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Radiographic image of primary teeth on right side. a) The arrow denotes carious lesion on the proximal surface of mandibular right first primary molar. b) The arrow denotes the composite restoration on first primary molar. c) Radiographic image of primary teeth on right side, 2 years after figure 1b. The arrow denotes the failed class II composite restoration because of extensive decay.
Source publication
Composite restorations have higher failure rates, more recurrent caries and increased frequency of replacement as compared to dental amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and failure. The gingival margin of compos...
Context in source publication
Context 1
... development of secondary decay indicates that the seal at the composite/tooth interface is not resistant to the physical, chemical, and mechanical stresses that are present in the mouth ( Figure 1). Indeed, the clinical failure of moderate to large composite restorations has been linked to a breakdown of the bond at the tooth surface/composite material interface [12,[15][16][17][18][19][20] and increased levels of the cariogenic bacteria, Streptococcus mutans, at the perimeter of these materials [21][22][23][24][25]. ...
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Objective:
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Background: Evaluation of microleakage is important for assessing the success of new restorative materials and methods.
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Materials and Methods: Standardized mesi-occlusal (MO) and...
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Citations
... Despite these advances in the composition of universal adhesives, the created adhesive interface is still subjected to degradation over time [2]. Several factors related to adhesive/dentin interface degradation are highlighted: the hydrolytic degradation of the polymer present in the hybrid or adhesive layers, or a poorly infiltrated hybrid layer with unprotect collagen fibers, that could be hydrolyzed by matrix metalloproteinase (MMPs) and cysteine cathepsines (CTs) [13,14]. These enzymes are activated by pH changes relevant to acid etching process and/or by an acidic pH from cariogenic bacteria, contributing to increased deterioration and undermining the durability of resin composites restorations [15,16]. ...
Objectives:
This study aimed to evaluate the effect of copper nanoparticles (CuNp) on the clinical performance of a universal adhesive system used as an etch-and-rinse or self-etch strategy.
Methods:
A total of 216 class V (non-carious lesions) restorations were randomly placed in 36 subjects according to the following groups: ERcu, adhesive in etch-and-rinse with 0.1% CuNp; ERct, adhesive in etch-and-rinse without CuNp; SEcu, adhesive in self-etch with 0.1% CuNp; and Sect, adhesive in self-etch without CuNp. Restorations were evaluated at baseline and at 6, 12, 18, 36, and 48 months, using the FDI and USPHS criteria. Appropriate statistical analyses were performed (α = 0.05).
Results:
After 48 months, 14 restorations were lost (two for ERcu, five for SEcu, and seven for SEct) and the retention rates (95% confidence interval [CI]) were 74.1% for ERcu (95% CI 61.1-83.8); 81.5% for ERct (95% CI 69.2-89.6); 64.8% (95% CI 51.5-76.2) for SEcu; and 64.8% (95% CI 51.5-76.2) for SEct, with statistical differences between SEct vs. ERct and SEcu vs. ERct (p < 0.05). No significant differences between the groups were observed when the secondary parameters were evaluated (p > 0.05). Nineteen restorations (two for ERcu, two for ERct, six for SEcu, and nine for SEct) showed minor marginal staining, and 44 restorations (7 for ERcu, 8 for ERct, 14 for SEcu, and 15 for SEct) presented minimal marginal adaptation defects.
Significance:
This is the first long-term clinical trial to show that the addition of CuNp to a universal adhesive system does not affect clinical performance.
... However, the failure of such restorations could be concise in the form of secondary caries, marginal discrepancies, postoperative sensitivity, and fracture in some cases if the restorations were not properly planned. [20][21][22][23][24][25] In this study, multimode universal adhesive was selected owing to the reported excellent bond performance in etching mode and self-etch method. 20 Also, it allows the clinicians to select the desired mode for usage rendering to the clinical situation. ...
Aim:
The aim of the present study is to evaluate the effect of Ag-Au NPs formulation as surface pretreatment by assessing the microshear bond strength, ultra-morphological, and elemental characteristics of gold-silver nanoparticle-treated dentin to resin composite with different adhesive modes.
