Clinical guidelines for posterior restorations based on Coverage, Adhesion, Resistance, Esthetics, and Subgingival management. The CARES concept: Part I – partial adhesive restorations.

Important changes have occurred over the last decades in the clinical application of the strategies for posterior restorations - from amalgam to composites in direct restorations and from traditional resistance form crowns to adhesive partial restorations such as onlays. Despite much evidence available for these advances, there are still very few established guidelines for common clinical questions: When does an indirect restoration present a clinical advantage over a direct one? When should one perform adhesive cusp coverage such as an onlay? When to implement resistance form designs in adhesive restorations? Which conditions create limitations for adhesion so that a resistance form preparation with a stiffer material such as a traditional crown might be more appropriate? In order to provide clinical guidelines, the present authors consider five parameters to support and clarify decisions - Coverage of cusps, Adhesion advantages and limitations, Resistance forms to be implemented, Esthetic concerns, and Subgingival management - the CARES concept. In Part I of this three-part review article, the focus is on clinical decisions for partial adhesive restorations regarding indications for direct versus indirect materials as well as the need for cusp coverage and/or resistance form preparations based on remaining tooth structure and esthetics.

To etch or not to etch, Part II: On the hydrophobic-rich content and fatigue strength of universal adhesives.

Objective: To determine whether smear layer management, via conservative etching protocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces.

Methods: Bar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta-phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal adhesive (Scotchbond Universal, 3M ESPE).

Influence of Smoking Habits on the Prevalence of Dental Caries: A Register-Based Cohort Study.

Objective: This study aimed to evaluate the influence of smoking habit on the prevalence of dental caries lesions in a follow-up study.

Materials And Methods: A total of 3,675 patients (2,186 females and 1,489 males) with an average age of 51.4 years were included.

To etch or not to etch, Part I: On the fatigue strength and dentin bonding performance of universal adhesives.

Objective: To characterize whether the bonding performance and fatigue strength of resin-dentin interfaces created by a universal adhesive would be affected by different HPO-application times to more accurately assess long-term durability.

Methods: Mid-coronal flat dentin surfaces with standardized smear-layers were produced on sound third molars, etched with 32% HPO for 0, 3 and 15 s, bonded with a mild universal adhesive (3M-ESPE) and restored with a nanofilled composite. Bonded specimens (0.

Risk Score to Predict Dental Caries in Adult Patients for Use in the Clinical Setting.

Background: There is a need for risk prediction tools in caries research. This investigation aimed to estimate and evaluate a risk score for prediction of dental caries.

Materials And Methods: This case-cohort study included a random sample of 177 cases (with dental caries) and 220 controls (randomly sampled from the study population at baseline), followed for 3 years.

Long-term In Vitro Adhesion of Polyalkenoate-based Adhesives to Dentin.

Purpose: To study the influence of a polyalkenoate copolymer (VCP) on the immediate (24 h) and 6-month dentin bonding stability of VCP-based adhesives, using microtensile bond strength (μTBS), nanoleakage (NL), and ultramorphological analyses (FE-SEM).

Materials And Methods: Eighty-four caries-free molars were randomly assigned to seven adhesives: Clearfil SE Bond (CSE, Kuraray Noritake); Adper Single Bond Plus (SB, 3M ESPE); SB without VCP (SBnoVCP, 3M ESPE); Scotchbond Universal Adhesive applied as a etch-and-rinse adhesive (SBU_ER); SBU without VCP applied as an etch-and-rinse adhesive (SBUnoVCP_ER); SBU applied as a self-etch adhesive (SBU_SE, 3M ESPE); SBU without VCP applied as a self-etch adhesive (SBUnoVCP_SE, 3M ESPE). Half of the beams were tested after 24 h, and the other half was aged in water for 6 months prior to testing.

Chemical Adhesion of Polyalkenoate-based Adhesives to Hydroxyapatite.

Purpose: To evaluate the chemical interaction between synthetic hydroxyapatite (HAp) and polyalkenoic acid copolymer- based (also known as Vitrebond copolymer [VCP]) adhesives.

Materials And Methods: Six dentin adhesive formulations were used: 1) Adper Single Bond Plus (SB); 2) SB formulation without VCP (SBnoVCP); 3) Adper Easy Bond (EB); 4) EB formulation without VCP (EBnoVCP); 5) Scotchbond Universal adhesive (SBU); 6) SBU formulation without VCP (SBUnoVCP). Each adhesive was mixed with HAp, polymerized, and analyzed using FTIR and 13C/31P NMR spectroscopy.

