Ti6Al4V substrates were electrochemically deposited with nano-crystalline hydroxyapatite (HA) from aqueous electrolytes. Cathodic HA coatings were obtained when the electrolyte was stirred using ultrasonic vibration. Two current densities of 20 mA/cm² and 50 mA/cm² were employed. Polarization and electrochemical impedance spectroscopy (EIS) were the techniques used to estimate the corrosion of coatings in simulated body fluid (SBF). The results indicate good corrosion resistance for the coating obtained at 50 mA/cm² from ultrasonic stirring of the electrolyte. Full article

The effects of different heights of ti-base abutments on the color of anterior screw-retained zirconia restorations fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technologies may affect the optical clinical outcome. The purpose of this study was to measure and compare the color parameters of zirconia crowns in different shades on ti-base abutments. Identical specimens (N = 160) were milled to restore the screw-retained central maxillary incisor crown, using 5% mol yttria zirconia (5Y-TZP). The specimens were designed using computer design software to match 3.5 mm and 5.5-mm ti-base abutments and milled using one CAD-CAM technology. Specimens were divided into four main groups depending on zirconia shade (A1/0, A2/3, A3.5/4 and B2/3) and then assigned to two subgroups according to ti-base height. Color measurements in the CIELab coordinates were made using a spectrophotometer under room-light conditions. Color difference (ΔE*) values were calculated using the CIE76 and CIEDE2000 formula. Within the group of A0/1 and A2/3, for 5.5 mm abutment height, a significant difference was found between the means of colors ∆E00 and ∆Eab (p < 0.01). Using a 5.5 mm-height ti-base abutment may produce a clinically unacceptable outcome (ΔEab > 2) in A1/0 and A2/3 color groups. Full article

This paper deals with direct restorations of teeth with non-carious cervical lesions (NCCL). NCCL defects are capable of gradual growth and are accompanied by the degradation of the surrounding tissue. Direct restorative treatment, in which the cavity is filled with a cementing agent, is considered to be an accessible and common treatment option. The study included simulations of the teeth without lesions, the teeth with V and U lesions and the tooth-restorative system. Parameterised numerical tooth models were constructed. Two cases with defect depths of 0.8 mm and ~1.7 mm and three variants with fillet radii of the defect end of 0.1, 0.2 and 0.3 mm were considered. The effect of two biomaterials for restorations was studied, namely Herculite XRV (Kerr Corp, Orange, CA, USA) and Charisma (Heraeus Kulzer GmbH, Hanau, Germany). The models were deformed with a vertical load of 100 to 1000 N from the antagonist tooth. The tooth-restorative system was considered, taking into consideration the contact interaction in the interface areas with the tooth tissues. Within the limits of the research, the character of the distribution of the deformation characteristics and their dependence on the level of loading, the depth of the defect and the radius of the curvature of the “wedge” were established. Full article

Background: The aim of this split-mouth design research was to compare the clinical performance of a glass-ionomer cement system on Class I/II cavities against the clinical performance of bulk-fill resin composite restoration materials. Methods: Thirty-five patients were randomized and enrolled in the study, aged between 10 and 12 years, all of whom had a matched pair of permanent mandibular carious molars with similar Class I/II. A total of 70 restoration placements were performed. The patients were each given two restorations consisting of either a glass-ionomer cement with a nano-filled coating or a bulk-fill resin composite after the use of a self-etch adhesive. The cumulative survival rates were estimated using log-rank test and the Kaplan–Meier method. For comparison of the restorative materials in line with the modified Ryge, the McNemar test and the Wilcoxon signed rank test were employed. Results: With regard to retention, the glass-ionomer cement system and bulk-fill resin composite performed similarly in permanent molars in Class I/II cavities over a period of up to 24-months (p > 0.05). Over the 24-month period, Class I restorations showed statistically better survival rates than Class II restorations (p < 0.05). In the case of glass-ionomer cement systems, over the two-year period, more common chipping and surface degradations were observed. Conclusions: The glass-ionomer cement system and bulk-fill resin composite restorative materials display good clinical performance over a period of 24-months. Full article

Due to an increase in prevalence of cervical lesions, it is important to use appropriate restorative materials to reduce the incidence of secondary lesions. Owing to having antibacterial properties, cervical composite restorations containing different ratios of Zinc Oxide nanoparticles (ZnO NPs) have been analyzed using the Finite Element method to determine the optimal incorporation ratio from mechanical and thermal perspectives. A numerical simulation is conducted for a mandibular first premolar with a cervical lesion (1.5 × 2 × 3 mm³) restored with composites containing 0 to 5% wt. ZnO NPs. Subsequently, the samples are exposed to different thermo-mechanical boundary conditions, and stress distributions at different margins are examined. The accumulated stress in the restoration part increases for the 1% wt. sample, whereas the higher percentage of ZnO NPs leads to the reduction of stress values. In terms of different loading conditions, the least and most stress values in the restoration part are observed in central loading and lingually oblique force, respectively. The change in the surface temperature is inversely correlated with the ratio of ZnO NPs. In conclusion, the composite containing 5% wt. ZnO NPs showed the most proper thermo-mechanical behavior among all samples. Full article

