Influence of Ambient Air and Different Surface Treatments on the Bonding Performance of a CAD/CAM Composite Block

PURPOSE

To evaluate the bond strengths of time elapsed after sandblasting with alumina particles on a CAD/CAM composite block treated with different surface conditioning methods.

MATERIALS AND METHODS

A CAD/CAM composite block (CCB) was cut into 72 slices of approximately 2 mm thickness. The CCB slices were divided into three groups according to sandblasting pressure (0.1 MPa, 0.2 MPa, or untreated), and then divided into two subgroups according to the time elapsed after sandblasting: same-day or one-week dry storage under controlled laboratory conditions before cementation. Surface roughness was observed by confocal laser microscopy (CLSM) (n = 20); then the wettability of the CCB surfaces was examined using a contact angle (CA) measuring device on a droplet of deionized water (n = 12). Next, CCB slices were divided into three subgroups according to the surface treatment: Clearfil Ceramic Primer (CP), Clearfil Universal Bond (UB), or a mixture of Clearfil Porcelain Bond Activator and Clearfil tri-S Bond ND Quick (NDP). All CCB slices were then cemented with Panavia V5 and stored at 37°C in distilled water for 24 h and cut into sticks (n = 10). The sticks were subjected to microtensile bond strength (µTBS) testing, and failure mode analysis was performed using scanning electron microscopy. The µTBS results were subjected to 3-way and 2-way ANOVA (α = 0.05).

RESULTS

All groups showed a statistically significant increase in wettability accompanied by decreased µTBS after one week; however, the UB group exhibited stable performance after one week.

CONCLUSION

The time elapsed after sandblasting with alumina particles affects the bond strength, but it had no significant effect on the UB group.

Effect of the Dentin Chelating Agents Phytic Acid and EDTA on Degree of Conversion, Microhardness, and Bond Strength of Chemical-curing Self-adhesive Cements

PURPOSE

To evaluate the effect of the chelating agents phytic acid and EDTA on the degree of conversion (DC), microhardness, and tensile bond strength (TBS) of two chemical-curing self-adhesive cements.

MATERIALS AND METHODS

A total of 110 samples were prepared, with n = 6 in the control group to measure microhardness, n = 6 for DC measurement, and n = 10 for TBS measurement. The bovine dentin specimens were divided into five groups according to treatment: group A (control group): no treatment; group B, 1% phytic acid with ultrasonic rinsing (UR); group C: 1% phytic acid without UR; group D: 18% EDTA with UR; group E: 18% EDTA without UR. A 1-mm-thick coat of self-adhesive cement, G-CEM LinkAce (GC) or RelyX Unicem 2 (3M) was placed on control and treated dentin surfaces and stored in a dark box at 37°C, 93% ± 1% ambient humidity. DC and microhardness of cement surfaces were measured after 1 hour, 1 day, 3 days, and 1 week using Fourier transform infrared spectroscopy and a Vickers microhardness tester, respectively. TBS on treated and control dentin was evaluated after 1 week of storage in the dark box. Data were analyzed using two-way ANOVA, followed by Tukey's post-hoc test, at the 0.05 level of significance.

RESULTS

DC and microhardness of both types of cement without UR were significantly lower than that of groups in which UR was performed. Neither chelating agent had a significant effect on the TBS of G-CEM. For Rely X, the phytic acid treatment with UR showed a significantly higher TBS than the control and the EDTA groups.

CONCLUSION

The chelating agents had a negative effect on DC and microhardness of the resin cements when UR was not used. Phytic acid increased the TBS of RelyX, while EDTA groups did not with either cement.

The repair bond strength to resin matrix in cured resin composites after water aging

The repair microshear bond strengths (µSBSs) to resin matrices in 4 different cured-composites after water storage (0, 60 s, 1 week, 1 month) were evaluated. Three different adhesive application methods to the cured-composites were performed; (1) none, (2) onestep self-etch adhesive application, and (3) one-step self-etch adhesive application with a silane coupling agent. Degree of conversion (DC) of the composite discs was determined using ATR/FT-IR with a time-based spectrum analysis. Initially, the amount of un-reacted resin monomers in the repaired cured-composite contributed to the bonding performance of newly-filled uncured-composite to resin matrix of the cured-composite. Adhesive application could not improve their repair µSBS. After 1-month of water-storage, the repair µSBS was dependent on material, which either reduced or did not and was not influenced by their amount of un-reacted resin monomers. When repairing aged composite resin, the appropriate adhesive application procedures were different among resin composites.

