The aim of this study was to examine the morphology of the hybrid layer (HL) of bonded water-stor... more The aim of this study was to examine the morphology of the hybrid layer (HL) of bonded water-stored specimens after different chemical pre-treatments of dentin.Materials and methods. Twenty-seven recently extracted human molars were selected. Fifty-four dentin disks in middle/deep dentin were obtained with a slow speed saw with a diamond-impregnated disk under water lubrication. Smear layers were created with 180 grit silicon carbide under running water for 1 min. Different pre-treatments of dentin were: Group (1) no treatment; Group (2) 35% H3PO4 etch for 15 s followed by 10% glutaraldehyde for 120 s; Group (3) 37% H3PO4 etch for 15 s followed by 5% NaOCl for 120 s. Three dentin bonding agents (DBAs), Prime and Bond NT (P and B), AdmiraBond (AB), and Clearfil SE Bond (SEB) were applied in association with a resin composite following the manufacturers' directions. Each specimen was then longitudinally sectioned and polished with wet SiC papers (up to #4000 grit). Impressions of the polished dentin were immediately taken with a silicone impression material. Bonded specimens were then stored for 3 or 12 h in deionized water. Further impressions of stored specimens were taken after air-drying of specimens for 10 s. Positive replicas were obtained using a polyether impression material. All the replicas and the original specimens were inspected by SEM.Results. A line of droplets (0.5–4 μm in diameter) was observed along the region of the adhesive–HL junction in all replicas of specimens stored in water, except in group 3, when P and B and AB were used. When SEB was used in each group the droplet were found in all groups except the zone of droplets was thinner. No differences in droplets dimensions were seen between 3 or 12 h water storage, or between the different dentin treatments.Conclusions. The replica procedure used in this study was able to detect water trapped in the adhesive–HL region that was released during the setting of the impression material. The droplets observed in this region support the hypothesis that there can be bidirectional water movement within the adhesive–HL complex.
Dentin adhesives have been proposed as desensitizing agents to seal exposed root dentin surfaces.... more Dentin adhesives have been proposed as desensitizing agents to seal exposed root dentin surfaces. Simplified ‘one-step’ dentin adhesives are highly permeable to water. The authors hypothesized that a lactic acid challenge may increase permeability of simplified adhesives and may induce fast degradation of bonding. This phenomenon adversely affects their durability as long term desensitizing agents. The aim of this in vitro study was to evaluate the ability of four dentin adhesives to seal root dentin surfaces that were exposed to water and lactic acid challenges.Four commercially-available dentin adhesives were applied with a small sponge to the root dentin of extracted human molars as de-sensitizing agents. Impression replicas of the adhesive-covered root dentin were fabricated after water immersion, as a control, and after lactic acid challenge. The replicas were examined with SEM for quantitative comparison of fluid droplet formation on the surfaces. The bonded specimens were also examined using reflected light confocal microscopy.Replicas of water droplets were observed on the adhesive surfaces, by SEM which corresponded with direct confocal observation of blisters and voids from the surface of the bonded specimens. There were significantly more water droplets from samples that were subjected to lactic acid challenge than water only immersion.Although the dentin adhesives examined were able to cover exposed root dentin, they all exhibited fluid transudation through the polymerized adhesives. Dentin adhesives were also susceptible to surface degradation after lactic acid challenge. As simplified self-etch adhesives were highly water permeable and exhibited the most extensive surface damage, they may not be the best adhesives to be used for long-term dentin desensitization. These preliminary in vitro findings warrant validation in vivo.