Materials and methods:
A total of 60 extracted sound human permanent molars were selected to test the microshear bond strength of composite resin to dentin (40 teeth) and 20 molars were used to assess the ultramorphological and elemental characteristics of silver-gold nanoparticles using environmental scanning electron microscope (ESEM) with energy-dispersive X-ray (EDX) analyzer. The specimens were randomly divided into two main groups according to measured tests either microshear bond strength or elemental analysis. For the bond-strength testing group, 40 teeth were equally distributed into two main groups (20 each) according to dentin-surface pretreatment with or without the use of silver-gold nanoparticles. Then, each group was further divided into two subgroups (10 specimens for each) according to adhesive mode. For ultramorphological and elemental analysis, 20 teeth were equally divided into similar previously mentioned groups according to treatment modalities (5 teeth per group). The multimode bonding agent used in this study was single-bond universal, 3M. The data were collected and statistically analyzed. The significance level was set at p ≤0.05.
Results:
The results showed that different etching modes had no statistically significant effect. Also, pretreatment had no statistically significant effect. The interaction between the two variables also had no statistically significant effect. Majority of samples in all groups had mixed failure mode. Ultramorphological examination of the tested samples treated with silver-gold nanoparticles revealed proper dispersion of nanoparticles in dentin.
Conclusions:
The new formulation of silver-gold nanoparticles did not interfere with the bond strength and sealing ability of resin composite restoration in different adhesion modes.
Clinical significance:
The cavity disinfection with silver-gold nanoparticles did not affect the marginal integrity of resin composite restoration. Further studies should be done to evaluate the impact of application of silver-gold nanoparticles in long duration with other adhesive systems in the clinical scenario.
... Adhesives are responsible for bonding resin composite to the dental substrate [4]. Hence, the adhesive interface is considered the Achille's heel of the restoration [5,6]. Development of adhesives with antibacterial activities is necessary to prevent destruction of the bonded interface caused by extrinsic bacteria [1,7]. ...
Nisin is a peptide that possesses potent antibacterial properties. This study evaluated the antibacterial activity of a nisin-doped adhesive against Streptococcus mutans, as well as its degree of conversion and microtensile bond strength (μTBS) to dentin. Nisin was added to the adhesive Adper Single Bond 2 (3M ESPE), resulting in four groups: Control Group (Single Bond 2); Group 1% (1 wt% nisin-incorporated), Group 3% (3 wt% nisin-incorporated) and Group 5% (5 wt% nisin-incorporated). Antibacterial activity against S. mutans was evaluated using colony-forming unit counts (CFU). The degree of conversion was tested using FTIR. Forty human teeth were restored for μTBS evaluation. Data were statistically analyzed with ANOVA and Tukey tests at α = 0.05. The nisin-doped adhesives, for all concentrations, exhibited a significant inhibition of the growth of S. mutans (p < 0.05); Incorporation of 5% and 3% nisin decreased the degree of conversion of the adhesive (p < 0.05). The μTBS (in MPa): Control Group—38.3 ± 2.3A, Group 1%—35.6 ± 2.1A, Group 3%—27.1 ± 1.6B and Group 5%—22.3 ± 1.0C. Nisin-doped adhesives exerted a bactericidal effect on S. mutans. The μTBS and degree of conversion of adhesive were not affected after incorporation of 1% nisin.
... The original systems were two-step, self-etching systems, but in an effort to increase the efficiency of the procedure and reduce technique sensitivity, the manufacturers developed all-in-one single-step adhesives. The increased concentration of acidic resin monomers provided a system that etched the dentin and enamel simultaneously (16). ...
Background: An in vitro evaluation and comparing the microleakage and shear bond strength between a self- adhesive flowable composite resin (Dyad Flow) and self-etch based flowable composite restorative material ( Nano Filtek Z 350XT) Materials and methods: A total of sixty specimens were prepared from extracted teeth, which were divided into two groups. For microleakage analysis, Group I consisting of thirty teeth which were further divided into two subgroups of fifteen teeth each that is Group IA and Group IB, on which standard class V cavity was prepared and restored with Dyad Flow and Nano Filtek Z 350XT respectively. The prepared specimens were immersed in 0.6% aqueous Rhodamine B dye for 24 hours. The sectioned samples were examined under a Confocal Microscope at 10 X magnification and microleakage scores were analyzed statistically using Mann-Whitney U test. For shear bond strength evaluation, Group II consisting of thirty teeth, which were subdivided into two subgroups of fifteen teeth each that is Group IIA and Group IIB.