Dental cements: Bioactivity, bond strength and demineralization progression around restorations

PURPOSE

To evaluate demineralization progression around indirect restorations placed with various cements using swept-source optical coherence tomography (OCT) and microshear bond strength (MSBS) to enamel and dentin.

METHODS

Resin inlays in cervical preparations (4×2 mm) were luted with two glass ionomer luting cements, Fuji I (FI) and RelyX Luting Cement (RL) and two adhesive cements, Adshield RM (AD) and RelyX Unicem 2 (UC). After 7-day artificial saliva incubation and 10,000 thermal cycles, specimens were demineralized (pH 4.5). Lesion progression at enamel and dentin margins was measured on OCT images after 1, 3 and 5 weeks demineralization (n= 8).

RESULTS

Repeated-measures ANOVA showed that demineralization period, cement type, and their interaction had a significant effect on lesion size in both substrates (P< 0.001). Enamel lesion progression was slower in RL, FI and AD, and was significantly different from UC and control (P< 0.001). RL dentin lesions were significantly different from FI and AD lesions (P< 0.05), which in turn were significantly different than UC and control lesions (P< 0.001). MSBS means of AD and UC were significantly higher than those of FI and RL (P< 0.001).

CLINICAL SIGNIFICANCE

A bioactive cement combining bioavailable calcium, functional monomer and glass-ionomer formulations showed better lesion progression inhibition around restorations than the adhesive resin cement, and higher bond strength than the resin-modified and conventional glass-ionomer cements.

Internal adaptation of composite restorations with or without an intermediate layer: Effect of polymerization shrinkage parameters of the layer material

OBJECTIVES

The purpose of this study was to compare the internal adaptation of resin composite restorations in Class I cavities with or without an intermediate layer, and to identify the relationships between the internal adaptation and the polymerization shrinkage parameters of the layer material.

METHODS

Class I cavities prepared in human third molars were treated with a one-step self-etch adhesive (G-Premio Bond, GC). In the control group, Tetric-EvoCeram Bulk-Fill (TBF, Ivoclar Vivadent) was placed using the bulk-fill technique and then light-cured. In the experimental groups, six different layer materials (three flowable resin composites, two bulk-fill resin composites, and a resin-modified glass-ionomer) were applied to a 1.5-mm thickness and light-cured, which was followed by TBF filling. After thermo-cycling, internal adaptation was measured using swept-source optical coherence tomography (SS-OCT) imaging and compared in terms of high brightness percentage (HB%) to represent the microgap. Shrinkage strain (SS), flexural modulus (FM), and polymerization shrinkage stress of the intermediate layer-resin composite complex (PS) were measured for each material. The relationships among HB%, SS, FM, and PS were evaluated statistically.

RESULTS

Groups with an intermediate layer showed lower HB% than the control group. The HB% correlated with PS (Pearson's correlation: R² = 0.883, p < 0.05), and the PS correlated with the product of SS and FM.

CONCLUSION

Internal adaptation depended on the polymerization shrinkage stress of the intermediate layer-resin composite complex.

CLINICAL SIGNIFICANCE

Bulk-fill resin composite, which can show low polymerization shrinkage stress, may be used as an intermediate layer for better internal adaptation.

Evaluation of discoloration of sound/demineralized root dentin with silver diamine fluoride: In-vitro study

The objective was to evaluate the effect of application of silver diamine fluoride (SDF) on discoloration of demineralized dentin over time. Dentin specimens were divided into four groups according to time of dentin demineralization. A 38% SDF solution was then applied to the dentin surfaces. Half of the specimens were placed in light-proof boxes while the remainder were exposed to light. Both groups were maintained at 37˚C. Color change was determined using a spectrophotometer at different time intervals. SEM/EDS analysis were also undertaken. The 13 h EDTA demineralized group showed the highest values for color change among different time intervals, with the control being the lowest. The light exposed groups showed more color change compared to the unexposed groups. We concluded that the degree of dentin demineralization leads to a significant increase of the rate of dentin color change after application of SDF.