Purpose: This study aims to evaluate the effectiveness of two ceramic and two composite polishing systems for a novel chairside computer-aided design/computer-aided manufacturing (CAD/CAM) lithium disilicate ceramic with three-dimensional and two-dimensional microscopy images. This ceramic material can be used for implant-supported or tooth-borne single-unit prostheses. Materials and Methods: Sixty flat samples of novel chairside CAD/CAM reinforced lithium disilicate ceramic (Amber Mill, Hass Bio) were divided into five groups (n = 15/group) and treated as follows: Group 1 (NoP), no polished treatment; group 2 (CeDi), polished with ceramic Dialite LD (Brasseler USA); group 3, (CeOp) polished with ceramic OptraFine (Ivoclar Vivadent); group 4, (CoDi) polished with composite DiaComp (Brasseler USA), and group 5 (CoAs), polished with composite Astropol (Ivoclar Vivadent). The polished ceramic surface topography was observed and measured with three-dimensional and two-dimensional images. Results: All polishing systems significantly reduced the surface roughness compared with the non-polished control group (Sa 1.15 μm). Group 2 (CeDi) provided the smoothest surface arithmetical mean eight with 0.32 μm, followed by group 3 (CeOp) with 0.34 μm. Group 5 (CoAs) with 0.52 μm provided the smoothest surface among the composite polishing kits. Group 4 (CoDi) with 0.66 μm provided the least smooth surface among all polishing systems tested. Conclusions: Despite the effectiveness of ceramic polishing systems being superior to composite polishing systems of the CAD/CAM lithium disilicate restorative material, both polishing systems significantly improved the smoothness. Full article

This study assessed the bond strength of prefabricated post systems at different root levels of endodontically treated teeth. One-rooted human premolars (N = 70; n = 10) were cut to 2 mm above the cement-enamel junction. Root canals were treated and randomly assigned to one of the seven post systems: T: Titanium (Mooser), ZrO: Zirconia (Cosmopost), G: Fiber (FRC Postec Plus), E1: Fiber (Direct) (Everstick post), E2: Fiber (Indirect) (Everstick post), PP: Fiber (PinPost), and LP: Injectable Resin/Fiber composite (EverX Posterior). All posts were luted using a resin cement (Variolink II), and the roots were sectioned at the coronal, middle, and apical root levels. Push-out tests were performed in the Universal Testing Machine (0.5 mm/min). Data (MPa) were analyzed using two-way ANOVA and Tukey’s tests (α = 0.05). The results showed that the bond strength (mean ± SD) of E2 posts were highest (5.3 ± 2.7) followed by PP (4.1 ± 2.0); G (4.0 ± 1.6); LP (2.6 ± 1.9): T (2.2 ± 1.5) and ZrO (1.9 ± 1.0) posts systems. No significant differences were found in bond strength of all post systems. The bond strength in the coronal root level was the highest with 3.6 ± 2.2 MPa. The bond strength of FRC post systems was significantly higher than those of rigid posts of titanium or ZrO₂. Bond strength results were the highest in the coronal root level for all tested post systems but did not differ significantly from the other two root levels. Full article

This study aimed to evaluate the color change of teeth bleached with light activation using two different objective color measurement approaches after two years of clinical follow-up. A cross-sectional retrospective clinical study according to STROBE was followed including 30 participants. The 25% hydrogen peroxide gel (Philips Zoom) was applied with a supplementary LED light for 15 min in four cycles. Tooth color was assessed based on CIEL*a*b* values using a spectrophotometer (Spectroshade) at different time points (baseline, post bleaching, 1 week, 1 year, and 2 years). Standardized digital photographs were taken at each time point. The L*, a*, and b* values were measured from the digital photographs using Adobe Photoshop software. The color difference (ΔE) was separately calculated using the L*, a*, and b* values obtained with spectrophotometric and photographic analyses at each evaluation time. Data were analyzed with non-parametric tests (p < 0.05). A color regression was detected by both measurement approaches after 1 and 2 years (p < 0.05). Greater ΔE values were acquired with the spectrophotometer compared to the digital photographic analysis (p < 0.05). Although a greater color change was observed with the spectrophotometer, both approaches were able to detect the color rebound using the 25% hydrogen peroxide light-activated in-office system. Digital photographic analysis might therefore be used to assess color change after bleaching. Full article

