Journal of Dental Medicine

After approximately 40 years of experience in the field of resin - bonded restorations (R.B.R),these restorations arc one of the most controversial. During these years, many suggestions have been made for better performance and increasing durability of these restorations. The aims of this paper are:1 - Reviewing the literature for the so many factors involving the success or failure of R.B.R.2 - Introducing a new and simplified method for increasing the durability and /or relention of R.B.R.

Statement Problem: A few studies have been conducted about bioglass posts.
Aim: The aim of this study was to compare bioglass posts with prefabricated metallic posts in clinical performance of extensive composite restorations for anterior endodontically treated teeth.

Materials and Methods: Sixty endodontocally maxillary anterior teeth, with horizontally or vertically destruction, were selected. Teeth were divided into two groups based on the kind of post: Metallic prefabricated parapost and bioglass post. Each group was divided into three subgroups based on anterior bite: normal, deep bite and edge to edge. Gutta-percha was removed from 2/3 of canal length for parapost and 1/3 for bioglass post. After etching with phosphoric-acid (37%) and applying dentine bonding syntac, Duo cement was used for the adhesion of bioglass post and a self cured composite (Degufil) for parapost. Restoration was done with a hybrid composite (Heliomolar). Follow up studies, radio-graphically and clinically, were done every three months for a 1.5-year period. Exact Fisher and Pearson tests were used for data analysis.
Results: Apical lesion was not observed in any of the radiographs. Post seal was increased by resin cement and dentin bonding agent. Post type did not significantly affect on the clinical success rate of the restorations. The retention of restoration, for both posts, was the same. Crown destruction had no significant effect on success rate. The type of anterior bite had a significant effect on success rate, as the total 6.6% failure rate was related to the patients with anterior deep bite.
Conclusion: It is suggested to use metallic paraposts and bioglass posts, in extensive composite restorations for patients with deep-bite, more conservatively.

Statement of Problem: Microleakage presents the major cause for restorations failure in the oral cavity resulting in postoperative sensitivity, pulp irritation and secondary caries formation.

Aim: The aim of this study was to compare two dentinal adhesive systems of fifth generation and copalite varnish in reducing microleakage of amalgam restorations in primary teeth.
Materials and Methods: In this in-vitro study, 100 class V amalgam restorations were prepared on the buccal or lingual surfaces of primary molar and canine teeth. Samples were randomly divided into four groups (25 samples each). No liner was used for the first group and the second group restorations were lined with copalite varnish. Two dentin adhesives, called Syntac C and Single Bond, were used for the third and fourth groups, respectively. At the next stage, the samples were immersed in 5% fuschin solution for 24 hours, then sectioned buccolingually, and examined under a stereomicroscope for microleakage evaluation.
Results: There was a significant difference between four groups statistically (PO.000I), Comparing four groups, the first and fourth ones, demonstrated the most and the least microleakage, respectively.

Conclusion: The present study showed that new dentinal adhesive systems caused microleakage reduction in amalgam restorations of primary teeth.

Statement of Problem: Parafunctional habits are the most important factor in the creation of non-carious cervical lesions and correcting of these habits may affect cervical lesions.

Purpose: The goal of this study was to survey the effects of one-year occlusal adjustment on clinical success of non- carious cervical restorations.

Materials and Methods: In this clinical study, sixty tooth-colored cervical restorations on canines and premolars in patients with parafunctional habits (bruxism and clenching) were studied. The teeth, according to the type of restorative material, were randomly divided into two groups: One group with a composite resin (Tetric Flow Group A: n=30) and the other group with a compomer (Compoglass Flow Group B: n=30). After restoration, each group was divided into two subgroups: (A1, B1) with occlusal adjustment (case group), (A2, B2) without occlusal adjustment (control group). The evaluation was perfumed single blind at 6 and 12 months after restorative operations according to Us Public Health Service (USPHS) classification. Assessment criteria included: marginal integrity, marginal discoloration, recurrent caries, postoperative sensitivity and loss of filling. Statistical analysis was completed using Fisher’s exact test.

