A. Minstens vijf van onderstaande symptomen zijn aanwezig geweest gedurende de laatste twee weken en wijzen op een verandering ten opzichte van het eerdere functioneren. Tenminste één van de symptomen is een depressieve stemming (1) of verlies van interesse of plezier (2). 1. Depressieve stemming gedurende het grootste deel van de dag, bijna elke dag; 2. Duidelijke vermindering van interesse of plezier in bijna alle activiteiten; 3. Duidelijke gewichtsvermindering zonder dat dieet wordt gehouden, of gewichtstoename; 4. Slapeloosheid of overmatige slaperigheid; 5. Psychomotore agitatie of remming; 6. Moeheid of verlies van energie, bijna elke dag; 7. Gevoelens (die waanachtig kunnen zijn) van waardeloosheid of overmatige schuldgevoelens, bijna elke dag; 8. Verminderd vermogen tot nadenken, concentratie of besluiteloosheid, bijna elke dag; 9. Terugkerende gedachten aan de dood, terugkerende suïcidegedachten zonder dat er specifieke plannen gemaakt zijn, of een suïcidepoging of een specifiek plan om suïcide te plegen. B. De patiënt heeft niet ook kenmerken van een manische episode. C. De symptomen veroorzaken in significante mate lijden of beperkingen in het sociaal of beroepsmatig functioneren of het functioneren op andere belangrijke terreinen. D. De symptomen zijn niet het gevolg van de directe fysiologische effecten van een middel (bijvoorbeeld drug, geneesmiddel) of een somatische aandoening (bijvoorbeeld hypothyreoidie).

Toolkit 설정 편집

This literature-based OPINION PAPER reflects in an introductory historical perspective on the rapid advancement of dental adhesive technology. Past and current techniques to bond to tooth tissue, in particular to dentin as the most challenging bonding substrate, are critically appraised. Including the historical perspective in (1), this paper focuses on fourteen items thought to be of primary importance with regard to the current status of dental adhesive technology. In (2) the primary mechanisms involved in adhesion to enamel and especially dentin are dealt with having (3) also revisited the previously introduced adhesion-decalcification concept (AD concept) as basis of biomaterial-hard tissue interaction; the worldwide accepted classification of today's adhesives into etchr nomination of the GOLD-STANDARD ER (11) description of the main bond-degradation pathways and eight strategies to preserve bond stability; (12) coverage of the PROS and CONS of the newest generation of UNIVERSAL adhesives. Looking into the future, some expected future developments in dental adhesive technology have been suggested in (13), along with (14) a first status determination of the latest research-and-development towards self-adhesive restorative materials that no longer require any pre-treatment.

From Buonocore's Pioneering Acid-Etch Technique to Self-Adhering Restoratives. A Status Perspective of Rapidly Advancing Dental Adhesive Technology.

Objectives To address contemporary concepts in adhesive dental materials with emphasis on the evidence behind their clinical use. Overview Adhesive dentistry has undergone major transformations within the last 20 years. New dental adhesives and composite resins have been launched with special focus on their user-friendliness by reducing the number of components and/or clinical steps. The latest examples are universal adhesives and universal composite resins. While clinicians prefer multipurpose materials with shorter application times, the simplification of clinical procedures does not always result in the best clinical outcomes. This review summarizes the current evidence on adhesive restorative materials with focus on universal adhesives and universal composite resins. Conclusions (a) Although the clinical behavior of universal adhesives has exceeded expectations, dentists still need to etch enamel to achieve durable restorations; (b) there is no clinical evidence to back some of the popular adjunct techniques used with dental adhesives, including glutaraldehyde-based desensitizers and matrix metalloproteinase inhibitors; and (c) the color adaptation potential of new universal composite resins has simplified their clinical application by combining multiple shades without using different translucencies of the same shade. Clinical significance New adhesive restorative materials are easier to use than their predecessors, while providing excellent clinical outcomes without compromising the esthetic quality of the restorations.

Adhesive dentistry: Current concepts and clinical considerations.