The goal of adhesive dentistry is to restore the peripheral seal of dentin lost from removal of e... more The goal of adhesive dentistry is to restore the peripheral seal of dentin lost from removal of enamel. Unfortunately, the hybrid layer (HL) that is used to create that seal is permeable to small ions or molecules, even in the absence of detectable, interfacial gap formation via nanoleakage. This nanoleakage results from several mechanisms including incomplete infiltration of adhesive monomers into demineralized collagen matrix, presence of hydrophilic monomers, and insufficient removal of solvent or water that remains trapped inside the HL. These mechanisms lead to a porous interface with nanometer-sized channels that increase the permeability of the HL. The null hypothesis tested in this study was that water and acidic solution storage are able to alter in vitro the resin-dentin interface, further increasing the marginal hybrid layer (MHL) permeability. Class II cavities were made in vitro. The specimens were stored in water for 1 week and in lactic acid solution for 3 days. Polyvinyl siloxane impressions of restoration margins were taken before and after storage in water and lactic acid solution. Polyether replicas were obtained using the silicon impressions as molds. Replicas and original samples were observed under scanning electron microscopy. Lines of water droplets were detected on MHLs and overlying adhesive only after storage. Replicas obtained after acidic solution storage showed great numbers of irregularities such as gaps, voids, and degradation of the dentin-restoration surface margin, but also a great number of droplets. Dentin-restoration resin interfaces absorb water and are damaged by storage in dilute lactic acid. The presence of water droplets probably indicates water that flows out of the interface during the setting time of the impression and thus represents an index of marginal HL water permeability.
Adhesive dentistry should effectively restore the peripheral seal of dentin after enamel removal.... more Adhesive dentistry should effectively restore the peripheral seal of dentin after enamel removal. We hypothesize that non-rinsing, simplified, one-step self-etch adhesives are effective for minimizing dentin permeability after tooth preparation procedures. Crown preparations in vital human teeth were sealed with Adper Prompt, Xeno III, iBond, or One-Up Bond F. Epoxy resin replicas were produced from polyvinyl siloxane impressions for SEM examination. Dentin surfaces from extracted human teeth were bonded with these adhesives and connected to a fluid-transport model for permeability measurements and TEM examination. Dentinal fluid droplets were observed from adhesive surfaces in resin replicas of in vivo specimens. In vitro fluid conductance of dentin bonded with one-step self-etch adhesives was either similar to or greater than that of smear-layer-covered dentin. TEM revealed water trees within the adhesives that facilitate water movement across the polymerized, highly permeable adhesives. Both in vitro and in vivo results did not support the proposed hypothesis.
The aim of this study was to evaluate the morphology of the enamel surface along margins of class... more The aim of this study was to evaluate the morphology of the enamel surface along margins of class V restorations following exposure to cariogenic solution. Restorations were placed in vitro in human third molars. The specimens were divided into groups according to resin composition: (1) Scotchbond 1 + Filtek Flow, (2) Scotchbond 1 + F2000, and (3) Prompt L-Pop + experimental flowable composite. Samples were stored in a demineralizing solution (lactic acid, pH 4.5, 0.1 M) at 37° for 1–4 weeks or in deionized water (control group). The solution was changed every day. Replicas of the specimens were obtained in order to exclude drying artifacts. Scanning electron microscopy (SEM) of original and replica specimens identified a distinct enamel zone, defined as perimarginal enamel showing numerous fractures, porosities, voids, and pits. After the 4-week treatment, perimarginal prismatic enamel was greatly removed, while interprismatic enamel was still in place and only partially dissolved. Enamel not in relation with composite/compomer margins (0.5–1 mm away) showed minor alterations. Perimarginal enamel fractures probably due to composite/compomer shrinkage or the bur preparation may greatly contribute to this marginal enamel demineralization by increasing the number and size of porosities, that enhance the penetration and diffusion of cariogenic solution and create a sort of demineralized enamel subsurface. Only compomer restorations revealed a thin caries inhibition zone (1–2 µm) probably related to fluoride release. Below this protected area, we observed the typical alterations of the other samples. These morphological alterations are probably related to secondary demineralization lesions and may affect the clinical life of restorations.