Results: In 12 month period between two groups of compoglass Flow restorations, group B1 showed superior results than group B2, however, no significant difference was found between both groups of tetric flow restorations (A1 and A2). There was also no difference in clinical conditions between A2 and B2 groups.

Conclusion: Considering the results of this study, it can be concluded that occlusal adjustment puts a considerable effect on clinical success of compoglass non- carious cervical restorations. However, it should be mentioned that such and effect was not found among Tetric flow restoration.

Statement of Problem: One of the greatest problems in metal –ceramic restorations is debonding of porcelain from dental alloys. Production of dental alloys by Iranian companies necessitates the evaluation of physical and handling properties of these products.

Purpose: In this study the bond strength between porcelain and two types of base metal alloys, Supercast (with beryllium) and Minalux (without beryllium) was investigated.

Materials and Methods: In this experimental study 10 cylindric bars from each base metal alloy were prepared. The bars were degassed and porcelain was applied around them in a disc form (8 mm diameter and 2 mm thickness). The bond strength of porcelain to metal bars was tested with the shear strength test by Instron. Data were analyzed with student t-test and P<0.05 was considered as the limit of significance.

Results: The mean failure load was 71.58±6.4 KgF for Supercast and 67.34±5.48 for Minalux alloy. The bond strength of Supercast and Minalux were 55.85±4.99 MPa and 52.54±4.27 MPa respectively. The difference was statistically significant (P0.001).

Conclusions: This study showed that nickel-chromium-beryllium alloy (Supercast) produced significantly better ceramometal bonding than nickel chromium alloy without beryllium (Minalux).

Background and Aim: Use of provisional restorations is one of the important phases in the treatment of patients who need fixed prosthesis. Some physical properties are required for these materials. The purpose of this study was the comparison of some physical properties of 4 kinds of resins: Trim, Tempron, Duralay (Aria Dent) and Acropars TRII.

Materials and Methods: In this experimental study, transverse-strength (TS), setting time (ST), polymerization shrinkage (PS) and temperature rise (TR) during polymerization were tested. In transverse strength test, 5 samples of each resin were made. TS testing was done with an Instron testing machine. ST testing (5 samples in each group) was done with Gilmore needle. In PS test, 11 cylindric samples were prepared from each resin and the shrinkage was examined with digital micrometer (up to 24 hours). In TR test, after mixing the powder and liquid of resins (8 samples in each group), the temperature rise was recorded with 10 seconds interval (up to 15 minutes). Data were analyzed with one-way ANOVA and Tukey HSD tests with p<0.05 as the limit of significance.

Results: In TS test, all samples of Trim were bent and no fracture was observed, while Tempron and Duralay showed no significant difference. Both Tempron and Duralay revealed high significant difference with Acropars TRII (P <0.01). In ST test, the difference between groups was significant (P<0.01). The lowest ST was observed in Acropars TRII (7 min), and the highest in Tempron (9.53 min). In PS test, significant difference was observed between Trim and Acropars TRII (P<0.01). PS was completed after 120 min in Tempron and Trim groups. However, PS continued to increase in other groups. In TR test, the difference between groups was significant (P<0.05). Duralay showed the highest TR and the lowest was seen in Trim.

Conclusion: In this study, Trim showed better properties than other studied groups. Acropars TRII had the lowest strength. The highest temperature rise was recorded for Duralay and Tempron, respectively.

Background and Aim: Replacing fractured ceramometal restorations may be the best treatment option, but it is costly. Many different bonding systems are currently available to repair the fractured ceramometal restorations. This study compared the shear bond strength of composite to a base metal alloy using 4 bonding systems.

