Occlusal loading and cross-linking effects on dentin collagen degradation in physiological conditions. UVA-activated riboflavin improves the strength of human dentin. Influence of EDC on Dentin-Resin Shear Bond Strength and Demineralized Dentin Thermal Properties Treating dentin hypersensitivity: therapeutic choices made by dentists of the northwest PRECEDENT network. Health-related quality of life in cancer patients treated with PD-(L)1 inhibitors: a systematic review Clinical evaluation of low-power laser and a desensitizing agent on dentin hypersensitivity A practice-based randomised controlled trial of the efficacy of three interventions to reduce dentinal hypersensitivity. Comparative study in desensitizing efficacy using the GaAlAs laser and dentin bonding agent. Thirteen-year wear rate comparison of highly crosslinked and conventional polyethylene in total hip arthroplasty: long-term follow-up of a prospective randomized controlled trial Dentin hypersensitivity after treatment with desensitizing agents: a randomized, double-blind, split-mouth clinical trial. Comparative evaluation of the effects of Nd:YAG laser and a desensitizer agent on the treatment of dentin hypersensitivity: a clinical study. Comparison of two different forms of varnishes in the treatment of dentine hypersensitivity: a subject-blind randomised clinical study. Psychiatric advance directives: qualitative study of informed deliberations by mental health service users. Dentin hypersensitivity: a randomized clinical comparison of three different agents in a short-term treatment period. Effect of irrigation solutions on dentin bonding agents and restorative shear bond strength. Using systematic reviews to inform NIHR HTA trial planning and design: a retrospective cohort In vitro remineralization of enamel subsurface lesions and assessment of dentine tubule occlusion from NaF dentifrices with and without calcium. The effect of smear layer removal on marginal contraction gaps. Adhesive performance of dentin bonding agents applied in vivo and in vitro. Effect of intrapulpal pressure and dentin depth. A randomized prospective clinical evaluation of two desensitizing agents on cervical dentine sensitivity. A pilot study. Comparative evaluation of calcium silicate-based dentin substitute (Biodentine®) and calcium hydroxide (pulpdent) in the formation of reactive dentin bridge in regenerative pulpotomy of vital primary teeth: Triple blind, randomized clinical trial Bond strengths of two adhesive systems to dentin contaminated with a hemostatic agent. Desensitizing treatments for dentin hypersensitivity: a randomized, split-mouth clinical trial.
OBJECTIVE This study evaluated the ability of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide hydrochloride ( EDC ) to improve the stability of demineralized dentin collagen matrices when subjected to mechanical cycling by means of Chewing Simulation ( CS ) . METHODS Demineralized dentin disks were r and omly assigned to four groups ( N=4 ) : ( 1 ) immersion in artificial saliva at 37 ° C for 30 days ; ( 2 ) pre-treatment with 0.5 M EDC for 60 s , then stored as in Group 1 ; ( 3 ) CS challenge ( 50 N occlusal load , 30 s occlusal time plus 30 s with no load , for 30 days ) ; ( 4 ) pre-treatment with 0.5 M EDC as in Group 2 and CS challenge as in Group 3 . Collagen degradation was evaluated by sampling storage media for ICTP and CTX telopeptides . RESULTS EDC treated specimens showed no significant telopeptides release , irrespective of the aging method . Cyclic stressing of EDC-untreated specimens caused significantly higher ICTP release at day 1 , compared to static storage , while by days 3 and 4 , the ICTP release in the cyclic group fell significantly below the static group , and then remained undetectable from 5 to 30 days . CTX release in the cyclic groups , on EDC-untreated control specimens was always lower than in the static group in days 1 - 4 , and then fell to undetectable for 30 days . SIGNIFICANCE This study showed that chewing stresses applied to control untreated demineralized dentin increased degradation of collagen in terms of CTX release , while collagen crosslinking agents may prevent dentin collagen degradation , irrespective of simulated occlusal function The aim of this study was to evaluate the effects of UVA-activated riboflavin ( UVA-RF ) on the mechanical properties of non-demineralized human dentin . Dentin specimens obtained from 20 teeth were r and omly divided into the following four groups : group 1 ( control ) : no treatment , group 2 ( low UVA-RF ) : specimens were exposed to UVA-RF for 10 min , group 3 ( medium UVA-RF ) : specimens were exposed to UVA-RF for 30 min , and group 4 ( high UVA-RF ) : specimens were exposed to UVA-RF for 60 min . Three-point flexural test and Raman spectroscopic analyses were performed . The mean flexural strengths ( MPa ) were 129.96 , 128.96 , 144.21 , and 147.54 , and the mean elastic modulus ( GPa ) were 8.59 , 8.38 , 10.21 , and 9.87 for groups 1 to 4 , respectively . Raman spectra showed chemical modifications of dental collagen under medium and high UVA-RF treatment . We conclude that medium and high UVA-RF increases the strength of non-demineralized human dentin  by collagen crosslinking This study aim ed to evaluate the bonding strength and thermal properties of demineralized dentin with and without EDC treatment .  