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INTRODUCTION: Immature teeth (IT) can be managed by using several treatment options, depending on the vitality of the tooth. The aim of this finite element stress analysis study was to evaluate the effect of different treatment procedures on the stresses in three-dimensional IT models. METHODS: Three-dimensional finite element stress analysis premolar tooth model was created as control (model 1), modified to simulate IT. Eleven models were created to simulate IT filled with (model 2) calcium hydroxide (CH), (model 3) mineral trioxide aggregate (MTA), (model 4) Biodentine (B), (models 5 and 6) MTA plug and B plug without root-filling, (models 7 and 8) MTA plug and B plug with root-filling with composite restoration, and amputation by using (model 9) CH, (model 10) MTA, and (model 11) B. Materials and structures were assumed to be homogenous and isotropic. A 300 N load was applied to the models from the functional cusps and central fossa with a 135° angle. Cosmosworks structural analysis program was used. The results were presented considering the von Mises criteria, and the scale range was limited to 0-10 + MPa. RESULTS: CH use in comparison with temporary filling increased the stresses within the root. MTA filling showed less stresses when compared with B filling. MTA and B plug increased the stresses at apical and root; however, when the roots were filled using gutta-percha and the crowns were restored with composite resin, the stresses at the coronal side of the roots were reduced. The stresses were distributed more favorably in the models simulating CH, MTA, or B amputation. Amputation by using MTA and B showed similar stresses with natural tooth model. CONCLUSIONS: CH is not a favorable dressing material for IT when compared with MTA and B. MTA or B plug increases the stresses at apical, whereas root-filling reduces the stresses within the root. Amputation by using CH, MTA, and B in combination with composite resin restoration may save both the coronal and root structure of IT.

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OBJECTIVE: The present study aimed to evaluate the effects of ozone and prophylactic antimicrobial applications on the shear bond strengths and bond failure interfaces of orthodontic brackets. METHODS: Sixty human canine teeth were randomly divided into three groups (n=20), receiving the following treatments: Group I-pumice prophylaxis (Isler Dental, Ankara, Turkey)+37% orthophosphoric acid (Dentsply, Rio de Janeiro, Brazil)+Transbond XT primer and adhesive (3M Unitek, Monrovia, USA); Group II-prophylaxis paste (Topex, NJ, USA)+37% orthophosphoric acid (Dentsply, Rio de Janeiro, Brazil)+ Transbond XT primer and adhesive paste (3M Unitek, Monrovia, USA); and Group III-ozone application (Biozonix GmbH, Munich, Germany)+37% orthophosphoric acid (Dentsply, Rio de Janeiro, Brazil)+Transbond XT primer and adhesive (3M Unitek, Monrovia, USA). All specimens were stored at 37°C water for 24 h. Shear bond strength was assessed using a universal testing device (Autograph AGS-X; Shimadzu, Japan). Adhesive remnant index (ARI) scores were obtained through examination of teeth under stereomicroscope at 10× magnification after debonding. RESULTS: Shear bond strengths of orthodontic brackets were 16.10, 18.01, and 19.23 MPa for Groups I, II, and III, respectively. No statistically significant difference in shear bond strength of orthodontic brackets was found among the groups (p=0.273), based on Kruskal-Wallis analysis. Additionally, no significant difference was found in the ARI scores of each group using chi-square analysis (p=0.992). CONCLUSION: Shear bond strength of orthodontic brackets and ARI scores was not found to be negatively impacted by ozone application.

