Treating dentin hypersensitivity: therapeutic choices made by dentists of the northwest PRECEDENT network. Dentin bond strengths of two ceramic inlay systems after cementation with three different techniques and one bonding system. Direct tooth-colored materials for noncarious lesions: a 3-year clinical report. Preliminary report of an experimental design for in vivo testing of bonded restorations applied to a new enamel-dentinal bonding agent. The use of collagen cross-linking agents to enhance dentin bond strength. Eroded dentin does not jeopardize the bond strength of adhesive restorative materials. A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. The effect of smear layer removal on marginal contraction gaps. Three-year clinical evaluation of the Clearfil Liner Bond system. A three-year clinical evaluation of two dentin bonding agents. In-vitro evaluation of bond strength of four self-etching cements. Effect of irrigation solutions on dentin bonding agents and restorative shear bond strength. Adhesive performance of dentin bonding agents applied in vivo and in vitro. Effect of intrapulpal pressure and dentin depth. Degradation of the resin-dentin bonds after simulated and inhibited cariogenic challenge in an in situ model. Postoperative sensitivity: a comparison of two bonding agents. Hypermineralization of Dentinal Lesions Adjacent to Glass-ionomer Cement Restorations Effects of dentin age and bonding on microgap formation. Four-year clinical evaluation of two self-etching dentin adhesives of different pH values used to restore non-retentive cervical lesions. Shear bond strength of six restorative materials. Effect of caries removal techniques on the bond strength of adhesives to caries-affected primary dentin in vitro. Composite resin restoration and postoperative sensitivity: clinical follow-up in an undergraduate program. Retention of three fissure sealants and a dentin bonding system used as fissure sealant in caries prevention: 12-month follow-up results. Caries and background factors in Norwegian and immigrant 5-year-old children.
BACKGROUND Methods used by dental practitioners to diagnose and treat dentin hypersensitivity are not well documented . The authors conducted a survey of dentists in the Northwest Practice -based REsearch Collaborative in Evidence -based DENTistry ( PRECEDENT ) to ascertain the treatment methods they used . Methods . Via an Internet survey , the authors collected data regarding methods used for diagnosis and treatment of dentin hypersensitivity from 209 Northwest PRECEDENT dentists . RESULTS The PRECEDENT dentists indicated that they most often used fluoride varnishes and gels , advice regarding toothbrushing and diet , bonding agents , restorative material s and glutaraldehyde/2-hydroxyethyl methacrylate ( HEMA ) to treat dentin hypersensitivity . They reported that the most successful treatments were fluorides , glutaraldehyde/HEMA , bonding agents , potassium nitrates and restorative treatments ; they considered observation , advice regarding toothbrushing and diet and laser therapy to be the least successful . Dentists listed fluorides , calcium phosphates , glutaraldehyde/HEMA and bonding agents as the treatments most desirable for inclusion in a future r and omized clinical trial of dental hypersensitivity treatments . CONCLUSIONS Dentists rely on patients to assess the severity of dentin hypersensitivity . Modalities for the diagnosis and treatment of hypersensitivity are diverse . Methods used to diagnose and treat dentin hypersensitivity in practice are challenging to justify . CLINICAL IMPLICATION S Practitioners should be aware of the diversity of methods available for diagnosing and treating dentin hypersensitivity as they manage the care of their patients with this condition STATEMENT OF PROBLEM Cementation of inlay restoration is critical . Because of its high organic content , dentin is a less favorable substrate for bonding than enamel . Therefore it is important to improve dentin adhesion when placing ceramic inlay restorations . PURPOSE The purpose of this study was to compare the dentin bond strengths of 2 different ceramic inlay systems after cementation with 3 different techniques and 1 bonding system . MATERIAL AND METHODS One hundred twenty freshly extracted caries- and restoration-free molar teeth used in this study were stored in saline solution at room temperature . St and ardized Class I preparations were made in all teeth . Each preparation had a length of 6 mm , a width of 3 mm , a depth of 2 mm , and 6-degree convergence of the walls . Teeth were r and omly assigned to 2 groups of 60 each to evaluate the bonding of 2 ceramic systems , Ceramco II ( Group I ) and IPS Empress 2 ( Group II ) , to dentin . Each of the 2 groups were further divided into 3 cementation technique groups of 20 each ( Group I A , B , and C and Group II A , B , and C ) . Groups I A and B and Groups II A and B used dentin bonding agent ( DBA ) Clearfil Liner Bond 2V , and resin cement ( Panavia F ) . Groups I C and II C served as control groups and used Panavia F without the dentin-bonding agent . In Groups I A and II A , the DBA was applied immediately after the completion of the preparations ( D-DBA ) . Impressions were then made , and the ceramic inlays were fabricated according to the manufacturers ' guidelines . In Groups I B and II B the DBA was applied just before luting the inlay restorations ( I-DBA ) . In Groups I C and II C , no bonding agent was used before the cementation of the inlay restorations ( No DBA ) . Cementation procedures followed a st and ard protocol . After cementation , specimens were stored in distilled water at 37 degrees C for 24 hours . The teeth were sectioned both mesial-distally and buccal-lingually along their long axis into three 1.2 x 1.2 mm wide |-shaped sections . The specimens were then subjected to microtensile testing at a crosshead speed of 1 mm/min , and the maximum load at fracture ( in kilograms ) was recorded . Two-way analysis of variance and Tukey honestly significant difference tests were used to evaluate the results ( P<.05 ) . Scanning electron microscopy analysis was used to examine the details of the bonding interface . The fractured surfaces were observed with a stereomicroscope at original magnification x22 to identify the mode of fracture . RESULTS Although no significant difference was found among the 2 ceramic systems with regard to dentin bond strengths ( P>.05 ) , the difference between the cementation techniques was found to be significant ( P<.001 ) . Comparison among techniques showed that the dentin bond strength in the D-DBA technique had a significantly higher mean ( 40.27 + /- 8.55 Kg ) than the I-DBA ( 30.20 + /- 6.78 Kg ) and No DBA techniques ( 32.43 + /- 8.58 Kg ) . As a result of scanning electron microscopy analysis , a distinct and thicker hybrid zone with more , and longer resin tags were found in specimens treated with the D-DBA technique than with the other 2 techniques . Most failures ( 353 of 360 ) were adhesive in nature at the bonding resin/dentin interface . Only 7 specimens showed cohesive failure within the bonding resin . CONCLUSION Within the limitations of this in vitro study , the cementation of the ceramic inlays tested with the D-DBA technique used result ed in higher bond strengths to dentin One hundred fifty-nine noncarious cervical lesions were restored with glass-ionomer cement , resin composite used with a dentinal bonding agent , or the laminate ( s and wich ) restoration , which combines both these material s. These restorations were evaluated at baseline , 1 year , and 3 years for color match , cavosurface marginal discoloration , anatomic form , marginal adaptation , and retention . There was a general deterioration of the restorations with time . Lesions restored with resin composite and a dentinal bonding agent exhibited the highest percentage of lost restorations Because of inconsistency often found between in vitro testing and in vivo performance , a new restorative bonding system was evaluated by the placement of  restorations in vivo in teeth to be extracted . The microleakage was determined following extraction after 3 months of clinical service . In each of the sample teeth , two restorations were placed on the labial surface , one in the middle of the enamel portion and the other extending over the cementoenamel portion . The results of this pilot study indicated that bonding to conditioned enamel with the new adhesive material is effective , and bonding to conditioned dentin appears to be clinical ly adequate UNLABELLED Type I collagen is a major component of the hybrid layer , and improvement of its mechanical properties may be advantageous during bonding procedures . OBJECTIVE To investigate the effect of three different cross-linking agents ( Glutaraldehyde [ GD ] , Grape seed extract [ GSE ] , and Genipin [ GE ] ) on the tensile bond strength ( TBS ) of resin-dentin bonds . MATERIAL S AND METHODS Sixty-four sound human molars were collected and their occlusal surfaces were ground flat to expose dentin . Dentin surfaces were etched using a phosphoric acid and then teeth were r and omly divided according to the dentin treatment : Control group ( no treatment ) , 5 % GD , 6.5 % GSE , or 0.5 % GE . Teeth were restored either with One Step Plus or Adper Single Bond Plus adhesive systems and resin composite . After 24 h , teeth were sectioned to produce a cross-sectional surface area of 1.0 mm(2 ) and tested for tensile bond strength . Data were statistically analyzed using ANOVA and Fisher 's PLSD tests ( p < 0.05 ) . There was a statistically significant interaction