Sound human molars were r and omly divided into seven treatment groups ( n = 20 ) : control , 80 % ethanol , and five EDC ethanol solutions ( 0.01–1.0 M ) . In each group , 16 sample s were used for bond strength assessment and 4 sample s were used for scanning electron microscopy ( SEM ) analysis . A further 70 intact molars were used to obtain a fine demineralized dentin powder , treated with the same solutions and were evaluated the crosslink degree by ninhydrin test and denaturation temperature ( Td ) by differential scanning calorimetry . EDC-treated specimens ( < 1.0 M ) had a higher bond strength , especially 0.3 and 0.5 M group , than the control counterpart . There was a significant drop in bond strength of 1.0 M EDC group . SEM revealed a homogeneous and regular interface under all treatments . EDC treatment significantly increased the demineralized dentin cross-link degree and Td compared with the control and ethanol treatments . The 0.3 and 0.5 M treatments showed the highest cross-link degree and Td . In terms of mechnical and theramal properties consideration , 0.3 and 0.5 M EDC solutions may be favorable for when applied with etch- and -rinse adhesives , but it is still needed further long-term study 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 ABSTRACT Introduction : A systematic review was performed to explore the health-related quality of life ( HRQoL ) outcomes among cancer patients receiving PD-(L)1 inhibitors compared to those receiving traditional cytotoxic therapy .  Areas covered : Citations from PubMed and the American Society of Clinical Oncology meeting library were examined . Cross-references from original studies and review articles were also review ed . Eligible trials included r and omized controlled trials of cancer patients treated with one of the PD-(L)1 inhibitors and reporting HRQoL outcomes .  A total of 11 studies were included in the current review . PD-(L)1 inhibitors were associated with a consistent prolongation of the time to symptomatic deterioration . This was shown with the three agents ( nivolumab , pembrolizumab , and atezolizumab ) as well as across a variety of solid tumors ( lung cancer , melanoma , head and neck cancer and urothelial cancer ) . Moreover , PD-(L)1 inhibitor therapy was associated with better symptomatic control at different follow-up points . This was observed regardless of the agent used of the solid tumor treated . Expert commentary : Across a variety of solid tumor indications as well as a variety of PD-(L)1 inhibitors , the use of PD-(L)1 inhibitors is associated with an improvement in the quality of life . The utility of patient-reported outcomes in predicting clinical benefit from these agents needs to be explored further The aim of this r and omized , longitudinal clinical study was to evaluate different protocol s for dentin hypersensitivity treatment with low-power laser at different dosages , desensitizing agent , and associations , for a period of 6 months . After analysis of the inclusion and exclusion criteria of volunteer participants , those who present pain result ing from non-carious cervical lesions were selected . Twenty-seven patients participated in the study , and 55 lesions were recorded . The lesions were divided into five groups ( n = 11 ) , treated , and evaluated : G1 : Gluma Desensitizer ( Heraeus ) ; G2 : low-power laser ( Photon Lase , DMC ) at low dose ( three vestibular points and one apical point of irradiation : 30 mW , 10 J/cm2 , 9 s per point with wavelength of 810 nm ) , three sessions were performed with an interval of 72 h between them ; G3 : low-power laser at high dose ( application at one cervical and one apical point : 100 mW , 90 J/cm2 , 11 s per point with wavelength of 810 nm ) , three sessions were performed with an interval of 72 h between irradiations ; G4 : low-power laser at low dose + Gluma Desensitizer ; and G5 : low-power laser at high dose + Gluma Desensitizer , the level of sensitivity of each volunteer was evaluated with a visual analog scale of pain ( VAS ) with the use of air from a triple syringe and exploration with a probe after time intervals of 5 min , 1 week , and 1 , 3 , and 6 months after treatment . Data were collected and subjected to statistical analysis . Kolmogorov – Smirnov