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PURPOSE: The aim of this finite-element stress analysis (FEA) was to determine the effect of degradation due to water storage on stress distributions in root-filled premolar models restored with composite using either a self-etch (SE) or an etch-and-rinse (E&R) adhesive. MATERIALS AND METHODS: Four premolar FEA models including root filling, MOD cavity, and composite restorations were created. The cavities were assumed to be treated by SE or E&R adhesives and stored in water for 18 months. The elastic properties of the adhesive-dentin interface after 24-h and 18-month water storage were obtained from the literature and applied to the FEA models. A 300-N load was applied on the functional cusps of the models. The SolidWorks/Cosmosworks structural analysis program was used and the results were presented considering the von Mises stresses. RESULTS: Stresses in the cervical region increased over time on the load-application side of the main tooth models (SE: 84.11 MPa to 87.51 MPa; E&R: 100.24 MPa to 120.8 MPa). When the adhesive interfaces (hybrid layer, adhesive layer) and dentin were evaluated separately, the stresses near the root canal orifices increased over time in both models; however, this change was more noticeable in the E&R models. Stresses at the cavity corners decreased in the E&R model (within the adhesive layer), while SE models showed the opposite (within the hybrid layer). CONCLUSION: Change in the elastic modulus of the adhesive layer, hybrid layer, and dentin due to water storage has an effect on stresses in root-filled premolar models. The location and the level of the stresses differed depending on the adhesive used.

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INTRODUCTION: This finite element analysis study was aimed at evaluating the effects of rotary systems on stresses in photopolymerized resin root models with oval-shaped canals. METHODS: Among the data collected by computed tomographic imaging, a mandibular second premolar tooth with an oval-shaped canal was selected, recorded as Digital Imaging and Communications in Medicine, and transferred to Materialise's Interactive Medical Image Control System software. Three-dimensional modeling was performed to produce photopolymerized resin root models. Root canals were prepared by OneShape (OS; MicroMega, Besancon, France); ProTaper Universal (PTU; Dentsply Tulsa Dental, Tulsa, OK); WaveOne (WO, Dentsply Maillefer, Ballaigues, Switzerland); Mtwo (MT; VDW, Munich, Germany); Twisted File (TF; Kerr Dental, Orange, CA); ProTaper Next (PTN, Dentsply Tulsa Dental), and hand files (HFs) (control). The models were scanned (micro-computed tomographic imaging; SkyScan 1174; Kontich, Belgium), finite element analysis models were created, and stresses were calculated under 300-N loading (at a 45° angle and vertically). RESULTS: The maximum stress values were found to be higher when the roots were loaded at an angle. The range of the stress values was PTU > MT > WO > HF > PTN > OS > TF. The stresses were forwarded toward the apical area in the PTN, OS, and TF models. When loaded vertically, the highest maximum stress values were recorded in the WO model. High stress concentrations were observed at coronal, thus less stress was forwarded toward the apical, giving an advantage to the root. The range of the others was as follows: PTN ≥ PTU > MT > TF > OS ≥ HF. The TF model showed lower maximum stress values, whereas the HF model showed more homogenous stress distribution. CONCLUSIONS: Considering the stress distributions and stress values within the models, it can be concluded that oval-shaped canals prepared by HFs and WO were less likely to result in root fracture.

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OBJECTIVE: The aim of this study was to determine whether there are any changes in the surface of bone or implant structures following the removal of a screwed dental implant. MATERIALS AND METHODS: For this, six individual samples of acid-etched and sandblasted implants from three different manufacturers' implant systems were used. They were screwed in a D1 bovine bone, and they were removed after primary stabilization. The bone and implant surfaces are evaluated with scanning electron microscope. RESULTS: Through examination of the surfaces of the bone prior to implantation and of the used and unused implant surfaces, it was found that inhomogeneity in the implant surface can cause microcracking in the bone. CONCLUSIONS: This is attributed to the stress induced during the implantation of self-tapping implants and suggests that a tap drill may be required in some instances to protect the implant surface.

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INTRODUCTION: Endodontic-periodontal (EP) lesions require both endodontic and periodontal therapies. Impermeable sealing of the root canal system after cleaning and shaping is essential for a successful endodontic treatment. However, complete healing of the hard and soft tissue lesions takes time, and diseased bone, periodontal ligament, and tooth fibrous joints are reported to have an increased failure risk for a given load. Considering that EP lesions may affect the biomechanics of teeth, this finite elemental analysis study aimed to test the effect of root fillings on stress distribution in premolars with EP lesions. METHODS: Three finite elemental analysis models representing 3 different types of EP lesions (primary endodontic disease [PED], PED with secondary periodontic involvement, and true combined) were created. The root canals were assumed as nonfilled or filled with gutta-percha, gutta-percha/apical mineral trioxide aggregate (MTA) plug, and MTA-based sealer. Materials used were assumed to be homogenous and isotropic. A 300-N load was applied from the buccal cusp of the crown with a 135° angle. The Cosmoworks structural-analysis program (SolidWorks Corp, Waltham, MA) was used for analysis. Results were presented considering von Mises criteria. RESULTS: Stresses at the root apex increased with an increase in lesion dimensions. Root filling did not affect stress distribution in the PED model. An MTA plug or MTA-based sealer created more stress areas within the root compared with the others in the models representing PED with periodontic involvement and true combined lesions. CONCLUSIONS: Stresses at the apical end of the root increase with increases in lesion dimensions. MTA-based sealers or an MTA plug creates more stresses when there is periodontic involvement or a true combined lesion.

