The use of collagen cross-linking agents to enhance dentin bond strength. Occlusal loading and cross-linking effects on dentin collagen degradation in physiological conditions. Influence of EDC on Dentin-Resin Shear Bond Strength and Demineralized Dentin Thermal Properties Resin bond strength to water versus ethanol-saturated human dentin pretreated with three different cross-linking agents Comparative evaluation of calcium silicate-based dentin substitute (Biodentine®) and calcium hydroxide (pulpdent) in the formation of reactive dentin bridge in regenerative pulpotomy of vital primary teeth: Triple blind, randomized clinical trial The effect of smear layer removal on marginal contraction gaps. Effect of 2% chlorhexidine on microtensile bond strength of composite to dentin. Influence of endodontic irrigants on bond strength of a self-etching adhesive. Effect of aluminum chloride hemostatic agent on microleakage of class V composite resin restorations bonded with all-in-one adhesive Adjunctive application of chlorhexidine and ethanol-wet bonding on durability of bonds to sound and caries-affected dentine. Reducing dentine hypersensitivity with nano-hydroxyapatite toothpaste: a double-blind randomized controlled trial Effect of irrigation solutions on dentin bonding agents and restorative shear bond strength. Shear bond strength of composite to deep dentin after treatment with two different collagen cross-linking agents at varying time intervals. Bond Strength between Fiber Posts and Root Dentin Treated with Natural Cross-linkers. [Prevention of intrauterine adhesion with auto-crosslinked hyaluronic acid gel: a prospective, randomized, controlled clinical study]. Adhesive performance of dentin bonding agents applied in vivo and in vitro. Effect of intrapulpal pressure and dentin depth. Evaluation of the mechanical and chemical control of dental biofilm in patients with Down syndrome.
UNLABELLED Type I collagen is a major component of the hybrid layer , and improvement of its mechanical properties may be advantageous during bonding procedures . OBJECTIVE To investigate the effect of three different cross-linking agents ( Glutaraldehyde [ GD ] , Grape seed extract [ GSE ] , and Genipin [ GE ] ) on the tensile bond strength ( TBS ) of resin-dentin bonds . MATERIAL S AND METHODS Sixty-four sound human molars were collected and their occlusal surfaces were ground flat to expose dentin . Dentin surfaces were etched using a phosphoric acid and then teeth were r and omly divided according to the dentin treatment : Control group ( no treatment ) , 5 % GD , 6.5 % GSE , or 0.5 % GE . Teeth were restored either with One Step Plus or Adper Single Bond Plus adhesive systems and resin composite . After 24 h , teeth were sectioned to produce a cross-sectional surface area of 1.0 mm(2 ) and tested for tensile bond strength . Data were statistically analyzed using ANOVA and Fisher 's PLSD tests ( p < 0.05 ) . There was a statistically significant interaction between factors ( treatment and adhesive p < 0.001 ) . Treatment affected TBS ( p < 0.0001 ) , while no differences were observed between the adhesive systems ( p = 0.6961 ) . CONCLUSION Chemical modification to the dentin matrix promoted by GD and GSE , but not GE , result ed in increased bond strength . The application of selective collagen cross-linkers during adhesive restorative procedures may be a new approach to improve dentin bond strength properties OBJECTIVE This study evaluated the ability of 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide hydrochloride ( EDC ) to improve the stability of demineralized dentin collagen matrices when subjected to mechanical cycling by means of Chewing Simulation ( CS ) . METHODS Demineralized dentin disks were r and omly assigned to four groups ( N=4 ) : ( 1 ) immersion in artificial saliva at 37 ° C for 30 days ; ( 2 ) pre-treatment with 0.5 M EDC for 60 s , then stored as in Group 1 ; ( 3 ) CS challenge ( 50 N occlusal load , 30 s occlusal time plus 30 s with no load , for 30 days ) ; ( 4 ) pre-treatment with 0.5 M EDC as in Group 2 and CS challenge as in Group 3 . Collagen degradation was evaluated by sampling storage media for ICTP and CTX telopeptides . RESULTS EDC treated specimens showed no significant telopeptides release , irrespective of the aging method . Cyclic stressing of EDC-untreated specimens caused significantly higher ICTP release at day 1 , compared to static storage , while by days 3 and 4 , the ICTP release in the cyclic group fell significantly below the static group , and then remained undetectable from 5 to 30 days . CTX release in the cyclic groups , on EDC-untreated control specimens was always lower than in the static group in days 1 - 4 , and then fell to undetectable for 30 days . SIGNIFICANCE This study showed that chewing stresses applied to control untreated demineralized dentin increased degradation of collagen in terms of CTX release , while collagen crosslinking agents may prevent dentin collagen degradation , irrespective of simulated occlusal function This study aim ed to evaluate the bonding strength and thermal properties of demineralized dentin with and without EDC treatment .  