{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:23:11Z","timestamp":1767856991519,"version":"3.49.0"},"reference-count":51,"publisher":"Operative Dentistry","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n        <jats:sec>\n          <jats:title>Purpose:<\/jats:title>\n          <jats:p>This study aimed to analyze the presence of defects within the adhesive interface formed with five bioactive dental materials and caries-affected dentin concerning the timing of radiotherapy (before or after the restorative procedures) by micro-CT.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods and Materials:<\/jats:title>\n          <jats:p>A total of 96 carious human molars were randomly allocated into the following groups based on the timing of the radiotherapy sequence: radiotherapy followed by restoration (RT1) or restoration followed by radiotherapy (RT2). Then, six subgroups were established within these groups based on the type of materials used (n=8). Following cavity preparation and caries removal, a universal adhesive (G-Premio Bond) was administered in self-etch mode or accompanied by applying suitable cavity conditioners according to the manufacturers\u2019 guidelines. Subsequently, restorations were performed using five bioactive restorative materials (resin-modified glass-ionomer [Fuji II LC], high-viscosity glass-ionomer hybrid [EQUIA Forte HT], giomer [Beautifil II], alkasite [Cention N], and dual-cure bulk-fill composite [Activa Bioactive Restorative]) and a conventional microhybrid resin composite (Filtek Z250). The radiotherapy regimen encompassed 60 Grays (Gy) administered at a rate of 2 Gy\/day over 6 weeks, 5 days a week. Micro-CT analysis was employed to assess adhesive defects at the interface between caries-affected dentin and the restorations. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Dunn tests (\u03b1=0.05).<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results:<\/jats:title>\n          <jats:p>RT2 caused significantly higher adhesive defects than RT1 for the Filtek Z250 and Activa Bioactive Restorative subgroups (<jats:italic>p<\/jats:italic>&lt;0.05). For RT1, no significant differences were found in adhesive defects among all tested subgroups (<jats:italic>p<\/jats:italic>&gt;0.05). By contrast, for RT2, adhesive defects were significantly higher for the Activa Bioactive Restorative and Cention N subgroups than for the EQUIA Forte HT and Beautifil II subgroups (<jats:italic>p<\/jats:italic>&lt;0.05).<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions:<\/jats:title>\n          <jats:p>When using most bioactive restorative materials, the timing of radiotherapy had no significant influence on the adhesive interface. Regarding restoration following a radiotherapy protocol, a favorable impact was identified with high-viscosity glass ionomer hybrid cement and giomer bioactive restorations compared with dual-cure bioactive bulk-fill composite and alkasite restorations.<\/jats:p>\n        <\/jats:sec>","DOI":"10.2341\/23-128-l","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:22:40Z","timestamp":1724286160000},"page":"551-563","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Radiotherapy on the Adhesive Interface of Caries-affected Dentin and Bioactive Restorations: A Micro-CT Analysis"],"prefix":"10.2341","volume":"49","author":[{"given":"LK","family":"K\u00f6se","sequence":"first","affiliation":[{"name":"*Leyla Kerimova K\u00f6se, DDS, Baskent University Faculty of Dentistry, Department of Restorative Dentistry, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Oglakci","sequence":"additional","affiliation":[{"name":"Burcu Oglakci, DDS, Bezmialem Vakif University Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ZC","family":"\u00d6zduman","sequence":"additional","affiliation":[{"name":"Z\u00fcmr\u00fct Ceren \u00d6zduman, DDS, Bezmialem Vakif University Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Akdur","sequence":"additional","affiliation":[{"name":"Kerime Akdur, Bezmialem Vakif University Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Mayada\u011fl\u0131","sequence":"additional","affiliation":[{"name":"Alpaslan