ObjectivesThe aims of this study were to conduct a systematic review of the microtensile bond strength (µTBS) of multi-mode adhesives to dentin and to perform a meta-analysis to assess the significance of differences in the µTBS of one of the most commonly used universal adhesives (Scotchbond Universal, 3M ESPE) depending on whether the etch-and-rinse or self-etch mode was used.Materials and MethodsAn electronic search was performed of MEDLINE/PubMed, ScienceDirect, and EBSCOhost. Laboratory studies that evaluated the µTBS of multi-mode adhesives to dentin using either the etch-and-rinse or self-etch mode were selected. A meta-analysis was conducted of the reviewed studies to quantify the differences in the µTBS of Scotchbond Universal adhesive.ResultsOnly 10 studies fulfilled the inclusion criteria for the systematic review. Extensive variation was found in the restorative materials, testing methodologies, and failure mode in the reviewed articles. Furthermore, variation was also observed in the dimensions of the microtensile testing beams. The meta-analysis showed no statistically significant difference between the etch-and-rinse and self-etch modes for Scotchbond Universal adhesive (p > 0.05).ConclusionsMulti-mode ‘universal’ adhesives can achieve substantial bonding to dentin, regardless of the used modes (either etch-and-rinse or self-etch).

Background: Resin composite preheating is an innovative method that could be clinically beneficial by improving the handling properties, marginal adaptation, and surface properties of uncured nanofilled resin composite materials. There is conflict and unclear information regarding the effect of preheating on the microhardness, fracture toughness and surface roughness of nanofilled resin composites. Thus, it is important to assess whether dental clinicians can adopt preheating procedures without compromising composite mechanical strength. Objective: The purpose of this study was to evaluate the effect of preheating on microhardness, fracture toughness and surface roughness of nanofilled resin composite. Material and Methods: In this study, one commercial nanofilled resin composite Filtek Z350 XT was used. A total of 28 disc-shaped specimens were fabricated in a Teflon mold (10 mm diameter x 2 mm thick) for Vickers microhardness indentation test and surface roughness test. The samples were divided into two groups of 14 samples each, one group of samples was light-cured at room temperature (24ºC) without preheating (non-heated group), and the other group was light-cured after preheating (preheated group). Vickers hardness measurements of 14 specimens (n=7) either preheated or non-heated of the top and bottom surfaces was measured by means of microhardness tester by applying 100 g load for 10 s. Surface Roughness measurements (Ra) were obtained from 14 specimens (n=7) either preheated or non-heated with the atomic force microscope. Fourteen single-edge-notched-beam specimens were prepared for fracture toughness test (n=7) either preheated or non-heated with measurements (2.5 x 5 x 25 mm3) and a crack 2.12 mm in length. The specimens were tested via three-point bending mode, using a universal testing machine at crosshead speed of 1.0 mm/min until failure occurred. Results: Independent sample t-tests revealed no significant difference between non-heated and preheated groups for all tests (p>0.05). However, for Vickers hardness test, there were significant differences between top and bottom surfaces for non-heated and preheated groups (p<0.05). Moreover, surface roughness average Ra (nm) mean values of preheated group was higher than non-heated group but no significant difference between them was found (p>0.05).

SUMMARY Objective: This study evaluated the effect of preheating resin composites (RCs) on the clinical performance of class I restorations during a 36-month period using a split-mouth, double-blinded randomized design. Methods and Materials: A total of 35 patients were selected. Every patient received one pair of class I nanofilled resin composite (RC, Filtek Z350 XT) posterior restorations (n=70). One side of the mouth received preheated composites; on the other side, the composite was placed in a nonheated state following the manufacturer’s instructions. These restorations were evaluated at 1-week (baseline), 12-months, 24-months, and 36-months using the FDI World Dental Federation criteria. The statistical analyses were also performed using the Wilcoxon and Friedman tests with the level of significance set at 0.05. Results: After 36 months, 33 patients attended the recall visits, and 66 restorations were evaluated. The Friedman and Wilcoxon signed-rank tests revealed insignificant differences between both groups (p&gt;0.05) for all FDI parameters. However, a significant difference was detected for staining as a criterion at 36 months (p=0.01). Moreover, a significant difference in the staining was detected when the baseline and 36 months were compared in the nonheated RC group (p=0.001). For esthetic, functional, and biological properties, the nonheated composite exhibited 93.9%, 100%, and 100% of the clinically accepted scores, respectively, and the preheated group presented 100% for all properties. Four restorations had postoperative sensitivity at baseline for nonheated (11.4%) and five for preheated (14.2%), but the postoperative sensitivity scores were considered highly acceptable at 12-, 24-, and 36-months. Conclusions: After 36 months, preheated nanofilled RCs showed an acceptable clinical performance similar to that of the nonheated ones in class I restorations, but with better resistance to marginal staining.

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ObjectivesThis paper presents a systematic review and meta-analysis of the effect of preheating on the hardness of nanofilled, nanoceramic, nanohybrid, and microhybrid resin composites.Materials and MethodsAn electronic search of papers on MEDLINE/PubMed, ScienceDirect, and EBSCOhost was performed. Only in vitro studies were included. Non-English studies, case reports, clinical trials, and review articles were excluded. A meta-analysis of the reviewed studies was conducted to quantify differences in the microhardness of the Z250 microhybrid resin composite using the Comprehensive Meta-Analysis software.ResultsOnly 13 studies met the inclusion criteria for this systematic review. The meta-analysis showed that there were significant differences between the non-preheated and preheated modes for both the top and bottom surfaces of the specimens (p < 0.05). The microhardness of the Z250 resin composite on the top surface in the preheated mode (78.1 ± 2.9) was higher than in the non-preheated mode (67.4 ± 4.0; p < 0.001). Moreover, the microhardness of the Z250 resin composite on the bottom surface in the preheated mode (71.8 ± 3.8) was higher than in the non-preheated mode (57.5 ± 5.7, p < 0.001).ConclusionsAlthough the results reported in the reviewed studies showed great variability, sufficient scientific evidence was found to support the hypothesis that preheating can improve the hardness of resin composites.