Project description:The effectiveness of a universal adhesive applied in three application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA) over 36 months. In 50 patients, three (n = 21) or four (n = 29) non-carious cervical lesions (NCCL) were restored with Venus® Diamond Flow (Kulzer GmbH, Hanau, Germany). The adhesive iBond® Universal (iBU, Kulzer, Germany) was used in self-etch (SE), etch-and-rinse (ER), or selective-enamel-etch mode (SEE). The etch-and-rinse adhesive OptiBondTM FL served as a control (OFL, Kerr GmbH, Herzogenrath, Germany). The restorations were clinically assessed (FDI criteria) at 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. FDI criteria and marginal gap and perfect margin were compared between and within groups and recalls using McNemar, Wilcoxon, or Mann-Whitney U-tests (α = 0.05). Starting with 12 months, cumulative failure rates were lower in iBU-SE (0.0%, p = 0.016) and iBU-ER groups (2.1%, p = 0.07) compared to OFL (16.7%). At two years, iBU-SEE also showed fewer failures (0.0% SEE vs. 34.6% OFL, p = 0.016), as did iBU-SE compared to iBU-ER after 36 months (2.2 and 19.6%, p = 0.039). From BL, the iBU-SEE group always had the fewest marginal gaps and the highest percentage of perfect margins. From BL, iBU-SEE (0%, p = 0.008) and iBU-ER (0.2%, p = 0.027) showed significantly fewer marginal gaps compared to OFL (2.5%) and more perfect margins were found with iBU-SEE starting at 6 months (p = 0.054). The SEE and ER modes ensured the most excellent marginal quality, with differences from the control appearing earlier with QMA than clinically. In restoring NCCls, iBU showed superior clinical performance over OFL, especially in modes SE and SEE.
Project description:ObjectivesTo compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs).Methods37 adults were recruited with 3 or 6 NCCLs (>1.5mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan-Meier method was used to compare the retention between adhesive materials.ResultsClinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p<0.0001). Both Scotchbond Universal self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively.ConclusionsScotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively.Clinical significance24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode.
Project description:Peptide-based biomimetic treatments have gained increased attention in the dental field due to their biocompatibility and minimally invasive qualities. These biomimetic approaches can replicate the native architecture of dental tissues, thus contributing to higher success rates and improved longevity of restorations. The aim of this study was first to examine the biocompatibility and stability of an amelogenin peptide-based chitosan hydrogel (P26-CS) against salivary enzymes. Second, we aimed to evaluate its efficacy in biomimetically repairing human dental lesions in situ. White spot lesions (WSLs) in enamel and non-carious cervical lesions (NCCLs) in dentin were artificially created. Chitosan (CS) improved peptide stability, while remineralization of enamel sections with P26-CS was not impeded by salivary enzymes. The peptide was not cytotoxic, irritating, or sensitizing. Fluorescently labeled P26-CS penetrated ~300 μm into the enamel of WSLs and ~100 μm into the dentin of NCCLs. After peptide treatment, quantitative light-induced fluorescence (QLF) and microcomputed tomography (μCT) indicated a gain in mineral density of WSLs. In NCCLs, scanning electron microscopy showed that the dentin was covered by a mineral layer of needle-shaped crystals. Our results show that the repair of artificial WSLs and NCCLs was achieved by P26 peptide-guided remineralization and demonstrate its potential to repair dental lesions.
Project description:ObjectiveTo compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial.Materials and methodsTwenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05).ResultsAfter 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months.ConclusionGH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism.Clinical significanceAfter 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.
Project description:ObjectiveTo determine the effect of adhesive strategy (total etch or self-etch) of universal adhesives in non-carious cervical lesions.Data sourceA search was made in PubMed, Scopus, Cochrane, Web Of Science, Open Gray, Clinical Registries.Data selectionRandomized Controlled Clinical Trials, studies on non-carious cervical lesions restored using Universal Adhesives, and studies in which universal adhesives have been used in total etch and self -etch strategies were included in this systematic review.Data extractionA total of 17 articles were included in the systematic review and 13 in the meta-analysis. Meta-analysis was conducted to assess the clinical performance of NCCLs in terms of retention, marginal adaptation, marginal discoloration, secondary caries and post-operative sensitivity at 18, 24, 36 month follow-up using USPHS as well as FDI criteria, separately.Data synthesisOverall there was no significant difference between total etch and self etch adhesive strategies for any of the five outcome measures using either the FDI or the USPHS criteria. p > 0.05, 95% CI, I2 value of 0%. A strongly suspected publication bias in the retention domain was seen at 18 month follow up under FDI criteria.ConclusionMost universal adhesives show acceptable clinical performance. There is no significant effect of the adhesive strategy of universal adhesives on their clinical performance according to the results of our meta-analysis.