Sound human molars were r and omly divided into seven treatment groups ( n = 20 ) : control , 80 % ethanol , and five EDC ethanol solutions ( 0.01–1.0 M ) . In each group , 16 sample s were used for bond strength assessment and 4 sample s were used for scanning electron microscopy ( SEM ) analysis . A further 70 intact molars were used to obtain a fine demineralized dentin powder , treated with the same solutions and were evaluated the crosslink degree by ninhydrin test and denaturation temperature ( Td ) by differential scanning calorimetry . EDC-treated specimens ( < 1.0 M ) had a higher bond strength , especially 0.3 and 0.5 M group , than the control counterpart . There was a significant drop in bond strength of 1.0 M EDC group . SEM revealed a homogeneous and regular interface under all treatments . EDC treatment significantly increased the demineralized dentin cross-link degree and Td compared with the control and ethanol treatments . The 0.3 and 0.5 M treatments showed the highest cross-link degree and Td . In terms of mechnical and theramal properties consideration , 0.3 and 0.5 M EDC solutions may be favorable for when applied with etch- and -rinse adhesives , but it is still needed further long-term study Context : Resin-dentin bonds are unstable owing to hydrolytic and enzymatic degradation . Several approaches such as collagen cross-linking and ethanol-wet bonding ( EWB ) have been developed to overcome this problem . Collagen cross-linking improves the intrinsic properties of the collagen matrix . However , it leaves a water-rich collagen matrix with incomplete resin infiltration making it susceptible to fatigue degradation . Since EWB is expected to overcome the drawbacks of water-wet bonding ( WWB ) , a combination of collagen cross-linking with EWB was tested . Aim : The aim of this study was to compare the effect of pretreatment with different cross-linking agents such as ultraviolet A (UVA)-activated 0.1 % riboflavin , 1 M carbodiimide , and 6.5 wt% proanthocyanidin on the immediate and long-term bond strengths of an etch and rinse adhesive system to water- versus ethanol-saturated dentin within clinical ly relevant application time periods . Setting s and Design : Long-term in vitro study evaluating the microtensile bond strength of adhesive-dentin interface after different surface pretreatments . Subjects and Methods : Eighty freshly extracted human molars were prepared to expose dentin , etched with 37 % phosphoric acid for 15 s rinsed , and grouped r and omly . They were blot-dried and pretreated with different cross-linkers : 0.1 % riboflavin for 2 min followed by UVA activation for 2 min ; 1 M carbodiimide for 2 min ; 6.5 wt% proanthocyanidin for 2 min and rinsed . They were then bonded with Adper Single Bond Adhesive ( 3 M ESPE ) , by either WWB or EWB , followed by resin composite build-ups ( Filtek Z350 , 3 M ESPE ) . Bonded specimens in each group were then sectioned and divided into two halves . Microtensile bond strength was tested in one half after 24 h and the other after 6 months storage in artificial saliva . Statistical Analysis Used : Analysis was done using SPSS version 18 software ( SPSS Inc. , Chicago , IL , USA ) . Intergroup comparison of bond strength was done using ANOVA with post hoc Tukey 's test , and intragroup comparison was done using paired t-test . Results : The microtensile bond strength of cross-linked groups was higher compared to control group ( P < 0.001 ) . EWB showed much higher bond strength values on cross-linked dentin compared to noncross-linked dentin . UVA-activated riboflavin group exhibited highest bond strengths followed by carbodiimide and proanthocyanidin groups , respectively , on both water- as well as ethanol-saturated dentin . Even after 6 months storage , cross-linked groups showed significantly higher values compared to initial bond strength values of control group ( P < 0.001 ) . Conclusions : 0.1 % riboflavin pretreatment of dentin followed by UVA activation for 2 min exhibited highest increase in bond strength values at 24 h and least