PURPOSE: This study was performed in order to assess the effect of the surface treatment methods and the use of bonding agent on the shear bond strength (SBS) between the aged CAD-CAM (computer aided design-computer aided manufacturing) hybrid materials and added composite resin. MATERIALS AND METHODS: LAVA Ultimate (LU) and VITA ENAMIC (VE) specimens were age treated by submerging in a 37℃ water bath filled with artificial saliva (Xerova solution) for 30 days. The surface was ground with #220 SiC paper then the specimens were divided into 9 groups according to the combination of the surface treatment (no treatment, grinding, air abrasion with aluminum oxide, HF acid) and bonding agents (no bonding, Adper Single Bond 2, Single Bond Universal). Each group had 10 specimens. Specimens were repaired (added) using composite resin (Filtek Z250), then all the specimens were stored for 7 days in room temperature distilled water. SBS was measured and the fractured surfaces were observed with a scanning electron microscope (SEM). One-way ANOVA and Scheffe test were used for statistical analysis (α=.05). RESULTS: Mostly groups with bonding agent treatment showed higher SBS than groups without bonding agent. Among the groups without bonding agent the groups with aluminum oxide treatment showed higher SBS. However there was no significant difference between groups except two subgroups within LU group, which revealed a significant increase of SBS when Single Bond Universal was used on the ground LU specimen. CONCLUSION: The use of bonding agent when repairing an aged LAVA Ultimate restoration is recommended.
Aluminum Oxide ; Baths ; Computer-Aided Design* ; Saliva, Artificial ; Water

Purpose: Immune checkpoint inhibitors (ICIs) have been shown significant oncological improvements in several cancers.However, ICIs are still in their infancy in hepatocellular carcinoma (HCC). Programmed cell death-ligand 1 (PD-L1), tumorinfiltrating lymphocytes (TILs), and epithelial-mesenchymal transition (EMT) have been known as prognostic factors in HCC. Therefore, we have focused on identifying the molecular mechanisms between each marker to evaluate a predictive role. Methods: Formalin-fixed paraffin-embedded samples were obtained from 166 patients with HCC who underwent surgery. The expression of PD-L1 and TILs and EMT marker were evaluated by immunohistochemical analysis. Results: The multivariate analysis showed that TIL expression (hazard ratio [HR], 0.483; 95% confidence interval [CI], 0.269–0.866; P = 0.015) were independent prognostic factors for overall survival. The prognostic factors for disease-free survival were EMT marker expression (HR, 1.565; 95% CI, 1.019–2.403; P = 0.005). Patients with high expression of TILs had significantly better survival compared to patients with low expression (P = 0.023). Patients who were TIL+/EMT– showed a significantly better prognosis than those who were TIL–/EMT+ (P = 0.049). Conclusion This study demonstrates that PD-L1 expression of TILs is closely associated with EMT marker expression in HCC. Clinical investigations using anti–PD-1/PD-L1 inhibitors in patients with EMT-associated PD-L1 upregulation are warranted.