Clinical evaluation of self-adhering flowable composite versus conventional flowable composite in conservative Class I cavities: Randomized controlled trial, Shaalan, Omar Osama, Zoghby Amira Farid El, and Abouauf Eman A. , Journal of conservative dentistry: JCD, Volume 21 , Issue 5 , p. 485-490, (2018) Abstract

Background:
Self-adhering flowable composite (SAFC) minimized the time-consuming application procedures encountered with the traditional adhesive systems and restorative materials. Self-adhering composite combines the merits of both adhesive and restorative material technologies (8th generation) in a single product, bringing new horizons, and ambitions to restorative procedures.

Aim:
The aim of this study was to evaluate the clinical performance of SAFC compared to conventional flowable composite in conservative Class I cavities.

Materials and Methods:
In a split-mouth design, after cavity preparation, 18 patients with conservative Class I cavities received randomly two pairs of restorations, either Vertise™ flow or Filtek™ Z350 XT Flowable combined with Scotchbond™ Universal Etchant and Single Bond Universal, all materials were applied according to the manufacturer's instructions. Restorations were evaluated at baseline and after 6 months by two calibrated assessors using the modified United States Public Health Service criteria measuring (retention, postoperative hypersensitivity, color match, marginal adaptation, and marginal discoloration).

Statistical Analysis:
Chi-square test was used to compare between flowable composite materials after different follow-up periods, Wilcoxon signed-rank test was used to explore changes over follow-up periods. A value of P ≤ 0.05 was considered statistically significant. Results: At baseline and 6 months, there was no statistically significant difference between both materials for all tested outcomes.

Conclusions:
SAFC has shown clinical performance similar to conventional flowable composite after 6 months of clinical service.

The Effect of Gamma Radiation on the Shear Bond Strength of Flowable Self-Adhesive Resin Composite, Hazem Hussein Kazem, and Abouauf Eman Ali , Egyptian Journal of Radiation Sciences and Applications, Volume 30 , Issue 2 , p.153-159, (2017) Abstract

THIS study is designed to investigate the influence of exposure to therapeutic gamma radiation on a self adhesive resin (Vertise-Flow). Twenty freshly extracted human molars were selected and used in the study. All the sound molars were examined and confirmed free of any cracks or defects. Standardized twenty discs were prepared from the selected molars of 2mm thickness, then a hole of 3mm diameter was prepared in each disc. The twenty holes prepared were restored with Vertise-Flow according to the manufacturer’s instructions. Ten discs were randomly selected and subjected to an exposure dose of gamma radiation simulating the treatment dose delivered to the cancer patients, while the remaining discs were kept as control. Each sample was tested by a compressive loading via computer controlled materials testing machine, with a load of 5 KN. The maximum failure loading was reported in N, while the shear bond strength (SBS) was calculated in MPa. It was found that the SBS of self-adhesive resins were reduced upon exposure to the therapeutic dose of gamma radiation. Yet, the difference was not statistically significant. Using simplified resin restorations as the self-adhesive composite restorations could be an efficient and easy restorative for patients receiving gamma radiotherapy.

Stem/progenitor cell-mediated pulpal tissue regeneration: a systematic review and meta-analysis, Fawzy El‐Sayed, KM, Ahmed G. M., Abouauf EA, and Schwendicke F. , International endodontic journal, Volume 52, p. 1573–1585, (2019) Abstract