between factors ( treatment and adhesive p < 0.001 ) . Treatment affected TBS ( p < 0.0001 ) , while no differences were observed between the adhesive systems ( p = 0.6961 ) . CONCLUSION Chemical modification to the dentin matrix promoted by GD and GSE , but not GE , result ed in increased bond strength . The application of selective collagen cross-linkers during adhesive restorative procedures may be a new approach to improve dentin bond strength properties This in vitro study evaluated the bond strength of adhesive restorative material s to sound and eroded dentin . Thirty-six bovine incisors were embedded in acrylic resin and ground to obtain flat buccal dentin surfaces . Specimens were r and omly allocated in 2 groups : sound dentin ( immersion in artificial saliva ) and eroded dentin ( pH cycling model - 3 × / cola drink for 7 days ) . Specimens were then reassigned according to restorative material : glass ionomer cement ( KetacTM Molar Easy Mix ) , resin-modified glass ionomer cement ( VitremerTM ) or adhesive system with resin composite ( Adper Single Bond 2 + Filtek Z250 ) . Polyethylene tubes with an internal diameter of 0.76 mm were placed over the dentin and filled with the material . The microshear bond test was performed after 24 h of water storage at 37ºC. The failure mode was evaluated using a stereomicroscope ( 400 × ) . Bond strength data were analyzed with two-way ANOVA and Tukey 's post hoc tests ( α = 0.05 ) . Eroded dentin showed bond strength values similar to those for sound dentin for all material s. The adhesive system showed the highest bond strength values , regardless of the substrate ( p < 0.0001 ) . For all groups , the adhesive/mixed failure prevailed . In conclusion , adhesive material s may be used in eroded dentin without jeopardizing the bonding quality . It is preferable to use an etch- and -rinse adhesive system because it shows the highest bond strength values compared with the glass ionomer cements tested OBJECTIVE The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo . METHOD AND MATERIAL S Forty-eight primary molars with carious lesions were r and omly assigned to 2 different treatments : group 1 ( control , n = 24)--All identifiable , irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material ; group 2 ( experimental , n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material . The control and experimental teeth were clinical ly monitored every 3 months and evaluated 12 months after restoration . The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy . RESULTS Retention rate , marginal integrity , and pulpal symptoms were identical in both groups . Radiographically , the radiolucent area associated with the experimental restorations did not increase with time in 75 % of the cases . For the control group , the adhesive system formed a hybrid layer . In the experimental group , there was morphologic evidence of the formation of an acid-resistant " altered hybrid layer . " An acid-resistant tissue , result ing from the interdiffusion of adhesive resin within the area of carious dentin , was observed adjacent to and under the altered hybrid layer . CONCLUSION Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration The presence of the smear layer prevents direct contact between dentine and a dentine adhesive . The use of agents to remove the smear layer theoretically should improve the bonding of composite resins to dentine . This study examined the effect of smear layer removal on the effectiveness of a dentine bonding agent in reducing marginal contraction gaps . The agent used for smear layer removal in this study was ethylenediamine tetra-acetic acid ( EDTA ) .  Eighty cavities measuring 2 mm in diameter and 1.5 mm in depth were prepared in dentine and r and omly assigned to two equal groups . The control group was restored with Prisma Universal Bond 2 Adhesive and Prisma Fil Resin . The experimental group was similarly restored after pretreatment of dentine with 0.5 % EDTA for 60 s. All specimens were thermocycled and the marginal contraction gaps were assessed using a Nikon Measures cope . The mean contraction gap was expressed as a percentage of the cavity diameter . Results showed that the experimental group registered smaller contraction gaps ( mean : 0.021 % ) than the control group ( mean : 0.027 % ) . No penetration of material into dentine was observed . Pretreatment with EDTA did not significantly improve the effectiveness of the dentine bonding agent used in terms of reduction of marginal contraction gaps Modern dental adhesive systems have improved the bond of restorative material s to mineralized tooth structures . The purpose of this study was to evaluate the clinical performance of composite restorations placed in abrasion and erosion lesions using the Clearfil Liner Bond dental adhesive system . Following ADA clinical guidelines for dentin and enamel adhesive material s , 62 facial class 5 smooth surface erosion or abrasion lesions with no undercuts and involving primarily root surfaces were restored in 25 adult male and female patients . The teeth were restored without preparations using Clearfil Liner Bond and Clearfil Photo Anterior composite resin . The clinical performance of the restorations was assessed by two examiners at baseline , 6 months , 1 , 2 , and 3 years using the following evaluative parameters : color match , marginal discoloration , and marginal integrity according to modified Ryge criteria ; the presence or absence of recurrent decay ; pre- and postoperative sensitivity ; and restoration failure due to loss of retention or other causes . At the end of 3 years , four of the 55 restorations remaining in the study failed due to lack of retention ( 92.7 % retention rate ) . The evaluations of the other clinical parameters demonstrated excellent performance by this system BACKGROUND A new restorative called a " giomer composite " has been introduced . The authors conducted a study to determine retention , anatomical form , caries , staining , marginal discoloration , marginal adaptation , surface roughness and sensitivity of giomer  compared with those of a microfilled composite . METHODS The authors placed 40 sets of restorations r and omly in canines and premolars in vivo . They used a giomer composite and a microfilled composite in erosion/abrasion/abfraction Class V lesions that were not altered with rotary instruments . They placed the restorations according to manufacturer 's recommendations , and two calibrated examiners evaluated the restorations independently using modified U.S. Public Health Service criteria at baseline and at six , 18 and 36 months . The lesions receiving the restorations did not differ from each other in the amount of circumferential enamel present , the percentage of the surface area of dentin or lesion type . RESULTS There were no differences in the restorations at baseline , an evaluation made two weeks after placement . At 36 months , the giomer and microfilled composite restorations were not significantly different from one another in any of the eight criteria evaluated . The percentage agreement between examiners was at least 83 percent for each criterion in each evaluation period . CONCLUSIONS Both the giomer and the microfilled composite used in this study meet the clinical portion of the Acceptance Program Guidelines for Dentin and Enamel Adhesives Material s established by the American Dental Association . CLINICAL IMPLICATION S Both the giomer and the microfilled composite used in this study can be used with confidence in Class V lesions Indirect restorations need to be attached with adhesive luting agents to prevent them from becoming dislodged and provide adequate marginal sealing . The aim of this study was to evaluate bond strength to dentin of self-etching resin cements . MATERIAL S AND METHODS 75 flat dentin surfaces were r and omly distributed among 5 groups , according to cements used ; Group 1 : RelyxU100 ( 3M/ESPE ) , Group 2 : Bis Cem ( Bisco ) , Group 3 : Max Cem ( Kerr ) , Group 4 : SeT PP ( SDI ) and Group 5 : Relyx ARC ( 3M/ESPE ) , control . Ceramic test cylinders ( IPS Empress 2 / Ivoclar-Vivadent ) 4.1 mm across were prepared and attached to the dentin surfaces using the different cements . A constant 25N load was applied for 1 minute and they were light-polymerized . Following storage for 24 hours at 100 % humidity and 37 ° C , the specimens were tested for bond strength under shear strain in an Instron testing machine at a crosshead speed of 1 mm/minute ; at 7 , 14 and 21 days . Data were analyzed by ANOVA and Tukey 's test . There were significant differences between material s ( p < 0.0001 ) , but not between times or material /time interaction . RelyXARC ( Control Group ) had the highest bond strength ( 15.52 MPa ) . Among the self-etching cements , the best behavior was found for Relyx U100 ( 10.80MPa ) , followed by BisCem ( 6.36 MPa ) , MaxCem ( 5.45 MPa ) and SeTPP ( 3.17 MPa ) . The bond strength of the self-adhesive cements evaluated was lower than that for resin cements which require previous treatment of the dental substrate ( control group ) . This should be taken into account during clinical selection , in particular for tooth preparations with poor retention STATEMENT OF PROBLEM The presence of irrigation solution prior to the application of dentin bonding agents may be one source of contamination and may adversely affect bond strength . PURPOSE The purpose of this in vitro investigation was to evaluate the effect of irrigation solutions of different purity levels on the shear bond strength of a hybrid composite to dentin . MATERIAL AND METHODS Forty extracted , intact human molars were h and -scaled . All soft tissue was removed , and the teeth were stored in room-temperature tap water for 1 week . Subsequently , each tooth was embedded in autopolymerizing acrylic resin with the coronal portion exposed . After complete polymerization of the resin , the dentin surfaces were exposed , and the crown was cut longitudinally on all 4 sides to produce flat dentin surfaces for bonding . The prepared specimens were assigned to 4 groups of irrigation solutions : tap water ( control ) , sterile water , 0.9 % NaCl irrigation solution , and filtered water . Within each irrigation group were 4 dentin bonding agent subgroups : Prime & Bond NT , One-Step , Single Bond Adhesive , and OptiBond Solo . The dentin surfaces ( n = 10 per irrigation/bonding agent pair ) were etched with 37 % phosphoric acid , rinsed with the assigned irrigation solution for 15 seconds , and then dried . Plastic cylinders ( 3 mm long x 3 mm inner diameter ) were filled with a hybrid composite ( Herculite XRV ) and bonded to the dentin . Specimens were loaded in a universal testing machine , and shear force was applied to the base of the composite cylinders , parallel to the dentin surfaces , at a crosshead speed of 0.05 in/min until fracture . Failure loads were recorded . Bond strength data were compared with analysis of variance ( P<.05 ) . Post-hoc comparisons of means were performed with t tests and P values adjusted for multiple comparisons ( Bonferroni method ) . RESULTS Tap water irrigation ( control ) produced no significant difference in bond strengths for all dentin bonding agents tested . When other irrigation solutions were used , One-Step consistently produced significantly lower bond strengths than other dentin bonding agents ( P<.05 ) . No preferential choice of irrigation solution could be made for Prime & Bond or Single Bond Adhesive . However , when One-Step or Solo was used , irrigation with normal saline significantly reduced bond strengths ( P<.05 ) . CONCLUSION Within the limitations of this study , the bond strength to dentin of a hybrid composite irrigated with different solutions was dependent on the dentin bonding agent used The purpose of this study was to evaluate the influence of intrapulpal pressure and dentin depth on bond strengths of an etch- and -rinse and a self-etching bonding agent to dentin in vitro and in vivo . Twenty-four pairs of premolars were r and omly divided into four groups ( n = 6 ) according to the dentin bonding agent , Single Bond and Clearfil SE Bond , and intrapulpal pressure , null or positive . Each tooth of the pair was further design ated to be treated in vivo or in vitro . The intrapulpal pressure was controlled in vivo by the delivery of local anesthetics containing or not a vasoconstrictor , while in vitro , it was achieved by keeping the teeth under hydrostatic pressure . Class I cavities were prepared and the dentin bonding agents were applied followed by incremental resin restoration . For the teeth treated in vitro , the same restorative procedures were performed after a 6 month-storage period . Beams with 1 mm(2 ) cross-sectional area were prepared and microtensile tested . Clearfil SE Bond was not influenced by any of the variables of the study , while bond strengths produced in vitro were significantly higher for Single Bond . Overall , lower bond strengths were produced in deep dentin , which reached statistical significance when Single Bond was applied under physiological or simulated intrapulpal pressure . In conclusion , in vitro bonding may overestimate the immediate adhesive performance of more technique-sensitive dentin bonding systems . The impact of intrapulpal pressure on bond strength seems to be more adhesive dependent than dentin morphological characteristics related to depth The aim of this study was to evaluate the resin-dentin bonds of two simplified etch- and -rinse adhesive after simulated cariogenic and inhibited cariogenic challenge in situ . Dental cavities ( 4 mm wide , 4 mm long , and 1.5 mm deep ) were prepared in 60 bovine teeth with enamel margins . Restorations were bonded with either adhesive Adper Single Bond 2 ( 3MESPE ) or Optibond Solo Plus ( Kerr ) .  