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pain at rest and on palpation and depression. SS therapy isalso better than nonoccluding splints in providing the pa-tient with greater efficiency at work. Method of allocation,blind outcome assessment, sample size, and duration offollow-up should be included in further RCTs to studythese therapies in greater detail. Future RCTs should alsoestablish a standard method of measuring treatment out-comes.
Al-Ani Z, Gray RJ, Davies SJ, et al: Stabilization splint therapy for thetreatment of temporomandibular myofascial pain: A systematic re-view. J Dent Educ 69:1242-1250, 2005
Reprints available from Z Al-Ani, TMD Unit, School of Dentistry, Univof Manchester, Higher Cambridge St, Manchester, UK M15 6FH; fax:44-0-161-275-6797; e-mail: [email protected]
Clinical Significance.—Complaints of myo-fascial discomfort confront clinicians regular-ly. What to do? Much work has been advancedfor use of splint therapy and much literaturedisparages its benefit. In this study, while nosuperiority was shown for splint over otherconservative, reversible therapies, splint ther-apy provided demonstrable improvementwhen compared with no treatment.
the data, relative risk values were calculated in addition to95% confidence intervals for binary data and weighted meandifference for continuous data. Measurements includedpain, movement, overall improvement, and quality of life.
Results.—Twelve RCTs met the criteria. Comparisonswere made between SS and minimal or no treatment,nonoccluding splint therapy, acupuncture, biteplates,biofeedback/stress management, jaw exercises, and relax-ation therapy. Compared with such conventional methodsas acupuncture, biteplates, and biofeedback, no evidencewas found that SS therapy achieved outcomes significantlybetter than those accomplished with these conventionalapproaches. The severity of pain, measured by a subjectivesymptoms score, was reduced comparably by SS andacupuncture. Compared with no or minimal treatment,weak evidence supported SS therapy as providing betterpain relief. Specifically, SS therapy was beneficial in reduc-ing the severity of pain at rest and on palpation and de-pression when the alternative was no treatment. Quality-of-life measures (sleep, work efficiency, participation in socialactivities, feeling depressed or anxious, and appetite)showed that SS therapy achieved a statistically significantimprovement in efficiency at work compared to the effectof nonoccluding splints.
Discussion.—Compared with no therapy, SS therapyappears to be able to reduce the severity of myofascial
Background.—The bond strength achieved with all-in-one adhesives to dentin is reportedly less than thebond strength achieved with 2-step self-etch systems. Itwas suggested that tensile bond strength may be in-creased by a double application of the all-in-one system,and a study of Adper Prompt L-Pop found this to be thecase. Whether various single-step adhesives show im-
proved bond strength when they were applied twice wasinvestigated.
Methods.—The systems evaluated included 3 that arecommercially available—specifically, Prompt L-Pop (APL),REACTMER BOND (RB), and XENO III (Xeno)—and 1 ex-perimental bonding system, OBF-2 (OB2). The adhesive
232 Dental Abstracts
General DentistrySingle versus double applications of all-in-one adhesives
Fig 2.—Microshear bond strength of all-in-one adhesives to dentinwith use of single-and double-application. (Courtesy of Nakaoki Y,Sasakawa W, Horiuchi S, et al: Effect of double-application of all-in-one adhesives on dentin bonding. J Dent 33:765-772, 2005.Copyright 2005, with kind permission from Elsevier Science Ltd,TheBoulevard, Langford Lane, Kidlington OX5 1GB, UK.)
Volume 51 • Issue 4 • 2006 233
peared that a single application of RB was sufficient to ob-tain good bond strength.
Xeno-treated surfaces did not differ in bond strengthbetween the samples having a single and those having adouble application of adhesive. The second applicationdid not appear to increase the infiltration of resinmonomers.
For OB2, no significant difference in bond strengthwas found between the single- and double-applicationsamples. When 2 coats were applied, the intertubulardentin of OB2 became more porous than when a singlecoat was used.
Discussion.—Double applications of APL tended toincrease bond strength, but the results were not signifi-cantly different from single applications. The OB2 sam-ples appeared overetched when 2 applications were used.Both RB and Xeno produced little difference in bondstrength between samples having a single and those hav-ing a double application of adhesive. Overall, there wasno statistically significant difference in the microshearbond strength of all-in-one adhesives applied once ortwice.
Nakaoki Y, Sasakawa W, Horiuchi S, et al: Effect of double-application of all-in-one adhesives on dentin bonding. J Dent33:765-772, 2005
Reprints available from Y Nakaoki, Cariology, Operative Den-tistry and Endodontology, Dept of Oral Health Science, GraduateSchool of Dental Medicine, Hokkaido Univ, North 13 West 7,Kita-ku, Sapporo 060-8586, Japan; fax: +81 11 706 4878; e-mail:[email protected]
Clinical Significance.—Single-step dentinbonding systems have thus far shown lowerdentin-bond strength compared with 2-stepsystems. Claims that double application ofthese single-step materials would increasebond strength were not verified in this study,and a second application actually lowered thebond strength with several materials.
was applied to the dentin surface following manufactur-er’s instructions or in a double application. Resin com-posite was then placed and light-cured for 40 seconds.The samples were immersed in water for 24 hours, thensubjected to a microshear bond test. All fractured dentinsurfaces were assessed under the microscope.
Results.—No significant differences in the bondstrengths of the samples were noted, whether they wereapplied in a single or double application (Fig 2). For APL,the double-application group showed a tendency toward astronger bond than the single-application group. The mor-phology of the fractured surfaces differed greatly betweenthe 2 methods of applying adhesive. Surfaces with singleapplications were porous, fibrous, and overetched. Thusthe single application produced an effect typical of a strongetchant, although there may be insufficient infiltration ofresin to demineralized dentin. Surfaces having double ap-plications showed a dense intertubular dentin. The secondapplication appeared to improve the resin infiltration intothe intertubular demineralized dentin.
RB surfaces that fractured showed adequate infiltrationof the adhesive resin into the demineralized dentin. It ap-