One-step self-etch adhesives behave as permeable membranes after polymerization, permitting water... more One-step self-etch adhesives behave as permeable membranes after polymerization, permitting water to move through the cured adhesives. We hypothesize that osmotic blistering occurs in bonded enamel when these adhesives are used without composite coupling. Tooth surfaces from extracted human premolars were bonded with 5 one-step self-etch adhesives. They were immersed in distilled water or 4.8 M CaCl(2), and examined by stereomicroscopy, field-emission/environmental SEM, and TEM. Water blisters were observed in bonded enamel but not in bonded dentin when specimens were immersed in water. They collapsed when water was subsequently replaced with CaCl(2). Blisters were absent from enamel in specimens that were immersed in CaCl(2) only. Water trees were identified from adhesive-enamel interfaces. Osmotic blistering in enamel is probably caused by the low water permeability of enamel. This creates an osmotic gradient between the bonded enamel and the external environment, causing water sorption into the interface.
Aim To compare residual root-end filling material in apical root-end cavities following their re... more Aim To compare residual root-end filling material in apical root-end cavities following their removal with ultrasonic retrotips.Methodology Thirty single-rooted teeth were filled with Thermafil and AH Plus sealer. Root-ends were resected at 90°, 3 mm from the apex. Root-end cavities were prepared with diamond burs and ultrasonic retrotips and filled with one of three filling materials: group I: Retro-TC (calcium silicate-based cement), group II: IRM (Dentsply, Germany), group III: Vitrebond (3M ESPE, USA). After 30 days of storage, ultrasonic retrotips were used to remove materials from the root-end cavities. The ultrasonic application time was fixed at 60 s. Polyether impressions and replicas of the root-ends were made. Root apices and replicas were examined by one operator under a scanning electron microscope. Remnants of residual materials were evaluated using a four-level scoring system; fractures, smear layer and exposed dentinal tubules were also examined.Results Forty per cent of the specimens filled with Retro-TC revealed complete removal of the material with exposure of dentinal tubules, whilst 60% contained residual cement. Twenty per cent of specimens filled with IRM were completely devoid of material, whereas 80% had retained material. Ten per cent of specimens filled with Vitrebond retained a moderate amount of material whilst 90% had substantial retention of the material. Statistically significant differences were found (P < 0.05) amongst the three groups of materials.Conclusions Retro-TC was successfully removed in 40% of cases using ultrasonics retrotips for 60 s, whereas IRM and Vitrebond specimens had evidence of retained material in 80% and 90% of all specimens respectively.
This in vivo study evaluated the effects of topical fluoride application on enamel by repeated sc... more This in vivo study evaluated the effects of topical fluoride application on enamel by repeated scanning electron microscopy analysis of replicas. Baseline fluid droplets were employed as qualitative indication of enamel permeability. CaF2-like globules were detected in vivo after fluoride application and were not found after professional brushing, ultrasound action, or chemical extraction. Absence of water permeability of enamel was demonstrated even after removal of CaF2-like globules. Droplets reappeared within 1 h in sodium fluoride-treated teeth, but they did not reappear even after 1 week following topical enamel treatment with acidulated phosphate fluoride. Teeth treated with an acidulate fluoride-free solution showed lack of CaF2-like globules and no droplets for at least 1 week as detected in acidulate phosphate fluoride-treated teeth. The caries-preventing action of fluoride may be due to its ability to decrease permeability and diffusion pathways. CaF2-like globules seem to be indirectly involved in enamel protection over time maintaining an impermeable barrier, and phosphoric acid seemed to play an unexpected fluoride-independent preventive role.