reduction in bond strength values after 6 months storage compared to other groups . Biomodification of dentin using collagen cross-linking followed by EWB exhibited a synergistic effect in improving the resin-dentin bond durability Background : Considering the biological concerns of calcium hydroxide ( CH ) as a pulpotomy agent , an alternative silicate based dentin substitute i.e. Biodentine ( Ca3SiO5 ) was evaluated clinical ly and radiographically . Aims : To evaluate the effectiveness of dentin substitute ( Biodentine ) in regenerative pulpotomy of vital primary teeth that would giv a biological base to its use in forming reactive dentin bridge and overcoming the drawbacks of calcium hydroxide . Material and Methods : R and omised clinical trial on 40 bilateral carious primary molars in 20 participant children ( aged 5 - 10 years ) was carried out by same operator using Ca3SiO5(group-1 ) and CH ( group-2 ) as vital pulpotomy agents . Blinded clinical and radiographic outcomes were observed at 3 , 6 and 12 months interval . Results : Clinical outcomes of both protocol s were analysed using Pearson 's chi-square test applied at P < 0.05 . Descriptive statistics were expressed as mean increase in dentin bridge formation in mms from two reference points in st and ardized radiographs using paired ' t'- test at baseline and 12 months and found to be statistically significant ( P < 0.05 ) in group-1 when compared with group-2 . Conclusion : Group-1 revealed statistically favourable regenerative potential along with clinical success compared to group 2 thereby sharing both indications and mode of action with CH , but without its drawbacks of physical and clinical properties The presence of the smear layer prevents direct contact between dentine and a dentine adhesive . The use of agents to remove the smear layer theoretically should improve the bonding of composite resins to dentine . This study examined the effect of smear layer removal on the effectiveness of a dentine bonding agent in reducing marginal contraction gaps . The agent used for smear layer removal in this study was ethylenediamine tetra-acetic acid ( EDTA ) .  Eighty cavities measuring 2 mm in diameter and 1.5 mm in depth were prepared in dentine and r and omly assigned to two equal groups . The control group was restored with Prisma Universal Bond 2 Adhesive and Prisma Fil Resin . The experimental group was similarly restored after pretreatment of dentine with 0.5 % EDTA for 60 s. All specimens were thermocycled and the marginal contraction gaps were assessed using a Nikon Measures cope . The mean contraction gap was expressed as a percentage of the cavity diameter . Results showed that the experimental group registered smaller contraction gaps ( mean : 0.021 % ) than the control group ( mean : 0.027 % ) . No penetration of material into dentine was observed . Pretreatment with EDTA did not significantly improve the effectiveness of the dentine bonding agent used in terms of reduction of marginal contraction gaps PURPOSE To evaluate the effect of 2 % chlorhexidine on the microtensile bond strength of composite resin to dentin treated with three dentin bonding systems . MATERIAL S AND METHODS Flat dentinal surfaces were prepared in 24 extracted human third molars . Teeth were r and omly divided into 8 distinct experimental groups according to the adhesive applied ( Prime & Bond NT , Single Bond and Clearfil SE Bond ) , the application ( yes/no ) of chlorhexidine , and the time point at which it was applied ( before or after acid etching the dentin ) . Composite resin blocks were built up over treated surfaces , and teeth were then stored in water at 37 degrees C for 24 h. Sample s were thermocycled , stored under the same conditions , and then vertically sectioned , thus obtaining specimens with 1.0 + /- 0.1 mm2 cross-sectional area . Specimens were stressed in tension at 0.5 mm/min crosshead speed . Bond strength results were evaluated using a one-way ANOVA ( p < 0.05 ) . The modes of failures were verified using optical microscopy . Dentin disks were obtained from 3 additional teeth treated in the same manner for observation under SEM . The most representative sample s of fractured specimens were also observed under SEM . RESULTS No statistically significant differences of bond strength values were found between any groups . Failures occurred mainly within the bond ; exclusively adhesive fractures ( adhesive-dentin ) were not observed . CONCLUSION The 2 % chlorhexidine solution , applied before or after acid etching of the dentin , did not interfere with the microtensile bond strength of composite