Clinical Relevance Some bulk-fill flowable resin composites produce less cuspal deflection than a conventional incrementally filled flowable resin composites. SUMMARY Objective: This study investigated simulated cuspal deflection and flexural properties of bulk-fill and conventional flowable resin composites. Methods and Materials: Five bulk-fill and six conventional flowable resin composites were evaluated. Aluminium blocks with a mesio-occlusal-distal cavity were prepared and randomly divided into groups for each of the different measurement techniques and were further subdivided according to the type of flowable resin composite. The simulated cuspal deflection caused by the polymerization of resin composite within an aluminium block was measured using a highly accurate submicron digimatic micrometer or a confocal laser scanning microscope (CLSM). In addition, the flexural properties of tested resin composites were measured to investigate the relation between cuspal deflection and flexural properties, and the resin composites were observed using scanning electron microscopy. Results: Simulated cuspal deflection of some bulk-fill flowable resin composites was found to be significantly lower than or similar to those for conventional counterparts, regardless of the measurement method. There were statistically significant differences in flexural properties depending on the material, regardless of the type of flowable resin composite. Pearson correlation analysis did not reveal a statistically significant relationship between flexural properties and cuspal deflection. Conclusion: These results indicate that some bulk-fill flowable resin composites exhibit lower cuspal deflection with the bulk-filling technique than is shown by conventional flowable resin composites using the incremental filling technique. Simulated cuspal deflection can be measured using either a micrometer or CLSM, but this experiment failed to show a significant relationship between cuspal deflection and flexural properties of flowable resin composites.

SUMMARY Objective: The purpose of this study was to evaluate the effect of reduced application times of universal adhesives on enamel bond fatigue and surface morphology of the treated enamel with constant force atomic force microscopy (AFM). Methods: Four universal adhesives—Adhese Universal (AU), Clearfil Universal Bond Quick (CU), G-Premio Bond (GP), and Scotchbond Universal Adhesive (SU)—were evaluated in a laboratory for their ability to adhesively bond resin composite to enamel. Shear bond strengths were initially determined using 15 specimens per test group for each adhesive. Shear fatigue strengths were then determined using 20 specimens per test group for each the adhesives. The fatigue specimens were loaded using a sine wave at a frequency of 20 Hz for 50,000 cycles or until failure occurred. AFM observations, surface Ra roughness measurements, and geometric surface area evaluations of enamel surface treated with the adhesive agents were also conducted. Results: A strong relationship was found between the initial shear bond strength and shear fatigue strength for enamel surface Ra roughness but not for geometric surface area. The initial shear bond strength and shear fatigue strength of CU and GP were not influenced by different application times, unlike those of AU and SU. While the surface area of enamel treated with the adhesive agents was not significantly influenced by different application times and type of adhesive, surface Ra roughness of the enamel in the AU and SU groups significantly increased with increasing application time, unlike CU and GP. Conclusions: The results of this study suggest that universal adhesives, used with reduced application times, have adequate Ra surface roughness to provide sufficient resistance to enamel bond fatigue at application times from <1 second to 20 seconds, while the geometric surface area of adhesive-treated enamel did not show any significant changes at these different application times.

SUMMARY The aim of this study was to use ultrasonography to evaluate the effect of the self-assembling peptide P11-4 on acid erosion prevention. Curodont Repair (CR), which includes peptide P11-4, was used. Rectangular prisms of bovine enamel (4×1×1 mm) were immersed in pure orange juice for a period of 5 minutes six times per day for 28 days. These samples were divided into four groups of six specimens each and treated differently for an additional period of 28 days: 1) baseline group specimens were stored in artificial saliva; 2) CR group specimens were exposed to curodont without acid challenge; 3) NCRA (no curodont+acid challenge) specimens were treated with orange juice without curodont exposure; and 4) CRA (CR+acid challenge) specimens were treated with curodont before treatment with orange juice. The propagation time of longitudinal ultrasonic velocity (UV) was measured. Ultrastructural observation of each tested enamel surface was carried out using field-emission scanning electron microscopy (SEM). The UV data were analyzed using two-way analysis of variance with time and treatment as confounding factors. Post hoc pairwise tests among groups were performed using the Tukey honestly significant difference test. The average UV in intact bovine enamel for the baseline group ranged from 4,483 to 4,549 m/s and did not vary significantly within the test period. The average ultrasonic velocity (UV) in all samples decreased after the initial erosion. The UV in NCRA decreased further over time. Increased UVs were found for CR and CRA. For CR and CRA, there was no significant difference in UV at the end of the experiment from the initial value before erosion. In the results of SEM observation, the CR and CRA groups had similar morphologic features in that etching patterns were not clearly due to precipitation between the enamel rods. From the results of this in vitro study, it might be concluded that applying enamel matrix derivatives and self-assembling peptides on erosive lesions can improve remineralization.