Bulk-filling of high C-factor posterior cavities: effect on

Currently, the availability of a wide variety of universal adhesives makes it difficult for clinicians to choose the correct system for specific bonding situations to dentin substrate. This study aimed to determine whether there are any alternative techniques or additional strategies available to enhance the bond strength of universal adhesives to dentin through a systematic review and meta-analysis. Two reviewers executed a literature search up to September 2020 in four electronic databases: PubMed, ISI Web of Science, Scopus, and EMBASE. Only in vitro studies that reported the dentin bond strength of universal adhesives using additional strategies were included. An analysis was carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic. A total of 5671 potentially relevant studies were identified. After title and abstract examination, 74 studies remained in systematic review. From these, a total of 61 studies were included in the meta-analysis. The bond strength of universal adhesives to dentin was improved by the use of one of the following techniques: Previous application of matrix metalloproteinases (MMP) inhibitors (p < 0.001), prolonged application time (p = 0.007), scrubbing technique (p < 0.001), selective dentin etching (p < 0.001), non-atmospheric plasma (p = 0.01), ethanol-wet bonding (p < 0.01), prolonged blowing time (p = 0.02), multiple layer application (p = 0.005), prolonged curing time (p = 0.006), and hydrophobic layer coating (p < 0.001). On the other hand, the use of a shortened application time (p = 0.006), and dentin desensitizers (p = 0.01) impaired the bond strength of universal adhesives to dentin. Most of the analyses performed showed a high heterogenicity. The in vitro evidence suggests that the application of universal adhesives using some alternative techniques or additional strategies may be beneficial for improving their bonding performance to dentin. This research received no external funding. Considering that this systematic review was carried out only with in vitro studies, registration was not performed.

Bond Strength of Universal Adhesives to Dentin: A Systematic Review and Meta-Analysis.

PURPOSE Universal adhesives use a combined primer/bonding resin applied either in 2-step etch-and-rinse (2-E&R) or 1-step self-etch (1-SE) mode. This study investigated whether three universal adhesives would benefit from an extra bonding layer (EBL), essentially making them 3-step E&R (3-E&R) and 2-SE adhesives, respectively. MATERIALS AND METHODS Microtensile bond strengths (μTBSs) to bur-cut dentin of Clearfil Universal Bond Quick (C-UBq, Kuraray Noritake), G-Premio Bond (G-PrB, GC) and Prime&Bond Active (P&Ba, Dentsply Sirona) were compared to those of the 2-SEa Clearfil SE Bond 2 (C-SE2, Kuraray Noritake) which was also employed in 3-E&R mode. A split-tooth design was applied with each adhesive used in E&R and SE mode on each tooth, half without/with EBL (C-SE2 Bond). All adhesives were light cured after application of the final layer. The μTBS of one-third of the specimens was measured after 1-month water storage without thermocycling (TC), with the remaining two-thirds aged with 25,000 and 50,000 TCs. All μTBSs were statistically analyzed using a linear mixed-effects model with specific contrasts (p < 0.05). RESULTS Overall, the four variables (adhesive, bonding mode, EBL, aging) significantly influenced μTBS. Solely G-PrB benefited from EBL when applied in SE mode. In E&R mode, P&Ba generally resulted in the highest µTBSs, C-UBq presented with intermediate and G-PrB with the lowest µTBSs, where the latter was significantly lower than the µTBSs recorded for C-SE2. In SE mode, P&Ba generally resulted in the highest µTBSs in 1- and 2-SE mode. Equally high µTBSs were recorded for G-PrB in 2-SE mode with EBL. Lower µTBSs were recorded for G-PrB in 1-SE mode and for C-UBq in 1- and 2-SE mode. CONCLUSION The overall effect of EBL on immediate and aged bonding efficacy depended on the specific universal adhesive and its bonding mode.

Do Universal Adhesives Benefit from an Extra Bonding Layer

This study aimed to measure the microtensile bond strength (μTBS) of a new universal adhesive (UA) bonded to dentin following a quick bonding mode. The experimental UA ‘SKB-100,’ now commercialized as Clearfil Universal Bond Quick (‘C-UBq’; Kuraray Noritake), was investigated, with Scotchbond Universal (‘SBU’; 3M Oral Care) and the two-step self-etch (SE) adhesive Clearfil SE Bond 2 (‘C-SE2’; Kuraray Noritake) serving as references. The adhesives were employed separately in etch&rinse (E&R) and SE modes on each tooth half following a split-tooth design and following their respective instructions for use, except for C-UBq that besides the manufacturer’s instructed quick bonding mode was also applied and left untouched for 20 s prior to light curing (‘C-UBq_20s’) and for C-SE2 that was also applied in the E&R mode. μTBS of half of the specimens was measured upon 1 week (1w), with the other half tested after 6-month (6m) storage in distilled water at 37 °C. Data were statistically analyzed using linear mixed-effects modeling and three-way ANOVA (p < 0.05). The adhesive–dentin interfaces were ultrastructurally characterized by TEM. C-UBq revealed a significantly lower μTBS than C-SE2. The highest μTBS was recorded for C-UBq_20s_1w and C-SE2_1w, both when applied in E&R mode. However, μTBS of C-UBq_20s significantly decreased upon aging in both modes. C-SE2 presented the significantly highest ‘aged’ μTBS. C-UBq applied in the quick bonding mode did not underperform to the UAs applied for 20 s. Superior bonding effectiveness was achieved by C-SE2 in SE and E&R bonding modes. Extended application time of C-UBq improved solely its immediate but not aged bonding effectiveness.