Abstract
Fawzy El-Sayed KM, Ahmed GM, Abouauf EA,
Schwendicke F. Stem/progenitor cell-mediated pulpal
tissue regeneration: a systematic review and meta-analysis.
International Endodontic Journal, 52, 1573–1585, 2019.
Background Stem/progenitor cell-mediated pulpal
regeneration could represent a promising therapeutic
alternative in the field of clinical endodontics.
Aim The present study aimed to systematically assess
and meta-analyse dental pulpal tissue regeneration, pulpal vitality and apical healing after the transplantation
of stem/progenitor cells versus no transplantation.
Data sources MEDLINE, Cochrane CENTRAL and
EMBASE were searched up to January 2019 for animal
experiments and human trials evaluating the pulpal
transplantation of stem/progenitor cells. Cross-referencing and hand search were additionally performed.
Study eligibility criteria, participants and
interventions Based on randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs),
conducted in animals or humans, the effect of the
transplantation of stem/progenitor cells compared to
no transplantation on pulpal tissue regeneration, pulpal vitality and apical healing was examined.
Study appraisal and synthesis methods The
primary outcome was histologically determined pulpal
tissue regeneration, whilst pulpal vitality and apical
healing were secondary outcomes. The SYstematic
Review Centre for Laboratory animal Experimentation
(SYRCLE) guidelines and the revised Cochrane risk of
bias tool (RoB 2.0) were used for risk-of-bias assessment. Pooled standardized differences in means (SDM)
and 95% confidence intervals (95% CI) were calculated using random-effects meta-analyses.
Results From 2834 identified articles, eight animal
experiments (82 animals with 336 experimental pulpal defects) and one human trial (40 humans with
40 pulpal defects) were included. Risk of bias of most
animal studies was high, whilst the human trial
revealed ‘some concerns’. Stem/progenitor cell-transplanted pulps demonstrated significantly increased
pulpal tissue regeneration compared with controls
(SDM [95%CI]: 6.29 [3.78–8.80]).
Limitations Data on pulpal vitality and apical healing were sparse and inconsistent. Heterogeneity across
studies was substantial, publication bias was present,
and mainly indirect, surrogate outcome measures were
applied. The overall strength of evidence was very low.
Conclusions and implications of key findings The transplanation of stem/progenitor cells
shows promise for pulp regeneration, whilst clinical
routine application is still not in reach. Further investigations, employing a comprehensive set of outcomes
including those demonstrating functional pulp regeneration relevant for patient-centred care, are required.
Keywords: meta-analysis, pulp, regeneration, stem
cells, systematic review.
Received 5 February 2019; accepted 20 June 2019

Effect of surface protection, staining beverages and aging on the color stability and hardness of recently introduced uncoated glass ionomer restorative material, Dalia Mohamed Abdel Hamid, Mahmoud Gouda Mohamed, Fatma El-Sharkawy M., and Auf Eman Aly Abou , Future Dental Journal , Volume 4 , Issue 2 , p.288-296, (2018) Abstract

Aim
Evaluation of the effect of coating, staining beverages and aging on the color stability and hardness of recently introduced glass ionomer (GI) restorative material and to determine whether there was a correlation between these two variables.

Materials and methods
Two commercially available conventional GI restorative materials were used; Ketac™ Universal Aplicap™ and Ketac™ Fil Plus Aplicap™ GI restoratives. A total of 84 disc-shaped specimens (5 × 2 mm) were prepared and divided into 3 main groups (n = 28). Fifty six specimens were prepared from Ketac Universal Aplicap where half of them was coated (CU) and the other half was uncoated (U) and 28 coated specimens from Fil Plus Aplicap™ (CF) that act as a control group. Coating was performed with Ketac Glaze. Each group was further subdivided into 4 subgroups (n = 7) according to the beverages (tea, coffee, coke and distilled water). Color changes (ΔE) and hardness (MPa) were measured by scanning spectrophotometer and Vickers's hardness (VH) test respectively. Measurements were recorded at the baseline, after 7 and 30 days of aging in each beverage. Chemical analysis of the glass powders was performed by EDXA. Additionally, the filler size was examined by the SEM. The data were statistically analyzed (P ≤ 0.05).

Results
The CU subgroups possessed lower ΔE than U subgroups in tea and coffee. The impact of staining beverages and aging on the ΔE was material's dependent. The CU subgroups recorded higher VH than the U and CF subgroups after aging in coke (30 days). Aging of the U subgroups in tea and coke significantly decreased its VH. The SEM revealed smaller average filler size in Ketac Universal Aplicap (7.2 μm) than Ketac Fil Plus Aplicap (17.9 μm).