Materials and Methods: In this experimental in vitro study, fifty discs, casted in a Ni-Cr-Be base metal alloy (Silvercast, Fulldent),were ground with 120, 400 and 600 grit sandpaper and divided equally into 5 groups receiving 5 treatments for veneering. Conventional feldspathic porcelain (Ceramco2, Dentsply Ceramco) was applied on control group (PFM or group1) and the remaining metal discs were air- abraded for 15 seconds with 50 mm aluminum oxide at 45 psi and washed for 5 seconds under tap water.Then the specimens were dried by compressed air and the  groups were treated with one of the bonding systems as follows: All-Bond 2 (AB), Ceramic Primer (CP), Metal Primer II (MP) and Panavia F2 (PF). An opaque composite (Foundation opaque) followed by a hybrid composite (Gradia Direct) was placed on the treated metal surface and light cured separately. Specimens were stored in distilled water at 37⁰C and thermocycled prior to shear strength testing. Fractured specimens were evaluated under a stereomicroscope. Statistical analysis was performed with one way ANOVA and Tukey HSD tests. P<0.05 was considered as the level of significance.

Results: Mean shear bond strengths of the groups in MPa were as follows: PFM group 38.6±2, All-Bond 2 17.06±2.85, Ceramic Primer 14.72±1.2, Metal Primer II 19.04±2.2 and Panavia F2 21.37±2.1. PFM group exhibited the highest mean shear bond strength and Ceramic Primer showed the lowest. Tukey's HSD test revealed the mean bond strength of the PFM group to be significantly higher than the other groups (P<0.001). The data for the PF group was significantly higher than AB and CP groups (P<0.05) and the shear bond strength of the MP group was higher than CP group, but was not significantly different from AB (P>0.05).

Conclusion: Based on the results of this study, the most reliable treatment for fractured metal-ceramic restorations would be the replacement of the restoration. If this is not possible, adhesive resin cements containing filler and phosphate-based monomers (especially MDP) such as Panavia F2 could be recommended for bonding composite to base metal alloys.

Background and Aim: Application of varnish and dentin bonding agents can effectively reduce microleakage under amalgam restorations. Also rebonding may show some effects on microleakage and its complications. The aim of this study was to evaluate the effect of liner/ adhesives on microleakage of Class V amalgam restoration with or without rebonding.

Materials and Methods: In this in vitro study Class V cavities were prepared on sixty sound human maxillary premolars with the gingival floor 1mm below the CEJ. Cases were divided into six groups of ten teeth each. Specimens in group 1 and 2 were lined with Copalite and Scotchbond Multi-Purpose (SBMP) respectively. In the third group (control) no liner was applied. The teeth were then restored with spherical amalgam. Specimens in group 4 to 6 received the same treatments but after filling, the interfaces of restorations and teeth were etched with 37% phosphoric acid gel, rinsed and dried. Adhesive resin of SBMP was applied over amalgam and tooth margins and polymerized (rebonding). Specimens were thermocycled, exposed to dye and sectioned. Microleakage was graded (0-3) using a stereomicroscope at X40 magnification. Data were analyzed with Kruskal-Wallis, Mann-Whitney and Wilcoxon pair wise statistical tests. P<0.05 was considered as the limit of significance.

Results: The groups lined with SBMP showed the lowest and the groups without liner the highest microleakage (p= 0.001). Significant difference was observed in microleakage mean rank of enamel and dentin margins (p=0.048). Rebonding with resin did not improve the seal (p> 0.05).

Conclusion: Based on the results of this study, total etch adhesive system had significant effect on microleakage of Class V amalgam restorations especially in cervical margin. Rebonding did not show a significant effect on microleakage.

Background and Aim: Microleakage has been always a major concern in restorative dentistry. The curing contraction of composites still presents a problem with controlling microleakage and postoperative sensitivity. The aim of this study was to investigate the effect of flowable and dual-cure resin composite liners on gingival microleakage of packable resin composite restorations.

Materials and Methods: Sixty Class II cavities with cervical margins 1 mm below the CEJ were prepared in 30 extracted human molars. The teeth were randomly divided into five groups of 12 each. In control group, each tooth was restored incrementally with Tetric Ceram composite without applying any liner. In the second and forth groups, flowable materials- Tetric Flow and dual-cure composite resin cement Relay X ARC were placed respectively as a 1-mm thick gingival increment and cured before the resin composite restoration, whereas, in the third and fifth groups liners were cured with the first increment of packable composite.The restored teeth were stored for one week in distilled water at 37⁰C, and thermocycled between 5⁰C and 55⁰C, sealed with nail varnish except the tooth - composite interface in cervical restoration margins and immersed in 2% basic fuchsin for 24 hours. Dye penetration was evaluated using a stereomicroscope with 28x magnification. The data were analyzed by Kruskal-Wallis and Mann-Whitney U-tests with p<0.05 as the level of significance.