The aim of the study was to investigate the effect of different repair procedures on the repair bond strength of bulk-fill and nanohybrid resin composites after different aging periods. The resin composite blocks (8 × 8 × 4 mm³) were prepared from a bulk-fill (reliaFIL Bulk) and a nanohybrid (reliaFIL LC) resin composite and grouped according to aging duration (6 months, 1 year, and 2 years). Following aging, the blocks were assigned to different surface treatments; air-abrasion with aluminum oxide powder, roughening with a diamond bur, and no treatment. After cleansing with phosphoric acid, a silane layer (Porcelain Primer) was applied on the surface of half of the specimens in each group. The specimens were subdivided into two groups (n = 5): Scotchbond Universal (3M Oral Care) and All-Bond Universal (Bisco). The blocks were repaired with the nanohybrid composite (8 × 8 × 8 mm ³). The repaired specimens were stored in distilled water (37 °C/24 h) and segmented into beams. Half of the beams were immediately subjected to microtensile μTBS testing (1 mm/min), while the other half was stored in distilled water (37 °C) for 6 months before testing. Failure modes were analyzed using stereomicroscope and SEM. Statistical analyses were performed with ANOVA and least significant difference tests (LSD) tests (p = 0.05). The extension of aging periods (6 months, 1 year, and 2 years) reduced the repair bond strength in some groups for both resin composites (p < 0.05). The air-abrasion and bur roughening improved the repair bond strength (p < 0.05). The silane application did not influence the repair bond strength and durability (p > 0.05). There was no difference among the universal adhesives in the same surface treatment groups (p > 0.05). The mechanical roughening treatments are necessary for the repair of resin composite. The universal adhesives might be used for the repair of resin composites regardless of silane content without prior silane application. Full article

The purpose of this study was to evaluate the effects of various fabrication techniques and materials used in implant-supported mandibular overdentures with a Hader bar attachment over added stress distribution. Three-dimensional geometric solid models, consisting of two implants (3.3 mm × 12 mm) placed at the bone level on both mandibular canine regions and a Hader bar structure, were prepared. Model 1 simulated a bar retentive system made from Titanium Grade 5 material by Computer Numerical Control (CNC) milling technique without using any converting adapter/multi-unit element on the implants, while Model 2 simulated the same configuration, but with converting adapters on the implants. Model 3 simulated a bar retentive system made from Cobalt-Chromium material, made by using conventional casting technique with converting adapters on the implants. Static loads of 100 Newton were applied on test models from horizontal, vertical and oblique directions. ANSYS R15.0 Workbench Software was used to compare Von Mises stress distribution and minimum/maximum principal stress values, and the results were evaluated by using Finite Element Analysis method. As a result, the highest stress distribution values under static loading in three different directions were obtained in Model 1. Stress was observed intensely around the necks of the implants and the surrounding cortical bone areas in all models. In scope of the results obtained, using converting adapters on implants has been considered to decrease transmission of forces onto implants and surrounding bone structures, thus providing a better stress distribution. It has also been observed that the type of material used for bar fabrication has no significant influence on stress values in those models where converting adapters were used. Full article

The aim of this study was to evaluate the effect of CAD/CAM composite thickness on micro-tensile bond strength (µTBS), microhardness (HV), and film thickness (FT) of different luting composites. Composite blocks (6.8 mm × 6.8 mm) were divided into 12 groups according to: CAD/CAM thickness and luting composite. For each group, 21 rods (1 mm × 1 mm) were tested in tension at crosshead speed of 1 mm/min. Fracture modes were categorized as adhesive, mixed, and cohesive. Microhardness (n = 5/group) was assessed using microhardness tester. Film thickness (12-rods/group) was evaluated using a stereomicroscope (×40). Data were analyzed using the two-way ANOVA/Tukey’s HSD test (p = 0.05). Parameters “thickness”, “cement”, and “thickness x cement” showed significant difference on µTBS and HV (p < 0.05). At 2 mm, heated x-tra fil composite showed the highest µTBS (45.0 ± 8.5 MPa), while at 4 mm thickness, Grandio Flow revealed the lowest µTBS (33.3 ± 6.3 MPa). Adhesive, mixed, and cohesive failures were reported. The HV of all composites decreased when photo-polymerized through 4 mm thickness (p < 0.05). Regardless of CAD/CAM thickness, photo-polymerized composites can be successfully used for luting CAD/CAM composite. Full article