test was used to verify the distribution of the data , and nonparametric Kruskal – Wallis and Friedman tests were performed for comparison among the experimental groups and time intervals studied , respectively . Statistically significant differences between the studied time intervals ( p < 0.05 ) were detected . From the difference in pain , it was observed that for both stimuli , the protocol with the Gluma desensitizing agent presented immediate effects of pain reduction . For low-level lasers , it was observed that there were distinct effects for the different doses ; however , both were efficient in reducing pain up to the 6 months of clinical follow-up . Therefore , it could be concluded that all the desensitizing protocol s were effective in reducing dentin hypersensitivity , but with different effects . The combination of protocol s is an interesting alternative in the treatment of cervical dentin hypersensitivity OBJECTIVES The aim of this study was to evaluate the efficacy of three different interventions ( non-desensitising toothpaste , desensitising toothpaste and professionally applied dentine bonding agent ) in reducing dentinal hypersensitivity  over a 2-week , 3-month and 6-month-period in a dental practice setting . METHODS This was a r and omised controlled , single-blind ; parallel-group trial conducted in general dental practice by a single general dental practitioner . Seventy-five subjects were r and omly allocated to three groups ; non-desensitising toothpaste ( NDT ) , desensitising toothpaste ( DT ) and professionally applied desensitising agent ( DA ) . Dentinal hypersensitivity was measured using a Visual Analogue Scale ( VAS ) to record the response from a st and ardised short blast of air from a triple syringe . Dentinal hypersensitivity was recorded at baseline , two weeks , three months and six months for all groups . RESULTS Dentinal hypersensitivity reduced significantly ( p<0.0001 ) in both groups DT and DA , in addition the reduction in sensitivity was sustained and continued to improve over a 6-month-period . The greatest reduction in dentinal hypersensitivity was recorded in group DA . CONCLUSIONS The results from this study suggest that application of dentine bonding agents , to teeth diagnosed with dentine hypersensitivity provides the greatest improvement in dentine hypersensitivity at 2 weeks and 6 months . This reduction in dentine hypersensitivity is greater than that achieved by the desensitising toothpaste tested and a non-desensitising toothpaste OBJECTIVE To compare the clinical efficacy of the GaAlAs laser and dentin bonding agent in treating dentin hypersensitivity . METHODS One hundred and forty teeth from 70 patients diagnosed with dentin hypersensitivity , were divided into two groups : In group I , teeth were irradiated with 30 mW GaAlAs laser for 1 min and in group II , teeth were applied with dentin bonding agent . Sensitivity was assessed by tactile and thermal tests , measured with the criteria proposed by Uchida at baseline and after treatment ; immediately , at 15 and at 30 days . RESULTS The reduction of dentin hypersensitivity was observed in both treatments using the GaAlAs laser and dentin bonding agent . However , a greater reduction was observed over time up to day 15 and no significant change was observed between days 15 and 30 . Statistically significant differences in the level of dentin hypersensitivity between bonding agent and the GaAlAs laser were found at each observation period ( p < 0.05 ) . CONCLUSION The GaAlAs laser had less desensitizing efficacy compared with dentin bonding agent . However , the desensitizing effect of the GaAlAs laser still could be considered an effective therapy for treating dentin hypersensitivity Background The purpose of this study was to report the radiographic wear rates from a previous r and omized controlled trial of first-generation highly crosslinked versus conventional polyethylene in  total hip arthroplasty ( THA ) at a minimum of 13 years ’ follow-up . Methods Patients returned for radiographic imaging and radiostereometric analysis ( RSA ) .  