Forty restorations were included in an intra-oral palatal appliance that was used for 10 adult volunteers while the remaining 20 dental blocks were not su bmi tted to any cariogenic challenge [ NC group ] and tested immediately . For the simulated cariogenic challenge [ C+DA ] , each volunteer dropped 20 % sucrose solution onto all blocks four times a day during 14 days and distilled water twice a day . In the inhibited cariogenic challenge group [ C + FA ] , the same procedure was done , but slurry of fluoride dentifrice ( 1.100 ppm ) was applied instead of water . The restored bovine blocks were sectioned to obtain a slice for cross-sectional Vickers microhardness evaluation and resin-dentin bonded sticks ( 0.8 mm(2 ) ) for resin-dentin microtensile evaluation . Data were evaluated by two-way ANOVA and Tukey 's tests ( α = 0.05 ) . Statistically lower microhardness values and degradation of the resin-dentin bonds were only found in the C + DW group for both adhesives . The in situ model seems to be a suitable short-term methodology to investigate the degradation of the resin-dentin bonds under a more realistic condition Historically , postoperative pain associated with temperature was considered a thermal conduction problem . More recently , pulpal hydrodynamics has been used to explain this sensitivity . Relative to restorations placed with dentin bonding agents that require a separate etching step , agents that include an acidic primer are believed to result in a better seal of the dentinal tubules . This study compared pain associated with a st and ardized cold stimulus in two groups of restorations . One group was placed with a self-priming resin that required a separate etch step , the other with a self-etching , self-priming dentin bonding agent . This was a community-based , r and omized , double-blind clinical trial . Two hundred and nine restorations were placed for 76 participants . All teeth were asymptomatic at the start of the trial . Immediately following application of a st and ardized cold stimulus , participants rated the pain for each restored tooth using a Visual Analog Scale ( VAS ) . For each group of restorations , VAS scores at 13 weeks were compared to preoperative scores . In addition , the preoperative score was subtracted from the 13-week score , and the two groups of restorations were compared . For both groups of restorations , the median scores were significantly reduced at 13 weeks . This decrease in the VAS score reflects a reduction in sensitivity below that which existed preoperatively . There was no significant difference between the two groups of restorations in terms of change in sensitivity at 13 weeks Previous reports have shown a release of fluoride from glass-ionomer cement ( GIC ) restorations into the oral fluids . Fluoride in the ambient fluids has a caries-preventive effect by enhancing remineralization and inhibiting demineralization of the dental hard tissues . Therefore , the current investigation was undertaken to determine whether GIC fillings could contribute to the remineralization of caries lesions in dentin . Small circular preparations were made in disks of dentin which had incipient caries-like lesions in the remaining tissue . The preparations were filled with amalgam or composite material s ( as controls ) or with GIC . The specimens thus contained a restoration close to a dentinal caries-like lesion . The specimens were placed contralaterally in the buccal surfaces of removable partial dentures and were worn intra-orally by volunteers for a 12-week experimental period , after which the specimens were sectioned and analyzed by microradiography . All specimens with GIC restorations exhibited hypermineralization in the tissue bordering the filling and in the wall of the preparation which had been in contact with the restoration . The ( caries-like ) lesions were remineralized , even under conditions of heavy plaque formation . In contrast , specimens with amalgam or composite restorations showed further extensive demineralization . This study demonstrates a significant remineralization potential exerted by the fluoride-releasing GIC restorative material . Consequently , the choice of the restorative material might be crucial for the occurrence or prevention of recurrent caries around restorations This study compared the effectiveness of dentin adhesives  in extracted molars from younger ( 16 - 26 ) and older ( 58 - 87 ) human subjects . Extracted molars were selected to be restored with one of two dentin bonding agents ( n = 22 per group ) . Opposite sides of each molar were ground flat and a 3 mm x 3 mm cylindrical preparation was milled into each surface . The opposing surfaces of each molar were then r and omly restored with either a dentin bonding system that adhered to the dentin smear layer or one which bonded to the dentin after the smear layer was removed . All sample s were examined at x150 to determine both the maximum gap in micrometers and extent of the gap in degrees . There were significantly shorter ( P < 0.05 ) microgaps in older dentin with a bonding system that removed smear layer . This bonding system also produced shorter gaps in older dentin than in younger dentin . However , there was no statistically significant difference in the percentage of gap-free margins between age groups PURPOSE To evaluate the clinical performance of two self-etching adhesives of different pH values when used to restore