... Entretanto, la dentina se caracteriza como un complejo biológico hidratado y poroso, compuesto por fluido dentinario y túbulos que se encuentran cercados por una zona peritubular altamente mineralizada, insertados en una matriz intertubular predominantemente constituída por colágeno tipo I y cristales de apatita. Su proporción en volumen es de 50 % de mineral, 30% de materia orgánica y 20 % de fluido similar al plasma 6,14 . ...
... Incluso sin el agente fijador (cloruro férrico), el HEMA, que es una molécula de bajo peso molecular, es capaz de infiltrarse entre las fibras colapsadas de colágeno y promover su re-expansión, garantizando la formación de una capa híbrida eficaz. El HEMA es un monómero presente hasta hoy en las formulaciones, que también actúa como un co-solvente para otros monómeros, previniendo la separación de las fases del adhesivo 14,15 . Sin embargo, esta molécula presenta desventajas como bajo potencial de polimerización por poseer cadena lineal, alta tasa de sorción de agua, baja contribución a las propiedades mecánicas y potencial citotóxico15. ...
... El ácido fosfórico al 35-37% es el agente acondicionador disponible comercialmente que permite lograr mayor profundidad de desmineralización en la dentina normal cuando se compara al acondicionamiento ácido con ácidos más débiles como el poliacrílico, maleico y cítrico 5,33,34 . Entretanto, existe la posibilidad de que los monómeros resinosos no se difundan en la dentina desmineralizada en toda su profundidad, exponiendo así a las fibras colágenas, que son susceptibles a la hidrólisis y degradación, lo que debilita la unión adhesiva, debido a la gran profundidad de desmineralización causada por el ácido fosfórico al 37% 14,15,18,25,46 . Así, se cree que una desmineralización con mínima profundidad podría permitir que el sistema adhesivo se difundiera por toda la extensión de la red de fibras colágenas, sin causar exceso de humedad, evitando así la degradación de estas fibras 6,15,42,43 . ...
RESUMEN Existen diferentes ácidos que son capaces de acondicionar el sustrato dentario, proporcionando patrones distintos de acondicionamiento, y que dependen del pH, del tiempo de exposición y de la concentración de dichos ácidos. El acondicionamiento ácido afecta las propiedades físicas y químicas, tanto de la parte mineral como de la parte orgânica del tejido. Así, el objetivo es describir los efectos de diversos acondicionadores ácidos sobre los sustratos esmalte y dentina, previos a la utilización de sistemas adhesivos. Este estudio fue realizado por medio de una recopilación bib-liográfica en las bases de datos PubMed, Scopus y Scielo. Se incluyeron artículos publicados, en inglés o portugués, entre 1950 y 2020. Se constató que: el uso de ácidos más débiles y en menor concentración, asociados o no a agentes estabilizantes/fijadores de colágeno, fue menos agresivo al sustrato dentinario que el ácido fosfórico, debido a que causa una menor profundidad de des-mineralización y consecuentemente menor exposición de fibras colágenas sujetas a hidrólisis, cu-ando no están incorporados por los monómeros adhesivos; las lesiones cervicales no cariosas rep-resentan el sustrato más desafiante y con resultados más impredecibles de adhesión longitudinal; la adhesión al esmalte sólo es efectiva con el acondicionamiento con ácido fosfórico; los adhesivos simplificados generalmente presentan resultados de resistencia adhesiva inferiores a los de frascos separados, principalmente aquellos que no presentan una capa hidrófuga externa; los resultados in vitro no pueden ser directamente extrapolados a situaciones in vivo; no existen evidencias científi-cas que apoyen el uso de inhibidores de MMP en la rutina del protocolo adhesivo.
... Dental composites are becoming more popular because of their strength, rapidness, and control of polymerization and aesthetic appearance. However, there is a large percentage of failures in a short period in these restorations [1]. Failures of composite restorations are observed mainly at the dentin/ adhesive interface. ...