Radiographs were review ed for the presence of osteolysis or component loosening . Femoral head penetration ( which includes both wear and creep ) was measured using RSA . We compared Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) , 12-Item Short Form Health Survey ( SF-12 ) and Harris Hip Scores ( HHS ) with preoperative values . Results There was 1 revision in each group . There was no difference in WOMAC , SF-12 , or HHS outcome scores  between the highly crosslinked and conventional polyethylene groups ( all p ≥ 0.13 ) . Wear rate was lower with crosslinked polyethylene than conventional polyethylene ( 0.04 ± 0.02 mm/year v. 0.08 ± 0.03 mm/year , p = 0.007 ) . Conclusion First-generation crosslinked polyethylene demonstrates greater wear resistance  than conventional polyethylene after 13 years of implantation . Crosslinked polyethylene continues to outperform conventional polyethylene into the second decade of implantation The aim of this study was to evaluate the efficacy of two desensitizing agents in the reduction of dentin hypersensitivity in a r and omized , double-blind , split-mouth clinical trial . Seventy-seven teeth from 13 patients that presented some degree of sensitivity to probing and /or air stimulation were treated with one of the following desensitizing agents : Oxa-Gel ( G1 ) , Sensi Kill ( G2 ) and placebo gel ( G3 - control ) . According to paired t-test , all treatments , even the placebo gel , were capable of reducing sensitivity scores for both stimuli . Analysis of data by ANOVA and Tukey 's test ( ? = 0.05 ) showed that the sensitivity scores were significantly lower only for Sensi Kill in comparison to the other products ( Oxa-Gel and placebo ) , when air stimulus was applied . It may be concluded that treatment with Sensi Kill presented a slightly better performance in reducing dentin hypersensitivity when compared to the other desensitizing agent UNLABELLED Abstract Objective : The aim of this r and omized longitudinal clinical study was to assess different treatment protocol s for dentin hypersensitivity with high-power laser , desensitizing agent , and its association between high-power laser and desensitizing agent , for a period of 6 months . BACKGROUND DATA The literature shows a lack of treatment for dentin hypersensitivity , and lasers are contemporary alternatives . METHODS After inclusion and exclusion analysis , volunteers were selected . The lesions were divided into three groups ( n=10 ) : G1 , Gluma Desensitizer ( Heraeus Kulzer ) ; G2 , Nd : YAG Laser ( Power Laser ( ™ ) ST6 , Lares Research ® ) contact mode , laser protocol of 1.5 W , 10 Hz , and 100 mJ,≈85 J/cm(2 ) , four irradiations performed , each for 15 sec , in mesiodistal and occluso-apical directions , totaling 60 sec of irradiation with intervals of 10 sec between them ; G3 , Nd : YAG Laser+Gluma Desensitizer . The level of sensitivity to pain of each volunteer was analyzed by visual analog scale ( VAS ) using cold air stimuli and exploratory probe 5 min , 1 week , and 1 , 3 , and 6 months after treatment . Data were collected and subjected to statistical analysis that detected statistically significant differences between the various studied time intervals of treatments ( p>0.05 ) . RESULTS For the air stimulus , no significant differences were found for each time interval . For the long-term evaluation , all groups showed statistical differences ( p>0.05 ) , indicating that for G2 and G3 , this difference was statistically significant from the first time of evaluation ( post 1 ) , whereas in G1 , the difference was significant from the post 2 evaluation ( 1 week ) . Comparison among groups using the probe stimulation showed significant differences in pain ( p<0.001 ) . Only in G1 and G3 did this difference become significant from post 01 . CONCLUSIONS All protocol s were effective in reducing dentinal hypersensitivity after 6 months of treatment ; however , the association of Nd : YAG and Gluma Desensitizer is an effective treatment strategy that has immediate and long-lasting effects PURPOSE Dentine hypersensitivity is one of the most frequently recorded complaints of dental discomfort . Current evidence implicates patent dentinal tubules in hypersensitive dentine , and it follows that one effective way to reduce dentine sensitivity is to occlude the dentinal tubules . The purpose of this study was to compare the efficacy of two different desensitising agents , Cervitec varnish and Gluma varnish . MATERIAL S AND METHODS Two hundred fifty patients self-reporting dentine hypersensitivity completed the paired split mouth r and omised , subject-blind study . Each participant had a minimum of two sensitive teeth in at least two different quadrants and displaying a response of ≥3 cm to an evaporative stimulus . The hypersensitivity levels were measured with a tactile  stimulus ( scratchometer )  ,  thermal stimulus ( cold water test ) , and an evaporative stimulus ( air blast test ) using a visual analogue scale . The teeth were evaluated immediately after treatment , and at 4 and 12 weeks after application of the chlorhexidine-containing varnish Cervitec and the glutaraldehyde-containing varnish , Gluma Desensitizer . RESULTS Statistical analysis indicated that both the desensitising varnishes were effective in alleviating dentine hypersensitivity at all time intervals compared to baseline . There was a highly statistically significantly greater reduction in dentine hypersensitivity to evaporative stimulus , cold stimulus , and tactile stimulus after