non-retentive cervical lesions . METHODS 84 paired non-retentive class 5 restorations were originally placed in 21 subjects in need of 2 , 4 or 6 restorations in incisors , canines and premolars . The retention of the placed restorations relied on the two adhesives only , which were iBOND NG plus B ( iB ) , now marketed as iBOND Self Etch , and Clearfil SE ( CB ) . Lesions were restored with a micro-hybrid composite ( Venus ) . Following a baseline evaluation , the subjects were recalled and evaluated after 3 months , 1 year , 2 years and 4 years . RESULTS At the 4-year evaluation , 17 subjects remained who had originally received 66 restorations ( 33 of each adhesive ) . Eight of these 66 restorations had dropped out during the 4 years ( 4 iB and 4 CB ) for different reasons . Two of the drop-outs ( one iB and one CB ) had fractured in the same patient , leaving a large piece of the composite still bonded to the dentin . Two other drop outs ( both material iB ) were not available for evaluation because they had been crowned ( one after endodontic treatment and one after cusp fracture ) , while the remaining drop-out iB restoration had debonded . Regarding material CB , except for the fractured and partly retained drop-out restoration , the remaining three drop-outs had debonded . Pair-wise comparison of the evaluated parameters using Fishers Exact Test revealed no statistically significant ( P < 0.05 ) differences between the two material The purpose of this study was to determine and compare the shear bond strength of a conventional glass-ionomer cement , a resin modified glass-ionomer , a composite resin and three compomer restorative material s. Dentin of the occlusal surfaces from sixty extracted human permanent molars were prepared for shear bond strength testing . The specimens were r and omly divided into six groups of 10 each . Dentinal surfaces were treated according to the instructions of manufacturers for each material . Each restorative material was placed inside nylon cylinders 2 mm high with an internal diameter of 3 mm , which were placed perpendicular to dentin surfaces . Shear bond strengths were determined using an Universal Testing Machine at crosshead speed of 0.5 mm/min in a compression mode . Conventional glass-ionomer , Ketac-Molar aplicap showed the lowest mean shear bond strength 3.77+/-1.76 ( X + /- SD MPa ) and the composite resin , Heliomolar showed the highest mean shear bond strength 16.54+/-1.65 while the mean bond strength of Fuji II LC was 9.55+/-1.06 . The shear bond strengths of compomer restorative material s were 12.83+/-1.42 , 10.64+/-1.42 and 11.19+/-1.19 for Compoglass , Hytac and Dyract respectively . ANOVA revealed statistically significant differences in the mean shear bond strengths of all groups ( P<0.001 ) . No statistically significant difference was found between the three compomer material s ( P>0.5 ) . Ketac-Molar and composite resin showed statistically significant difference ( P<0.0005 ) . The mode of fracture varied between material s. It is concluded that the compomer restorative material s show higher shear bond strength than conventional glass-ionomer and resin modified glass-ionomer , but less than composite resin . The fracture mode is not related to the shear bond strengths values AIM The aim of this in vitro study is to evaluate the effects of three different caries removal techniques on the microtensile bond strength of adhesive material s to caries-affected dentin . MATERIAL S AND METHODS Thirty primary molar teeth were used . The teeth were r and omly divided into three groups according to the caries removal technique employed : conventional steel bur ( group 1 ) ; Er : YAG laser ( group 2 ) ; chemomechanical method ( group 3 ) . Each group was divided into two subgroups according to bonding agents : one-step self-etch adhesive and etch- and -rinse adhesive . The teeth were restored with composite resin . Vertical sticks were obtained and subjected to tensile stress . Data were analyzed by two-way analysis of variance ( ANOVA ) , Tukey 's test and an independent sample s t-test . RESULTS The values for the laser groups were significantly lower than those of the bur groups for both bonding agents ( p<0.05 ) . There were no significant differences between the bur and chemomechanical groups ( p > 0.05 ) . CONCLUSION Bur and chemomechanical techniques in primary teeth were found more successful . Similar results were found according to the adhesives used for each caries removal techniques OBJECTIVES To analyze the relationship between the cavity depth and liners with postoperative sensitivity of  resin composite restorations .  