Effect of Water Aging of Adherend Composite on Repair Bond Strength of Nanofilled Composites

PURPOSE

To evaluate the effect of water aging of adherend composite on repair bond strength to nanofilled composites with specific fillers using different bonding agents.

MATERIALS AND METHODS

Three nanofilled composites - Beautifil II with S-PRG filler (BE) / Filtek Supreme ultra with nanocluster filler (SP) / Estelite Σ Quick (ES) - and one microhybrid composite, Clearfil APX (AP), were used in this study. The composite disks were immersed in water for different durations (immediate, 1 week, 2 weeks or 1 month), and then the polished surfaces were treated with one of three bonding agents - no treatment (control), application of Clearfil SE One (SE), application of Clearfil SE One plus Clearfil Porcelain Bond Activator (PB) - then filled with a repair composite. The bonded composite disks were subjected to the microshear bond strength (µSBS) test. Additionally, water sorption (Wsp) and solubility (Wsl) of the resin composite were measured. The µSBS data were was statistically analyzed using a three-way ANOVA and t-test with Bonferroni correction for multiple comparisons.

RESULTS

Water aging of adherend composite affected the repair bond strength (p < 0.05). For BE, SP, and ES, application of an adhesive agent improved repair bond strengths to water-aged composites (p < 0.05), but adding a silane coupling agent could not (p > 0.05). For AP, the µSBS significantly increased, with control group < SE group < PB group (p < 0.05).

CONCLUSION

Microhybrid composite was a more suitable material for composite repair than nanofilled composite, due to adhesion to exposed, larger silica fillers. S-PRG filler and nanocluster filler in the nanofilled composites played a slight role in improving their repair bonding performances with the bonding agents tested.

Influence of FCP-COMPLEX on bond strength and the adhesive-artificial caries-affected dentin interface

FCP-COMPLEX is a newly developed solution containing fluoride, calcium, and phosphoric acid that has the potential to reinforce caries-affected dentin. This study evaluated the effect of FCP-COMPLEX on micro-tensile bond strength (µTBS) and acid-challenge at the dentin-adhesive interface. FCP-COMPLEX, 2% NaF, and distilled water were applied to artificial caries-affected dentin (ACAD) and the effect on acid-induced damage after resin composite restoration was observed. Scanning electron microscopy and X-ray absorption fine structure (XAFS) were used to evaluate tooth morphology. The µTBS test revealed no effect of FCP-COMPLEX either immediately or after 3 months' storage. The area of acid damage in caries-affected dentin was reduced by FCP-COMPLEX. XAFS analysis revealed that absorbed fluorine on the surface would form CaF₂. In conclusion, FCP-COMPLEX significantly reduced the damage of acidic attack at the ACAD-adhesive interface, while the µTBS value was maintained after storage.

Effect of Calcium-phosphate Desensitizers on Staining Susceptibility of Acid-eroded Enamel

OBJECTIVE

To investigate the effect of calcium-phosphate-based desensitizers, Teethmate AP paste (TMAP) and Teethmate Desensitizer (TMD) (Kuraray Noritake Dental, Tokyo, Japan), on the prevention of staining on acid-eroded enamel.

METHODS AND MATERIALS

Forty polished enamel samples (4×4×1 mm) from bovine incisors were randomly divided into five groups (n=8). After immersion in 50 mL of 0.5% citric acid (pH 2.5) for 15 minutes to form acid-eroded surfaces, the surfaces were subjected to different treatments with TMAP, TMD, and NaF (0.21% means 950 ppm) for five minutes. Another eroded group was not treated with desensitizer. For the control group, the samples were not eroded or treated. All the samples were stored in artificial saliva (AS) at pH 7.2 for 24 hours at 37°C. The TMAP, TMD, or NaF was reapplied at eight and 16 hours during the 24 hours of storage time. The surface roughness (Sa) was evaluated following ISO 25178 for surface texture using confocal laser scanning microscopy (VK-X 150 series, Keyence, Osaka, Japan) before acid erosion, after acid erosion, and after 24 hours of incubation in AS. Afterward, the color difference was measured with a dental colorimeter (Shade Eye NCC, Shofu, Kyoto, Japan) before and after staining with tea solution.