Quick Bonding Using a Universal Adhesive

PURPOSE To measure microtensile bond strength (μTBS) of universal adhesives immediately and after 6-month aging, with or without an additional adhesive layer applied on a separately light-cured or non-light-cured universal adhesive. MATERIALS AND METHODS Eighty human third molars were randomly assigned to 8 experimental groups. The universal adhesives Clearfil Universal Bond (Kuraray Noritake) and Single Bond Universal (3M Oral Care) were used in self-etch mode (following the manufacturer's directions), and either light cured or not before application of an extra hydrophobic adhesive layer (Clearfil SE Bond bond, Kuraray Noritake). The two-step self-etch adhesives Clearfil SE Bond (Kuraray Noritake) and OptiBond XTR (Kerr) were used as references. After composite buildups were bonded to mid-coronal occlusal dentin surfaces, the specimens were stored in water (37°C/24 h) and sectioned into microspecimens (0.96 ± 0.04 mm2). Half of the specimens were immediately subjected to μTBS testing (1.0 mm/min), while the other half was stored in water (37°C) for 6 months prior to testing. Failure analysis was performed using stereomicroscopy and SEM. Data were analyzed with two-way repeated measures ANOVA, Tukey's and paired t-tests (p = 0.05). RESULTS The immediate μTBS was similar for the universal adhesives when applied following the different application strategies (p > 0.05). Application of an extra layer of hydrophobic adhesive improved the aged μTBS of the universal adhesives, which was statistically significant when the universal adhesives were first light cured (p < 0.05). The reference adhesives Clearfil SE Bond and OptiBond XTR exhibited a significantly higher immediate and aged μTBS to dentin than did the universal adhesives (p < 0.05). CONCLUSION The bond durability of universal adhesives, applied in self-etch mode, was found to benefit from the application of an extra hydrophobic adhesive layer when the universal adhesives were first light cured.

Universal Adhesives Benefit from an Extra Hydrophobic Adhesive Layer When Light Cured Beforehand.

Purpose The material structure and chemical elemental composition of a new self-adhesive composite hybrid were investigated. The bonding performance when applied on flat (FLAT) vs high C-factor class-I cavity-bottom (CAVITY) dentin and in light-cure (LC) vs self-cure (SC) mode was determined. Materials and methods The self-adhesive bulk-fill composite Surefil One (Su-O; Dentsply Sirona) was compared with the resin-modified glass-ionomer Fuji II LC Improved (Fuji2LC; GC) and the ion-releasing alkasite material Cention N (CentionN; Ivoclar Vivadent). The material structure was examined with SEM and TEM, while the chemical elemental composition was analyzed using EDS. The immediate and aged microtensile bond strength (μTBS) of Su-O_LC/SC was compared to that of Fuji2LC applied without any pre-treatment, and to that of CentionN applied following bonding with Adhese Universal (AU) (Ivoclar Vivadent) in self-etch mode (AU/CentionN). All restorative materials were bonded onto FLAT and CAVITY dentin. Statistical analysis was performed with the Kruskal-Wallis nonparametric test. Results EDS analysis revealed that Su-O was richer in C and P than the reference restorative materials. Applied to FLAT dentin, the significantly highest immediate and aged μTBS were recorded for AU/CentionN, which were not significantly different only from Su-O_LC. Applied to CAVITY dentin, the significantly highest immediate μTBS was recorded for AU/CentionN, which did not differ significantly only from Su-O_SC. Su-O_LC bonded to CAVITY dentin suffered from a high incidence of pre-test failures. Conclusion While Su-O_LC bonded effectively and durably to FLAT dentin, Su-O_SC bonded more favorably than Su-O_LC in class-I cavities, which was probably related to shrinkage stress variously challenging the respective bond.

Mohammed H Ahmed

Papers

Do Universal Adhesives Benefit from an Extra Bonding Layer

Quick Bonding Using a Universal Adhesive

Universal Adhesives Benefit from an Extra Hydrophobic Adhesive Layer When Light Cured Beforehand.

Structural/Chemical Characterization and Bond Strength of a New Self-Adhesive Bulk-fill Restorative.

Bonding to enamel using alternative Enamel Conditioner/etchants.