The aim of this study was to assess the microcrack formation of moderately and severely curved root canals following instrumentation with Neoniti rotary files using micro-computed tomography. This in vitro study evaluated 18 extracted sound mandibular molars with two separate mesial canals and foramina in two groups (n = 9) with 5–20° (moderate) and 20–40° (severe) root canal curvature. The number of microcracks in the root canal walls was counted at baseline by micro-CT. Subsequently, the root canals were instrumented with 0.20/0.06 v Neoniti files as single files with a torque of 1.5 Ncm and a speed of 400 rpm. The number of microcracks was counted again postoperatively on micro-CT images using Amira software. Statistical analysis was performed using the Shapiro–Wilk test, Levene’s test and repeated-measures ANOVA (α = 0.05). The mean number of microcracks significantly increased postoperatively in both the moderately curved (11.59 ± 9.74 vs. 8.2 ± 7.4; p = 0.001) and the severely curved (13.23 ± 5.64 vs. 7.20 ± 5.94; p < 0.001) groups. However, the differences between the two groups were not significant (p = 0.668). Based on the results obtained, it can be stated that the instrumentation of moderately and severely curved root canals with Neoniti rotary files increases the number of microcracks. However, the higher degree of curvature does not necessarily translate to a higher number of microcracks after root canal instrumentation with this specific rotary system and methodological procedures. Full article

This study evaluated the effects of different simulated chairside grinding and polishing protocols on the physical and mechanical properties of surface roughness, hardness, and flexural strength of monolithic zirconia. Sintered monolithic zirconia specimens (15 mm × 3 mm × 3 mm) were abraded using three different burs: diamond bur, modified diamond bur (zirconia specified), and tungsten carbide bur, along with a group of unprepared specimens that served as a control group. The study was divided into two phases, Phase 1 and Phase 2. Surface roughness, surface hardness, and flexural strength were assessed before and after the grinding procedure to determine the ‘best test group’ in Phase 1. The best abrasive agent was selected for Phase 2 of the study. The specimens in Phase 2 underwent grinding with the best abrasive agent selected. Following the grinding, the specimens were then polished using commercially available diamond polishing paste, a porcelain polishing kit, and an indigenously developed low-temperature sintered zirconia slurry. The physical and mechanical properties were again assessed. Results were analyzed using one-way ANOVA test. Specimens were observed under scanning electron microscopy (SEM) and X-ray diffraction (XRD) for their microstructure and crystalline phases, respectively. Grinding with diamond burs did not weaken zirconia (p > 0.05) but produced rougher surfaces than the control group (p < 0.05). Tungsten carbide burs did not significantly roughen the zirconia surface. However, specimens ground by tungsten carbide burs had a significantly reduced mean flexural strength (p < 0.05) and SEM revealed fine surface cracks. Phase transformation was not detected by XRD. Polishing with commercially available polishing agents, however, restored the surface roughness levels to the control group. Dental monolithic zirconia ground with tungsten carbide burs had a significantly reduced flexural strength and a smooth but defective surface. However, grinding with diamond burs roughened the zirconia surface. These defects may be reduced by polishing with commercially available polishing agents. The use of tungsten carbide burs for grinding dental zirconia should not be advocated. Grinding with diamond abrasives does not weaken zirconia but requires further polishing with commercially available polishing agents. Full article

Bonding to zirconia presents a great challenge, as the clinical guidelines for predictable adhesion are not sufficiently validated. The aim of this study was to assess the influence of various bonding methodologies of various resin cements on zirconia, using different aging protocols. Manufactured zirconia specimens (N = 300 and n = 20 per group) were randomly assigned to three luting protocols: 1—in mould incremental build up; 2—in mould incremental build up with mould removal; 3—in mould non-incremental bulk build up. Five dual, photo- and chemical-cure resin cements were used, namely, Variolink Esthetic (Ivoclar), Tetric (Ivoclar), Panavia (Kuraray), TheraCem (Bisco), and RelyX UniCem (3M ESPE), and were applied on primed zirconia using photopolymerization protocols. Thereafter, the specimens were subjected to the following three ageing methods: 1—dry; 2—thermocycling (×5000; 5–55 °C); 3—3–6 months of water storage. Using a universal testing machine, the specimens were loaded under shear, at 1 mm/min crosshead speed. An analysis of the data was performed using three-way ANOVA and the Bonferroni method. The moulding type, ageing and luting cement significantly affected the results (p < 0.05). Among all the protocols under dry conditions, TheraCem (16 ± 3; 11 ± 1; 16 ± 3) showed the best bond strength, while, after thermocycling, TheraCem (7 ± 2) and Tetric (7 ± 2) performed the best with Protocol 1. In Protocol 2, RelyX (7 ± 3) presented the highest result, followed by TheraCem (5 ± 3) and Tetric (5 ± 1) (p < 0.05). Using Protocol 3, RelyX (10 ± 6) showed the highest result, followed by TheraCem (7 ± 2) and Panavia21 (7 ± 2) (p < 0.05). Six months after water storage, TheraCem presented the highest result (10 ± 2) in Protocol 1, while, in Protocols 2 and 3, Tetric (10 ± 2; 15 ± 5) presented the highest result, followed by TheraCem (6 ± 2; 8 ± 3). Adhesion tests using the incremental or bulk method, using moulds, showed the highest results, but removing the mould, and the subsequent ageing, caused a decrease in the adhesion of the resin cements tested on zirconia, probably due to water absorption, with the exclusion of Tetric. Full article