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STATEMENT OF PROBLEM: Information about the effect of occlusal preparation designs on the stress distribution in different ceramic crowns and the prepared tooth is limited. PURPOSE: The purpose of this study was to investigate the effects of anatomic and nonanatomic occlusal preparation designs on the stress distribution in ceramic crowns, teeth, and bone. MATERIAL AND METHODS: Finite element analysis was performed on models of a mandibular second premolar. A load of 400 N was applied to the models to test ceramic materials (In-Ceram, Empress Esthetic) and occlusal preparation (anatomic, nonanatomic) designs. RESULTS: The lowest stress value occurred in the core material in the Empress Esthetic model prepared with the nonanatomic occlusal preparation design. In all groups, higher stress values were found to be concentrated in the lingual half of the dentin. Lower stress values were located near the apex of the pulp tissue and bony tissue that surround the root apex. CONCLUSIONS: Differences in preparation designs did not result in differences in the distribution or amount of stress in pulp, dentin, or bone. The use of different ceramic materials resulted in no differences in the amount or distribution of stress in pulp and bone. The use of a crown with a high elastic modulus led to increases in stress values in the restoration and the dentin margin, and decreases in stress values in the occlusal surface of the dentin. The nonanatomic design can be recommended as a favorable preparation design for Empress Esthetic ceramic.

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STATEMENT OF PROBLEM: Surface-finishing protocols have a mechanical impact on ceramic surfaces that could eventually affect surface topography and light scattering. An optimum protocol is needed to avoid damaging the optical properties of ceramics. PURPOSE: The purpose of this study was to determine the effects of different surface-finishing protocols on the surface roughness, color change, and translucency of ceramic and metal ceramic restorations. MATERIAL AND METHODS: Standardized disk-shaped specimens (1.5 × 10 mm, n=128) were fabricated from 3 different ceramic core materials (aluminum oxide [Al2O3]-AL, zirconium oxide [ZrO2]-ZR, lithium disilicate [Li2Si2O5]-LIT), veneered (V) with dentin ceramics (n=32 per group), and placed in the following groups: ALV, ZRV, and LITV. The metal ceramic group acted as the control (n=32). Four different surface-finishing methods were tested. Airborne-particle abrasion with 50 µm Al2O3, polishing with adjustment kit, polishing with adjustment kit plus diamond polishing paste, and autoglazing (n=8 subgroup) were applied on the veneering ceramics. The specimens were analyzed with a profilometer for surface roughness, and color change and translucency were measured with a clinical spectrophotometer. Statistical analyses were performed with 1-way ANOVA and the Tukey honest significant difference tests (α=.05). RESULTS: Specimens treated with the airborne particle abrasion method showed significantly higher mean profilometer for surface roughness values in all groups (P<.05). The polishing with adjustment kit and autoglazing methods revealed statistically similar surface roughness values in all groups (P>.05). With the diamond polishing paste method, lower surface roughness values were achieved in the ZRV and metal ceramic groups acted as the control groups. Different surface-finishing methods affected the color change of the ceramic systems, except for ZRV. Surface-finishing protocols significantly affected the translucency values of the ALV, LITV, and metal ceramic groups (P<.05). CONCLUSIONS: No single surface-finishing protocol can be recommended to obtain the smoothest surface and the least color change without affecting translucency for the ceramics tested. The airborne-particle abrasion protocol created rougher surfaces and decreased translucency, and color change in zirconia was not affected by the finishing protocols.