Results: The results of this study indicated that there were significant statistical differences between control - cured flowable liner, control-flowable liner without separately curing, control-cured dual cure composite resin cement groups.However there were no significant differences between dual-cure composite resin cement without separately curing-control,cured flowable liner-cured dual cure composite resin cement, flowable liner without separately curing-dual cure composite resin cement without separately curing groups.

Conclusion: The results of this study indicated that none of techniques could thoroughly eliminate microleakage in gingival floor, however the effect of flowable or a dual-cure liner on reducing the gingival microleakage was found to be statistically significant in tested restorative material.

Background and Aims: Soft tissue management with providing the esthetic for restoration of a single implant in the anterior maxilla is of great importance. Tissue training helps to develop a proper emergence profile and natural tooth appearance. The aim of this article was to report a nonsurgical management of undesirable contours of soft tissue around maxillary anterior implants to achieve an optimum appearance.

Materials and Methods: A 23-year-old female with congenital missing of maxillary lateral incisors, after completion of a fixed orthodontic treatment and gain enough space, received 2 dental implants. After second phase surgery and healing period, construction of the restorations was not possible through conventional method because of severe soft tissue collapse. In this case, soft tissue contours were corrected using a provisional restoration and then final restoration was made and delivered.

Conclusion: Tissue training with a provisional restoration helps to re-establish normal gingival tissue contours and interdental papillae around the restoration of maxillary anterior implants.

Background and Aims: Marginal adaptation is important for the long-term success of full-coverage restorations. Preparation design is one of the important factors influencing the marginal integrity. Therefore, the purpose of this study was to compare the effect of radial shoulder and chamfer finish line designs on the marginal adaptation of all-ceramic Cercon restorations.
Materials and Methods: This in vitro study was done using single blind experimental technique. One stainless steel die with 7 mm height and 5 mm diameter was prepared by milling machine. The preparation design consisted of half radial shoulder with 1mm depth and half chamfer with 0.8mm depth. All walls had a convergence angle of 10º. Ten stone dies and ten ZrO2 copings of Cercon (Cercon Smart Ceramics, DeguDent, Hanau, Germany) were made and after cementation were ground at buccolingual direction. Then marginal gap of each sample was measured by scanning electron microscopy. Data were then analyzed using t-test.
Result: The mean marginal gap for radial shoulder was 98.4µ and for chamfer was 39.7µ. The difference was statistically significant (P=0.002).
Conclusion: The marginal gap of chamfer preparation is less than that of radial shoulder.

Background and Aims: This ex vivo study was done to evaluate the effect of different adhesive systems on microleakage of class V composite restorations.
Materials and Methods: Thirty extracted human third molar teeth were selected and class V cavities were prepared (3×3×1.5 mm) on buccal and lingual surfaces. Then, teeth were divided into 3 groups. Adhesives used in this study were Excite (Ivoclar/Vivadent), AdheSE(Ivoclar/Vivadent) and AdheSE-one Ivoclar (Vivadent/Vivadent). After application of adhesives, cavities were restored with a resine composite (InTen-S A1/ Ivoclar), in 3 increments and cured with QTH light curing unit (700 mW/cm). After 24 hours storage of teeth in 370C water, teeth were thermocycled (500 cycles in 5-550C) and stored in 1% basic fushin for 24 hours. After that, the specimens were rinsed with running water and mounted in a self-cured acryl. Finally, the specimens were sectioned and maximum depth of dye penetration for each restoration was measured using stereomicroscopy. The results were statistically analyzed with Mann-Whitney U test.
Results: In comparison between enamel and dentin margins in each group, microleakage in enamel margins were less than that of dentin margins. This difference was statistically significant in Excite and AdheSE-one groups (P=0.001, P=0.043). AdheSE showed the least microleakage in dentin margins however, there was no significant difference between 3 bonding agents (P=0.14). In enamel margins, there were significant differences between 3 bonding agents (P=0.001). Excite showed the lowest microleakage and AdheSE-one had the highest microleakage.
Conclusion: The least enamel microleakage was associated with the total-etch and least dentin microleakage was observed in the two-step self-etch adhesive system.