There is limited information on the effect of melatonin on the cytotoxicity of dental materials. The study evaluated the cytotoxic effects of heat- and auto-polymerized acrylic resin, particulate filler composite resin and a thermoplastic material on L-929 fibroblast cell viability at different incubation periods in artificial saliva without and with melatonin. Disk-shaped specimens were prepared according to each manufacturer’s instructions and divided into two groups to be stored either in artificial saliva (AS) and AS with melatonin (ASM). The measurements were performed using an MTT (3-(4,5)-dimethylthiazol-2-yl)-2,5-diphenyl tetrazoliumbromide) assay, in which the L-929 mouse fibroblasts cell culture was used. For the MTT test, extracts were examined at 1, 24, 72 h and 1 and 2 weeks. Data were analyzed using 3-way ANOVA and Tukey’s tests. No significant difference was found between groups AS and ASM (F = 0.796; p = 0.373). Incubation period significantly affected all materials tested (p < 0.001). Storing resin-based materials in artificial saliva with melatonin solution for 24 h may reduce cytotoxic effects on the fibroblast cells for which the highest effect was observed. Soaking resin prosthesis or orthodontic appliances in artificial saliva with melatonin at least 24 h before intraoral use or rinsing medium containing melatonin may be recommended for decreasing the cytotoxicity of dental resin materials. Full article

Contamination of zirconia restorations before cementation can impair the resin–zirconia bonding durability. The objective of this study was to evaluate the effect of human saliva or blood decontamination with 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-containing cleaner on the resin–zirconia shear bond strength (SBS). Methods: A total of 220 zirconia specimens were prepared and air-abraded and randomly distributed into 11 groups (n = 20 per group). Except for the control group (no contamination), zirconia specimens were contaminated with either human saliva (five groups) or blood (five groups), and then subjected to one of five cleaning methods: water rinsing, 38% phosphoric acid etchant (Pulpdent Corp., Watertown, MA, USA), 70% isopropanol alcohol (Avalon Pharma, Riyadh, Saudi Arabia), Ivoclean (Ivoclar Vivadent, Schaan, Lichtenstein) and Katana Cleaner (Kuraray Noritake, Tokyo, Japan). The resin–zirconia SBS was tested at 24 h and after thermocycling (10 k cycles). Three-way ANOVA followed by Tukey’s multiple comparisons test were utilized to analyze the SBS data. Failure modes were evaluated using a scanning electron microscope. Results: Both blood and saliva significantly affected resin–zirconia SBS as contaminants. After thermocycling, there was no statistically significant difference between SBS obtained after decontamination with the Katana Cleaner (blood, 6.026 ± 2.805 MPa; saliva, 5.206 ± 2.212 MPa) or Ivoclean (blood, 7.08 ± 3.309 MPa; saliva, 6.297 ± 3.083 MPa), and the control group (no contamination, 7.479 ± 3.64 MPa). Adhesive and mixed failures were the most frequent among the tested groups. Conclusion: Both 10-MDP-containing cleaner (Katana Cleaner) and zirconium oxide-containing cleaner (Ivoclean) could eliminate the negative effect of saliva and blood contamination on resin–zirconia SBS. Full article

This study assesses the effect of the material type (lithium disilicate, zirconia, and polymer-infiltrated ceramic) and dental bonding substrates (dentin, dentin with intra-coronal cavity, and dentin with composite filling) on the fracture resistance and failure mode of molars restored by occlusal veneers. Methods: Ninety occlusal veneers, fabricated from either lithium disilicate, zirconia, or polymer-infiltrated ceramic, were adhesively bonded to teeth prepared with either dentin, dentin with intra-coronal cavity, or dentin with composite filling. All specimens were thermally aged (5000 cycles), then load cycled (120,000 cycles). Each specimen was subjected to a compressive load through fracture, then was examined (×20) to identify the fracture type. Data were statistically analyzed. Results: Material type and dental substrate had no significant effect on the fracture resistance of adhesively retained occlusal veneer restorations. For each material, no significant differences were found between veneers bonded to dentin, dentin with intra-coronal cavity, and dentin with composite filling. Additionally, within each bonding substrate, there were no significant differences between lithium disilicate, zirconia, and polymer-infiltrated ceramic veneers. The adhesive failure was recorded mainly with zirconia occlusal veneer restorations. Conclusions: Considering the fracture results, lithium disilicate, zirconia, and polymer-infiltrated ceramic occlusal veneers perform well whatever the type of dental bonding surface. When the dental bonding surface varies, different occlusal veneer materials should be considered. Occlusal veneers bonded to dentin, dentin with composite filling, or dentin with an intra-coronal cavity exhibited a fracture resistance exceeding the average human masticatory forces in the molar area. Full article