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PURPOSE: The purpose of this study was to investigate the possible radioactive potential of zirconium dioxide (ZrO2) dental ceramics. Such information is necessary since they became an integral part of routine prosthetic rehabilitations and devoid of scientific information about their radioactivity creates some concern in the dental community. METHODS: Four different types of commercial ZrO2 ceramics, namely Lava, Cercon, ICE Zirkon, and Everest Bio ZS were investigated before and after the sintering process. Sintering temperatures were applied according to each manufacturer's instructions. The compositions of the presintered and sintered specimens were analyzed using x-Ray Fluorescence Spectrometer (XRF). Concentrations of the elements and compounds were also measured by this method. Determination of radioactivity continued with Gamma-spectrometry measurements and Gross alpha/Beta analyses. RESULTS: The activity of gamma and Gross alpha/beta was below minimum detection limits (MDL) for presintered and sintered ZrO2. The MDLs of gross alpha/beta counting system were 0.02 Bq/g and 0.01 Bq/g for alpha and beta radioactivity, respectively. The sintering process played only a minor role in the composition of the compounds. CONCLUSIONS: Radioactivity of the ZrO2 ceramics studied showed negligible radionuclide activity that can be considered lower than many hazardous radioactive appliances in our environment.

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PURPOSE: The aim of this finite element analysis (FEA) study was to test the effect of different restorative techniques on stress distribution in roots with flared canals. MATERIALS AND METHODS: Five three-dimensional (3D) FEA models that simulated a maxillary incisor with excessive structure loss and flared root canals were created and restored with the following techniques/materials: 1) a prefabricated post: 2) one main and two accessory posts; 3) i-TFC post-core (Sun Medical); 4) the thickness of the root was increased by using composite resin and the root was then restored using a prefabricated post; 5) an anatomic post was created by using composite resin and a prefabricated glass-fiber post. Composite cores and ceramic crowns were created. A 300-N static load was applied at the center of the palatal surface of the tooth to calculate stress distributions. SolidWorks/Cosmosworks structural analysis programs were used for FEA analysis. RESULTS: The analysis of the von Mises and tensile stress values revealed that prefabricated post, accessory post, and i-TFC post systems showed similar stress distributions. They all showed high stress areas at the buccal side of the root (3.67 MPa) and in the cervical region of the root (> 3.67 MPa) as well as low stress accumulation within the post space (0 to 1 MPa). The anatomic post kept the stress within its body and directed less stress towards the remaining tooth structure. CONCLUSION: The creation of an anatomic post may save the remaining tooth structure in roots with flared canals by reducing the stress levels.

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This study tested whether exhaled humid conditions would affect the adhesion of etch-and-rinse, two-step and one-step self-etch adhesive resins to enamel. Enamel surfaces of human maxillary anterior teeth (N=240, n=20) were exposed to four humid conditions (H1: 63-68%, H2: 73-78%, H3: 93-98%, H4: 36-45% RH) during bonding with Adper Single Bond 2 (SB2), Clearfil SE Bond (CSE) and Adper Easy Bond (AEB). Specimens were stored in distilled water at 37 ºC for 24 h and tested to failure using micro-shear bond strength (µSBS) test. Data were analyzed using two-way ANOVA and Tukey's test (p<0.05). The µSBS to enamel with SB2, CSE and AEB was not significantly affected by humidity parameters. AEB resulted in significantly lower µSBS in all conditions. The frequency of adhesive failures was the highest at H2, H3 for SB2, H3 for CSE and H1-4 for AEB indicating that humidity conditions may decrease adhesion quality to enamel.