Influence of a hydrophobic resin coating on the immediate and 6-month dentin bonding of three universal adhesives.

Objective: To test the influence of a hydrophobic resin coating (HC) on the immediate (24h) and 6-month (6m) microtensile dentin bond strengths (μTBS) and nanoleakage (NL) of three universal adhesives applied in self-etch (SE) or in etch-and-rinse (ER) mode.

Methods: Sixty caries-free extracted third molars were assigned to 12 experimental groups resulting from the combination of the factors "adhesive system" (Scotchbond Universal Adhesive [SBU], 3M ESPE; All-Bond Universal [ABU], Bisco Inc.; and G-Bond Plus [GBP], GC Corporation); "adhesive strategy" (SE or ER); "hydrophobic resin coating" [HC] (with or without Heliobond, Ivoclar Vivadent); and "storage time" (24h or 6m).

Effects of solvent evaporation time on immediate adhesive properties of universal adhesives to dentin.

Objective: To evaluate the microtensile bond strengths (μTBS) and nanoleakage (NL) of three universal or multi-mode adhesives, applied with increasing solvent evaporation times.

Methods: One-hundred and forty caries-free extracted third molars were divided into 20 groups for bond strength testing, according to three factors: (1) Adhesive - All-Bond Universal (ABU, Bisco, Inc.), Prime&Bond Elect (PBE, Dentsply), and Scotchbond Universal Adhesive (SBU, 3M ESPE); (2) Bonding strategy - self-etch (SE) or etch-and-rinse (ER); and (3) Adhesive solvent evaporation time - 5s, 15s, and 25s.

Influence of a hydrophobic resin coating on the bonding efficacy of three universal adhesives.

Objectives: To evaluate the effect of an additional hydrophobic resin coating (HE) on the resin-dentine microtensile bond strengths (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of three universal adhesives used in the etch-and-rinse (ER) and the self-etch (SE) modes.

Methods: Sixty caries-free extracted third molars were divided into 12 groups according to the combination of the factors adhesive (All-Bond Universal [ABU]; G-Bond Plus [GBP] and Scotchbond Universal [SBU]), adhesive strategy (ER and SE), and the use of HE (Heliobond; yes or no). After restorations were constructed, specimens were stored in water (37°C/24h) and sectioned into resin-dentine beams (0.

Effects of industrial noise on circumpulpar dentin--a field emission scanning electron microscopy and energy dispersive spectroscopy analysis.

Chronic exposure to Industrial Noise (IN), rich in Low Frequency Noise (LFN), causes systemic fibrotic transformation and sustained stress. Dental wear, significantly increased with exposure to LFN, affects the teeth particularly through the circumpulpar dentin. Our goal is to understand the consequences of IN exposure on the circumpulpar dentin of Wistar rats.

Prefabricated veneers - bond strengths and ultramorphological analyses.

Purpose: To measure the microshear bond strengths (μSBS) of composite resin to the intaglio surface of prefabricated indirect veneers and analyze the FE-SEM ultramorphology of the pretreated intaglio surfaces as well as the fracture modes.

Materials And Methods: Three veneer systems (veneer and respective luting material) were used in this study: two prefabricated veneer types, Cerinate One-hour (CER, DenMat) and Componeer (CMP, Coltene), and a laboratory- made veneer, IPS e.max Press (IPS, Ivoclar Vivadent) used as the control.

Effect of substrate age and adhesive composition on dentin bonding.

Purpose: To study the effect of dentin age and adhesive composition on the microtensile dentin bond strengths (μTBS) of five dentin adhesives.

Materials And Methods: Sixty extracted caries-free human teeth were assigned to the appropriate age group: less than 21 years of age (<21), 21-40 years of age (21-40), and greater than 40 years of age (>40). For each age group, specimens were randomly divided into five dentin adhesives: (1) Adper Easy Bond (EB, 3M ESPE), a one-step self-etch adhesive; (2) Experimental Adper Easy Bond without the Vitrebond Co-polymer (CP) (EBnoCP, 3M ESPE); (3) Adper Single Bond Plus (SB, 3M ESPE), a two-step etch&rinse adhesive; (4) Experimental Adper Single Bond Plus without CP (SBnoCP, 3M ESPE); and (5) Adper Scotchbond Multi-Purpose (MP, 3M ESPE), a three-step etch&rinse adhesive, as the control group.