Polycarbonates are polymers of bisphenol A (BPA), a well-known endocrine disruptor. This study evaluated the release of BPA from polycarbonate crowns that were (1) milled from Temp Premium Flexible (ZPF, Zirkonzahn, Italy) or Tizian Blank Polycarbonate (TBP, Schütz Dental, Germany), or (2) 3D-printed (Makrolon 2805, Covestro, Germany). Commercial prefabricated polycarbonate crowns (3M, USA) and milled poly(methyl methacrylate) (PMMA) crowns (Temp Basic, Zirkonzahn, Italy) were included for comparison. The crowns were stored at 37 °C in artificial saliva (AS) or methanol, which represented the worst-case scenario of BPA release. Extracts were collected after 1 day, 1 week, 1 month and 3 months. BPA concentrations were measured using liquid chromatography-tandem mass spectrometry. The amounts of released BPA were expressed in micrograms per gram of material (μg/g). After 1 day, the highest amounts of BPA were measured from milled polycarbonates, TBP (methanol: 32.2 ± 3.8 μg/g, AS: 7.1 ± 0.9 μg/g) and ZPF (methanol 22.8 ± 7.7 μg/g, AS: 0.3 ± 0.03 μg/g), followed by 3D-printed crowns (methanol: 11.1 ± 2.3 μg/g, AS: 0.1 ± 0.1 μg/g) and prefabricated crowns (methanol: 8.0 ± 1.6 μg/g, AS: 0.07 ± 0.02 μg/g). Between 1 week and 3 months, the average daily release of BPA in methanol and AS decreased below 2 μg/g and 0.6 μg/g, respectively. No BPA was released from PMMA in AS, and the cumulative amount released in methanol was 0.2 ± 0.06 μg/g. In conclusion, polycarbonates could be a relevant source of BPA, but the current tolerable daily intake of BPA (4 μg/kg body weight) should not be exceeded. Full article

This paper assesses the impact of preheating of adhesive cement on the fracture resistance of lithium disilicate and zirconia restorations. Methods: A total of 80 human maxillary premolar teeth were assigned into 8 groups (n = 10) according to material type (either lithium disilicate or zirconia) and type of resin cement (either LinkForce or Panavia SA) with preheating temperature at 54 °C or at room temperature (25 °C). Teeth were prepared and restored with either lithium disilicate or zirconia restorations. After cementation, specimens were thermal cycled (10,000 cycles, 5 °C/55 °C), then load cycled for 240,000 cycles (50 N). Each specimen was statically loaded until fracture and the load (N) at fracture was recorded, then the failure mode was detected. Statistical analysis of data was performed (p ≤ 0.05). Results: There was no significant difference (p = 0.978) in fracture mean values between LinkForce and Panavia SA. Statistically significant difference (p = 0.001) was revealed between fracture resistance of lithium disilicate restorations cemented with LinkForce at 25 °C and at 54 °C; however there was no significant difference (p = 0.92) between the fracture resistance of lithium disilicate restorations cemented with Panavia SA used at 25 °C and at 54 °C. Regarding the interaction between ceramic material, cement type, and cement preheating, there was no significant effect (p > 0.05) in fracture resistance. The cement type does not influence the fracture resistance of ceramic restorations. Preheating of resin cement has negatively influenced the fracture resistance of all tested groups, except for lithium disilicate cemented using LinkForce cement. Full article