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OBJECTIVES: The aim of the study was to evaluate the effect of three desensitizing toothpastes on bonding of resin cements to dentin. MATERIALS AND METHODS: The occlusal surfaces of 72 maxillary third molars were ground to obtain flat dentin surfaces and then divided into three groups according to three desensitizing toothpastes used: Sensodyne Rapid Relief (GlaxoSmithKline, SmithKline Beecham Ltd., Slough, UK), Signal Sensitive Expert (Unilever Sanayi ve Ticaret Türk A.S., Ümraniye, Istanbul, Turkey) and Colgate Sensitive Pro-Relief (Colgate Palmolive, New York, NY). Following bonding of the resin cement (Clearfil™ SA Cement, Kuraray Co, Osaka, Japan) to dentin, the specimens were light cured for 40 s with a LED (Elipar S10, 3M Espe, St. Paul, MN). The strength measurements were accomplished with a micro-shear testing machine (Bisco, Schaumburg, IL) at a cross-head speed of 0.5 mm/min until the failure occurs. Failure modes were examined using a stereomicroscope and scanning electron microscope. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). RESULTS AND CONCLUSION: ANOVA revealed that the application of desensitizing toothpastes had significant effects on bond strength of the resin cement tested to dentin (p < 0.05). Mixed failures were observed in all of the groups. CLINICAL SIGNIFICANCE: The use of a desensitizing toothpaste before cementation might alter the bond strength of adhesively luted restorations.

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This study evaluated the effect of different amounts of dentin powder (DP) mixed in Clearfil SE Bond (CSB) or Single Bond (SB) on adhesion to dentin. Human third molars (n=96) were sectioned to expose the mid-coronal dentin and divided into eight experimental groups (n=12 per group), namely, Group 1: CSB, Group 2: CSB+1.5 mg DP, Group 3: CSB+3 mg DP, Group 4: CSB+4.5 mg DP, Group 5: SB, Group 6: SB+1.5 mg DP, Group 7: SB+3 mg DP, and Group 8: SB+4.5 mg DP. Filtek Z250 composite was bonded onto dentin, and all specimens were subjected to shear bond strength test at a crosshead speed of 1 mm/min. Highest bond strength was obtained in Groups 1, 2, and 3 (15.1, 13.5, and 16.4 MPa respectively; p>0.05) and the lowest in Groups 6, 7, and 8 (5.5, 5.6, 4 MPa; p>0.05). DP addition, regardless of amount, adversely affected the bond strength of SB. Bond strength of CSB was not affected when 1.5 or 3 mg of DP was added.

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The purpose of this in vitro study was to evaluate the effect of endodontic treatment with or without fiber-post restorations on the fracture strength of abutment teeth under fixed partial dentures (FPDs). Seventy extracted premolar and canine teeth were used. Groups of fiber-post-retained and root-filled teeth were endodontically treated. The teeth were embedded in an acrylic resin perpendicular to the horizontal plane to create fixed partial dentures. The following groups were created using different abutments: (1) sound (S) canine/S premolar, (2) S canine/endodontically treated (ET) premolar, (3) ET canine/S premolar, (4) ET canine/ET premolar, (5) S canine/fiber-post-restored (FPR) premolar, (6) FPR canine/S premolar, and (7) FPR canine/FPR premolar. Each tooth was prepared for a complete-coverage full-metal crown. Impressions were taken; metal frameworks were fabricated and cemented. The samples were exposed to 5,000 cycles of thermomechanical fatigue and loaded compressively until fracture (2 mm/min). The data were statistically analyzed using (Kruskal-Wallis test, α = 0.05). No significant difference was found among the mean fracture strengths of the groups (p = 0.696). There were distinct differences in failure patterns. All of the fracture types were horizontal, and neither vertical nor non-restorable root fractures were recorded. Premolars seemed to be a critical abutment compared to canines when they were sound under FPDs. The percentage of cervical fractures was high in endodontically treated teeth when compared to post-retained groups. In case of post-debonding, the abutment fracture did not occur. When root-filled teeth are used as abutments for FPDs, fiber-post restorations or the creation of abutments from similar structures (ET/ET or FPR/FPR) results in improved conservation of root structure under loading when compared to the abutments from different structures (S/ET, ET/S, FPR/S, S/FPR).

