Comparison of two-step versus four-step composite finishing/polishing disc systems: evaluation of a new two-step composite polishing disc system. The effect of different polishing systems on surface roughness and gloss of various resin composites. Clinical performance of ormocer, nanofilled, and nanoceramic resin composites in Class I and Class II restorations: a three-year evaluation. Two-year clinical evaluation of ormocer, nanohybrid and nanofill composite restorative systems in posterior teeth. The effects of finishing and polishing techniques on surface roughness and color stability of nanocomposites. SURFACE DEGRADATION OF COMPOSITE RESINS BY ACIDIC MEDICINES AND pH-CYCLING Effect of surface roughness on stain resistance of dental resin composites. Surface Roughness of Nanofill and Nanohybrid Composite Resin and Ormocer-based Tooth-colored Restorative Materials after Several Finishing and Polishing Procedures Effect of Bleaching Gels on Surface Roughness of Nanofilled Composite Resins Eighteen-month clinical evaluation of microhybrid, packable and nanofilled resin composites in Class I restorations. The influence of one-step polishing systems on the surface roughness and microhardness of nanocomposites. Finishing systems on the final surface roughness of composites. The effect of finishing and polishing procedures on the surface roughness of composite resin materials. A 12-month clinical evaluation of composite resins in class III restorations. Clinical evaluation of nanofill and nanohybrid composite in Class I restorations: a 12-month randomized trial. Efficacy and safety of low-dose submicron diclofenac for the treatment of osteoarthritis pain: a 12 week, phase 3 study A new one-step dental flowable composite for orthodontic use: an in vitro bond strength study. Influence of sodium hypochlorite and EDTA on the microtensile bond strength of a self-etching adhesive system Plaque, gingival bleeding and calculus formation after supragingival scaling with and without polishing: a randomised clinical trial. Resin composite class I restorations: a 54-month randomized clinical trial. Mineral loss on adjacent enamel glass ionomer cements restorations after cariogenic and erosive challenges. Inhibition of demineralization adjacent to tooth-colored restorations in primary teeth after 2 in vitro challenges. Cariostatic effect of fluoride-containing restorative systems associated with dentifrices on root dentin.
OBJECTIVE The purpose of this study was to evaluate surface finish and gloss of a two-step  composite finishing/polishing ( F/P ) disc system compared with two multistep systems on five composites . METHODS Seventy-five disc-shaped composite specimens ( D=10.0 mm , 2 mm thick , n=15 per composite ) were made of microfill ( Durafill-D ) , nanofill ( Filtek Supreme-FS ) , nanohybrid ( Premise-PR ) , and microhybrids ( Filtek Z250-FZ , Esthet-EX ) . One side of each specimen was initially finished with a carbide bur . Five specimens of each resin composite were r and omly assigned to receive full F/P by each of the disc systems : two-step ( Enhance Flex NST-EF ) and four-step ( Sof-Lex-SL , Super-Snap-SS ) . Surface gloss was measured with a glossmeter and surface roughness was measured with a profilometer . Results were analyzed by two-way analysis of variance (ANOVA)/Tukey 's ( α<0.05 ) . RESULTS No difference in gloss was noted among the three F/P systems when used with D and EX ; no difference between SL and EF when used with any composite , except for FS ; and no difference between SL and SS when used with any composite . SL and EF showed similar surface roughness when used on all composites , except for EX . EF and SS showed similar surface roughness on PR . SL and SS showed similar surface roughness values on every composite , except for FZ . CONCLUSIONS EF was capable of providing similar gloss and surface roughness to SL on four composites evaluated but was not able to produce as glossy or as smooth a surface as SS for three of the five composites PURPOSE The purpose of this in vitro study was to evaluate the surface finish and gloss of five direct resin composites polished with six polishing systems . MATERIAL S AND METHODS One hundred and fifty disk-shaped composite specimens ( D=10.0 mm , 2-mm-thick , N=30 per material ) were made . One side of each specimen was finished with a 16-fluted carbide finishing bur and then polished . Five specimens of each resin composite were r and omly assigned to one of the six polishing systems . The surface roughness and gloss were measured with a surface profilometer and a glossmeter . The results were analyzed by two-way analysis of variance and Tukey 's t-test ( p < or= 0.05 ) . RESULTS There was no significant interaction between the composite and the polishing systems for surface roughness ( p=0.059 ) . The order of surface roughness ranked according to composite was : Durafill < Esthet-X < Supreme < Z250 < Z100 ; and the ranking for the polishing system was : Pogo < Sof-Lex < Diacomp/Enamelize < Diacomp < ComposiPro brush < Jiffy . There was interaction of gloss values between the composites and the polishing systems ( p < 0.001 ) . The highest gloss value was recorded for Supreme + Pogo ; the lowest was recorded for Z100 + Jiffy . Pogo showed the highest gloss values for all composites . CLINICAL SIGNIFICANCE The nanofill ( Supreme ) and minifill ( Esthet-X ) composites presented a surface roughness comparable to a microfill ( Durafill ) , independent of the polishing system used , and a gloss comparable to a microfill , when polished with a