The aim of this study was to evaluate four test methods on the adhesion of resin composite to resin composite, and resin composite to glass ceramic. Resin composite specimens (N = 180, Quadrant Universal LC) were obtained and distributed randomly to test the adhesion of resin composite material and to ceramic materials (IPS e.max CAD) using one of the four following tests: (a) Macroshear SBT: (n = 30), (b) macrotensile TBT: (n = 30), (c) microshear µSBT: (n = 30) and (d) microtensile µTBT test (n = 6, composite-composite:216 sticks, ceramic-composite:216 sticks). Bonded specimens were stored for 24 h at 23 °C. Bond strength values were measured using a universal testing machine (1 mm/min), and failure types were analysed after debonding. Data were analysed using Univariate and Tukey’s, Bonneferroni post hoc test (α = 0.05). Two-parameter Weibull modulus, scale (m), and shape (₀) were calculated. Test method and substrate type significantly affected the bond strength results, as well as their interaction term (p < 0.05). Resin composite to resin composite adhesion using SBT (24.4 ± 5)^a, TBT (16.1 ± 4.4)^b and µSBT (20.6 ± 7.4)^a,b test methods presented significantly lower mean bond values (MPa), compared to µTBT (36.7 ± 8.9)^b (p < 0.05). When testing adhesion of glass ceramics to resin composite, µSBT (6.6 ± 1)^B showed the lowest and µTBT (24.8 ± 7)^C,D the highest test values (MPa) (SBT (14.6 ± 5)^A,D and TBT (19.9 ± 5)^A,B) (p < 0.05). Resin composite adhesion to ceramic vs. resin composite did show significant difference for the test methods SBT and µTBT (resin composite (24.4 ± 5; 36.7 ± 9 MPa) vs. glass ceramic (14.6 ± 5; 25 ± 7 MPa)) (p > 0.05). Among substrate–test combinations, Weibull distribution presented the highest shape values for ceramic–resin in µSBT (7.6) and resin–resin in µSBT (5.7). Cohesive failures in resin–resin bond were most frequently observed in SBT (87%), followed by TBT (50%) and µSBT (50%), while mixed failures occurred mostly in ceramic–resin bonds in the SBT (100%), TBT (90%), and µSBT (90%) test types. According to Weibull modulus, failure types, and bond strength, µTBT tests might be more reliable for testing resin-based composites adhesion to resin, while µSBT might be more suitable for adhesion testing of resin-based composites to ceramic materials. Full article

This study aimed to establish the minimum radiant exposure and irradiance to trigger an adequate polymerization of a photo-polymerized resin cement. In total, 220 disc-shaped specimens (diameter of 10 mm and thickness of 0.1 mm) were fabricated using a photo-polymerized resin cement (Variolink N-transparent, Ivoclar Vivadent). To investigate the minimum radiant exposure, the specimens were polymerized with radiant exposures of 1, 2, 3, 4, 5, 6, and 18 J/cm² (n = 20). During polymerization, the irradiance was maintained at 200 mW/cm². To investigate the minimum irradiance, the specimens were polymerized with irradiances of 50, 100, 150, and 200 mW/cm² (n = 20). During polymerization, the radiant exposure was maintained at the previously determined minimum radiant exposure. The Vickers microhardness (HV) and degree of conversion (DC) of the carbon double bond of the specimens were measured to determine the degree of polymerization of the specimens. The results were analyzed using one-way analysis of variance (ANOVA) and Tukey’s test (p < 0.05). In the investigation of the minimum radiant exposure, the HV and DC of the specimens polymerized with a radiant exposure from 1 to 5 J/cm² were significantly lower than those with 18 J/cm² (all p < 0.05). However, no significant difference in HV and DC was found between the specimens polymerized with 6 J/cm² and 18 J/cm² (p > 0.05). In the investigation of the minimum irradiance, the specimens polymerized with an irradiance of 50 mW/cm² had significantly lower HV and DC than the specimens polymerized with an irradiance of 200 mW/cm² (p < 0.05). However, no significant difference in the HV and DC was found among the specimens cured with irradiances of 100, 150, and 200 mW/cm² (p > 0.05). In conclusion, the minimum radiant exposure and irradiance to trigger an adequate polymerization of the light-cured resin cement were 6 J/cm² and 100 mW/cm², respectively. Full article

The aim of this study was to evaluate the surface roughness of fixed prosthodontic materials after polishing or roughening with a stainless steel curette or ultrasonic scaler and to examine the effect of these on Streptococcus mutans adhesion and biofilm accumulation. Thirty specimens (10 × 10 × 3 mm³) of zirconia (Zr), pressed lithium disilicate (LDS-Press), milled lithium disilicate glazed (LDS-Glaze), titanium grade V (Ti) and cobalt-chromium (CoCr) were divided into three groups (n = 10) according to surface treatment: polished (C), roughened with stainless steel curette (SC), roughened with ultrasonic scaler (US). Surface roughness values (Sa, Sq) were measured with a spinning disc confocal microscope, and contact angles and surface free energy (SFE) were measured with a contact angle meter. The specimens were covered with sterilized human saliva and immersed into Streptococcus mutans suspensions for bacterial adhesion. The biofilm was allowed to form for 24 h. Sa values were in the range of 0.008–0.139 µm depending on the material and surface treatment. Curette and ultrasonic scaling increased the surface roughness in LDS-Glaze (p < 0.05), Ti (p < 0.01) and CoCr (p < 0.001), however, surface roughness did not affect bacterial adhesion. Zr C and US had a higher bacterial adhesion percentage compared to LDS-Glaze C and US (p = 0.03). There were no differences between study materials in terms of biofilm accumulation. Full article