Objective:
To evaluate the physicochemical (sorption (SOR), solubility (SOL), and degree of conversion (DC)) and mechanical (flexural strength (FS), modulus of elasticity (ME), and compressive strength (CS)) properties of adhesives with different water contents (D2O).
Materials and methods:
An adhesive was formulated: 55 wt% BisGMA, 45 wt% HEMA, 0.5 wt% camphorquinone, 0.5 wt% EDMAB, and 1.0 wt% DPIHP. D2O was added into the adhesives (0 wt%, 10 wt%, and 16 wt%). DC was monitored through the FTIR. FS, ME, CS, SOR, and SOL were tested. The adhesive samples were aged in deionized water, ethanol, and acetone. Data were submitted to ANOVA and Tukey's tests (5%).
Results:
For DC, the 0 wt% group showed a significant reduction (68.09 ± 0.14A) compared with the 10 wt% (87.07 ± 0.81B) and 16 wt% groups (89.87 ± 0.24B); 10 wt% showed the highest FS (MPa) mean values (141.6 ± 6.71B) compared with the 0 wt% (109.4 ± 20.5A) and 16 wt% (107.8 ± 15.8A). For the CS (MPa) and ME (GPa), the 16 wt% showed the lowest mean values (98.8 ± 18.0B and 2.2 ± 0.3B, respectively) compared with the 10 wt% and 0 wt%. For the SOR, 16 wt% of water showed the highest mean values and the ethanol showed the lowest mean values of SOL regardless of water content.
Conclusion:
The amount of water content and the types of aging solvents significantly affect the adhesive properties.
... The ideal HL would be characterized as a polymer/collagen network that provides both a continuous and stable link between the adhesive and dentin substrate (Spencer et al., 2010;Spencer et al., 2012). The clinical success of a restoration depends not only on the quality of the HL but more importantly on its long-term stability, and durability between the adhesive agent and dentin tissue (Łukomska-Szyma nska & Łapi nska, 2017). ...
To evaluate the caries‐affected dentin and composite‐resin interface with scanning electron microscopy (SEM) after different caries removal methods in human molars. Twelve with extensive approximal caries lesions that did not reach the pulp and five caries‐free molars (control group [CG]) were used. Carious teeth were divided into four experimental groups: Atraumatic Restorative Treatment (ART), Rotary Instrument (RI), Photo‐Ablation, and Papain‐Based Enzymatic Gel (Brix 3000®, Brix, Brazil). Class II slot cavities were prepared with RI in the CG. Then all caries removed teeth and control groups were restored (All‐Bond Universal, BISCO, USA; Clearfil MajestyES‐2, Kuraray, Japan). Specimens were prepared for SEM examinations. Hybrid layer (HL) thicknesses were measured using ImageJ programme. Gap measurements were performed with micro‐CT. Data were analyzed with ANOVA and posthoc Dunnett's t‐tests ( p < .05). The highest HL thickness was found in Photo‐Ablation Group, and a statistically significant difference was observed among the control and experimental groups ( p < .05). The lowest HL thickness was measured in the Enzymatic Gel Group. In terms of internal gap formation, CG showed statistically significant differences compared to the other groups ( p < .05). The highest internal gap was observed in RI Group, while the lowest gap was observed in CG. According to SEM, a uniform HL and resin tags were seen in the CG. Smear layer, irregular HL, and gap formation were observed in ART Group. In RI Group, nonuniform HL formation and resin tags were observed. In Photo‐Ablation Group, a uniform HL without smear layer and internal gap was observed. In the Enzymatic Gel Group, both opened dentinal tubules, and melting‐like formations were observed on the dentin surface. Especially melting‐like formations were observed in peritubular dentin. It can be concluded that all caries removal methods except rotary instrumentation were conservative methods, which preserve more healthy dental tissues.
Research highlights
Among the caries removal procedures, the photo‐ablation caries removal method stands out with the highest hybrid layer (HL) thickness and the lowest internal gap formation. Despite having the lowest HL thickness, the enzymatic gel method can be advantageous for patients requesting an alternative caries removal instead of a rotary instrument.