one-step system ( Pogo ) . As compared with the multiple-step systems , the smoothest surfaces and the highest gloss values were achieved using the one-step system ( Pogo ) for all the evaluated composites PURPOSE This prospect i ve long-term clinical trial evaluated and compared the three-year clinical performance of an ormocer , a nanofilled , and a nanoceramic resin composite with that of a microhybrid composite placed in Class I and Class II cavities . METHODS Forty patients , each with four Class I and II restorations under occlusion , were enrolled in this study . A total of 160 restorations were placed , 25 % for each material , as follows : an ormocer-based composite , Admira ; a nanofilled resin composite , Filtek Supreme XT ; a nanoceramic resin composite , Ceram X ; and a microhybrid resin composite , Tetric Ceram . A single operator placed all restorations according to the manufacturers ' instructions . Immediately after placement the restorations were finished/polished . Clinical evaluation was performed at baseline and at yearly intervals after placement by two other independent examiners using modified US Public Health Service ( USPHS ) criteria . The changes in the USPHS parameters during the three-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after three years . Only two ormocer , one nanofilled , and one microhybrid restorations in molars failed because of loss of retention . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p>0.05 ) . CONCLUSIONS The ormocer , nanofilled , and nanoceramic composites provided acceptable clinical performance over a three-year period PURPOSE To evaluate and compare the 2-year clinical performance of an ormocer , a nanohybrid , and a nanofill resin composite with that of a microhybrid composite in restorations of small occlusal cavities made in posterior teeth . MATERIAL S AND METHODS Thirty-five patients , each with 4 occlusal restorations under occlusion , were enrolled in this study . A total of 140 restorations  was placed , 25 % for each material : an ormocer-based composite , Admira ; a nanohybrid resin composite , Tetric EvoCeram ; a nanofill resin composite , Filtek Supreme ; and a microhybrid resin composite , Tetric Ceram . Two operators placed all restorations according to the manufacturers ' instructions . One week after placement , the restorations were finished/polished and patients were advised to return for follow-up at 6 months , 1 year , and 2 years . All patients attended the 2-year visit where the clinical performance of all restorations was evaluated . Two independent examiners made all evaluations according to the USPHS modified Ryge criteria immediately after placement of restorations and at subsequent recall visits . The changes in the USPHS parameters during the 2-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after 2 years . Only one  ormocer and one  microhybrid composite restoration had failed after 2 years . No failure was detected in nanohybrid and nanofill composite restorations . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p > 0.05 ) . CONCLUSION After 2 years , the ormocer , nanohybrid , and nanofill composites showed acceptable clinical performance similar to that of the microhybrid resin composite OBJECTIVES The aim of this in vitro study was to evaluate the effects of different finishing and polishing techniques on the surface roughness and color stability of nanocomposites . METHODS Two  nanohybrid  ( Gr and io , Aelite Aesthetic Enamel ) , two nanofill ( Filtek Supreme XT Dentin and Translucent ) , and a microhybrid ( Filtek Z250 ) composites were used . Two hundred and eighty disc-shaped specimens were cured under a mylar strip . Seven specimens of each resin composite were r and omly assigned to one of the seven polishing systems . A profilometer was used for assessing surface roughness . ΔE was calculated with a colorimeter at baseline and 48 h after storage in a coffee solution . The results were analysed by two-way ANOVA and Tukey 's HSD test ( α=0.05 ) . Regression analysis was used to examine the correlation between surface roughness and color stability ( α=0.01 ) . RESULTS There was no significant difference in R(a ) values between mylar strips and Sof-Lex polishing discs ( p>0.05 ) . The highest ΔE and R(a ) values were obtained from Gr and io ( p<0.05 ) , and Aelite Aesthetic Enamel had the lowest ΔE values ( p<0.05 ) . The Enhance system showed the lowest color differences among all the finishing systems . The highest ΔE values were found in the composite resin groups under mylar strips and finished with diamond burs ( p<0.05 ) . CONCLUSIONS While the Sof-Lex discs provided the lowest surface roughness , the Enhance Polishing system provided the most stain-resistant groups . Gr and io presented the highest surface roughness and staining susceptibility after storage in coffee solution . Aelite Aesthetic Enamel , which did not include TEGDMA in its composition , showed the least discoloration . CLINICAL SIGNIFICANCE The composites with smaller filler size did not necessarily show low surface roughness and discoloration . Staining of composite resins was dependent on monomer structure , as well as surface irregularities This study evaluated the effects of acidic medicines ( Dimetapp ® and Claritin ® ) , under pH-cycling conditions , on the surface degradation of four composite resins ( microhybrid : TPH , Concept , Opallis and Nanofilled : Supreme ) . Thirty disc-shaped specimens ( Ø = 5.0 mm / thickness = 2.0 mm ) of each composite were r and omly assigned to 3 groups ( n = 10 ) : a control and two experimental groups , according to the acidic medicines evaluated . The specimens were finished and polished with aluminum oxide discs , and the surface roughness was measured by using a profilometer . After the specimens were su bmi tted to a pH-cycling regimen and immersion in acidic medicines for 12 days , the surface roughness was measured again . Two specimens for each material and group were analyzed by scanning electron microscopy ( SEM ) before and after pH-cycling . Data were analyzed by the Student's-t test , ANOVA , Duncan 's multiple range test and paired t-test ( α=0.05 ) . Significant increase in roughness was found only for TPH in the control group and TPH and Supreme immersed in Claritin ® ( p<0.05 ) . SEM analyses showed that the 4 composite resins underwent erosion and surface degradation after being subjected to the experimental conditions . In conclusion , although the roughness was slightly affected , the pH-cycling and acidic medicines caused surface degradation of the composite resins evaluated . Titratable acidity seemed to play a more crucial role on surface degradation of composite resins than BACKGROUND Surface quality of dental restorations is one of the important factors that determine the success of the restoration . Unfortunately , exterior discoloration is still a problem for dental resin composites . PURPOSE The purpose of the study was to investigate the influential factors on stain resistance of dental resin composites . MATERIAL S AND METHODS Filtek Supreme ( nanocomposite ) , Filtek A110 ( microfilled composite ) , Filtek Z250 ( microhybrid composite ) , and Filtek P60 ( microhybrid composite ) ( all products from 3 M ESPE , St. Paul , MN , USA ) were tested . Thirty-six specimens per material were prepared and r and omly assigned to 6 groups . The specimens in 5 groups were polished against 1,000- , 1,200- , 1,500- , 2,000- , and 2,500-grit s and paper , respectively . The specimens in a sixth group were polished with 2,500-grit or 1,200-grit s and paper and used as controls . Surface roughness ( Ra ) and gloss of the specimens were measured with a profilometer and a glossmeter , respectively . Specimens were immersed in a coffee solution ( control group in distilled water ) and kept in a 37 degrees C incubator .  Color was measured by a spectrophotometer at baseline , 3 days , 7 days , and 14 days , and color change ( DeltaE*(ab ) ) was calculated . RESULTS Coffee , material , Ra , and the interaction of material x Ra had statistically significant influences on the stain resistance of the dental composites tested . For most material s in coffee solution , time squared and Ra had significant effects on the discoloration . CONCLUSIONS Coffee had a significant influence on discoloration of the dental resin composite material s tested . The different composites behaved differently in coffee solution .  Discoloration increased as Ra increased for the composites tested , except with Filtek A110 . The discoloration process was accelerated with time The purpose of this study was to evaluate the effect of several finishing and polishing procedures on the surface roughness of nanofill and nanohybrid composites and ormocer-based dental restorative material s. The material s included a nanofill composite ( Supreme ) ; a nanohybrid composite ( Gr and io ) ; and an ormocer ( organically modified ceramic ) ( Admira ) . Forty specimens of each material were prepared using a Mylar strip ( polyester strip ) and r and omly divided into four finishing and polishing groups ( n 1/4 10 ) : ( I ) Diamondbur/Super-snapRainbowTechniqueKit(Al2O2-coated , grade d abrasive discs ) ; ( II ) Diamond bur/Astropol and Astrobrush system ( silicone abrasive polishers and brush system ) ; ( III ) Tungsten carbide bur/Super-snap Rainbow Technique Kit ; and ( IV ) Tungsten carbide bur/Astropol and Astro-brush system . The average surface roughness ( Ra ) in micrometers was measured using a “ Mahr Perthometer S4P ” Surface Roughness Tester and the data were compared using ANOVA at P 0.05 . The results of this study indicated that the Mylar strip produced the smoothest surface on all material s and among the finishing-polishing methods the first and the third methods performed significantly smoother surfaces than the second and the fourth methods for the three restoratives . Ormocer ( Admira ) performed the lowest variability in initial surface roughness among the tested material s . This study has shown that Super-snap abrasive discs produced a smoother surface than the Astropol and Astrobrush silicone polishers for composite and ormocer-based restorative material s , but the results would be valid clinical ly for readily accessible and flat surfaces i.e. , not for all areas in the mouth . Therefore silicone polishers are necessary for posterior areas and for concave and convex surfaces Objectives : The aim of this study was to investigate the superficial texture of composite restorations after different bleaching protocol s. Methods : Filtek Supreme ( S ) , Filtek Z350 ( F ) , and Gr and io ( G ) were compared to Opallis ( O ) and Filtek Z250 ( Z ) ( control microhybrid composites ) and to bovine enamel using three different bleaching agents : 35 % hydrogen peroxide Whiteness HP ( WHP ) , 35 % Whiteness HP MAXX ( WMAXX ) and 16 % carbamide peroxide Whiteness St and ard ( WS ) .  