Şişmanoğlu S, et al. J Adv Prosthodont. 2020 Feb;12(1):22-32. https://doi.org/10.4047/jap.2020.12.1.22

Objective: This study aimed to assess the remineralization efficacy of casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP), silver diamine fluoride/potassium iodide (SDF/KI), and sodium fluoride with functionalized tricalcium phosphate (NaF/fTCP) on artificial early enamel lesion using laser fluorescence and micro‐CT analysis.Methodology: On extracted impacted third molars, artificial enamel lesions were prepared. Twenty‐eight specimens were randomly assigned to four groups (n = 7 per group): a control group (artificial saliva), CPP‐ACP (GC Tooth Mousse), SDF/KI (Riva Star), and NaF/fTCP (Clinpro White varnish). Following the manufacturer's instructions, the remineralization agents were applied to demineralized surfaces. Laser fluorescence and micro‐CT were used to evaluate the remineralization efficacy of the agents and analyzes were performed during four stages: before demineralization, after demineralization, 1st day of remineralization and 30th day of remineralization. Shapiro–Wilk test, repeated measures two‐way ANOVA, and Spearman correlation tests were used for statistical analysis. A significant level of p < 0.05 was established.Results: SDF/KI significantly reduced the lesion area and lesion volume on the demineralized enamel surface after 30 days of remineralization. In the T3 period, SDF/KI increased the mineral density statistically significantly compared to the T1 period. The laser fluorescence values for all three remineralizing agents exhibited a linear decrease. A significant correlation between the fluorescence values and the mineral density was found (p = 0.01).Conclusion: All three investigated agents were showed positive remineralization efficacy on artificial enamel lesion. However, SDF/KI, containing silver diamine fluoride and potassium iodide exhibited superior than other agents in promoting remineralization.Clinical Significance: Although all three remineralization agents showed positive remineralization efficacy on artificial enamel lesions, SDF had higher remineralization performance over the other two agents. SDF has potential to prevent progression of demineralization in treating children with high caries risk in the long‐term.

The purpose of this in vitro study was to evaluate the influence of different surface treatments and aging on the microtensile bond strength (μTBS) of bulk-fill composite resins. Bulk-fill composites (Filtek One; 3M ESPE) randomly received five different surface treatments: (1) no treatment, control, (2) 37% phosphoric acid etching (PA), (3) 9% hydrofluoric acid etching (HF), (4) air-borne particle abrasion with 50-μm alumina particles (Al₂O₃), (5) tribochemical silica coating (CoJet). Following, the specimens were divided into three subgroups according to universal adhesive applied: Clearfil Universal Bond (CU; Kuraray), Prime&Bond Universal (PBU; Dentsply Sirona), or Single Bond Universal (SBU; 3M ESPE). A nanofill composite (Filtek Ultimate; 3M ESPE) was employed as a repair. Bonded specimens were stored in water for 24 h at 37 °C or thermal aged, then subjected to the μTBS test. Additionally, specimens were analyzed with a contact profilometer and were evaluated with scanning electron microscopy. Control and PA treatments were showed the lowest µTBS (p < 0.05), and there was no significant difference between these two groups (p > 0.05). Al₂O₃ and CoJet treatments generally exhibited a similar influence on µTBS values. In addition, a correlation was found between surface roughness and bond strength (r = 0.831). CoJet resulted in significantly higher repair µTBS values when compared to the other surface treatments. In addition, the use of silane-containing universal adhesive was increased the cohesive failure rate and maintained the repair µTBS values after thermocycling.

Purpose: Space maintainers are important for the health and placement of children’s primary and permanent teeth. However, plaque and caries levels can be negatively affected when a dental appliance is in the mouth. This study aims to evaluate the oral health of pediatric patients that have space maintainers applied as a result of early tooth loss. Methods: This study included 100 systemically healthy patients between the ages of 4-15 years that were treated with space maintainers due to early loss of teeth. Decayed, missing, filled tooth index values and dental plaque status of the participants were recorded. Controls were performed in the 6th and 12th month. The index results were compared and evaluated statistically using ANOVA and paired-t-tests. Results: A total of 116 space maintainers, including 36 band and loops, 16 lingual arches, 21 palatal arches, 43 removable appliances, were evaluated in the study. Statistically significant differences were found between the pre-treatment and post-treatment index values (p<0.001). In the group of band and loops and removable space maintainers; the increases in DMFT/dft values of 6th month and 12th month according to initial DMFT/dft values were statistically significant (p<0.05). For plaque index, the increase in 12th month of all types of appliances were found statistically significant (p<0.001). The greatest increase in plaque index level was seen in the teeth of patients that had been treated with a lingual arch. Conclusions: Incompatible space maintainers can lead to caries, increased plaque accumulation, demineralized areas, and periodontal problems. The accumulation of plaque and difficulty of cleaning the teeth, especially in the fixed space maintainers, negatively affects the health of teeth. For this reason, good oral hygiene should be provided to patients and controls should be regularly performed.

Aim: To evaluate the microshear bond strength (µSBS) of mineral trioxide aggregate and Biodentine to various resin-based materials using different adhesive strategies. Materials and Methods: Three resin-based materials—a self-adhering resin composite with or without acid etching (Vertise flow; Kerr, Orange, CA, USA), a conventional flowable composite with a total-etch adhesive (Filtek Ultimate Flowable; 3M ESPE, St. Paul, MN, USA), and a flowable resin-modified glass ionomer cement (RMGIC) without any surface modification (Ionoseal; VOCO GmbH, Cuxhaven, Germany)—and two calcium-silicate-based materials—Biodentine and BIOfactor mineral trioxide aggregate (MTA)—were tested. A total of 100 cylindrical acrylic molds were prepared. Biodentine and BIOfactor MTA were prepared and placed into the central holes on the molds. Specimens were divided into two main groups according to materials and into five subgroups ( n = 10). µSBS were evaluated using a µSBS testing device. The failure modes were examined under a stereomicroscope with magnification. They were categorized as adhesive, cohesive, or mixed. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey test. The significance level was taken as α = 0.05. Results: It was observed that both calcium-silicate-based material type and resin-based material type influenced the µSBS significantly according to two-way ANOVA. Biodentine exhibited higher bond strength values than MTA. However, no statistically significant interaction was demonstrated between these factors ( P = .396). The µSBS values of intermediate materials to Biodentine and MTA were listed from the lowest to the highest as follows: RMGIC < Acid Etch + RMGIC < SARC (self-adhering resin composite) < FC (flowable composite) < Acid Etch + SARC. Conclusion: Self-adhering composites can be used on calcium-silicate-based materials in vital pulp treatments because of their mechanical properties. Acid-etching ensures high µSBS values. Although the µSBS of Biodentine were higher than MTA according to this study’s results, there was no statistically significant difference in µSBS of FC and acid-etched SARC to MTA.