application of Cervitec than after Gluma Desensitizer ( P < 0.001 ) . CONCLUSION Both the varnishes have a therapeutic potential to alleviate dentine hypersensitivity at all time intervals compared to baseline . However , Cervitec varnish is more efficacious in reducing dentine hypersensitivity  than Gluma varnish at both 4 weeks and 12 weeks post-treatment BACKGROUND Established legal m and ates and high expectations for psychiatric advance directives are not matched by empirical evidence documenting their actual implementation . AIMS To explore the interests , concerns and planning activities of informed mental health service users contemplating such directives . METHOD St and ard qualitative research techniques were used : field observations , interviews , focus groups , archival research and key informant interviews ;  33 persons participated in the interviews and focus groups .  Transcripts were coded and analysed for thematic content , and results were member-checked . RESULTS Training set in motion labour-intensive projects : conceptualising how a psychiatric advance directive would work in one 's life , mobilising re sources , review ing past experiences and assessing risks . Especially meaningful was the prospect of being treated as a responsible agent in future interactions with the mental health system . CONCLUSIONS Advance directives are best thought of as complex planning tools for future psychiatric crisis management , rather than focal interventions to enhance compliance . Research is needed to explore the institutional response to this prospect i ve decision-sharing initiative OBJECTIVE Dentin hypersensitivity , or what patients may describe as " sensitive teeth , " is defined as a short , sharp pain arising from exposed dentin in response to thermal , evaporative , tactile , electrical , osmotic or chemical stimuli . It is widely accepted that dentin hypersensitivity is an uncomfortable condition that also affects function and quality of life . This study determines the differences in efficiency of three desensitizing products when compared with a placebo . METHODS A r and omized controlled clinical trial was conducted to compare three different  professional dentin desensitizer agents in 52 patients . The age and sex of the patients was recorded .  Gluma Desensitizer ( Heraeus Kulzer ) , UltraEZ ( Ultradent Products , Inc ) and Duraphat ( Colgate Oral Pharmaceuticals , Inc , New York , NY , USA ) were used as desensitizer agents and distilled water was used as the placebo . The baseline measurement of the dentin hypersensitivity was made by using a visual analog scale ( VAS ) . Twenty-four hours and seven days after application of the desensitizer agents and placebo , a new VAS analysis was conducted for patients ' sensitivity level . The desensitizer agents were compared in terms of mean values , and ANOVA was used for testing differences among the groups ( p<0.05 ) . RESULTS The results showed that the mean pain scores of the placebo group were significantly higher than that of the study groups ( p<0.05 ) . The VAS analysis revealed a significant decrease in dentin hypersensitivity over time with the use of agents ( p<0.05 ) . No statistically significant difference was found among the three desensitizing agents ( p>0.05 ) . CONCLUSIONS These three desensitizing agents , which contain different active ingredients , were effective in relieving dentin hypersensitivity . However , no superiority was found in dentin sensitivity relief among the agents 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 Background Chalmers and Glasziou ’s paper published in 2014 recommends research funding bodies should m and ate that proposals for additional primary research are built on systematic review s of existing evidence showing what is already known . Jones et al. identified 11 ( 23 % ) of 48 trials funded during 2006–8 by the National Institute for Health Research Health Technology Assessment ( NIHR HTA ) Programme did not reference a systematic review . This study did not explore the reasons for trials not referencing a systematic review or consider trials using any other evidence in the absence of a systematic review . Referencing a systematic review may not be possible in certain circumstances , for instance if the systematic review does not address the question being proposed in the trial . The current study extended Jones ’ study by exploring the reasons for why trials did not reference a systematic review and included a more recent cohort of trials funded in 2013 to determine if there were any changes in the referencing or use of systematic review s. Methods Two cohorts of NIHR HTA r and omised controlled trials were included . Cohort I included the same trials as Jones et al. ( with the exception of one trial which was discontinued ) . Cohort II