Six specimens from each composite were treated using each bleaching agent , according to the manufacturers ’ instructions . Three r and om sites were measured for superficial roughness ( Hommel Tester T 1000 ) weekly for each sample . Data were analyzed for each bleaching system using two-way ANOVA and Bonferroni tests at 5 % significance level . Results : WHP treatment significantly altered the Filtek Supreme composite over time . When WMAXX was used , Gr and io displayed the most significant alterations in surface roughness throughout the evaluation period , which was not observed for the other nanocomposites . Using WS , Filtek Z250 presented significant surface alterations over time , which was not seen in the nanofilled material s. Conclusions : Surface roughness alteration was material and time-dependent . The bleaching gels affected nanofilled and microhybrid composite resins . Enamel was the surface less affected by bleaching The aim of this article was to report the results of an 18-month longitudinal r and omized clinical trial that evaluated the clinical performance of microhybrid , packable and nanofilled resin composite restorations placed in Class I cavities of molar teeth . Three Class I resin composite restorations were placed in each of 35 patients . Each patient received one microhybrid ( ' Point 4 ' ; Kerr , Orange , CA , USA ) , one packable ( ' Packable Premise ' ; Kerr , Orange , CA , USA ) and one nanofilled ( ' Nanofilled Premise ' ; Kerr , Orange , CA , USA ) resin composite restoration .  Clinical evaluation was performed at baseline ( 2 weeks after placement ) , and after 6 , 12 and 18 months after placement using modified Ryge criteria . No patients were lost from the study . At the final appointment ( after 18 months ) , 95.4 % , 93.7 % and 96.2 % respectively of the microhybrid ( ' Point 4 ' ) , packable ( ' Packable Premise ' and nanofilled ( ' Nanofilled Premise ' ) resin composite restorations received Alfa ratings . Regardless of the type of restorative material , no significant changes were observed in the modified Ryge criteria at the baseline and 18-month recalls ( P < or=0.05 ) . Three restorations ( one from each group ) exhibited post-operative sensitivity at the baseline and 6-month appointment . After 18 months , one packable resin composite restoration  failed because of secondary caries , while secondary caries was not detected on any of the other restorations . The clinical performance of microhybrid ( ' Point 4 ' ) , packable ( ' Packable Premise ' ) and nanofilled ( ' Nanofilled Premise ' ) resin composite restorations was acceptable after 18 months . Further studies with longer follow-up periods are recommended to investigate the long-term survival of these restorations OBJECTIVES This in vitro study evaluated the surface roughness and microhardness of nanocomposites that contain nanoparticles and a microhybrid composite finished and polished with two different one-step polishing systems and a conventional multi-step polishing system . METHODS AND MATERIAL S The material s evaluated were Filtek Supreme XT , Gr and io , Ceram X , Aelite Aesthetic Enamel , Tetric EvoCeram and Filtek Z250 .  A total of 240 specimens ( 10-mm in diameter , 2 mm thick ) were fabricated for both tests ( n=120 each test ) in a plexiglass mold covered with a Mylar strip . After polymerization , five specimens per group received no polishing treatment and served as the control for both tests . For each composite group ( n=15 ) , the specimens were r and omly divided into three polishing systems : PoGo , OptraPol and Sof-Lex . All polishing systems were applied according to the manufacturers ' instructions after being ground wet with 1200 grid silicon carbide paper . The surface roughness values were determined using a profilometer . The microhardness measurements were performed using a digital microhardness tester ( load 500 g ; dwell time 15 seconds ) . The data were analyzed using the one-way ANOVA test at a significance level of 0.05 for both tests . Multiple comparison was performed with the Duncan Multiple Range test . RESULTS The smoothest surfaces were achieved under Mylar strips in all composite groups ( p<0.05 ) . There were no statistically significant differences between polishing systems in the Filtek Supreme XT , Ceram X , Aelite Aesthetic Enamel and Gr and io groups for surface roughness ( p>0.05 ) . In the Tetric EvoCeram group , Sof-Lex exhibited the highest roughness values . No statistically significant differences were evaluated between polishing systems ( p>0.05 ) ; whereas , the surfaces under Mylar Strip showed statistically significant lower values than the polished surfaces in terms of microhardness ( p<0.05 ) . CONCLUSION One-step polishing systems may be successfully used for polishing nanocomposites AIM This study evaluated differences in surface roughness of a  microhybrid ( Gradia Direct , GC America ) and a nanofil  ( Filtek Supreme , 3 M ESPE ) composite using four polishing systems : PoGo/Enhance ( DENTSPLY/Caulk ) , Sof-Lex ( 3 M ESPE ) , Astropol ( Ivoclar Vivadent ) , and Optidisc ( KerrHawe ) . METHODS AND MATERIAL S An aluminum mold was used to prepare 2 X 60 composite disks ( 10 mm X 2 mm ) . Composite was packed into the mold , placed between two glass slabs , and polymerized for 40 seconds from the top and bottom surfaces . Specimens were finished to a st and ard rough surface using Moore 's disks with six brushing strokes . Specimens were rinsed and stored in artificial saliva in individual plastic bags at 36 degrees C for 24 hours prior to testing . Specimens were r and omly assigned to one of the four polishing systems and were polished for 30 seconds ( 10 seconds per grit ) with brushing strokes according to the manufacturer 