Background and Aims: Reliable bonding between tooth substrate and zirconia-based ceramic restorations is always of great importance. The laser might be useful for treatment of ceramic surfaces. The aim of the present study was to investigate the effect of laser irradiation on the shear bond strength of zirconia ceramic surface to dentin.

Materials and Methods: In this experimental in vitro study, 40 Cercon zirconia ceramic blocks were fabricated. The surface treatment was performed using sandblasting with 50-micrometer Al2O3, CO₂ laser, or Nd:YAG laser in each test groups. After that, the specimens were cemented to human dentin with resin cement. The shear bond strength of ceramics to dentin was determined and failure mode of each specimen was analyzed by stereo-microscope and SEM investigations. The data were statistically analyzed by one-way analysis of variance and Tukey multiple comparisons. The surface morphology of one specimen from each group was investigated under SEM.

Results: The mean shear bond strength of zirconia ceramic to dentin was 7.79±3.03, 9.85±4.69, 14.92±4.48 MPa for CO₂ irradiated, Nd:YAG irradiated, and sandblasted specimens, respectively. Significant differences were noted between CO₂ (P=0.001) and Nd:YAG laser (P=0.017) irradiated specimens with sandblasted specimens. No significant differences were observed between two laser methods (P=0.47). The mode of bond failure was predominantly adhesive in test groups (CO₂ irradiated specimens: 75%, Nd:YAG irradiated: 66.7%, and sandblasting: 41.7%).

Conclusion: Under the limitations of the present study, surface treatment of zirconia ceramics using CO₂ and Nd:YAG lasers was not able to produce adequate bond strength with dentin surfaces in comparison to sandblasting technique. Therefore, the use of lasers with the mentioned parameters may not be recommended for the surface treatment of Cercon ceramics.

Background and Aims: When composite resin polymerizes, shrinkage stresses tend to produce gaps at the tooth/ restoration interfaces. Surface sealants may reduce or avoid problems related to the marginal interface. The aim of this study was to evaluate the effect of two different surface sealants (Fortify and Optiguard) on the microleakage of class V resin composite restorations.

Materials and Methods: Twenty three sound noncarious molars were collected. Totally, 45 Class V cavities with the occlusal margins in enamel and cervical margins in cementum were prepared in both buccal and lingual surfaces. The specimens were randomly assigned in three groups (15 cavities in each group) and then restored with a resin composite. After the finishing and polishing procedures, the restorations in each group were covered with a specific surface sealant, except for the control samples, which were not sealed. After placing restorations, the specimens were thermocycled and then immersed in a 50% silver nitrate solution (tracer agent) for four hours, sectioned longitudinally and analyzed for leakage using a stereomicroscope in a blind manner. The marginal microleakage was evaluated at the occlusal and cervical interfaces and compared among the three groups using the Kruskall-Wallis and the Mann-Whitney U tests.

Results: Microleakage was found in all groups at both occlusal and cervical margins. Significantly greater leakage was observed at the cervical margins compared to the enamel margins of the material groups (P=0.005). There was no statistically significant difference among the groups at occlusal margins (P=0.66). In the cervical region, Fortify showed improved results and statistically presented the lowest degree of microleakage (P=0.003).

Conclusion: The used sealant materials presented different rates of effectiveness and Fortify decreased marginal microleakage significantly.

Background and Aims: Using the conservative adhesive resin restoration (CAR) in uncooperative children lead to numerous problems because of being time consuming. The purpose of this study was to compare the microleakage of conservative adhesive resin restoration under separate curing and co-curing.