included NIHR HTA trials funded in 2013 . Data extraction was undertaken independently by two review ers using full applications and trial protocol s. Descriptive statistics was used and no formal statistical analyses were conducted . Results Five ( 11 % ) trials of the 47 funded during 2006–2008 did not reference a systematic review . These 5 trials had warranted reasons for not referencing systematic review s. All trials from Cohort II referenced a systematic review . A quarter of all those trials with a preceding systematic review used a different primary outcome than those stated in the review s. Conclusions The NIHR requires that proposals for new primary research are justified by existing evidence and the findings of this study confirm the adherence to this requirement with a high rate of applications using systematic review UNLABELLED Currently , fluoride is the most effective preventive treatment for remineralization of incipient carious lesions and dentinal hypersensitivity due to wasting disorders . The products containing fluoride , calcium and phosphate are also cl aim to remineralize early , non-cavitated enamel demineralization . The aim of this study was to investigate and compare the efficacy of two such products , Tooth Mousse and Clinpro tooth crème on remineralization and tubule occluding ability with 5000ppm fluoride-containing toothpaste . MATERIAL S AND METHODS Thirty third molar teeth were placed in  demineralizing solution  for 5 days such that only a window of 1 mm x 5 mm was exposed to the environment to produce artificial caries-like lesions and r and omly assigned to three groups : Group I , 5000ppm sodium fluoride ; Group II , GC MI paste plus and Group III , Clinpro tooth crème . Axial longitudinal sections of 140 - 160 μm of each tooth which included the artificial carious lesion taken and were photographed under polarized light microscope . The demineralized areas were then quantified with a computerized imaging system . The experimental material s were applied onto the tooth sections as a topical coating and subjected to pH-cycling for 28 days . To evaluate tubule occlusion ability , thirty dentin specimens of 2 mm thickness were obtained from cervical third of sound third molars . Specimens were ultrasonicated and etched with 6 % citric acid for 2 minutes to simulate the hypersensitive dentin . Specimens were r and omly divided into above mentioned three groups ( n=10 ) . The test agents were brushed over the specimens with an electric toothbrush , prepared and observed under Scanning Electron Microscope for calculation of the percentage of occluded tubules . RESULTS Group I showed a significantly greater percentage of remineralization than Group III and Group II . Comparison of the remineralization potential between group II and group III were not significant . In case of dentine hypersensitivity , Group I and group III showed greater percentage of tubule occlusion ability than Group II . Intergroup comparison of the tubule occlusion potential of group I and group III were not significant . INTERPRETATION AND CONCLUSION Within the limitations of our study , sodium fluoride showed relatively greatest remineralizing and dentinal tubule occlusion property when compared with GC MI paste plus and Clinpro tooth crème 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 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 prospect i ve clinical pilot study was to evaluate the pain alleviation effectiveness of two desensitizing agents ( VivaSens and Seal&Protect ) on 30 patients suffering from cervical dentine sensitivity ( CDS ) over a six month period . Analysis of possible differences in pain alleviation effect between the agents and over time was performed . Further , the experienced pain was registered in a question naire regarding to what extent the treatment improved oral health/life quality among the patients . The patients ( 23 female , 7 male ) were r and omly divided into two groups . Each group was treated with one of the two desensitizing agents .  Sensitivity measurements were recorded before treatment ( baseline ) and after treatment at time points of one week and six months . The patients were asked to rate the sensitivity experienced in the area during air stimulation by marking on a Visual Analogue Scale ( VAS ) . At six months , 27 patients ( 90 % ) had completed the clinical trial . The results showed that a significant reduction of CDS was achieved by using VivaSens or Seal&Protect after both one week and six months . However , there were no differences found on treatment effects between the two desensitizing agents . The results from the question naire showed that the patients experienced improved oral health/life quality when comparing the status before and after treatment ( 0.000 < or = p < or = 0.0021 ) and there