's instructions . Mean surface roughness ( Ra ) was recorded with a surface-analyzer 24 hours after storage in artificial saliva , both before and after polishing . Means were analyzed using two-way and one-way analysis of variance ( ANOVA ) and Tukey multiple comparison tests at p < 0.05 . RESULTS There was a statistically significant difference for baseline measures between Filtek and Gradia ( p=0.0338 ) . For Filtek , Sof-Lex provided a significantly smoother surface ( Ra=0.80 + /- 0.21 ) than Optidisc ( Ra=0.93 + /- 0.28 ) , Astropol ( Ra=1.15 + /- 0.24 ) , and Pogo/Enhance ( Ra=1.39 + /- 0.39 ) . For Gradia , Sof-Lex provided a significantly smoother surface ( Ra=0.47 + /- 0.09 ) and Astropol provided a significantly rougher surface ( Ra=1.39 + /- 0.19 ) than Pogo/Enhance ( Ra=1.11 + /- 0.20 ) and Optidisc ( Ra=1.15 + /- 0.18 ) . There was no significant difference in roughness between composites for individual polishing systems ( p=0.3991 ) . CONCLUSION Filtek specimens were smoother than Gradia specimens after baseline roughening . Sof-Lex provided the smoothest final surface when used with either composite . Astropol provided a rough surface for Gradia specimens AIMS The aims of this study were to evaluate the effect of various finishing and polishing procedures on the surface roughness of six different composite resin material s ( Artemis Enamel , TPH Spectrum , Filtek A-110 , Filtek Supreme Enamel , Solitaire 2 , and Filtek P-60 ) as well as to evaluate the effectiveness of the surface sealant application ( BisCover ) on the surface roughness after finishing and polishing procedures of tested composites . METHODS AND MATERIAL S Specimens ( n=168 ) measuring 5 mm in diameter x 2 mm in thickness were fabricated in a plexiglass well covered with a Mylar strip using six composite resins . A control group of seven specimens of each material received no polishing after being cured under the Mylar strip . Twenty-one specimens for each composite were r and omly divided among three finishing and polishing groups ( n=7 ) . Each group was polished using a different system : Carbide bur/Sof-Lex disc , Carbide bur/Enhance disc with polishing paste , and Carbide bur/Edenta composite finishing kit . The average surface roughness ( Ra , microm ) of the control and treated specimens were measured with the Mitutoyo Surftest-402 Surface Roughness tester . After a surface sealant ( BisCover ) was applied to all treated specimens , according to manufacturer 's instructions , the average roughness ( Ra ) was measured again . Results were statistically analyzed using analysis of variance ( ANOVA ) and the post-hoc Scheffe 's test at a p<0.05 significance level . RESULTS Significant differences were found for the surface roughness ( p<0.05 ) with interaction among composite resins and the finishing systems used ( p<0.05 ) . Enhance/Biscover finishing and polishing procedure surface was not significantly different from the Mylar strip surface groups ( p>0.05 ) . The Mylar strip group was not significantly different from the Sof-Lex/BisCover and Edenta/BisCover groups . The ranking of mean Ra values by material s was as follows : Filtek Supreme Enamel < Filtek A110 < TPH Spectrum < Artemis < Filtek P-60 < Solitaire 2 . The ranking of mean Ra values by polishing systems was as follows : Enhance/BisCover < Mylar Strip < Sof-Lex/BisCover < Edenta/BisCover < Sof-Lex < Enhance < Edenta . CONCLUSION Smoother surfaces were recorded for the Enhance/BisCover and the Mylar strip-formed surface groups . The composite finishing kit Edenta significantly increased the Ra for all tested composites ( p<0.05 ) . But after finishing with Edenta , the use of a surface sealant ( BisCover ) significantly improved the surface smoothness of all tested composites ( p<0.05 ) . Use of BisCover surface sealant on anterior and posterior resin composite restorations after finishing and polishing procedures is recommended PURPOSE This paired-tooth r and omized controlled prospect i ve clinical study compared the clinical performance of three composite resins in Class III cavities after 12 months . MATERIAL S AND METHODS Three material s were evaluated : a microfilled composite resin ( Durafill VS ) , a hybrid composite resin ( Filtek Z250 ) , and a nanofilled composite resin ( Filtek Supreme ) .  Thirty-eight patients having at least three Class III restorations were enrolled in this study . A total of 114 restorations were placed by two calibrated operators according to the manufacturers ' instructions . The adhesive system ( Clearfil SE Bond ) was either applied according to manufacturer 's instructions ( CSE non-etch ) or enamel margins were first etched with phosphoric acid ( CSE etch ) . One week later , the restorations were finished and polished . Two other independent examiners evaluated the restorations at baseline according to the USPHS criteria and USPHS modified criteria for the items color match and surface appearance . The restoration location was taken into consideration during the analysis of each item . A nonparametric analysis of variance ( Friedman test ) and the Wilcoxon test were used for statistical analysis ( alpha = 0.05 ) . RESULTS The restoration location did not influence the evaluated items . Filtek Z250 showed the best color match at baseline , and after 6 and 12 months . No significant difference in the item surface appearance was detected at baseline ; however , after 6 and 12 months , Filtek Z250 showed the worst performance on this item . No significant difference was found between CSE non-etch and CSE