The aim of this study was to visualize fluid movement through dental enamel in vivo. Fifty perman... more The aim of this study was to visualize fluid movement through dental enamel in vivo. Fifty permanent upper central incisors, from subjects aged 10–70 yr, and 5 permanent central just-erupted incisors, from subjects aged 6–7 yr, were included in the study. An impression was obtained by vinyl polyxiloxane, and replicas were then obtained by polyether impression material. The hydrophobic vinyl polyxiloxane material yielded a morphological image in situ of outward fluid flow through tooth enamel. The study confirmed in vivo that enamel is a permeable substrate, as shown by the presence of droplets on its surface, and demonstrated that age and enamel permeability are closely related. Samples from subjects of different ages showed a decreasing number and size of droplets with increasing age: freshly erupted permanent teeth showed many droplets covering the entire enamel surface. Droplets in permanent teeth were prominent along enamel perikymata.
The aim of this clinical study was to evaluate class V and class III cavities restored with a pol... more The aim of this clinical study was to evaluate class V and class III cavities restored with a polyacid-modified resin composite (compomer) restorative material in association with two different dentin-enamel bonding systems: Dyract-PSA (Primer Sealer Adhesive-DentSply, Germany) and Prime&Bond 2.0 (DentSply, Germany). The control group was a hybrid composite used with ProBond bonding system (DentSply, Germany). A total of 116 restorations (79 class V, 37 class III) were made and reevaluated after 1, 2 and 3 years in 55 patients in two private practices and in a university department. Class V nonretentive cavities were located at the CEJ level and class III at interproximal level close to CEJ. Each cavity was prepared using a water-cooled, high-speed handpiece with a fine diamond burr. A small bevel was prepared along enamel margin. Cavity dimensions were no more than 3.5×3.5 mm (using burr as reference point). Each restoration was finished immediately with fine diamond burrs and Sof-Lex disks (3 M, USA). The criteria that were evaluated by the USPHS method included: retention, color match, marginal integrity, marginal discoloration, and secondary caries. Results indicated that all compomer restorations were fully retained at 3 years, and that no secondary caries detected. Seven composite restorations were lost during the 3-year study. No statistical differences were observed between class III and class V or among other conditions (e.g., upper-lower arc, sex, age). This study demonstrates that compomers are suitable restorative materials for class III–V restorations. They may represent a clinical alternative to composites in class V and III restorations.
The aim of this study was to examine the morphology of the hybrid layer (HL) of bonded water-stor... more The aim of this study was to examine the morphology of the hybrid layer (HL) of bonded water-stored specimens after different chemical pre-treatments of dentin.Materials and methods. Twenty-seven recently extracted human molars were selected. Fifty-four dentin disks in middle/deep dentin were obtained with a slow speed saw with a diamond-impregnated disk under water lubrication. Smear layers were created with 180 grit silicon carbide under running water for 1 min. Different pre-treatments of dentin were: Group (1) no treatment; Group (2) 35% H3PO4 etch for 15 s followed by 10% glutaraldehyde for 120 s; Group (3) 37% H3PO4 etch for 15 s followed by 5% NaOCl for 120 s. Three dentin bonding agents (DBAs), Prime and Bond NT (P and B), AdmiraBond (AB), and Clearfil SE Bond (SEB) were applied in association with a resin composite following the manufacturers' directions. Each specimen was then longitudinally sectioned and polished with wet SiC papers (up to #4000 grit). Impressions of the polished dentin were immediately taken with a silicone impression material. Bonded specimens were then stored for 3 or 12 h in deionized water. Further impressions of stored specimens were taken after air-drying of specimens for 10 s. Positive replicas were obtained using a polyether impression material. All the replicas and the original specimens were inspected by SEM.Results. A line of droplets (0.5–4 μm in diameter) was observed along the region of the adhesive–HL junction in all replicas of specimens stored in water, except in group 3, when P and B and AB were used. When SEB was used in each group the droplet were found in all groups except the zone of droplets was thinner. No differences in droplets dimensions were seen between 3 or 12 h water storage, or between the different dentin treatments.Conclusions. The replica procedure used in this study was able to detect water trapped in the adhesive–HL region that was released during the setting of the impression material. The droplets observed in this region support the hypothesis that there can be bidirectional water movement within the adhesive–HL complex.