were no statistically significant difference in treatment effects between the products . In conclusion , both desensitizing agents were effective in relieving cervical dentin hypersensitivity during the time course of the study as evaluated both by air stimulation and a question naire related to oral health/ quality of life status Background : Considering the biological concerns of calcium hydroxide ( CH ) as a pulpotomy agent , an alternative silicate based dentin substitute i.e. Biodentine ( Ca3SiO5 ) was evaluated clinical ly and radiographically . Aims : To evaluate the effectiveness of dentin substitute ( Biodentine ) in regenerative pulpotomy of vital primary teeth that would giv a biological base to its use in forming reactive dentin bridge and overcoming the drawbacks of calcium hydroxide . Material and Methods : R and omised clinical trial on 40 bilateral carious primary molars in 20 participant children ( aged 5 - 10 years ) was carried out by same operator using Ca3SiO5(group-1 ) and CH ( group-2 ) as vital pulpotomy agents . Blinded clinical and radiographic outcomes were observed at 3 , 6 and 12 months interval . Results : Clinical outcomes of both protocol s were analysed using Pearson 's chi-square test applied at P < 0.05 . Descriptive statistics were expressed as mean increase in dentin bridge formation in mms from two reference points in st and ardized radiographs using paired ' t'- test at baseline and 12 months and found to be statistically significant ( P < 0.05 ) in group-1 when compared with group-2 . Conclusion : Group-1 revealed statistically favourable regenerative potential along with clinical success compared to group 2 thereby sharing both indications and mode of action with CH , but without its drawbacks of physical and clinical properties This study evaluated the bond strength of a total-etch and a self-etch adhesive to dentin contaminated with a hemostatic agent containing aluminum chloride ( AlCl3 ) . Eighteen occlusal dentin discs were prepared from human molars . Each disc was ground and sectioned into two halves , one for normal dentin and the other for contaminated dentin . The specimens of both normal and contaminated dentin were r and omly divided into three groups and treated with the following material s : ( 1 ) Excite ( EX ) ; ( 2 ) Clearfil SE Bond with 20-second primer application time ( CB 20 ) and ( 3 ) Clearfil SE Bond with 40-second primer application time ( CB 40 ) . The microshear bond strength specimens were prepared using the resin composite Clearfil APX . The bond strengths were evaluated on a universal testing machine . Statistical analysis was performed at alpha = 0.05 . The surface micromorphology and aluminum content of the different dentin conditions were also examined . In EX , no significant difference was found between the bond strengths of normal dentin and contaminated dentin . The bond strength of CB20 to contaminated dentin was significantly lower than that to normal dentin . The extension of primer application time from 20 to 40 seconds significantly increased the bond strength of CB to contaminated dentin The aim of this r and omized , controlled , split-mouth , clinical study was to differentiate and clinical ly qualify the effectiveness of different desensitizing agents in the treatment of painful symptoms caused by cervical dentin hypersensitivity ( CDH ) . Two hundred- and -fifty-two teeth of 42 patients were distributed into seven groups ( n = 36 ) : G1 - placebo ; G2 , G3 , G4 and G6 - fluoride varnishes ; G5 - sodium fluoride ; G7 - potassium oxalate . Three applications were made one week apart . A three-score system ( Alfa = 0 , Bravo = 2 , and Charlie = 3 , respectively for no sensitivity , slight sensitivity and high sensitivity ) was used to assess CDH after each application and after 30 days . The data were subjected to statistical analysis using the Kruskall-Wallis and Dun tests . After the second week , statistically significant differences were observed for all material s compared with the baseline . After 30 days , Group G7 had presented a significant gradual reduction along all the evaluated time intervals . It was concluded that all the desensitizing agents were capable of reducing dentin hypersensitivity , with the exception of the placebo and the sodium fluoride groups
Both synthetic and naturally derived crosslinkers have been found to exhibit significant effects in biomodification of dentine via their multiple interactions with the dentine matrix .
A stable matrix network or a durable hybrid layer in dentine bonding could be achieved , where the dentine collagen fibrils show improved biochemical and biomechanical properties and enzymatic biodegradation is reduced .
This aim of this review is to explore the current research related to  crosslinking agents used on dentine .