etch groups . CONCLUSION The hybrid composite resin showed an excellent immediate and 12-month color match , which was superior to the nanofilled and microfilled composites tested . On the other h and , the nanofilled and microfilled composites showed the best surface appearance after 12 months . Additional etching of the enamel cavity margins did not influence the clinical performance of the adhesive Clearfil SE Bond This r and omized trial evaluated the 12-month clinical performance of nanofill , a nanohybrid , and a microhybrid composite in restorations in occlusal cavities of posterior teeth . This study utilized 41 patients , each of whom had three molars affected by primary caries or the need to replace restorations . All restorations were performed in accordance with the manufacturer 's recommendations and evaluated in accordance with U.S. Public Health Service-modified criteria . Based on the results of the present study , the material investigated demonstrated acceptable clinical performance after 12 months of clinical service . Long-term re-evaluations are necessary for a more detailed analysis of these composites Abstract Objective : NSAIDs , such as diclofenac , are the most commonly used medications to treat osteoarthritis ( OA ) , but they are associated with dose-related adverse events ( AEs ) . Low-dose su bmi cron diclofenac was developed using a new , proprietary dry milling process that creates su bmi cron drug particles ( SoluMatrix Fine Particle Technology ) , enabling effective treatment at lower doses than other commercially available diclofenac drug products . This phase 3 study evaluated the efficacy and safety of low-dose su bmi cron diclofenac 35 mg three times daily ( tid ) and twice daily ( bid ) in patients with OA pain . Research design and methods : This double-blind study enrolled patients ≥40 years of age with clinical ly and radiographically confirmed ( Kellgren – Lawrence grade II – III ) hip or knee OA . Eligible patients were chronic NSAID and /or acetaminophen ( APAP ) users with baseline Western Ontario and McMasters Universities Osteoarthritis Index ( WOMAC ) pain subscale scores ≥40 mm by visual analog scale and an OA flare ( ≥15 mm increase in WOMAC pain subscale score following discontinuation of NSAIDs/APAP at screening ) . Patients were r and omized  to su bmi cron diclofenac 35 mg tid , su bmi cron diclofenac 35 mg bid , or placebo for 12 weeks . Clinical Trials.gov identifier : Clinical Trials.gov identifier : NCT01461369 . Main outcome measures : Efficacy parameters included mean change from baseline in WOMAC pain subscale score at week 12 ( primary efficacy parameter ) and in average total WOMAC score over 12 weeks . Results : Su bmi cron diclofenac 35 mg tid significantly improved WOMAC pain subscale scores from baseline at 12 weeks ( −44.1 ; p = 0.0024 ) compared with placebo ( −32.5 ) . Su bmi cron diclofenac 35 mg bid provided numerical improvement in pain at week 12 that did not reach statistical significance ( −39.0 ; p = 0.0795 ) compared with placebo . Su bmi cron diclofenac 35 mg tid ( −35.9 ; p = 0.0002 ) and 35 mg bid ( −30.3 ; p = 0.0363 ) improved the average total WOMAC score in treated patients over 12 weeks compared with placebo ( −23.2 ) . The most frequent AEs in the su bmi cron diclofenac-treated groups were diarrhea , headache , nausea , and constipation . The inclusion of patients with a documented requirement for analgesic therapy ( OA ‘ flare ’ ) at baseline and the high rates of rescue medication usage in the placebo group may have impacted the study outcome for the su bmi cron diclofenac treatment groups . Conclusions : Low-dose su bmi cron diclofenac is an effective therapeutic option for the treatment of OA pain A new flowable composite , Denfil Flow , has shown an acceptable shear bond strength for bonding orthodontic brackets , when used with an intermediate , unfilled , low-viscosity resin . According to the manufacturer , it also shows a good viscosity for use with no preliminary adhesive . This could reduce the total time of bonding procedure while maintaining clinical ly useful bond strength . The aim of the current research was to assess this property . Eighty extracted human premolars were r and omly divided into four equal groups . Stainless steel brackets were bonded to etched enamel using ( 1 ) Denfil Flow , ( 2 ) a traditional flowable composite ( Dyract Flow ) , ( 3 ) Denfil Flow composite resin and an intermediate liquid resin , and ( 4 ) Transbond XT adhesive . Debonding was performed with a shearing force . The residual adhesive on the enamel surface was evaluated using the adhesive remnant index . The bond strength of Denfil Flow ( 34.8 MPa ) showed no significant difference with the other control groups and was clinical ly acceptable . Denfil Flow and Dyract Flow tended to display cohesive failure within the adhesive . Denfil Flow can be used without liquid resin to reduce the bonding procedure time while maintaining acceptable bond strength . Further studies are required to evaluate the enamel surface of the teeth after the same polishing procedure in the four groups Chemical substances used during biomechanical preparation of root canals can alter the composition of dentin surface and affect the interaction with restorative material s. Objective The purpose of this study was to evaluate the microtensile bond strength ( µTBS ) of a self-etching adhesive system to dentin irrigated with sodium hypochlorite ( NaOCl ) and ethylenediaminetetraacetic acid ( eDTA ) . Material and Methods Thirty human third molars were sectioned 3 mm below the occlusal surface , polished with 600- to 1200-grit silicon carbide papers , and r and omly divided into 3 groups : G1 ( control ) : no irrigating solution ; G2 : 1 % NaOCl ; and G3 : 1 % NaOCl followed by the application of 17 % eDTA . The specimens received the self-etching adhesive system ( XeNO III - Dentsply ) , restored with microhybrid composite resin ( Z250 - 3 M ESPE ) , sectioned and trimmed to create 4 hourglass-shaped slabs of each tooth . The slabs were tested in microtensile strength in a universal testing machine ( emic DL 2000 ) at a crosshead speed of 0.5 mm/min until fracture . The results were analyzed statistically by ANOVA and Newman-Keuls test . Results Mean µTBS values and st and ard deviations in MPa were : G1 = 11.89 ± 4.22 ; G2 = 19.41 ± 5.32 ; G3 = 11.34 ± 4.73 . 