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INTRODUCTION: This study examined the hypothesis that the shear-bond strengths of AH Plus (AH) and Hybrid Root Seal (HRS) to root dentin might be optimized by using a powdered dentin-reinforced bonding procedure. METHODS: The surfaces of root halves obtained from extracted human premolars were ground (800-grit silicon carbide paper), treated (5.25% NaOCl 17% EDTA for 5 minutes followed by distilled water) and randomly allocated into two groups according to the sealer and then into three subgroups according to bonding procedure. Dentin particles with a maximum size of 25 µm were incorporated into the adhesive of Clearfil Liner Bond 2V, and groups were created as follows: no adhesive, adhesive alone, and with powdered dentin reinforced adhesive; 3 × 3 mm high buildups were created using sealer and allowed to set (37 °C, 100% humidity, 72 hours). Shear tests were performed (1 mm/min). Data were calculated as MPa and analyzed (two-way analysis of variance, Tukey test). RESULTS: A significant difference was found between the groups (P = .000). Adhesive or reinforced adhesive had a negative effect on the shear-bond strength of AH, but they significantly increased the shear-bond strength of HRS (P = .000). HRS showed a similar bond strength with either adhesive alone or adhesive reinforced with powdered dentin. AH group was characterized by mixed failure, whereas the predominant failure type of the HRS group was cohesive failure within the sealer. CONCLUSIONS: Reinforcing adhesive resin with powdered dentin may be considered an alternative for optimizing the bonding of methacrylate-based sealers to root dentin and might affect the shear bond strength.

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OBJECTIVES: The aim of this finite elemental stress analysis study was to evaluate the effect of cavity shape and hybrid layer on the stress distribution of the mandibular premolar tooth under occlusal loading. METHODS: The mandibular premolar tooth was selected as the model based on the anatomical measurements suggested by Wheeler. Four different mathematical models were evaluated: 1) a saucer-shaped non-carious cervical lesion restored with a composite without a hybrid layer, 2) a saucer-shaped non-carious cervical lesion restored with a composite with a hybrid layer, 3) a wedge-shaped non-carious cervical lesion restored with a composite without a hybrid layer, and 4) a wedge-shaped non-carious cervical lesion restored with a composite with a hybrid layer. A 200 N force was applied from the buccal tubercule and central fossa of the premolar tooth. The findings were drawn by the SAPLOT program. RESULTS: In models 2 and 4, the output showed that a hybrid layer acts as a stress absorber. Additionally, when the cavity shape was changed, the stress distribution was very different. CONCLUSIONS: Cavity shape and hybrid layer play an important role in stress distribution in cervical restorations.

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The aim of this finite element method (FEM) study was to test two different restorative techniques used for construction of severely damaged endodontically treated premolar teeth using Finite Element Stress Analysis Method. In this study, four types of three-dimensional (3-D) FEM mathematical models simulating (1) a sound lower single rooted premolar tooth with supporting structures; (2) a root-filled lower premolar tooth without lingual cusp, restored with resin composite; (3) a root-filled lower premolar tooth without lingual cusp restored with resin composite in combination with a polyethylene fiber which is placed circumferentially to help to create a composite lingual wall; (4) a root-filled lower premolar tooth without lingual cusp restored with resin composite in combination with a glass fiber post, were modeled. A 300-N static vertical occlusal load was applied on the node at the center of occlusal surface of the tooth to calculate stress distributions. Solidworks/Cosmosworks structural analysis programs were used for FEM analysis. The analysis of the von Mises stress values revealed that maximum stress concentrations were located at loading areas for all models. Root dentine tissue, lingual cortical bone, and apical bone structures were other stress concentration regions. There were stress concentration differences among the models at root dentine tissue. Although the distribution pattern was similar with composite resin restored tooth model, highest stress values were observed at root dentine in the model restored with post-and-core. Post structure accumulated more stress on its own body. Stress distribution patterns of sound tooth and fiber-reinforced restoration models were found as similar. The present study showed that the use of post material increased the stress values at root dentine structure while reinforcing the restoration with a fiber decreases stress transmission. Fiber-reinforced restoration provided stress distributions similar to sound tooth.

