Background: The purpose of this study was to evaluate the effect of different bonding agents on bond-strength to demineralized enamel after remineralizing treatments and resin infiltration. Methods: Buccal enamel of 120 bovine incisors was polished and then were divided into five experimental groups: SE (sound enamel); DE (demineralized enamel); AS (demineralized enamel immersed in artificial saliva for eight weeks); NaF (demineralized enamel treated with 0.05% sodium fluoride solution (one minute) for eight weeks); Ic (demineralized enamel infiltrated with a low-viscosity resin (Icon-DGM). These groups were subdivided according to adhesive system used: self-etching adhesive Adper Easy One (3M/ESPE) and etch-and-rinse adhesive Single Bond (3M/ESPE). The composite resin blocks were fabricated using a Teflon matrix. A thermomechanical cycling machine was used to carry out the artificial aging of the specimens and thus were sectioned into sticks. The microtensile tests were performed using a universal testing machine at a cross-head speed of 1 mm/min. Data (in MPa) were subjected to two-way ANOVA and Tukey’s tests (5%). Results: Significant differences were found for both factors tested and interactions (p<0.05). Tukey’s test results of µTBS (mean ± SD) were: etch-and-rinse SE (28.79±3.93); DE (30.41±7.22); AS (29.03±3.33); NaF (29.81±4.06)a; Ic (29.47±5.5);  and self-etching SE (30.37±6.96); DE (14.62±4.47); AS (9.79±2.32); NaF (9.36±2.31); Ic (30.78±8.68).   Conclusions: Resin infiltration did not affect the bond strength of demineralized enamel for both adhesive systems tested. For etch-and-rinse adhesive, no differences were observed for the tested groups. For self-etching adhesive, only the resin-infiltrated group showed similar bond strength to sound enamel. Both etch-and-rinse and self-etching adhesive systems can be used in resin-infiltrated enamel, if a composite restoration needs to be further performed. In enamel that has undergone the de/remineralization process, the use of a total-etch adhesive might be preferable for the restorative procedure.

Objective: This study compared the clinical performance of large indirect restorations (IRs) versus direct restorations (DRs) in posterior teeth.Methods: Thirty subjects received two class II restorations (n = 60), one fabricated from a precured composite block (Grandio Blocs, VOCO) for the indirect technique (IT) and the other with light-cured composite (GrandioSO, VOCO) for the direct technique (DT). For IT, the restoration was created using the computer-aided design and computer-aided manufacturer (CAD/CAM) system. For DT, the material was applied light-cured by using a layering technique. All restorations were evaluated by using the World Dental Federation criteria.Results: Twenty-three subjects attended the 2-year recall, and 46 restorations were evaluated. No significant differences were detected between the techniques for most parameters analyzed (p > 0.05). For "color match" at 7 days and 6 months, better results were observed for the DT. In relation to the overall scores, all restorations were esthetically acceptable after 2 years, while 93.3% of DT and 90% of IT showed acceptable function. For biological scores, 96.67% of DRs and 100% of IRs was acceptable after 24 months. Considering all properties, the success rates were 93.3% for DRs and 90% for IRs.Conclusions: After 2 years, both restorations presented similar and good clinical behavior for all the properties analyzed.

Objectives This article evaluated the effect of substrates rigidities on the post-fatigue fracture resistance of adhesively cemented simplified restorations in lithium disilicate glass ceramic. Methods Precrystalized computer-aided design/computer-aided manufacturing ceramic blocks were processed into disc-shaped specimens (n = 10, Ø = 10 mm), mimicking a simplified restoration at two thicknesses (0.5 and 1.0 mm). Thereafter, the discs were cemented onto different base substrates (dentin analogue [control], dentin analogue with a central core build-up of resin composite [RC], or glass ionomer cement [GIC]). The specimens were subjected to mechanical cycling in a chewing simulator (100 N, 1 × 106 cycles, 4 Hz) and then subjected to thermocycling aging (10,000 cycles, 5/37/55°C, 30 seconds). After the fatigue protocol, the specimens were loaded until failure (N) in a universal testing machine. Finite element analysis calculated the first principal stress at the center of the adhesive interface. Results The results showed that “restoration thickness,” “type of substrate,” and their interaction were statistically significant (one-way analysis of variance; p < 0.001). Regardless the restoration thickness a higher fracture load was observed for specimens cemented to dentin analogue. Among the base materials, RC build-up presented the highest fracture load and lower stress magnitude for both restoration thicknesses in comparison with GIC build-up. The 0.5-mm restoration showed higher stress peak and lower fracture load when submitted to the compressive test. Conclusion More flexible base material reduces the fracture load and increases the stress magnitude of adhesively cemented lithium disilicate restorations regardless the ceramic thickness. Therefore, more rigid substrates are suggested to be used to prevent restoration mechanical failures.

Nisin is a peptide that possesses potent antibacterial properties. This study evaluated the antibacterial activity of a nisin-doped adhesive against Streptococcus mutans, as well as its degree of conversion and microtensile bond strength (μTBS) to dentin. Nisin was added to the adhesive Adper Single Bond 2 (3M ESPE), resulting in four groups: Control Group (Single Bond 2); Group 1% (1 wt% nisin-incorporated), Group 3% (3 wt% nisin-incorporated) and Group 5% (5 wt% nisin-incorporated). Antibacterial activity against S. mutans was evaluated using colony-forming unit counts (CFU). The degree of conversion was tested using FTIR. Forty human teeth were restored for μTBS evaluation. Data were statistically analyzed with ANOVA and Tukey tests at α = 0.05. The nisin-doped adhesives, for all concentrations, exhibited a significant inhibition of the growth of S. mutans (p < 0.05); Incorporation of 5% and 3% nisin decreased the degree of conversion of the adhesive (p < 0.05). The μTBS (in MPa): Control Group—38.3 ± 2.3A, Group 1%—35.6 ± 2.1A, Group 3%—27.1 ± 1.6B and Group 5%—22.3 ± 1.0C. Nisin-doped adhesives exerted a bactericidal effect on S. mutans. The μTBS and degree of conversion of adhesive were not affected after incorporation of 1% nisin.