Dentin adhesives have been proposed as desensitizing agents to seal exposed root dentin surfaces.... more Dentin adhesives have been proposed as desensitizing agents to seal exposed root dentin surfaces. Simplified ‘one-step’ dentin adhesives are highly permeable to water. The authors hypothesized that a lactic acid challenge may increase permeability of simplified adhesives and may induce fast degradation of bonding. This phenomenon adversely affects their durability as long term desensitizing agents. The aim of this in vitro study was to evaluate the ability of four dentin adhesives to seal root dentin surfaces that were exposed to water and lactic acid challenges.Four commercially-available dentin adhesives were applied with a small sponge to the root dentin of extracted human molars as de-sensitizing agents. Impression replicas of the adhesive-covered root dentin were fabricated after water immersion, as a control, and after lactic acid challenge. The replicas were examined with SEM for quantitative comparison of fluid droplet formation on the surfaces. The bonded specimens were also examined using reflected light confocal microscopy.Replicas of water droplets were observed on the adhesive surfaces, by SEM which corresponded with direct confocal observation of blisters and voids from the surface of the bonded specimens. There were significantly more water droplets from samples that were subjected to lactic acid challenge than water only immersion.Although the dentin adhesives examined were able to cover exposed root dentin, they all exhibited fluid transudation through the polymerized adhesives. Dentin adhesives were also susceptible to surface degradation after lactic acid challenge. As simplified self-etch adhesives were highly water permeable and exhibited the most extensive surface damage, they may not be the best adhesives to be used for long-term dentin desensitization. These preliminary in vitro findings warrant validation in vivo.
The goal of adhesive dentistry is to restore the peripheral seal of dentin lost from removal of e... more The goal of adhesive dentistry is to restore the peripheral seal of dentin lost from removal of enamel. Unfortunately, the hybrid layer (HL) that is used to create that seal is permeable to small ions or molecules, even in the absence of detectable, interfacial gap formation via nanoleakage. This nanoleakage results from several mechanisms including incomplete infiltration of adhesive monomers into demineralized collagen matrix, presence of hydrophilic monomers, and insufficient removal of solvent or water that remains trapped inside the HL. These mechanisms lead to a porous interface with nanometer-sized channels that increase the permeability of the HL. The null hypothesis tested in this study was that water and acidic solution storage are able to alter in vitro the resin-dentin interface, further increasing the marginal hybrid layer (MHL) permeability. Class II cavities were made in vitro. The specimens were stored in water for 1 week and in lactic acid solution for 3 days. Polyvinyl siloxane impressions of restoration margins were taken before and after storage in water and lactic acid solution. Polyether replicas were obtained using the silicon impressions as molds. Replicas and original samples were observed under scanning electron microscopy. Lines of water droplets were detected on MHLs and overlying adhesive only after storage. Replicas obtained after acidic solution storage showed great numbers of irregularities such as gaps, voids, and degradation of the dentin-restoration surface margin, but also a great number of droplets. Dentin-restoration resin interfaces absorb water and are damaged by storage in dilute lactic acid. The presence of water droplets probably indicates water that flows out of the interface during the setting time of the impression and thus represents an index of marginal HL water permeability.
Adhesive dentistry should effectively restore the peripheral seal of dentin after enamel removal.... more Adhesive dentistry should effectively restore the peripheral seal of dentin after enamel removal. We hypothesize that non-rinsing, simplified, one-step self-etch adhesives are effective for minimizing dentin permeability after tooth preparation procedures. Crown preparations in vital human teeth were sealed with Adper Prompt, Xeno III, iBond, or One-Up Bond F. Epoxy resin replicas were produced from polyvinyl siloxane impressions for SEM examination. Dentin surfaces from extracted human teeth were bonded with these adhesives and connected to a fluid-transport model for permeability measurements and TEM examination. Dentinal fluid droplets were observed from adhesive surfaces in resin replicas of in vivo specimens. In vitro fluid conductance of dentin bonded with one-step self-etch adhesives was either similar to or greater than that of smear-layer-covered dentin. TEM revealed water trees within the adhesives that facilitate water movement across the polymerized, highly permeable adhesives. Both in vitro and in vivo results did not support the proposed hypothesis.