Background: The aim of this study was to test the impact of hot acids etching and two types of adhesive cement on the retention of zirconia crowns. Methods: Forty maxillary premolars were prepared, and zirconia crowns were designed and fabricated with proximal extensions, then divided into 4 groups (n = 10). Group AP; the crowns were air-abraded and cemented using Panavia SA Cement. Group AL; the crowns were air- abraded and cemented using GC LinkForce. Group AHP; the crowns were air-abraded, etched with the hot acids (48% hydrofluoric acid and 69% nitric acid), and cemented using Panavia SA Cement. Group AHL; the crowns were air-abraded, etched with the hot acids, and cemented using GC LinkForce. Each zirconia crown was pre-treated and bonded to its corresponding tooth. After thermocycling (5–55 °C/10,000), the retention test was performed and the load required to dislodge the crown was reported in Newton (N), and mode of failure was recorded. The retention strength (MPa) was calculated for each tested variable and statistically analyzed. Results: Group AHP showed the highest mean value of the retention strength, followed by group AP then group AHL. Group AL showed the lowest value. A statistically significant effect (p = 0.001) of the hot acids etching on the retention of zirconia crown was found. Also, there was a significant effect (p = 0.000) of the cement type. The interaction between surface treatment and the cement type has no significant impact (p = 0.882). The main mode of failure for Panavia SA Cement is mixed mode of failure, while for G-CEM LinkForce is adhesive failure. Conclusions: Hot acid etching pre-treatment improved the retention of zirconia crown. Usage of Panavia SA Cement with hot acids etching is effective can be used for adhesive cementation of zirconia crown. Full article

The goal of this study was to evaluate the stress distribution in an endocrown restoration according to different provisional restorative materials. An endodontically treated maxillary molar model was selected for conducting the finite element analysis (FEA), with a determined amount of dental remnant of 1.5 mm. The model was imported to the analysis software (ANSYS 19.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts were considered perfectly bonded. The mechanical properties of each structure were considered isotropic, linear, elastic, and homogeneous. Three different provisional restorative materials were simulated (acrylic resin, bis-acrylic resin, and resin composite). An axial load (300 N) was applied at the occlusal surface in the center of the restoration. Results were determined by colorimetric stress maps of maximum principal stress, maximum shear stress, and total deformation. The different materials influenced the stress distribution for all structures; the higher the material’s elastic modulus, the lower the stress magnitude on the cement layer. In the present study, all provisional restorative materials showed similar stress patterns in the endocrown and on the cement layer however, with different magnitude. Based on this study limitation, the use of resin composite to manufacture provisional endocrowns is suggested as a promising material to reduce the stresses in the cement layer and in the dental tissue surfaces. Full article

Researchers have developed novel nanocomposites that incorporate additional biomaterials with dimethylaminohexadecyl methacrylate (DMAHDM) in order to reduce secondary caries. The aim of this review was to summarize the current literature and assess the synergistic antibacterial and remineralizing effects that may contribute to the prevention of secondary caries. An electronic search was undertaken in MEDLINE using PubMed, Embase, Scopus, Web of Science and Cochrane databases. The initial search identified 954 papers. After the removal of duplicates and screening the titles and abstracts, 15 articles were eligible for this review. The amalgamation of 2-methacryloyloxyethyl phosphorylcholine (MPC) and silver nanoparticles (AgNPs) with DMAHDM resulted in increased antibacterial potency. The addition of nanoparticles of amorphous calcium phosphate (NACP) and polyamidoamine dendrimers (PAMAM) resulted in improved remineralization potential. Further clinical studies need to be planned to explore the antibacterial and remineralizing properties of these novel composites for clinical success. Full article

Objective: The objective of this review was to evaluate the effect of non-thermal atmospheric plasma (NTAP) on adhesives resin–dentin micro-tensile bond strength (μTBS) in previously published studies. Methods: Electronic search was conducted using the Medline, Cochrane library, and Scopus databases. The included studies were laboratory studies that investigated the effect of NTAP on adhesives μTBS to coronal dentin. Studies that evaluated the effect of NTAP on bond strength to indirect substrates, enamel or root dentin, were excluded. The methodological quality of included studies was assessed. Results: Thirteen studies were included in this systematic review. All the included studies were considered to have a medium risk of bias. NTAP significantly improved μTBS at 24 h or after short-term aging in five studies (38.5%) and both immediate and after long-term aging in 5 studies (38.5%). In two studies (15.4%), NTAP resulted in a short-term material-dependent effect that was not stable after long-term aging. Interestingly, in one study (7.7%), NTAP had a positive effect only in the etch-and-rinse (ER) mode after long-term aging. Conclusion: Within the limitations of this systematic review, NTAP application could enhance resin–dentin μTBS of ER adhesives or universal adhesives (UAs) applied in the ER mode. In the ER mode, the rewetting step after NTAP seems to be unnecessary. Because of the limited information currently available in the literature, further studies are required to evaluate the effect of the NTAP application on self-etch (SE) adhesives or UAs applied in the SE mode. Full article