Materials and Methods: In this experimental study, 120 intact premolar teeth were collected and 120 vertical grooves were prepared on them. Then the teeth were divided into four groups: group 1, separated curing of bonding agent, flowable composite and sealant group 2, co-curing of all materials for 60 seconds group 3,
co-curing of all materials for 40 seconds and group 4, co-curing of all materials for 20 seconds. Then the specimens were thermocycled and immersed in basic fuchsin solution. The teeth were sectioned horizontally and dye penetration was evaluated with stereomicroscope. Date were analyzed using one-way ANOVA and Scheffe test.

Results: Mean value of dye penetration in groups 1, 2, 3, and 4 was 1.53±0.6, 2.06±0.6, 2.5±0.7 and 3.53±0.6, respectively. There was a statistically significant difference between group 1 and the other groups (P=0.0001).

Conclusion: Considering the problems caused by microleakage in conservative resin adhesive restorations, co-curing method should not be used. In the case of using co-curing method, 60 second curing time is suggested for sufficient polymerization.

Background and Aims: Although composite resin restorations have many advantages, they can lead to several clinical problems. The primary reason for these problems is microleakage. The aim of this study was to compare the rebonding effect on microleakage of class V composite restorations using two low viscosity resins.
Materials and Methods: In this in vitro study, 60 class V composite restorations were performed in buccal and lingual surfaces of human extracted premolars with the occlusal margin in enamel and the gingival margin in dentin/cementum. The teeth were randomly divided into 3 groups: (I) restorations with no rebonding, (II) restoration margins rebonded with an enamel adhesive (Margin Bond), (III) restoration margins rebonded with a specific unfilled resin. The specimens were then thermocycled and immersed in 0.5% fuchsin dye solution. The samples were sectioned longitudinally and observed under a stereomicroscope for assessment of microleakage. The data were analyzed by Kruskal-Wallis, Wilcoxon and Mann-Whitney tests. P<0.05 was considered as the level of significance.
Results: Statistical analysis showed a significant difference in the microleakage of gingival margins (P<0.0001), but not in enamel margins (P=0.148). Microleakage at the gingival margins of group (III) was significantly less than that of group (II). Group (I) showed the highest amount of microleakage.
Conclusion: Rebonding by a low viscosity resin reduces microleakage at the gingival margins of class V composite restorations, but has no significant effect on the occlusal margins.

Background and Aims: The marginal integrity of fixed restorations always is a major matter of concern for dental clinicians. Any cause of distortion, including veneering processes, in the marginal integrity is supposed to be detrimental for long-term success of fixed dental prostheses. The aim of this in vitro study was to compare the marginal adaptation of two different full ceramic restoration systems (Zirkouzahu&Cercon) and possible changes in marginal integrity following the multiple veneering process.

Materials and Methods: Twelve all-ceramic crowns in the form of coping were fabricated on a pre-made standard metal die with finish line of shoulder preparation from two commercial systems: Cercon® and Zirkonzahn®. The specimens were not cemented. The Crown/Die discrepancy were measured by means of a precise stereo microscope (accuracy±0.1 μm), at various points (n=12) selected along circumferential margin of the restorations. Same procedure was accomplished after applying the veneering porcelain. The mean gap dimensions were calculated and data were analyzed by multivariate (b) test.

Results: Mean marginal gap dimensions before and after veneering porcelain firing cycles, for Cercon® were (59.67±13.46 µm) and (63.75±14.16 µm) and for Zirkonzahn® were (65.81±24.37 µm) and (64.74±21.94 µm), respectively. Hotelling trace Multivariate(b) test method showed that the rate of mismatching marginal integrity in two groups (Cercon® and Zirkonzahn®) had no significant difference before and after porcelain firing (P>0.05).

Conclusion: Within the limitation of this study, the marginal integrity of both systems were seems to be within the clinically acceptable standard dimension, i.e. 120μm.The marginal gap of both all-ceramic systems were not affected by veneering porcelain firing cycles.