RESULTS

One-way repeated measures analysis of variance showed that acid erosion significantly increased Sa (p<0.001). TMAP- and TMD-treated groups exhibited lower Sa values than the NaF group and the no-desensitizer treatment group. The greatest staining was observed in the NaF group and the no-desensitizer group, while the TMAP and TMD groups significantly decreased the formation of stains.

CONCLUSIONS

Acid-eroded enamel increased surface roughness and tended to absorb more stains. However, the application of TMAP and TMD moderated the roughness and thus prevented the formation of extrinsic stains.

Effect of sodium fluoride pretreatment on the efficacy of an in-office bleaching agent: An in vitro study

This in vitro study evaluated the effect of sodium fluoride (NaF) on the bleaching efficacy using an artificial discolored bovine tooth model. Twenty specimens were prepared from bovine teeth by staining with black tea extract and were divided into two groups (n = 10). In control group, specimens were immersed in distilled water for 30 min. In NaF group, specimens were applied with 0.2% NaF for 30 min. Then, the specimens in each group were bleached by an in-office bleaching material (Shofu Hi-Lite, Shofu, Kyoto, Japan). The CIE L*a*b* values were measured by a dental colorimeter before and after 10 consecutive bleaching treatments, and the color difference (ΔE) was calculated. Brightness and color difference (ΔE) increased in both groups per bleaching cycle. There were no statistical differences in ΔE values between both groups (p > 0.05). It was concluded that the application of NaF before bleaching did not interfere with the bleaching effect.

The effect of different cleaning agents on saliva contamination for bonding performance of zirconia ceramics

The effects of contamination and cleaning methods on bonding of self-adhesive resin cement to zirconia ceramics were examined. Airborne particle-abraded zirconia (Zpex Smile) specimens were divided into the following four groups: control (con), contaminated with saliva and cleaned with tap water (HS), cleaned with Ivoclean (IC), and cleaned with Multi Etchant (ME). The pretreated specimens were bonded using three self-adhesive resin cements, and tensile bond strengths were measured using a universal testing machine at a crosshead speed of 2 mm/min. Con and IC groups showed significantly higher bond strength than those of HS and ME groups. Separately, the surface chemical composition of the groups was determined using X-ray photoelectron spectroscopy (XPS). XPS revealed that the N/Zr ratio increased in the HS group but decreased in the IC and ME groups. Cleaning agents can improve the adverse effect of saliva contamination on zirconia, but this effect varies depending on the product.

Effect of fluoride mouthrinse on adhesion to bovine root dentin

The purpose of this study was to evaluate the effect of fluoride mouthrinses on dentin bonding performance of a two-step selfetch adhesive; Clearfil SE Bond. Bovine root dentin surface was treated with either 450, 900, or 9,000 ppm F solutions for 30 s (immediate), and continually treated for one month (one month) before the bonding procedures. Microtensile bond strength (µTBS) test and scanning electron microscopic (SEM) observation of the acid-base resistance zone (ABRZ) were performed. Chemical state of fluorine on dentin surface was analyzed by X-ray absorption fine structure (XAFS). The 450 and 900 ppm F fluoride mouthrinses did not influence the µTBS to dentin, while the 9,000 ppm F fluoride solution adversely affected the µTBSs. The fluoride application to dentin significantly enhanced acid resistance at the adhesive/dentin interface including the ABRZ. The XAFS analysis indicated different concentrations of fluoride might create different chemical compounds on the dentin surface, influencing the µTBS results.

Assessment of root caries under wet and dry conditions using swept-source optical coherence tomography (SS-OCT)

The purpose of this study was to compare optical properties of root caries under two observing conditions using swept-source optical coherence tomography (SS-OCT). In vitro and natural root caries were observed by SS-OCT under wet and dry conditions, followed by confocal laser scanning microscope (CLSM) and transverse microradiography (TMR). Signal intensity (SI), distance between SI peaks (SI-distance) and optical lesion depth were obtained from OCT. Lesion depth was measured from CLSM; lesion depth (LD_TMR) and mineral loss (ML) were obtained from TMR. In vitro root caries under wet and dry conditions showed different OCT images and SI patterns. Lesion depth of OCT and that of CLSM, SI-distance and LD_TMR, LD_TMR and ML significantly correlated. Under dry conditions, half natural root caries showed similar OCT images and SI patterns as in vitro root caries. The base of demineralized dentin could be detected more clearly under dry conditions than under wet conditions.