Mayada\u011fl\u0131, MD, Bezmialem Vakif University Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Arhun","sequence":"additional","affiliation":[{"name":"Neslihan Arhun, PhD, DDS, Baskent University Faculty of Dentistry, Department of Restorative Dentistry, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1188","reference":[{"issue":"1","key":"b1","series-title":"Medicina Oral, Patolog\u00eda Oral Y Cirug\u00eda Bucal","first-page":"e96","article-title":"The impact of head and neck radiotherapy on the dentine-enamel junction: A systematic review","volume":"25","author":"Fonseca\n              JM","year":"2020","unstructured":"Fonseca\n              JM\n            , TroconisCCM, PalmierNR, Gomes-SilvaW, de Pauli PaglioniM, Ara\u00fajoALD, ArboledaLPA, Vechiato FilhoAJ, Gonz\u00e1lez-ArriagadaWA, & de GoesMF (2020) The impact of head and neck radiotherapy on the dentine-enamel junction: A 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TF","year":"2014","unstructured":"Watson\n              TF\n            , AtmehAR, SajiniS, CookRJ, & FestyF (2014) Present and future of glass-ionomers and calcium-silicate cements as bioactive materials in dentistry: Biophotonics-based interfacial analyses in health and diseaseDental Materials30(1) 50-61."},{"issue":"4","key":"b12","series-title":"International Journal of Prosthodontics and Restorative Dentistry","first-page":"120","article-title":"Comparative evaluation of mechanical properties of Cention N with conventionally used restorative materials\u2014An \u0131n vitro study","volume":"8","author":"Agarwal\n              M","year":"2018","unstructured":"Agarwal\n              M\n            , SinghG, QureshiR, SinghSK, MishraA, & KhuranaN (2018) Comparative evaluation of mechanical properties of Cention N with conventionally used restorative materials\u2014An \u0131n vitro studyInternational Journal of Prosthodontics and Restorative Dentistry8(4) 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HH","year":"2013","unstructured":"Hamama\n              HH\n            , YiuCKY, BurrowMF, & KingNM (2013) Chemical, morphological and microhardness changes of dentine after chemomechanical caries removalAustralian Dental Journal58(3) 283-292."},{"issue":"1","key":"b17","series-title":"Analyst","first-page":"72","article-title":"Characterization of a novel calibration method for mineral density determination of dentine by X-ray micro-tomography","volume":"134","author":"Zou\n              W","year":"2009","unstructured":"Zou\n              W\n            , GaoJ, JonesAS, HunterN, & SwainM V (2009) Characterization of a novel calibration method for mineral density determination of dentine by X-ray micro-tomographyAnalyst134(1) 72-79."},{"issue":"8","key":"b18","series-title":"Journal of Dentistry","first-page":"986","article-title":"Radiation therapy alters microhardness and microstructure of enamel and dentin of permanent human teeth","volume":"42","author":"Gon\u00e7alves\n              LMN","year":"2014","unstructured":"Gon\u00e7alves\n              LMN\n            , Palma-DibbRG, Paula-SilvaFWG, de OliveiraHF, Nelson-FilhoP, da SilvaLAB, & de QueirozAM (2014) Radiation therapy alters microhardness and microstructure of enamel and dentin of permanent human teethJournal of Dentistry42(8) 986-992."},{"issue":"3","key":"b19","series-title":"Cancers","first-page":"28","article-title":"Paradigm shift in radiation biology\/radiation oncology\u2014exploitation of the \u201cH2O2 effect\u201d for radiotherapy using low-LET (linear energy transfer) radiation such as X-rays and high-energy electrons","volume":"8","author":"Ogawa\n              Y","year":"2016","unstructured":"Ogawa\n              Y\n            \n           (2016) Paradigm shift in radiation biology\/radiation oncology\u2014exploitation of the \u201cH2O2 effect\u201d for radiotherapy using low-LET (linear energy transfer) radiation such as X-rays and high-energy electronsCancers8(3) 28."