Dentin bond strengths of four adhesion strategies after thermal fatigue and 6-month water storage.

Statement Of Problem: The stability of current dental adhesives after artificial aging may depend on the adhesion strategy.

Purpose: To evaluate the effect of thermal fatigue and water storage on the dentin microtensile bond strengths (µTBS) of four adhesion strategies.

Materials And Methods: Forty-eight human molars were assigned to four dentin adhesives: FL--OptiBond FL (Kerr Corporation, Orange, CA, USA); SOLO--OptiBond SOLO Plus (Kerr Corporation); XTR--OptiBond XTR (Kerr Corporation); and AIO--OptiBond All-in-One (Kerr Corporation).

Laboratory bonding ability of a multi-purpose dentin adhesive.

Purpose: To evaluate the laboratory dentin and enamel microtensile bond strengths (microTBS) and interfacial ultra-morphology of a new multi-purpose dental adhesive applied under different bonding strategies.

Methods: microTBS - 36 extracted caries-free human molars were assigned to six groups: Group CSE - Clearfil SE Bond, a 2-step self-etch adhesive (self-etch control); Group SBU-SE - Scotchbond Universal Adhesive (SBU), applied as a one-step self-etch adhesive; Group OSLm - OptiBond SOLO Plus (OSL), a 2-step etch-and-rinse adhesive applied on moist dentin (etch-and-rinse control); Group OSLd - OSL applied on air-dried dentin; Group SBU-ERm - SBU applied as a 2-step etch-and-rinse adhesive on moist dentin; Group SBU-ERd - SBU applied as a 2-step etch-and-rinse adhesive on air-dried dentin. Build-ups were constructed with Filtek Z250 and cured in three increments of 2 mm each.

Microtensile bond strengths and interfacial examination of a polyalkenoate-based 1-step adhesive.

Purpose: To study the effect of acid etching and the application of a hydrophobic bonding resin on the microtensile bond strengths (microTBS) and marginal sealing of the 1-step self-etch adhesive Adper Easy Bond (AEB).

Methods: Middle dentin was exposed in 30 extracted molars and randomly divided into six groups: (1) AEB applied as per manufacturer's directions; (2) as in AEB, but one coat of hydrophobic resin (HR) was applied and cured over AEB (AEB+HR); (3) etching with 35% H3PO4 for 15 seconds followed by AEB (Etch+AEB); (4) as in group Etch+AEB, but one coat of HR was applied and cured over AEB (Etch+AEB+HR); (5) Adper Single Bond Plus, the 2-step etch-&-rinse adhesive control (ASB); (6) Adper Scotchbond Multi-Purpose, the 3-step etch-&-rinse adhesive control (SBMP). Buildups were constructed with Filtek Z250 and cured in three increments of 2 mm each.

Bonding ability of three ethanol-based adhesives after thermal fatigue.

Purpose: To study the effect of thermal fatigue on the microTBS and interfacial morphology of three ethanol-based etch-&-rinse 2-bottle adhesives.

Methods: microTBS - 24 third molars were randomly assigned to one of three adhesive systems: (1) Adper Single Bond Plus (SBP, 3M ESPE); (2) Ambar (AMB, FGM); (3) Excite (EXC, Ivoclar Vivadent), and restored with a hybrid resin composite. For each adhesive, half of the specimens were thermocycled (TC) for 20,000 cycles (5-55 degrees C) while the other half was kept in distilled water for 24 hours at 37 degreesC (control).

In vitro sealing potential of a self-adhesive pit and fissure sealant.

Objective: To study the sealing ability of a self-adhesive sealant.

Method And Materials: Thirty-five extracted molars were assigned to seven groups: group 1, 35% phosphoric acid (PA) followed by Clinpro Sealant (CL) as the control group; group 2, Enamel Loc (EL), a self-adhesive sealant; group 3, PA followed by EL; group 4, Adper Prompt L-Pop (AP) followed by CL; group 5, AP followed by EL; group 6, PA followed by Adper Single Bond Plus (SB) and CL; and group 7, PA followed by SB and EL. Specimens were thermocycled and immersed in 50 wt% ammoniac silver nitrate.