adhesive (3M ESPE) + Filtek Z250 (3M ESPE)] or silorane [Filtek LS adhesive (3M ESPE) + Filtek LS composite (3M ESPE)] restorative systems, light-cured using a LED unit (Bluephase 16i, Vivadent). After restorative procedure and thermocycling (1000 cycles), the specimens were immersed in methylene blue for 2 h. The specimens were triturated and the powder was used for analysis in an absorbance spectrophotometer. Data were statistically analyzed by 2-way ANOVA (alpha = 0.05)., Results: No statistical difference between the restorative materials tested with or without previous acid etching of enamel in Class II marginal microleakage was observed (p > 0.05)., Conclusions: The use of acid etching prior to self-etching adhesives did not interfere on the microleakage of methacrylate- or silorane-based restorations.

Objective: The aim of this study was to evaluate the effect of different surface treatments on the microtensile bond strength (μTBS) and shear bond strength (SBS) of resin-modified glass ionomer cement (RMGIC) to dentin., Materials and Methods: Fifty-two extracted human molars were flattened to obtain dentin surfaces. For SBS assessment 40 teeth were divided into four groups according to their surface treatments (acid etching, Er:YAG laser QSP mode, Er:YAG laser MSP mode and control-SiC) (n = 10). A plastic cylinder was placed over the differently treated dentin surfaces and RMGIC was placed into the rings and polymerized. Twelve teeth were used for the μTBS test. The treated dentin surfaces described above were restored with 4 mm high RMGIC and light cured; then, the specimens were sectioned into serial sticks (n = 15) and μTBS and SBS were tested for failure in a testing machine with a 1 mm/min crosshead speed. The data were analyzed by one-way ANOVA and Tukey HSD tests (α = 0.05)., Results: Acid etching showed significantly higher SBS than the other groups (p < 0.05). Er:YAG QSP and MSP-treated groups showed higher SBS values than the control group, but the difference was not statistically significant (p > 0.05). Er:YAG MSP showed the highest μTBS value followed by acid etching, whereas the control group exhibited the lowest value (p < 0.05) and the differences between the control group and Er:YAG QSP were not significant (p > 0.05)., Conclusions: The application of Er:YAG MSP mode and acid etching to dentin can be used for improving the bond strength of RMGIC.

Statement of Problem: Information is lacking of the polymerization depth of dual-polymerized flowable composite resin foundation materials in simulated root canals., Purpose: The purpose of this study was to investigate the hardness gradients and the polymerization depth of dual-polymerized flowable composite resin foundation materials in simulated root canals., Material and Methods: Slots in steel split cylinders with 1 open end were filled with the following 6 materials: Luxa Core, Para Core, Clearfil DC Core, Multi Core Flow, Gradia Core, and Core-Flo DC. After filling, they were subjected to a light intensity of 1250 mWcm(-2) with a light-emitting diode light through their open ends for 20 seconds. The resulting specimens were stored in a light-proof box at 37°C, and the Knoop hardness gradients of each polymerized material were measured after 0.5 hour, 24 hours, and 120 hours. The surface readings were obtained in 1-mm intervals at 1 mm to 10 mm away from the open ends. The collected data were analyzed by 2-way ANOVA and the Student-Newman-Keuls test (α=.05)., Results: Before the Knoop hardness numbers of the 6 materials became stable, they decreased gradually in depth at each time point (P<.001). However, the depths at which they became stable differed. The Knoop hardness numbers of Luxa Core and Core-Flo DC reached stability at a depth of 3 mm, Para Core at 4 mm, and Clearfil DC Core, Multi Core Flow, and Gradia Core at 5 mm. Additionally, at 120 hours after exposure, the ratios of the Knoop hardness numbers at a depth of 5 mm to those at 1 mm were 63.08% for Luxa Core, 70.48% for Clearfil DC Core, 81.38% for Para Core, 80.49% for Gradia Core, 86.30% for Multi Core Flow, and 96.28% for Core-Flo DC., Conclusions: In simulated root canals, the flowable composite resin foundation materials tested had better polymerization under dual polymerizing than under chemical polymerizing, and their chemical-polymerized capabilities could determine the definitive polymerization depth., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)