resin to the dentin treated with Prime & Bond NT , Single Bond , or Clearfil SE Bond bonding systems The aim of this in vitro study was to evaluate the bond strength of a self-etching adhesive system to dentine irrigated with sodium hypochlorite ( NaOCl ) , chlorhexidine solution ( CX ) and ethylene diamine tetra acetic acid ( EDTA ) by microtensile testing . Sixty human third molars were sectioned 3 mm below the occlusal level and then r and omly divided into six groups : G1(control ) , without irrigant solution ; G2 , 1 % NaOCl ; G3 , 1 % NaOCl followed by the application of 17 % EDTA ; G4 , 2 % CX ; G5 , 2 % CX followed by the application of 17 % EDTA and G6 , 17 % EDTA . The specimens received the self-etching adhesive system were restored with composite resin , then sectioned and trimmed to obtain four hourglass-shaped slabs from each tooth . The specimens were su bmi tted to the microtensile test in a Universal Testing Machine at a crosshead speed of 0.5 mm min(-1 ) until fracture . The results were su bmi tted to statistical analysis by anova /Newman-Keuls . The means and st and ard deviations ( MPa ) were : G1 , 26.88 ( ±3.81 ) ; G2 , 19.08 ( ±3.89 ) ; G3 , 18.16 ( ±2.21 ) ; G4 , 18.14 ( ±4.32 ) ; G5 , 34.30 ( ±3.32 ) ; G6 , 13.61 ( ±1.21 ) . It was concluded that the application of 2 % CX followed by the application of 17 % EDTA result ed in increasing the bond strength of the self-etching adhesive system to dentine , when compared with the results obtained for the other tested groups Objectives : Since hemostatic agents can induce changes on enamel and dentin surfaces and influence composite resin adhesion , the aim of the present study was to evaluate the effect of the aluminum chloride hemostatic agent on the gingival margin microleakage of class V ( Cl V ) composite resin restorations bonded with all-in-one adhesive . Study design : Cl V cavities were prepared on the buccal surfaces of 60 sound bovine permanent incisors . Gingival margins of the cavities were placed 1.5 mm apical to the cemento-enamel junction ( CEJ ) . The teeth were r and omly divided into two groups of 30 . In group 1 , the cavities were restored without the application of a hemostatic agent ; in group 2 , the cavities were restored after the application of the hemostatic agent . In both groups all-in-one adhesive and Z250 composite resin were used to restore the cavities with the incremental technique . After finishing and polishing , the sample s underwent a thermocycling procedure , followed by immersion in 2 % basic fuschin solution for 24 hours . The sample s were sectioned and gingival microleakage was evaluated under a stereomicroscope . The non-parametric Mann-Whitney U test was used to compare microleakage between the two groups . Statistical significance was defined at P<0.05 . Results : A statistically significant difference was observed in microleakage between the two groups ( P<0.001 ) . Conclusions : Contamination of Cl V composite resin restorations bonded with all-in-one adhesive with aluminum chloride hemostatic agent significantly increases restoration gingival margin microleakage . Key words : All-in-one adhesive resin , composite resin restoration , hemostatic agent , microleakage OBJECTIVES To examine the effect of adjunctive application of chlorhexidine ( CHX ) and ethanol-wet bonding ( EWB ) on bond durability and nanoleakage of hydrophobic adhesive to sound ( SD ) and caries-affected dentine ( CAD ) . METHODS Dentine surfaces of molars were etched after caries removal and r and omly allocated to four groups ( n=12 ) . In Groups 1 and 2 , dentine surfaces were saturated with either 2 ml of 100 % ethanol or 2 ml of ethanol with 2 % CHX for 60s . In Groups 3 and 4 , dentine surfaces were saturated with either 15 μL of distilled water or 15 μL of distilled water with 2 % CHX for 60s . Two coats of primer , followed by neat resin were applied and light-cured for 40s . Resin composite build-ups were placed and bonded specimens were sectioned for bond strength testing after 24 h and 12 months ' storage in artificial saliva . Bond strength data were analyzed using 3-way ANOVA and SNK tests . Interfacial nanoleakage was evaluated after 24 h and 12 months using a field-emission scanning electron microscopy and data were analyzed using Kruskal-Wallis test . RESULTS Significant differences were observed for the three factors : " substrate " ( p<0.001 ) , " rewetting agents " ( p<0.001 ) and " time " ( p<0.001 ) on bond strength . Incorporation of 2 % CHX to EWB preserved bond strength to SD and CAD and reduced interfacial nanoleakage after 12 months . Incorporation