The aim of this study was to evaluate the morphology of the enamel surface along margins of class... more The aim of this study was to evaluate the morphology of the enamel surface along margins of class V restorations following exposure to cariogenic solution. Restorations were placed in vitro in human third molars. The specimens were divided into groups according to resin composition: (1) Scotchbond 1 + Filtek Flow, (2) Scotchbond 1 + F2000, and (3) Prompt L-Pop + experimental flowable composite. Samples were stored in a demineralizing solution (lactic acid, pH 4.5, 0.1 M) at 37° for 1–4 weeks or in deionized water (control group). The solution was changed every day. Replicas of the specimens were obtained in order to exclude drying artifacts. Scanning electron microscopy (SEM) of original and replica specimens identified a distinct enamel zone, defined as perimarginal enamel showing numerous fractures, porosities, voids, and pits. After the 4-week treatment, perimarginal prismatic enamel was greatly removed, while interprismatic enamel was still in place and only partially dissolved. Enamel not in relation with composite/compomer margins (0.5–1 mm away) showed minor alterations. Perimarginal enamel fractures probably due to composite/compomer shrinkage or the bur preparation may greatly contribute to this marginal enamel demineralization by increasing the number and size of porosities, that enhance the penetration and diffusion of cariogenic solution and create a sort of demineralized enamel subsurface. Only compomer restorations revealed a thin caries inhibition zone (1–2 µm) probably related to fluoride release. Below this protected area, we observed the typical alterations of the other samples. These morphological alterations are probably related to secondary demineralization lesions and may affect the clinical life of restorations.
One-step self-etch adhesives behave as permeable membranes after polymerization, permitting water... more One-step self-etch adhesives behave as permeable membranes after polymerization, permitting water to move through the cured adhesives. We hypothesize that osmotic blistering occurs in bonded enamel when these adhesives are used without composite coupling. Tooth surfaces from extracted human premolars were bonded with 5 one-step self-etch adhesives. They were immersed in distilled water or 4.8 M CaCl(2), and examined by stereomicroscopy, field-emission/environmental SEM, and TEM. Water blisters were observed in bonded enamel but not in bonded dentin when specimens were immersed in water. They collapsed when water was subsequently replaced with CaCl(2). Blisters were absent from enamel in specimens that were immersed in CaCl(2) only. Water trees were identified from adhesive-enamel interfaces. Osmotic blistering in enamel is probably caused by the low water permeability of enamel. This creates an osmotic gradient between the bonded enamel and the external environment, causing water sorption into the interface.
Aim To compare residual root-end filling material in apical root-end cavities following their re... more Aim To compare residual root-end filling material in apical root-end cavities following their removal with ultrasonic retrotips.Methodology Thirty single-rooted teeth were filled with Thermafil and AH Plus sealer. Root-ends were resected at 90°, 3 mm from the apex. Root-end cavities were prepared with diamond burs and ultrasonic retrotips and filled with one of three filling materials: group I: Retro-TC (calcium silicate-based cement), group II: IRM (Dentsply, Germany), group III: Vitrebond (3M ESPE, USA). After 30 days of storage, ultrasonic retrotips were used to remove materials from the root-end cavities. The ultrasonic application time was fixed at 60 s. Polyether impressions and replicas of the root-ends were made. Root apices and replicas were examined by one operator under a scanning electron microscope. Remnants of residual materials were evaluated using a four-level scoring system; fractures, smear layer and exposed dentinal tubules were also examined.Results Forty per cent of the specimens filled with Retro-TC revealed complete removal of the material with exposure of dentinal tubules, whilst 60% contained residual cement. Twenty per cent of specimens filled with IRM were completely devoid of material, whereas 80% had retained material. Ten per cent of specimens filled with Vitrebond retained a moderate amount of material whilst 90% had substantial retention of the material. Statistically significant differences were found (P < 0.05) amongst the three groups of materials.Conclusions Retro-TC was successfully removed in 40% of cases using ultrasonics retrotips for 60 s, whereas IRM and Vitrebond specimens had evidence of retained material in 80% and 90% of all specimens respectively.