},{"issue":"3","key":"b20","series-title":"Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology","first-page":"416","article-title":"Dosimetric distribution to the teeth of patients with head and neck cancer who underwent radiotherapy","volume":"120","author":"Morais-Faria\n              K","year":"2015","unstructured":"Morais-Faria\n              K\n            , MEnegussiG, VasconcelosK, MartaG, FernandesPM, DiasRB, RibeiroACP, LopesMA, CerneaCR, & Brand\u00e3oTB (2015) Dosimetric distribution to the teeth of patients with head and neck cancer who underwent radiotherapyOral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology120(3) 416-419."},{"issue":"1","key":"b21","series-title":"Critical Reviews in Oral Biology & Medicine","first-page":"13","article-title":"The mechanical properties of human dentin: A critical review and re-evaluation of the dental literature","volume":"14","author":"Kinney\n              JH","year":"2003","unstructured":"Kinney\n             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study","volume":"23","author":"Comba\n              A","year":"2021","unstructured":"Comba\n              A\n            , BaldiA, TempestaRM, VerganoEA, AlovisiM, PasqualiniD, & ScottiN (2021) Influence of curing mode and layering technique on the 3D interfacial gap of bulk-fill resin composites in deep class-i restorations: A micro-CT volumetric studyJournal of Adhesive Dentistry23(5) 421-428."},{"issue":"6","key":"b28","series-title":"Journal of Dentistry","first-page":"405","article-title":"Effects of CPP-ACP with sodium fluoride on inhibition of bovine enamel demineralization: A quantitative assessment using microcomputed tomography","volume":"39","author":"Hamba\n              H","year":"2011","unstructured":"Hamba\n              H\n            , NikaidoT, InoueG, SadrA, & TagamiJ (2011) Effects of CPP-ACP with sodium fluoride on inhibition of bovine enamel demineralization: A quantitative assessment using microcomputed tomographyJournal of Dentistry39(6) 405-413."},{"key":"b29","author":"America\n              GC","unstructured":"America\n              GC\n            , FujiGCLCII. 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GuinotF (2023) Comparison of shear bond strength and microleakage between ActivaTM Bioactive RestorativeTM and bulk-fill composites\u2014An \u0131n vitro studyPolymers15(13) 2840."},{"issue":"1","key":"b41","series-title":"Clinical and Experimental Dental Research","first-page":"329","article-title":"Marginal microleakage and modified microtensile bond strength of Activa Bioactive, in comparison with conventional restorative materials","volume":"8","author":"Tohidkhah\n              S","year":"2022","unstructured":"Tohidkhah\n              S\n            , KermanshahH, AhmadiE, JalalianB, & Ranjbar OmraniL (2022) Marginal microleakage and modified microtensile bond strength of Activa Bioactive, in comparison with conventional restorative materialsClinical and Experimental Dental Research8(1) 329-335."},{"issue":"1","key":"b42","series-title":"Investigations in Dentistry","first-page":"90","article-title":"Adhesion and marginal adaptation of a claimed bioactive, restorative material Biomaterial","volume":"6","author":"Benetti\n              AR","year":"2019","unstructured":"Benetti\n              AR\n            , MichouS, LarsenL, PeutzfeldtA, PallesenU, & Van DijkenJWV (2019) Adhesion and marginal adaptation of a claimed bioactive, restorative material BiomaterialInvestigations in Dentistry6(1) 90-98."},{"issue":"4","key":"b43","series-title":"Operative Dentistry","first-page":"E188","article-title":"Interfacial bond strength and morphology of sound and caries-affected dentin surfaces bonded to two resin-modified glass \u0131onomer cements","volume":"47","author":"Al-Hasan\n              RM","year":"2022","unstructured":"Al-Hasan\n              RM\n             & Al-TaeeLA (2022) Interfacial bond strength and morphology of sound and caries-affected dentin surfaces bonded to two resin-modified glass \u0131onomer cementsOperative Dentistry47(4) E188-E196."},{"issue":"1","key":"b44","series-title":"BMC Oral Health","first-page":"334","article-title":"The impact of an alkasite restorative material on the pH of Streptococcus mutans biofilm and dentin remineralization: An in vitro study","volume":"22","author":"Wiriyasatiankun\n              P","year":"2022","unstructured":"Wiriyasatiankun\n              P\n            , SakoolnamarkaR, & ThanyasrisungP (2022) The impact of an alkasite restorative material on the pH of Streptococcus mutans biofilm and dentin remineralization: An in vitro studyBMC Oral Health22(1) 334."