... 20 Degradation of the hybrid layer could be broadly divided into two major categories: hydrolytic degradation of the collagen matrix and hydrolytic degradation of the adhesive within the hybrid layer (the resinous part in the form of plasticization). 21,22 In this study, the used universal adhesive represents a type of self-etching (SE) adhesives. The durability and stability of bonded interfaces created by this adhesive continue to be questionable. ...
Aim:
This study was conducted to evaluate the marginal adaptation, marginal staining, and postoperative sensitivity of resin composite restorations after disinfection of class II cavities with NanoCare Gold and chlorhexidine in class II cavities immediately, after 6 months, 1, and 2 years using World Dental Federation (FDI) criteria for assessment of dental restorations.
Materials and methods:
In this study, 19 participants were recruited, 3 carious lesions in each one. After preparation of these lesions, they were randomly allocated into three parallel groups according to the disinfection protocol. The first group was for NanoCare Gold, the second was for chlorhexidine, and the third was for the control. The three groups were evaluated clinically and radiographically using (FDI) criteria at different intervals till 2 years of clinical service.
Results:
There was no statistically significant difference in age, gender, arch, and tooth type distribution among study groups. Regarding marginal adaptation, there was no statistically significant difference among the different groups but the difference was only statistically significant within each group after 2 years. Regarding the marginal staining, the difference was only significant between the NanoCare and the other groups after 2 years. In case of postoperative sensitivity, there was no statistically significant difference among the different groups and within each one at different intervals.
Conclusion:
NanoCare Gold could be promising in durability preservation of direct tooth-colored restorations. Marginal staining and postoperative sensitivity are regulated by other factors than surface pretreatment.
Clinical significance:
As long as restorations are inserted under rubber dam isolation, proper application steps, proper filling, and adequate finishing and polishing, the performance of the restorations would be satisfactory up to 1 year without any surface disinfection. However, after a longer follow-up, some changes may be noticed. NanoCare Gold and chlorhexidine are accepted as a cavity disinfectant without any negative effect on marginal adaptation of resin composite restorations.
... Although the prevalence of dental caries in the world has declined significantly over the last few years [1], clinicians still spend considerable time preparing and restoring dental cavities to replace the dental structure lost due to caries lesion progression [2]. The most used restorative material to repair the lost dental tissue in the last decade is the composite resin, representing 65% of direct restorations placed in the USA [3,4]. ...
... 3. Posterior restorations were performed in children. 4. If one group involved indirect restoration. ...
Objectives
This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies.MethodsA systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0–2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration’s tool version 1.0.ResultsA total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal’s impact factor was not correlated with the overall CONSORT score (p = 0.36).Conclusions
The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement.Clinical relevanceMost RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.
... Although it has been indicated that such events do not necessarily impact material stiffness, it has been indicated that they can lead to the development and propagation of cracks. 33,34 Accordingly, this might be associated with a significant reduction in strength and can lead to channel formation due to increased moisture ingress. In addition, in a previous investigation of vinyl ester carbon composite, Siriruck and Penumadu evaluated the fatigue ability of these compounds on exposure to seawater and reported that they noticed a 50% reduction in the fatigue cycles compared to 85% for single-side exposure and complete immersion, respectively. ...
Research has offered many advances in the dentistry field and variable types of dental composites have been widely validated to be effectively used with many favorable outcomes. Among the differently reported composites, hybrid ones are the most commonly reported and used in clinical settings. However, the characteristics of these composites vary hugely based on the materials and the environmental factors that they might be potentially exposed to. In this literature review study, we have discussed the types and characteristics of the dental composites, elaborating the effect of different environmental factors on the degradation of the different composite materials. Our results indicate that dental composites are hugely affected by environmental factors as temperature, moisture, chemical reactions and impact blunt. Furthermore, enhancing the quality of the materials by using more flexible approaches might enhance their quality in achieving better outcomes. Moreover, research should be directed within this area to improve the functions of the dental composites and improve the quality of life for the corresponding patients. Composites based on nanotechnology seem promising. However, these are not adequately investigated, and further research is encouraged for adequate validation.