The strategies used for curing universal adhesives affect the micro-bond strength of resin cement used to lute indirect resin composites to human dentin

We evaluated the effect of different curing strategies for universal adhesives on micro-tensile bond strength (μTBS) between resin cement and dentin and/or between resin cement and indirect resin composite. Flat coronal dentin surfaces and composite resin disks were pretreated with silane-containing universal adhesives, with or without light-curing on the dentin-side and/or composite resin disk-side. Resin disks were luted onto the pretreated dentin surfaces with the corresponding dual-cure adhesive resin cements and light-cured, and cut into beams after 24-h water storage. After 0 or 10,000 thermocycles (5ºC/55ºC) in a water bath, the μTBS of the composite resin disk-dentin beam was tested. The μTBS was highest when universal adhesives were applied to both the dentin- and the indirect composite resin disk-side, followed by light-curing. Thermocycling decreased μTBS in all but the Scotchbond Universaltreated group, with light-curing on both sides. The effect of curing strategies is dependent upon the materials.

Adhesive materials and technology – Brazil & Japan

BRAZIL-JAPAN JOINT SYMPOSIUM ON ADHESIVE DENTISTRY 2017

Effect of Glutathione Bio-Molecule on Tooth Discoloration Associated with Silver Diammine Fluoride

This study evaluated the effect of Glutathione (GSH) bio-molecule on the reduction of enamel and dentin discoloration after application of 38% silver diammine fluoride solution (SDF). One hundred and twenty bovine teeth specimens were used. The enamel and dentin specimens were divided into three groups: (1) SDF only (control); (2) SDF followed by application of a potassium iodide solution (KI); and (3) SDF mixed with 20% GSH. Half the specimens were exposed to light and the remainder kept in dark conditions (n = 10) Color changes were measured using a spectrophotometer at the following time intervals: before solution application (baseline) and immediately after application, then 3, 6, 24, 48, 72 h, and 7, 10 and 14 days. SEM/EDS analysis was performed on treated enamel and dentin. Statistical analysis was done using a repeated measures ANOVA test. The spectrophotometer results showed that the SDF group exhibited the greatest color changes under both light exposed and dark conditions, while SDF + GSH group was effective in decreasing the color changes in both light and dark conditions. The SDF + KI group showed an insignificant color changes over time. SEM/EDS analysis showed different patterns for the silver crystal formation in each group (SDF, SDF + GSH, and SDF + KI group). It was concluded GSH can effectively minimize color changes after application of SDF, especially on enamel and to a lesser extent on dentin.

Three-dimensional diagnosis of dentin caries beneath composite restorations using swept-source optical coherence tomography

The aims of this study were to assess the diagnostic accuracy of swept-source optical coherence tomography (SS-OCT) for detection of caries beneath composite restorations and to compare the results with those obtained by radiography. Flat dentin surfaces with and without natural caries were bonded with 1- or 2-mm thick composite restorations. SS-OCT scanning was performed over the composite restorations to construct three-dimensional (3D) images of the resin-dentin interface. Images were chosen from the 3D constructions to detect caries beneath the restorations. The sensitivity, specificity, false positive and negative predictive values for caries detection, and Az values from receiver-operating characteristic analysis were calculated and compared with those of digital dental radiography at a significance level of α=0.05. Intraexaminer and interexaminer reproducibility was compared between SSOCT and radiography. SS-OCT could detect caries, which appeared as a bright zone beneath composite up to 2-mm thick. SS-OCT provided greater diagnostic accuracy than radiography.