},{"key":"b45","series-title":"Journal of Dentistry","first-page":"103474","article-title":"Evaluation of F, Ca, and P release and microhardness of eleven ion-leaching restorative materials and the recharge efficacy using a new Ca\/P containing fluoride varnish","volume":"102","author":"Ruengrungsom\n              C","year":"2020","unstructured":"Ruengrungsom\n              C\n            , BurrowMF, ParashosP, & PalamaraJEA (2020) Evaluation of F, Ca, and P release and microhardness of eleven ion-leaching restorative materials and the recharge efficacy using a new Ca\/P containing fluoride varnishJournal of Dentistry102103474."},{"issue":"10","key":"b46","series-title":"Materials","first-page":"2313","article-title":"Commercially available fluoride-releasing restorative materials: A review and a proposal for classification","volume":"13","author":"Francois\n              P","year":"2020","unstructured":"Francois\n              P\n            , FouquetV, AttalJ-P, & DursunE (2020) Commercially available fluoride-releasing restorative materials: A review and a proposal for classificationMaterials13(10) 2313."},{"issue":"2","key":"b47","series-title":"Journal of Oral Science","first-page":"139","article-title":"Flexural properties and dentin adhesion in recently developed self-adhesive bulk-fill materials","volume":"63","author":"Fran\u00e7ois\n              P","year":"2021","unstructured":"Fran\u00e7ois\n              P\n            , RemadiA, Le GoffS, Abdel-GawadS, AttalJ-P, & DursunE (2021) Flexural properties and dentin adhesion in recently developed self-adhesive bulk-fill materialsJournal of Oral Science63(2) 139-144."},{"key":"b48","series-title":"International Journal of Dentistry","first-page":"5599042","article-title":"Fracture strength and marginal adaptation of conservative and extended MOD cavities restored with Cention N","volume":"2021","author":"Firouzmandi\n              M","year":"2021","unstructured":"Firouzmandi\n              M\n            , AlaviAA, JafarpourD, & SadatsharifeeS (2021) Fracture strength and marginal adaptation of conservative and extended MOD cavities restored with Cention NInternational Journal of Dentistry20215599042."},{"issue":"2","key":"b49","series-title":"Journal of Dentistry for Children","first-page":"69","article-title":"Radiotherapy impairs adhesive bonding in primary teeth: An in vitro study","volume":"87","author":"Mellara\n              T de S","year":"2020","unstructured":"Mellara\n              T de S\n            , Paula-SilvaFWG, AridJ, de OliveiraHF, Nelson-FilhoP, Bezerra SilvaRA, TorresFM, FaraoniJJ, Palma-DibbRG, & de QueirozAM (2020) Radiotherapy impairs adhesive bonding in primary teeth: An in vitro studyJournal of Dentistry for Children87(2) 69-76."},{"issue":"2","key":"b50","series-title":"Journal of Conservative Dentistry","first-page":"148","article-title":"Ionizing irradiation affects the microtensile resin dentin bond strength under simulated clinical conditions","volume":"16","author":"Yadav\n              S","year":"2013","unstructured":"Yadav\n              S\n             & YadavH (2013) Ionizing irradiation affects the microtensile resin dentin bond strength under simulated clinical conditionsJournal of Conservative Dentistry16(2) 148-151."},{"issue":"6","key":"b51","series-title":"Journal of Prosthetic Dentistry","first-page":"1038","article-title":"Development and validation of a risk-of-bias tool for assessing in vitro studies conducted in dentistry: The QUIN","volume":"131","author":"Sheth\n              VH","year":"2024","unstructured":"Sheth\n              VH\n            , ShahNP, JainR, BhanushaliN, & BhatnagarV (2024) Development and validation of a risk-of-bias tool for assessing in vitro studies conducted in dentistry: The QUINJournal of Prosthetic Dentistry131(6) 1038-1042."}],"container-title":["Operative 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