Clinical significance
It is advisable to use the recently introduced uncoated GI restorative material for patients who are not consuming tea and/or coffee but with surface protection to maintain its color acceptability up to 3 year clinically. Not all color changes could be associated with surface degradation.

Chemical and mechanical degradation of nano-ionomer after two different surface protections: An in vitro study., man Ibrahim ElSayad, and Abouauf EA , American journal of dentistry, Volume 29 , Issue 2 , p.110-114, (2016) Abstract

To evaluate the effect of food-simulating liquids prior to brushing on surface roughness of a nano-ionomer restorative protected with two surface protection agents. 90 specimens were divided into three groups according to surface protection; the first group: no surface protection; the second group: copal varnish; the third group: light cure Ketac Glaze. Each group was subdivided into three subgroups relative to the immersion solution: artificial saliva; citric acid 0.02 M; or 50% ethanol. Specimens were stored for 7 days in one of the solutions in an incubator. One surface of each specimen was subjected to brushing with a sonic electric toothbrush while the other surface was not brushed. Surface roughness was measured with a stereo-microscope. Data were analyzed using one way ANOVA followed by paired t-test (P< 0.05). The surface roughness of the nano-ionomer specimens immersed in ethanol was significantly higher than those immersed in citric acid. No significant differences were found between surface protection agents or between brushed and un-brushed specimens. The highest surface roughness mean value was recorded with brushed unprotected specimens immersed in ethanol. While the lowest surface roughness mean value was recorded with un-brushed copal varnish protected specimens immersed in ethanol.

Eman abouauf, Abouauf, Eman A. , (2019)
Tissue Engineering Approaches for Enamel, Dentin, and Pulp Regeneration: An Update, Ahmed, Geraldine M., Abouauf Eman A., AbuBakr Nermeen, Dörfer Christof E., and Fawzy El-Sayed Karim , Stem Cells International, Volume 2020, (2020) Abstract5734539.pdfWebsite

Stem/progenitor cells are undifferentiated cells characterized by their exclusive ability for self-renewal and multilineage differentiation potential. In recent years, researchers and investigations explored the prospect of employing stem/progenitor cell therapy in regenerative medicine, especially stem/progenitor cells originating from the oral tissues. In this context, the regeneration of the lost dental tissues including enamel, dentin, and the dental pulp are pivotal targets for stem/progenitor cell therapy. The present review elaborates on the different sources of stem/progenitor cells and their potential clinical applications to regenerate enamel, dentin, and the dental pulpal tissues.

Clinical evaluation of flowable resin composite versus conventional resin composite in carious and noncarious lesions: Systematic review and meta-analysis., Shaalan, Omar Osama, Abou-Auf Eman, and Zoghby Amira Farid El , Journal of conservative dentistry : JCD, 2017 Nov-Dec, Volume 20, Issue 6, p.380-385, (2017) Abstract

The purpose of this systematic review was to evaluate clinical performance of flowable composite in carious and noncarious lesions. An electronic search was conducted using specific databases (PubMed, Embase, Cochrane Library, and LILACS) through March 2017. Clinical trials for restoration of carious and noncarious lesions were included with no date restrictions; follow-up was 6 months at least and dental restorations were evaluated using the United States Public Health Service criteria. The systematic search generated 908 papers, of which 35 papers were included for full-text review. Inclusion criteria were met by eight papers, six papers were for noncarious lesions and two papers were for restoration of carious lesions. The results of this review have shown no statistical or clinical difference between flowable and conventional composites for all tested outcomes in both carious and noncarious lesions. Both materials have shown clinically acceptable scores for all criteria, with no evidence of clinically unacceptable scores except in retention, with a retention rate of 83% in both materials after 36 months. Flowable composites had clinical efficacy after 3 years of service similar to that of conventional composite in both carious and noncarious lesions, these results are based on low quality of evidence. Based on the available literature and the best available evidence, flowable composites can be used in restoration of noncarious cervical lesions and minimally invasive occlusal cavities.