Micro-CT assessment of comparative radiopacity of adhesive/composite materials in a cylindrical cavity

This study was performed to evaluate the comparative radiopacity of adhesive/resin composite materials in cylindrical cavities using micro-computed X-ray tomography (μCT). The two-step self-etch adhesive systems, Clearfil SE Bond (SE) and FL-Bond II (FL), and flowable resin composites, Beautifil Flow F10 (BF) and Clearfil Majesty ES Flow High (MJ), were used. The radiopacity of bovine tooth structures and restorative materials was measured by μCT. In addition, cylindrical cavities prepared in bovine teeth were restored with the following adhesive/composite combinations: SE-BF, SE-MJ, FL-BF, and FL-MJ. The mean gray values of the composite restorations were calculated. The threshold values of the μCT images were evaluated using the Otsu's thresholding method. The current results show that the comparative radiopacity of the materials and tooth structure varied, which affected distinguishing the μCT images of the composite restorations in the cylindrical cavity. The proper combination of restorative materials should be considered when conducting in vitro μCT assessments of composite restorations.

The effect of warm air-blowing on the microtensile bond strength of one-step self-etch adhesives to root canal dentin

PURPOSE

The use of warm air-blowing to evaporate solvents of one-step self-etch adhesive systems (1-SEAs) has been reported to be a useful method. The purpose of this study was to evaluate the effect of warm air-blowing on root canal dentin.

METHODS

Four 1-SEAs (Clearfil Bond SE ONE, Unifil Core EM self-etch bond, Estelink, BeautiDualbond EX) were used. Each 1-SEA was applied to root canal dentin according to the manufacturers' instructions. After the adhesives were applied, solvent was evaporated using either normal air (23±1°C) or warm air (80±1°C) for 20s, and resin composite was placed in the post spaces. The air from the dryer, which could be used in normal- or hot-air-mode, was applied at a distance of 5cm above the root canal cavity in the direction of tooth axis. The temperature of the stream of air from the dryer in the hot-air-mode was 80±1°C, and in the normal mode, 23±1°C. After water storage of the specimens for 24h, the μTBS were evaluated at the coronal and apical regions. The μTBSs were statistically analyzed using three-way ANOVA and Student's t-test with Bonferroni correction (α=0.05).

RESULTS

The warm air-blowing significantly increased the μTBS of all 1-SEAs at the apical regions, and also significantly increased the μTBS of two adhesives (Estelink and BeautiDualBond EX) at coronal regions.

CONCLUSIONS

The μTBS of 1-SEAs to root canal dentin was improved by using warm air-blowing.

µCT-3D visualization analysis of resin composite polymerization and dye penetration test of composite adaptation

This study evaluated the effects of the light curing methods and resin composite composition on composite polymerization contraction behavior and resin composite adaptation to the cavity wall using μCT-3D visualization analysis and dye penetration test. Cylindrical cavities were restored using Clearfil tri-S Bond ND Quick adhesive and filled with Clearfil AP-X or Clearfil Photo Bright composite. The composites were cured using the conventional or the slow-start curing method. The light-cured resin composite, which had increased contrast ratio during polymerization, improved adaptation to the cavity wall using the slow-start curing method. In the μCT-3D visualization method, the slow-start curing method reduced polymerization shrinkage volume of resin composite restoration to half of that produced by the conventional curing method in the cavity with adhesive for both composites. μCT-3D visualization method can be used to detect and analyze resin composite polymerization contraction behavior and shrinkage volume as 3D image in the cavity.

Comparison of resin-based and glass ionomer sealants with regard to fluoride-release and anti-demineralization efficacy on adjacent unsealed enamel

This study compared resin-based and glass ionomer sealants with regard to their fluoride-release behavior and anti-demineralization potential on adjacent unsealed enamel surfaces. Sealant cavities prepared on bovine enamel blocks were filled with fluoride-containing resin sealants [TeethmateF-1 (TF), Clinpro^TM (CP)], and glass ionomer sealant [Fuji VII (FVII)]. Specimens were then incubated in artificial saliva for 14 days to measure fluoride. Thereafter, demineralization was performed for 10 days, and the anti-demineralization efficacy was assessed by Swept Source Optical Coherence Tomography (SS-OCT), and cross-sectional nanohardness. All data were statistically analyzed by using ANOVA. FVII exhibited the highest fluoride release. SS-OCT and nanohardness findings indicated that anti-demineralization efficacy of TF was the greatest, whereas FVII was not significantly different from that of CP. Resin sealants released a lower amount of fluoride but exhibited anti-demineralization effects on the adjacent unsealed enamel surfaces that were comparable to that of a glass ionomer sealant.