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OBJECTIVES: The aim of this finite elemental stress analysis study was to evaluate the effect of a hybrid layer and the hybrid layer thickness on the shear stress distribution in mandibular premolar teeth under occlusal loading. METHODS: The mandibular premolar tooth was selected based on the anatomical measurements suggested by Wheeler. The analysis was performed with a computer with the SAP 2000 structural analysis program. Three different mathematical models were evaluated; 1) composite restoration without a hybrid layer 2) composite restoration with a 1.5 mum thick hybrid layer and 3) composite restoration with a 3 mum thick hybrid layer. A total of 200 N of occlusal loading force was simulated from the buccal tubercule and central fossa of the premolar tooth. The findings were drawn by the Saplot program. RESULTS: In model B, the output showed that hybrid layer reduced the shear stress concentration especially on gingival margin of the composite. Similarly shear stress intensity was decreased by a thick hybrid layer in model C, especially on the gingival margin of the composite. CONCLUSIONS: The hybrid layer and its thickness plays an important role on stress distribution and intensity in cervical restorations.

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This in vitro study observed and compared the resin and non-carious sclerotic dentin interfaces generated by three different adhesives and two different techniques, using a scanning electron microscope (SEM). Thirty-two human premolars, with buccal, non-carious cervical lesions, were used. The teeth were randomly divided into eight groups. Group 1: Sclerotic dentin was treated with Single Bond (3M). Group 2: After superficial sclerotic dentin was removed with a diamond bur (Diatech, Coltene), the dentin surfaces were treated with Single Bond. Group 3: Sclerotic dentin was treated with Clearfil SE Bond (Kuraray). Group 4: After superficial sclerotic dentin was removed with a diamond bur, Clearfil SE Bond was applied. Group 5: Sclerotic dentin was treated with Xeno III (Dentsply). Group 6: After superficial sclerotic dentin was removed with a bur, Xeno III was applied to the dentin surfaces. For Groups 7 and 8, after the superficial sclerotic dentin was removed with a diamond bur, Clearfil SE Bond, with an additional 37% phosphoric acid gel, was used on the sclerotic dentin surfaces in Group 7 and Xeno III was used in Group 8. In all groups, the cavities were restored with Filtek Supreme (3M). All the specimens were sectioned longitudinally and polished along the cut surface. The sections were treated with 37% orthophosphoric acid for five seconds, rinsed with water and treated with 5% NaOCL for 10 minutes. The specimens were then gold-sputter coated and evaluated under SEM. The thickness of the hybrid layer was measured on the gingival, occlusal and axial dentin interfaces. ANOVA was performed to determine whether there were any statistically significant differences in hybrid layer thickness. Post-hoc multiple comparisons were done with Tukey's test. Hybrid layer thickness was increased with all adhesives when superficial dentin was removed with a bur. Hybrid layer thickness showed significant differences between total-etch and self-etch systems.

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PURPOSE: The aim of this in vitro study was to evaluate the effect of two fibers (polyethylene or glass) and a flowable resin liner on microleakage in Class II adhesive restorations. MATERIALS AND METHODS: Class II adhesive cavities were prepared on mesial and distal surfaces of 40 extracted sound human molars. The cavity margins were below or above the CEJ. The teeth were randomly divided into four groups according to the restoration technique: group 1: restored with a resin composite (AP-X, Kuraray) in bulk after SE Bond (Kuraray) treatment; group 2: flowable resin liner (Protect Liner F, Kuraray) was used before composite restoration; in group 3, a polyethylene fiber (Ribbond) and in group 4, a glass fiber (everStick NET, StickTech) was placed into the bed of flowable resin before composite restoration. Samples were finished, stored in distilled water for 7 days at room temperature, and then thermocycled for 300 cycles between 5 degrees C and 55 degrees C. After sealing the apices, the teeth were varnished within 1 mm of the margins and placed in 0.5% basic fuchsin dye for 24 h at 37 degrees C. After rinsing, the teeth were sectioned longitudinally through the restorations and microleakage was evaluated with a stereomicroscope. Marginal penetration was scored on a 0 to 4 scale, and the data were statistically analyzed using Kruskal-Wallis and the Mann-Whitney U-test. RESULTS: Flowable resin, everStick NET, and Ribbond THM used in combination with flowable resin significantly reduced leakage at occlusal margins in cavities with enamel margins (p < 0.05). When the leakage values on cervical dentin margins were evaluated, there was no statistically significant difference among the tested groups (p > 0.05). CONCLUSION: Use of flowable composite alone or in combination with polyethylene or glass fibers reduces occlusal leakage in Class II adhesive cavities with enamel margins.

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