1 % NaOCl  increased the adhesive resistance significantly ( p<0.001/ F=22.5763 ) . The application of 1 % NaOCl/17 % eDTA result ed in statistically similar µTBS to the control group . Conclusions None of the irrigants affected negatively the µTBS of XeNO III to dentin . The use of 1 % NaOCl alone result ed in higher bond strength than the other treatments . The combination of 1 % NaOCl and 17 % eDTA produced similar bond strength to that of untreated dentin PURPOSE The aim of this study was to compare the effect of polishing after scaling and root planing on  supragingival plaque , calculus formation , and gingival bleeding . MATERIAL S AND METHODS The study was design ed as a split-mouth r and omised clinical trial . Seventy-six patients were su bmi tted to supragingival scaling on the six m and ibular anterior teeth with manual curettes until a smooth surface was achieved . Subsequently , quadrants were r and omly selected to be polished ( test ) or not ( control ) with a rubber cup and pumice . One , two and three weeks following treatment , a blinded examiner evaluated the visible plaque index , gingival bleeding index and the presence of supragingival calculus on the lingual tooth surfaces . RESULTS The results showed that unpolished surfaces exhibited higher mean percentages of visible plaque in the third week . No statistically significant differences were observed between unpolished and polished sites related to gingival bleeding . Calculus formation was higher on unpolished sites than on polished sites at 2 and 3 weeks . Dental polishing after supragingival scaling contributed to reducing plaque and calculus formation . CONCLUSIONS Polishing exerts an inhibitory effect on plaque and calculus formation The objective of this longitudinal clinical r and omized trial was to evaluate the clinical performance of a nanofilled and a nanohybrid resin composite in Class I occlusal restorations of posterior teeth over the course of 54 months . Forty-one adolescents participated in the study . The teeth were restored with Adper Single Bond 2 ( 3 M ESPE ) and nanofilled ( Filtek Z350 , 3 M ESPE ) , nanohybrid ( Esthet-X , Dentsply ) and microhybrid Filtek Z250 ( 3 M ESPE ) used as a control . After 54 months , the restorations were evaluated in accordance with the modified United States Public Health Service criteria . The McNemar and Friedman tests were used for statistical analysis , at a level of significance of 5 % . Five failed restorations were observed during the follow-up . A change to unacceptable restoration occurred for one Esthet-X , two Filtek Z350 , and two Filtek Z250 restorations , which received the clinical ly unacceptable score , Charlie , for both anatomic form and marginal adaptation . Secondary caries and postoperative sensitivity occurred in one Filtek Z250 and one Filtek Z350 restoration . When the five evaluation periods ( baseline and six , 12 , 30 , and 54 months ) were compared , significant differences were found in the marginal adaptation of Filtek Z250 and Filtek Z350 . Significant differences in the roughness criteria ( p=0.005 ) were also observed when the three composites were compared after 54 months ( Filtek Z350 > Filtek Z250 > Esthet-X ) , always within clinical ly acceptable limits . The material s investigated showed acceptable clinical performance for Class I restoration after 54 months . Long-term reevaluations are necessary for a more detailed analysis of these composites OBJECTIVES the purpose of this study was to determine the mineral loss on surrounding enamel restored with glass ionomer cements ( GIC ) after erosive and cariogenic challenges . METHODS Bovine enamel specimens were r and omly assigned into six groups according to the restorative material : G1 - composite resin ; G2 - high viscous GIC ; G3 - resin-modified glass ionomer with nanoparticles ; G4 - encapsulated resin-modified GIC ; G5 - encapsulated high viscous GIC ; G6 - resin-modified GIC . After restorative procedures , half of specimens in each group were su bmi tted to caries challenge using a pH cycling model for 5 days , and the other half were su bmi tted to erosive challenge in citric acid for 10 min . Before and after the challenges , surface Knoop microhardness assessment s were performed and mineral changes were calculated for adjacent enamel at different distances from restorative margin . RESULTS Data were compared for significant differences using two-way ANOVA and Student-Newman-Keuls tests ( p<0.05 ) . Erosive challenge significantly reduced enamel surface hardness , but no significant difference was observed irrespectively restorative material s ( p>0.05 ) . The cariogenic challenge promoted a higher surface hardness loss for the resin-modified GIC ( G4 ) and only for the High viscous GIC ( G2 ) an increase in surface hardness was observed . For enamel analyses , significant differences were observed with respect to the different material s ( p<0.001 ) and distances ( p=0.023 ) . Specimens restored with the composite resin presented higher mineral loss and specimens restored with the conventional high viscous GIC and the encapsulated resin-modified GIC presented the lowest values for mineral loss . CONCLUSION The GICs exerts protective effect only for cariogenic challenge PURPOSE As clinical diagnosis of secondary caries is the most common reason for restoration replacement , fluoride-releasing restorative material s have been developed to address this problem . The purpose s of this study were to verify demineralization inhibition produced by 5 restorative material s su bmi tted to two methods of in vitro cariogenic challenge and verify whether these methods influence material behavior by means of polarized light microscopy and microhardness . METHODS Class V cavities were prepared on buccal surfaces of 100 extracted primary molars and r and omly restored with 1 of the 4 fluoride-releasing material s , Fuji IX , Vitremer , Dyract , Tetric Ceram , and Filtek Z250 as control material ( N=10 ) . Specimens were su bmi tted to in vitro caries induction by two different methods , acid gel immersion , and pH cycling . Teeth su bmi tted to gel were then sectioned and prepared for polarized light microscopy in water , while teeth cycled were prepared for microhardness evaluation . RESULTS Polarized light microscopy : Means of demineralization areas ( microm(2 ) ) differed significantly , depending on the restorative material . Tukey 's test revealed the smallest demineralization areas adjacent to Fuji IX and Vitremer restorations , with no difference between them ( P>.05 ) . The greatest demineralization area mean values were verified using Dyract and Filtek Z250 , without differences between them ( P>.05 ) . Microhardness : Glass ionomer cements ( GICs ) performed better on the area of great cariogenic challenge , closer to the surface , than other material s indicating minor mineral loss during pH cycling . The compomer Dyract presented similar performance to GICs and composite resin Tetric Ceram , but it was better than Filtek Z250 . CONCLUSION The experimental model of caries lesion induction may influence material performance . GICs , however , are superior in preventing in vitro demineralization independently of the method OBJECTIVE The aim of this in vitro study was to evaluate the interaction between two sources of fluoride ( restorative systems and dentifrices ) in inhibiting artificial root caries development . METHODS One hundred and eighty tooth segments were embedded in polyester resin , and s and ed flat . Cylindrical cavities 1.0mm-deep and 1.5mm-diameter were prepared in root dentin and r and omly restored by fluoride-containing restorative systems : Ketac-fil/Espe ( Ke ) , Fuji II LC/GC Corp ( Fj ) , F2000/3 M ( F2 ) , Surefil/Dentsply ( Su ) or a control : Filtek Z250/3 M ( Z2 ) . Ten experimental groups were made to test the association among the five restorative systems and two dentifrices : with F(- ) ( Sensodyne Baking Soda ) or without F(- ) ( Sensodyne Original ) ( n=18 ) . After surface polishing , a 1mm-wide margin around the restorations was demarcated and initial dentin surface Knoop microhardness values ( KHN(i ) ) were obtained . The specimens were su bmi tted to a pH-cycling model , and to applications of slurries of dentifrice . Afterwards the final dentin surface Knoop microhardness values ( KHN(f ) ) were measured . RESULTS The differences between KHN(i ) and KHN(f ) , and the covariate KHN(i ) were considered by the ANCOVA and Tukey 's test ( alpha=0.05 ) . The interaction between restorative system and dentifrice was statistically significant ( p=0.0026 ) . All restorative systems provided some protection against artificial caries challenge when associated with the fluoride-containing dentifrice treatment . The means ( st and ard deviation ) of reductions in Knoop hardness values for systems associated with the fluoride-containing dentifrice were : Ke : 40.0(1.02)(a ) , Fj : 41.9(1.02)(b ) , F2 : 43.3(1.04)(c ) , Su : 43.5(1.00)(c ) , Z2 : 44.0(1.02)(c ) ; and with the non-fluoride-containing dentifrice were : Ke : 42.9(1.02)(a ) , Fj : 44.7(1.01)(b ) , F2 : 45.2(1.09)(bc ) , Su : 46.0(0.99)(c ) , Z2 : 46.6(0.99)(c ) ( statistical differences were expressed by different letters ) . CONCLUSION The cariostatic effect shown by the fluoride-containing dentifrice could enhance that shown by Ketac-fil and Fuji II LC , and could mask that shown by F2000
There is no in vitro evidence to support the choice for nanofill or su bmi cron composites over traditional microhybrids based on better surface smoothness and /or gloss , or based upon maintenance of those superficial characteristics after surface challenges
OBJECTIVES Despite nanofill and su bmi cron composites ' aim to provide high initial polishing combined with superior smoothness and gloss retention , the question still remains whether clinicians should consider using these new material s over traditional microhybrids .
The aim of this paper was to systematic ally review the literature on how nanofills and su bmi crons react to polishing procedures and surface challenges in vitro compared with microhybrids .
The paper has also given an overview of the compositional characteristics of all resin composites and polishing systems whose performance was presented herein .