This in vivo study evaluated the effects of topical fluoride application on enamel by repeated sc... more This in vivo study evaluated the effects of topical fluoride application on enamel by repeated scanning electron microscopy analysis of replicas. Baseline fluid droplets were employed as qualitative indication of enamel permeability. CaF2-like globules were detected in vivo after fluoride application and were not found after professional brushing, ultrasound action, or chemical extraction. Absence of water permeability of enamel was demonstrated even after removal of CaF2-like globules. Droplets reappeared within 1 h in sodium fluoride-treated teeth, but they did not reappear even after 1 week following topical enamel treatment with acidulated phosphate fluoride. Teeth treated with an acidulate fluoride-free solution showed lack of CaF2-like globules and no droplets for at least 1 week as detected in acidulate phosphate fluoride-treated teeth. The caries-preventing action of fluoride may be due to its ability to decrease permeability and diffusion pathways. CaF2-like globules seem to be indirectly involved in enamel protection over time maintaining an impermeable barrier, and phosphoric acid seemed to play an unexpected fluoride-independent preventive role.
The aim of this study was to visualize fluid movement through dental enamel in vivo. Fifty perman... more The aim of this study was to visualize fluid movement through dental enamel in vivo. Fifty permanent upper central incisors, from subjects aged 10–70 yr, and 5 permanent central just-erupted incisors, from subjects aged 6–7 yr, were included in the study. An impression was obtained by vinyl polyxiloxane, and replicas were then obtained by polyether impression material. The hydrophobic vinyl polyxiloxane material yielded a morphological image in situ of outward fluid flow through tooth enamel. The study confirmed in vivo that enamel is a permeable substrate, as shown by the presence of droplets on its surface, and demonstrated that age and enamel permeability are closely related. Samples from subjects of different ages showed a decreasing number and size of droplets with increasing age: freshly erupted permanent teeth showed many droplets covering the entire enamel surface. Droplets in permanent teeth were prominent along enamel perikymata.
The aim of this clinical study was to evaluate class V and class III cavities restored with a pol... more The aim of this clinical study was to evaluate class V and class III cavities restored with a polyacid-modified resin composite (compomer) restorative material in association with two different dentin-enamel bonding systems: Dyract-PSA (Primer Sealer Adhesive-DentSply, Germany) and Prime&Bond 2.0 (DentSply, Germany). The control group was a hybrid composite used with ProBond bonding system (DentSply, Germany). A total of 116 restorations (79 class V, 37 class III) were made and reevaluated after 1, 2 and 3 years in 55 patients in two private practices and in a university department. Class V nonretentive cavities were located at the CEJ level and class III at interproximal level close to CEJ. Each cavity was prepared using a water-cooled, high-speed handpiece with a fine diamond burr. A small bevel was prepared along enamel margin. Cavity dimensions were no more than 3.5×3.5 mm (using burr as reference point). Each restoration was finished immediately with fine diamond burrs and Sof-Lex disks (3 M, USA). The criteria that were evaluated by the USPHS method included: retention, color match, marginal integrity, marginal discoloration, and secondary caries. Results indicated that all compomer restorations were fully retained at 3 years, and that no secondary caries detected. Seven composite restorations were lost during the 3-year study. No statistical differences were observed between class III and class V or among other conditions (e.g., upper-lower arc, sex, age). This study demonstrates that compomers are suitable restorative materials for class III–V restorations. They may represent a clinical alternative to composites in class V and III restorations.
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