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  1. Akram Z, Abduljabbar T, Sauro S, Daood U
    Photodiagnosis Photodyn Ther, 2016 Dec;16:142-153.
    PMID: 27619532 DOI: 10.1016/j.pdpdt.2016.09.004
    BACKGROUND: To assess the efficacy of antimicrobial photodynamic therapy (aPDT) or laser therapy (LT) alone as an adjunct to scaling and root planing (SRP) on the gingival crevicular fluid (GCF) inflammatory proteins in periodontal disease.

    METHODS: Databases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched from 1980 up to and including July 2016. The addressed PICO question was: "What effect does aPDT and/or LT as an adjunct to SRP have on the GCF inflammatory proteins in periodontal disease patients?"

    RESULTS: Eight studies used aPDT while 10 studies used laser alone. Eight cytokines including tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10, interferon gamma (IFN-γ), matrix metalloproteinase (MMP)-8 and granulocyte colony-stimulating factor (GM-CSF) were eligible for qualitative analysis for aPDT and LT studies. Four aPDT studies showed significant reduction in IL-1β while one study showed significant reduction in TNF-α levels after aPDT application at follow-up. One study showed significant reduction of IFN-γ, IL-8 and GM-CSF levels after aPDT at follow-up. IL-1β significantly reduced in 4 LT studies, while one study showed significant decrease for IL-6 and TIMP-1 levels. MMP-8 and TNF-α showed significant reduction in three and one study respectively.

    CONCLUSION: It remains debatable whether adjunctive aPDT or LT is effective in the reduction of GCF inflammatory proteins in periodontal disease due to non-standard laser parameters and short follow up period. These findings should be considered preliminary and further studies with long-term follow up and standardized laser parameters are recommended.

  2. Al-Nabulsi M, Daud A, Yiu C, Omar H, Sauro S, Fawzy A, et al.
    Materials (Basel), 2019 Aug 07;12(16).
    PMID: 31394743 DOI: 10.3390/ma12162504
    Objective: To evaluate the effect of a new application method of bulk-fill flowable composite resin material on bond-strength, nanoleakage, and mechanical properties of dentine bonding agents.

    MATERIALS AND METHODS: Sound extracted human molars were randomly divided into: manufacturer's instructions (MI), manual blend 2 mm (MB2), and manual blend 4 mm (MB4). Occlusal enamel was removed and flattened, dentin surfaces were bonded by Prime & Bond universal (Dentsply and Optibond FL, Kerr). For the MI group, adhesives were applied following the manufacturer's instructions then light-cured. For MB groups, SDR flow+ bulk-fill flowable composite resin was applied in 2- or 4-mm increment then manually rubbed by a micro brush for 15 s with uncured dentine bonding agents and the mixture was light-cured. Composite buildup was fabricated incrementally using Ceram.X One, Dentsply nanohybrid composite resin restorative material. After 24-h water storage, the teeth were sectioned to obtain beams of about 0.8 mm2 for 24-h and thermocycled micro-tensile bond strength at 0.5 mm/min crosshead speed. Degree of conversion was evaluated with micro-Raman spectroscopy. Contraction gaps at 24 h after polymerization were evaluated and atomic force microscopy (AFM) nano-indentation processes were undertaken for measuring the hardness across the interface. Depth of resin penetration was studied using a scanning electron microscope (SEM). Bond strength data was expressed using two-way ANOVA followed by Tukey's test. Nanoindentation hardness was separately analyzed using one-way ANOVA.

    RESULTS: Factors "storage F = 6.3" and "application F = 30.11" significantly affected the bond strength to dentine. For Optibond FL, no significant difference in nanoleakage was found in MI/MB4 groups between baseline and aged specimens; significant difference in nanoleakage score was observed in MB2 groups. Confocal microscopy analysis showed MB2 Optibond FL and Prime & Bond universal specimens diffusing within the dentine. Contraction gap was significantly reduced in MB2 specimens in both adhesive systems. Degree of conversion (DC) of the MB2 specimens were numerically more compared to MS1 in both adhesive systems.

    CONCLUSION: Present study suggests that the new co-blend technique might have a positive effect on bond strengths of etch-and-rinse adhesives to dentine.

  3. Daood U, Sauro S, Pichika MR, Omar H, Liang Lin S, Fawzy AS
    Dent Mater, 2020 01;36(1):145-156.
    PMID: 31818524 DOI: 10.1016/j.dental.2019.11.003
    OBJECTIVE: To modify a universal dentine adhesive with different concentrations of riboflavin and D-Alpha 1000 Succinate polyethylene (VE-TPGS) as a chemical enhancer and to assess the micro-tensile bond strength (24h/12 months), determine resin penetration, measurement of intermolecular interactions and cytotoxicity.

    MATERIALS AND METHODS: An experimental adhesive system based on bis-GMA, HEMA and hydrophobic monomer was doped with RF0.125 (RF - Riboflavin) or RF/VE-TPGS (0.25/0.50) and submitted to μTBS evaluation. Resin dentine slabs were prepared and examined using SEM and TEM. Adhesion force was analysed on ends of AFM cantilevers deflection. Quenched peptide assays were performed using fluorescence scanner and wavelengths set to 320nm and 405nm. Cytotoxicity was assessed using human peripheral blood mononuclear cell line. Molecular docking studies were carried out using Schrödinger small-molecule drug discovery suite 2018-2. Data from viable cell results was analyzed using one-way ANOVA. Bond strength values were analysed by two-way ANOVA. Nonparametric results were analyzed using a Kruskal-Wallis test at a 0.05 significance level.

    RESULTS: RF/VE-TPGS0.25 groups showed highest bond strength results after 24-h storage in artificial saliva (p<0.05). RF/VE-TPGS0.50 groups showed increased bond strength after 12-months of ageing. RF/VE-TPGS modified adhesives showed appreciable presence of a hybrid layer. Packing fraction indicated solid angle profiles describing well sized density and topology relations for the RF/VE-TPGS adhesives, in particular with the RF/VE-TPGS0.50 specimens. Qualitative analysis of the phenotype of macrophages was prominently CD163+ in the RF/VE-TPGS0.50. Both the compounds showed favourable negative binding energies as expressed in terms of 'XP GScore'.

    CONCLUSION: New formulations based on the incorporation of RF/VE-TPGS in universal adhesives may be of significant potential in facilitating penetration, distribution and uptake of riboflavin within the dentine surface.

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