Project description:BackgroundNon-carious cervical lesions (NCCLs) have shown a significant incidence and prevalence and have been increasingly associated with people's lifestyles and youths. This cross-sectional study aimed to determine the prevalence of NCCLs in footballers and to address potential risk indicators.MethodsFourty-three male semi-professional footballers with an average of 27 years old completed a questionnaire and were subjected to intraoral examination in terms of cervical tooth wear, morphological characteristics of NCCLs, tooth sensitivity, occlusal/incisal wear, and malocclusion classification. Also, laboratory assays were performed to determine salivary parameters: flow rate, pH, buffer capacity, level of Ca (calcium), Na (sodium), and K (potassium) ions, and level of cortisol. The data obtained from the questionnaire and intraoral examinations were subjected to Chi-square and Poisson regression models while the data obtained from the laboratory assays were analyzed by using analysis of variance (p < 0.05).ResultsThe prevalence of NCCLs was 39.5%. The participants presented predominantly initial lesions with signs of mechanical stress. The daily training time was found as a significant risk indicator (p = 0.028). The multivariate analysis showed a significant difference in the variables daily training time (p = 0.023), lemon water intake while fasting (p = 0.002), toothpaste type (p = 0.004), tooth sensitivity (p = 0.006); previous orthodontic treatment (p = 0.003), and occlusion type (p = 0.008). All participants presented normal salivary parameters and levels of cortisol.ConclusionThe prevalence of NCCLs among footballers was remarkable. The premolars were the most affected teeth and presented symptoms/signs of initial lesions. The daily training time was a dominant risk indicator of NCCLs development. Footballers presented adequate salivary parameters and cortisol levels.
Project description:ObjectiveThe purpose of this clinical trial was to evaluate and compare the performances of three different universal adhesives used with a highly filled flowable universal resin composite in the restoration of non-carious cervical lesions (NCCLs) over a 60-month period.Material and methodsNinety-nine NCCLs were restored at 18 participants. NCCLs were divided into three different universal adhesive groups: Clearfil Universal Bond (CU) (n = 31), iBOND Universal (IU) (n = 33), and G-Premio Bond (GP) (n = 35). Prior to the adhesive procedures, selective enamel etching was performed with 37% phosphoric acid in all experimental groups. Adhesive systems were applied following the manufacturers' instructions, and the lesions were restored with a highly filled flowable resin composite (G-ænial Universal Flo). Restorations were finished and polished immediately after placement. All restorations were scored with regard to retention, marginal discoloration, marginal adaptation, sensitivity, surface texture, and color match using modified United States Public Health Service (USPHS) criteria after 1 week (baseline) and 6, 12, 18, 24, 36, and 60 months. Statistical analyses were performed using chi-square and McNemar's and Kaplan Meier tests. The level of significance was set at p < 0.05.ResultsAfter 60 months, the recall rate was 72.2%. Survival rates of CU, IU, and GP restorations were 87%, 85.2%, and 96.5%, respectively. Five CU (25%), 8 IU (34.8%), and 12 GP (42.9%) restorations exhibit bravo scores for marginal adaptation. However, no differences were seen among them. CU showed lower bravo score than IU and GP for marginal discoloration (CU, 0%; IU, 26.1%; GP, 32.1%). Two CU, 7 IU, and 6 GP restorations showed bravo scores for surface texture, and 2 (9.1%) CU and 1 (3.3%) GP restorations were scored as bravo score for color match (p > 0.05).ConclusionThe tested universal adhesives showed similar success rates during the 60-month follow-up. However, CU showed better clinical performance than IU and GP in terms of marginal adaptation and discoloration.Trial registrationClinicalTrials.gov Identifier: NCT03415412 CLINICAL RELEVANCE: The long-term clinical performances of the three universal adhesives in the restoration of NCCLs using selective enamel etching mode were successful after 60 months.