of 2 % CHX to WWB also preserved bond strength to SD after ageing . CONCLUSIONS Incorporation of chlorhexidine to ethanol-wet bonding has an interaction effect on preservation of bond durability to sound and caries-affected dentine . CLINICAL SIGNIFICANCE Incorporation of chlorhexidine to ethanol-wet bonding with hydrophobic adhesive enhances the success rate of aesthetic bonded restorations Objectives The present r and omized double-blind clinical trial aim ed to compare the efficacy in reducing dentin hypersensitivity of a dentifrice formulation containing nano-hydroxyapatite with a fluoride dentifrice and a placebo . Methods and material sOne hundred and five subjects were recruited to participate in the study . A computer-generated r and om table with blocking to one of the three study treatments was used in order to have 35 subjects per group : ( 1 ) nano-hydroxyapatite 2 % gel toothpaste fluoride free ; ( 2 ) fluoride gel toothpaste ; ( 3 ) placebo . Groups 1 , 2 , and 3 were instructed to treat their teeth for 10 min twice a day with the provided toothpaste gel . The participant ’s dentin hypersensitivity was evaluated at baseline and after 2 and 4 weeks using airblast and tactile tests . In addition , a subjective evaluation using a visual analogue scale was used . Results Significant lower values of cold air sensitivity and tactile sensitivity ( p < 0.05 ) were found for the test group at 2 weeks and 4 weeks . In addition , statistically significant ( p < 0.05 ) lower values of sensitivity were reported for group 1 compared to those for groups 2 and 3 at 2 and 4 weeks , respectively . The VAS scores were significantly lower ( p < 0.05 ) in the test group at 2 and 4 weeks compared to those at baseline and in the control groups . Conclusion The application of nano-hydroxyapatite in gel toothpaste fluoride free is an effective desensitizing agent providing relief from symptoms after 2 and 4 weeks STATEMENT OF PROBLEM The presence of irrigation solution prior to the application of dentin bonding agents may be one source of contamination and may adversely affect bond strength . PURPOSE The purpose of this in vitro investigation was to evaluate the effect of irrigation solutions of different purity levels on the shear bond strength of a hybrid composite to dentin . MATERIAL AND METHODS Forty extracted , intact human molars were h and -scaled . All soft tissue was removed , and the teeth were stored in room-temperature tap water for 1 week . Subsequently , each tooth was embedded in autopolymerizing acrylic resin with the coronal portion exposed . After complete polymerization of the resin , the dentin surfaces were exposed , and the crown was cut longitudinally on all 4 sides to produce flat dentin surfaces for bonding . The prepared specimens were assigned to 4 groups of irrigation solutions : tap water ( control ) , sterile water , 0.9 % NaCl irrigation solution , and filtered water . Within each irrigation group were 4 dentin bonding agent subgroups : Prime & Bond NT , One-Step , Single Bond Adhesive , and OptiBond Solo . The dentin surfaces ( n = 10 per irrigation/bonding agent pair ) were etched with 37 % phosphoric acid , rinsed with the assigned irrigation solution for 15 seconds , and then dried . Plastic cylinders ( 3 mm long x 3 mm inner diameter ) were filled with a hybrid composite ( Herculite XRV ) and bonded to the dentin . Specimens were loaded in a universal testing machine , and shear force was applied to the base of the composite cylinders , parallel to the dentin surfaces , at a crosshead speed of 0.05 in/min until fracture . Failure loads were recorded . Bond strength data were compared with analysis of variance ( P<.05 ) . Post-hoc comparisons of means were performed with t tests and P values adjusted for multiple comparisons ( Bonferroni method ) . RESULTS Tap water irrigation ( control ) produced no significant difference in bond strengths for all dentin bonding agents tested . When other irrigation solutions were used , One-Step consistently produced significantly lower bond strengths than other dentin bonding agents ( P<.05 ) . No preferential choice of irrigation solution could be made for Prime & Bond or Single Bond Adhesive . However , when One-Step or Solo was used , irrigation with normal saline significantly reduced bond strengths ( P<.05 ) . CONCLUSION Within the limitations of this study , the bond strength to dentin of a hybrid composite irrigated with different solutions was dependent on the dentin bonding agent used OBJECTIVE This in vitro study evaluated the shear bond strength of composite resin to deep dentin