METHODS A clinical follow-up was conducted on 319 resin composite restorations made in the final year of an undergraduate program over a 3-year period . Along with the analyses of cavity type , cavity depth , type of pulpal protection and the material s used , the postoperative sensitivity was also examined on each restoration . RESULTS Thirty-nine percent of the restorations had no protective layer ( Group 1 ) . As the depth of the prepared cavities increased , the restorations received one of the three pulpal protection methods ; a calcium hydroxide base ( Group 2 ) , glass ionomer cement ( Group 3 ) , or protection with a calcium hydroxide base in combination with glass ionomer cement ( Group 4 ) . The incidence of postoperative sensitivity showed no significant difference among Groups 1 , 2 and 3 , but was significantly lower in Group 1 than in Group 4 . The restorations made in shallow and medium depth cavities demonstrated significantly less-postoperative sensitivity than those made in deep cavities . The newer generation dentine-bonding agents showed a significantly lower incidence of postoperative sensitivity than the early generation group . CONCLUSIONS Postoperative sensitivity in resin  composite restorations was not related to the absence of protective layers but increased with the depth of cavities restored with the resin composite . The type of dentine-bonding agents could also be responsible for postoperative sensitivity BACKGROUND Bonding agents could be used as fissure sealants . This study compares the retention three fissure sealants ( Delton , Delton Plus and Concise ) and a filled dentin bonding system ( Optibond Solo ) . METHODS . Fifty-six children aged 7 - 8 years received fissure sealants  either in the four permanent first molars , in the four deciduous second molars , or in all eight of these teeth . Every child received a different sealing material in each quadrant on a r and om basis . Clinical evaluation at 12 months was performed by a single blind examiner , and the retention was classified as either a success ( total retention ) or a failure ( partial retention or not present ) . RESULTS There were no statistically significant differences among the four material s in permanent maxillary molars or deciduous molars . In permanent m and ibular molars , Optibond Solo showed a lower percentage of retention ( 40.9 % ) , significantly different ( p=0.002 ) to that of Delton ( 89.5 % ) , Delton Plus ( 87.5 % ) and Concise ( 76.5 % ) . CONCLUSION One bottle dentin bonding system used as a sealant does not improve the retention of conventional fissure sealants . CLINICAL IMPLICATION Because of the scarcity of studies on the use of dental adhesives as sealants , further studies are warranted for the final support of that conclusion OBJECTIVES The purpose of this study was to assess the  caries status of 5-year-olds in a low caries area , and study associations between dental caries and parent-related factors : parents ' education , national origin , oral health behaviours and attitudes . METHODS The material consisted of 523 children and was a stratified r and om sample . Clinical and radiographic examination was performed in 2007 . Enamel and dentine caries were recorded at surface level . Parents filled in question naires regarding socioeconomic status , their own oral health behaviours and attitudes . RESULTS Most participants ( 66 % ) had no caries experience and 16 % had enamel caries only . Dentine caries experience was present in 18 % of the children , and 5 % had dentine caries experience in five or more teeth . Surfaces with enamel caries constituted half of all surfaces with caries experience . In multiple logistic regression , statistically significant risk indicators for the child having dentine caries experience at the age of five were : having one or both parents of non-western origin ( OR = 4.8 ) , both parents ( OR = 3.0 ) or one parent ( OR = 2.1 ) with low education , parental laxness about the child 's tooth brushing ( OR = 2.8 ) , parents ' brushing their own teeth less than twice a day ( OR = 2.2 ) and having parents with frequent sugar intakes ( OR = 1.8 ) . CONCLUSION Caries prevalence in 5-year-olds was strongly associated with parent-related factors signifying that information on parents ' socioeconomic status , dental behaviours and attitudes should be considered when planning dental services for young children . Our results suggest that the real high risk group is non-western children whose parents have low education
Experimental  methacrylate-based adhesives , either when incorporating calcium/sodium phosphate-phyllosilicates or calcium silicate cements , demonstrated to promote therapeutic/protective effects on the micro-mechanical and ultramorphological properties of resin bonded-dentine interfaces associated with mineral deposition over time .
The origin of ion-releasing dentine bonding agents lies in a change in attitude regarding the qualities dem and ed of a restorative dental material .