Project description:This prospective, double-blind, six-arm parallel randomised controlled trial aimed to compare the performance of two universal adhesives (UAs) in non-carious cervical lesions (NCCLs), using the FDI criteria, and analysed if participants/NCCLs' characteristics influenced the outcome. Thirty-eight 18- to 65-year-old participants were seeking routine dental care at a university clinic. At baseline, 210 NCCLs were randomly allocated to six groups (35 restorations' each). The UAs tested were FuturabondU (FBU) and AdheseUniversal (ADU) applied in either etch-and-rinse (ER) and self-etch (SE) modes. FuturabondDC (FBDC) in SE and in SE with selective enamel etching (SE-EE) modes were controls. NCCLs were restored with AdmiraFusion. The analysis included nonparametric tests, Kaplan-Meier and log-rank tests (α = 0.05). At 2-years, of 191 restorations, ten were missed due to retention loss (all groups, p > 0.05). FBDC (p = 0.037) and FBU (p = 0.041) performed worse than ADU in SE mode. FBDC and FBU also showed worse functional success rate (p = 0.012, p = 0.007, respectively) and cumulative retention rates (p = 0.022, p = 0.012, respectively) than ADU. Some participants/NCCLs' characteristics influenced (p < 0.05) the outcomes. FBU did not perform as well as ADU, especially in SE mode and due to functional properties. Participants' age and NCCLs' degree of dentin sclerosis and internal shape angle influenced FBU performance.
Project description:Dentists routinely encounter non-carious cervical lesions (NCCLs) in daily clinical practices. The dental literature is contradictory regarding the occlusal etiology of NCCLs. NCCL is defined as the loss of dental structure at the cemento-enamel junction, with no association of bacteria. The aim of this study was to evaluate the association of dynamic occlusal factors and dental hygiene practices with NCCLs. In total, 100 participants were selected by the random stratified sampling method, 50 each for control and NCCL groups. Information regarding oral hygiene practices, including frequency, duration, force, and technique of brushing, was recorded. Dynamic occlusal parameters like initial contact, occlusion time (OT), disocclusion time (DT), and center of force were recorded with T-scan analysis. The obtained data were analyzed with Pearson's correlation and binary logistic regression. We found that 68% of participants in the NCCL group and 31% in the control group utilized the horizontal brushing technique; 46% of NCCL group participants used hard brush against 7% of participants in the control group. The mean OT was 0.727 and 0.516 s for NCCL and control groups, respectively. The OT and left and right lateral DT were strongly related to NCCL, with r-values of 0.661, 0.642, and 0.534, respectively, with p ≤ 0.001. Using a hard toothbrush was found to be associated with NCCL. The NCCL group had extended mean occlusion time and disocclusion time in all eccentric mandibular movements.
Project description:ObjectiveThis systematic review aims to evaluate the potential benefits and underlying mechanisms of combining SDF with light curing, based on available studies.Materials and methodsA systematic search of publications was conducted with the keywords "silver diamine fluoride" or "silver fluoride" and "dental light curing," "LED curing," "dental laser," and "dental polymerization" in 4 databases: PubMed, EBSCO, Scopus, and Google Scholar to identify English-language articles published up to March 2023. Duplicate publications were deleted. Two reviewers screened the titles and abstracts and excluded irrelevant publications. The full text of the remaining publications was retrieved. Studies investigating the effect of light-curing on SDF-treated carious lesions were included.ResultsThe 175 publications initially found included 5 laboratory studies investigating the effects of light curing on 38% SDF-treated dentine carious lesions, but no clinical study was found. Four of these studies were conducted on extracted primary teeth, and one was on extracted permanent teeth. SDF with light curing increased microhardness (n = 3, p < .05) showed a higher mineral density (n = 1, p < .041) and had more silver ion precipitation in infected dentine (n = 1, p < .016) compared to SDF without light curing. Moreover, no significant differences in the antibacterial activity were observed between SDF with light curing and SDF alone (n = 1, p > .05).ConclusionDrawing from the limited number of laboratory studies, incorporating light curing subsequent to the SDF application yields potential favorable outcomes that include augmented microhardness, elevated mineral density, and heightened silver ion precipitation within infected dentine. Future clinical research is required to confirm or refute the benefit of light curing on SDF-treated carious lesions.