using a total etch adhesive after treatment with two collagen cross-linking agents at varying time intervals . MATERIAL S AND METHODS Thirty freshly extracted human maxillary central incisors were sectioned longitudinally into equal mesial and distal halves ( n=60 ) . The proximal deep dentin was exposed , maintaining a remaining dentin thickness ( RDT ) of approximately 1 mm . The specimens were r and omly divided into three groups based on the surface treatment of dentin prior to bonding as follows : group I ( n=12 , control ) : no prior dentin surface treatment ; group II ( n=24 ) : dentin surface pretreated with 10 % sodium ascorbate ; and group III ( n=24 ) : dentin surface pretreated with 6.5 % proanthocyanidin . Groups II and III were further subdivided into two subgroups of 12 specimens each , based on the pretreatment time of five minutes ( subgroup A ) and 10 minutes ( subgroup B ) . Shear bond strength of the specimens was tested with a universal testing machine , and the data were statistically analyzed . RESULTS Significantly higher shear bond strength to deep dentin was observed in teeth treated with 10 % sodium ascorbate ( group II ) and 6.5 % proanthocyanidin ( group III ) compared to the control group ( group I ) . Among the collagen cross-linkers used , specimens treated with proanthocyanidin showed significantly higher shear bond strength values than those treated with sodium ascorbate . No significant difference was observed between the five-minute and 10-minute pretreatment times in groups II and III . CONCLUSION It can be concluded that dentin surface pretreatment with both 10 % sodium ascorbate and 6.5 % proanthocyanidin result ed in significant improvement in bond strength of resin composite to deep dentin INTRODUCTION The aim of this study was to investigate the effects of a proanthocyanidin-rich extract ( grape seed extract [ GSE ] ) on the bond strength and stability of the adhesion of fiber posts to the root dentine using 2 adhesive systems : a total-etch and a self-etch adhesive system . METHODS Single-rooted human teeth were r and omly divided into 6 groups : G1 ( control ) , untreated + total-etch adhesive Adper Scotchbond Multi- Purpose ( 3 M ESPE , St Paul , MN ) ; G2 , 6.5 % GSE for 5 minutes + SB ; G3 , 10 % GSE for 5 minutes + SB ; and G4 to G6 groups were similar to previous ones ; however , the self-etch adhesive system Clearfil SE Bond ( Kuraray , Kurashiki , Japan ) was used . Fiber posts were cemented with RelyX ARC ( 3 M ESPE ) , and the specimens were immediately tested for push out or stored for 12 months . The bond strength means were analyzed by analysis of variance and Games-Howell post hoc tests ( α = 0.05 ) . Additionally , matrix metalloproteinase inhibition by 0.65 % , 0.065 % , and 0.0065 % GSE was examined with gelatin zymography . RESULTS The use of GSE did not affect immediate bond strength to dentin and contributed to preserve the bond strength after 12 months ( P < .05 ) for both adhesives . The bond strength of SB was significantly higher than Clearfil SE Bond ( P < .05 ) . Gelatin zymography showed reduced matrix metalloproteinase activity when recombinant enzymes were incubated with both 0.65 % and 0.065 % GSE , with complete inhibition at the highest concentration . CONCLUSIONS The pretreatment with GSE can be used as a natural alternative to improve bond strength stability of dentin-adhesive interfaces in root canals OBJECTIVE To evaluate the efficacy and safety of auto-crosslinked hyaluronic acid ( HA ) gel for preventing intrauterine adhesion ( IUA ) after hysteroscopic adhesiolysis . METHODS A prospect i ve , r and omized , double blinded and controlled clinical trial ( level I ) was performed . According to American Fertility Society ( AFS ) scoring system , 120 patients ( treatment group : 60 cases , control group : 60 cases ) with moderate to severe IUA were enrolled . Upon completion of adhesiolysis , a Foley balloon catheter was first introduced into the uterine cavity and then 3 ml of auto-crosslinked HA gel for patients in the treatment group ; patients in the control group , however , only received Foley balloon catheter . Second-look hysteroscopic examination was performed to all patients at 3 months postoperatively for evaluation of IUA . Primary endpoint was the reduction rate of IUA at 3 months after surgery . The secondary endpoints include total AFS score , score of each individual AFS category . RESULTS At 3 months after surgery , auto-crosslinked HA gel result ed in significantly higher effective rate for reduction of adhesion , the effective rate were 76 % ( 42/55 ) and 48 % ( 