  Background and Aims: The ability of composite restorations to prevent microleakage needs desirable bonding material for proper sealing . The purpose of this study was to evaluate class V composite restorations microleakage in premolars with/without electric current while applying variant dentin bonding in vitro.

  Materials and Methods: 120 non-carious human premolars were used for this study and standardized class v cavities were prepared. The tooth roots were cut by discs at a distance of 5 mm from CEJ and pulp tissue was removed. The teeth were divided into six groups of 20. In the first group, electric current was applied, Single bond (3M ESPE, St Paul, MN, USA) with a broom motion attached to the cathode and a sponge containing bonding was used as anode. The used current was 15µA and the Single bond in the second group was used without electricity. Then two bondings PQ1 (Ultradent, Germany) and Optibond solo plus (Kerr, USA) were used with and without electricity. After adhesive application and curing the bonding agents, cavities were restored by a composite (Valux Plus). The root ends were sealed by wax and all teeth surfaces, except 1 mm around the restorations were covered with a nail varnish. The specimens were thermocycled for 1000 cycles and placed in fushin for 24 hours and were then sectioned vertically and examined under a stereomicroscope. Data were scored on a 0-4 scale based on microleakage at the gingival margins and analyzed using Kruskal-Wallis and Mann-whitney test.

  Results: Based on the results, the extent of microleakage in the groups of electric current was significantly less than the groups without using the electric current (P=0.05). The lowest degree of microleakage was found in PQ1 group, and the greatest difference between the groups with and without electricity was also found in PQ1 group. Single bond and Optibond Solo Plus with electric current showed a lower degree of microleakge.

  Conclusion: The result showed that use of electric current during the application of dental adhesives could reduce the extent of microleakage.

  Background and Aims: The most effective preventing tooth decay method is fluoride compounds applications. Some studies suggested that APF gels caused changes on the superficial physical properties of composite. Therefore, the purpose of this study was to evaluate the marginal microleakage of class V composite restorations before and after AFP gel application.

  Materials and Methods: The class V cavities in buccal surfaces of 45 molar teeth were made in such a way that occlusal margin was placed in enamel and cervical margin in cement. In group 1, at first fluoride-therapy and then cavity preparation and restoration by composite resin was done. In group 2, at first the class V cavities were prepared and restored, then fluoride-therapy was carried out. In group 3, cavities were prepared and restored with no fluoride-therapy. The dye penetration rate in occlusal and cervical margins was examined by stereomicroscope. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney test.

  Results: There was no statistically significant difference between groups ( P=0.975).

  Conclusion: Fluoride-therapy using AFP gel before and after class V composite restorations, had no significant effect on the microleakage of dentin and enamel margins.

  Background and Aims: Tooth crowning often leads to changes in periodontal index through changes in emergence profile zone. The purpose of this study was to compare the effect of metal-ceramic with that of
All-Ceramic restorations on the plaque a accumulation.

  Materials and Methods: In this clinical trial, we used 102 teeth covered with metal-ceramic and all-ceramic restorations. Before and after crowning, plaque index (PI) and gingival indexes (MGl) were measured. Data were analyzed using covariance (ANCOVA) test.

  Results: Measured PI and MGI (Mean±SD) in PFM Group prior to crowning were (1.96±0.38) and (1.45±0.48), respectively. In metal-ceramic restorations group, six months after crowning, measured PI and MGI (Mean±SD) were (1.22±0.49) and (1.82±0.61), respectively. Measured PI and MGI (Mean±SD) in All-Ceramic Group prior to crowning were (1.22±0.52) and (1.25±0.29), respectively. In All-Ceramic, six months after crowning, measured PI and MGI (Mean±SD) were (0.88±0.51) and (1.43±0.50), respectively. ANOVA test showed statistical significance difference between metal-ceramic and All-Ceramic Groups in Indexes (P<0.001).

  Conclusion: Metal-ceramic and All-Ceramic crowns were associated with inflammatory changes in gingival. Metal-ceramic restorations were associated with higher inflammatory indexes compared with All-Ceramic crowns.