27/56 ) respectively ( P = 0.000 9 ) ; the total AFS score of treatment group was 2.1 ± 1.1 , and significantly lower than that of control group ( 3.7 ± 2.5 , P = 0.000 8) . Application of auto-crosslinked HA gel after surgery significantly enhanced the improvement for each individual patient with regard to their adhesive type and menstrual pattern ( P = 0.037 8 , P = 0.000 4 ) . The treatment group had significantly lower proportion of patients with moderate to severe adhesive stages than that of control group [ 13 % ( 7/55 ) versus 38 % ( 21/56 ) , P = 0.000 6 ] . No adverse events and complications were observed . CONCLUSIONS Auto-crosslinked HA gel coule be able to reduce IUA , decrease adhesion severity , and improve menopause postoperatively . This absorbable auto-crosslinked HA gel is proposed as a barrier for preventing IUA after intrauterine procedures The purpose of this study was to evaluate the influence of intrapulpal pressure and dentin depth on bond strengths of an etch- and -rinse and a self-etching bonding agent to dentin in vitro and in vivo . Twenty-four pairs of premolars were r and omly divided into four groups ( n = 6 ) according to the dentin bonding agent , Single Bond and Clearfil SE Bond , and intrapulpal pressure , null or positive . Each tooth of the pair was further design ated to be treated in vivo or in vitro . The intrapulpal pressure was controlled in vivo by the delivery of local anesthetics containing or not a vasoconstrictor , while in vitro , it was achieved by keeping the teeth under hydrostatic pressure . Class I cavities were prepared and the dentin bonding agents were applied followed by incremental resin restoration . For the teeth treated in vitro , the same restorative procedures were performed after a 6 month-storage period . Beams with 1 mm(2 ) cross-sectional area were prepared and microtensile tested . Clearfil SE Bond was not influenced by any of the variables of the study , while bond strengths produced in vitro were significantly higher for Single Bond . Overall , lower bond strengths were produced in deep dentin , which reached statistical significance when Single Bond was applied under physiological or simulated intrapulpal pressure . In conclusion , in vitro bonding may overestimate the immediate adhesive performance of more technique-sensitive dentin bonding systems . The impact of intrapulpal pressure on bond strength seems to be more adhesive dependent than dentin morphological characteristics related to depth OBJECTIVE To evaluate the mechanical and chemical control of dental biofilm in patients with Down syndrome , using different experimental dentifrices . MATERIAL AND METHODS Forty institutionalized children between ages 7 and 13 years in the mixed dentition phase participated in this study . An experimental cross-over , blind clinical trial was used , having the following protocol s : fluori date d dentifrice ( protocol G1 ) ; fluori date d dentifrice + chlorhexidine ( protocol G2 ) ; fluori date d dentifrice + chlorhexidine + plaque-disclosing agent ( protocol G3 ) ; and fluori date d dentifrice + plaque-disclosing agent ( protocol G4 ) . Each experimental stage lasted 10 days with a 15-day washout . The evaluated parameters were Plaque Index and gingival bleeding . RESULTS The initial clinical conditions between each stage were similar . Statistical differences were observed ( P < 0.001 ) for the clinical conditions evaluated before and after the treatments . The dentifrices containing plaque-disclosing agent , irrespective of their association with chlorhexidine , produced a greater reduction in the final plaque index . As for gingival bleeding , the dentifrice containing erythrosine and the one containing chlorhexidine produced similar results . The dentifrice containing an association of chlorhexidine and erythrosine gave the best results . CONCLUSION With the methodology employed , it was possible to conclude that the combination of drugs ( chlorhexidine , fluorine and erythrosine ) within one dentifrice can be useful in controlling dental biofilm and in the reduction of gingival bleeding
Both synthetic and naturally derived crosslinkers have been found to exhibit significant effects in biomodification of dentine via their multiple interactions with the dentine matrix .
A stable matrix network or a durable hybrid layer in dentine bonding could be achieved , where the dentine collagen fibrils show improved biochemical and biomechanical properties and enzymatic biodegradation is reduced .
This aim of this review is to explore the current research related to  crosslinking agents used on dentine .