Reversal of compromised bonding to oxidized etched dentin

The effects of different irrigation solutions on the bond strength of cemented fiber posts

Objective

To study effect of root canal irrigant solutions on the bond strength of cemented fiber posts, and resin cement-tags in root canal dentin.

Materials and methods

Fifty-two human single-rooted anterior teeth were selected and stored in 1% sodium azide. Crowns were sectioned 2 mm incisal to the cemento enamel junction with diamond bur at high speed under water-cooling. After standard root canal treatment to tested teeth, they were randomly assigned into four groups (n=13) corresponding to the endodontic irrigant solution that was used during post space preparation. The treatment groups were: Group 1: 6.15% sodium hypochlorite; Group 2: 17% EDTA; Group 3: 6.15% NaOCl +17% EDTA; Group 4: 6.15% NaOCl +0.12% chlorhexidine solution. Parallel-sided fiber posts were used for all specimens. Samples were embedded in a cylindrical PVC mounting jig to facilitate perpendicular sectioning. With low speed diamond saw, cervical and apical specimens from each tooth were obtained and subjected to push-out test using universal testing machine. SEM was used to examine the root-canal dentin surface.

Results

Statistical analysis revealed significant difference among the groups at P<0.05. Group 2 treated with EDTA, had the highest bond strength; 18.63±2.85 MPa in cervical specimens and 13.49±3.67 MPa in apical specimens. The cervical specimens of Groups 2 and 3 were significantly different than the apical specimens in the same group. Adhesive failure between cement and dentin was the main failure mode observed in all groups. Groups irrigated with EDTA showed cleaner dentin surface and better resin tag formation, while groups treated with NaOCl showed less resin tag formation and insufficient smear layer removal.

Conclusion

NaOCl had adverse effect on bond strength of self-adhesive resin cement to radicular dentin. EDTA irrigant solution produced higher bond strength and was more effective in removing smear layer than NaOCl.

Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin.

MATERIALS AND METHODS

An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: 'dentin' or 'hypochlorous acid' or 'sodium hypochlorite' and 'self-etch adhesive.' The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin.

RESULTS

Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa).

CONCLUSIONS

In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

Antibacterial activity and dentin bonding ability of combined use of Clearfil SE Protect and sodium hypochlorite

The aim of this study was to evaluate the antibacterial activity and dentin bonding ability of a commercial self-etch adhesive Clearfil SE Protect (Kuraray Noritake Dental, Tokyo, Japan) in combination with sodium hypochlorite (NaOCl). Agar disc diffusion tests and measurement of minimum inhibitory/bactericidal concentrations (MIC/MBC) against Streptococcus mutans were performed to evaluate antibacterial effects. The mixture solution of 5.25% NaOCl and the primer of Clearfil SE Protect demonstrated less antibacterial activity than primer only. In microtensile bond strength tests using non-carious human molars, pretreatment with 5.25% NaOCl aqueous solution had no influence on the bond strength of Clearfil SE Protect. These results indicate that pretreatment with NaOCl does not influence the bonding ability of Clearfil SE Protect, while their combined use does not enhance cavity disinfecting effects.

A comparative evaluation of shear bond strength of composite resin to pulp chamber dentin treated with sodium thiosulfate and proanthocyanidin: An in vitro study

Aim:

Based on the importance of coronal sealing right after endodontic treatment, this in vitro study aimed to evaluate the difference of shear bond strength to pulp chamber dentin treated with sodium thiosulfate and proanthocyanidin (PA).

Materials and Methods:

Fifteen extracted mandibular molar teeth were decoronated at the level of cementoenamel junction horizontally. The individual teeth were then sectioned mesiodistally to expose the pulp chamber dentin using a diamond disc. The specimens were randomly divided into three groups (n = 10). Group A: control group, treated with 5.25% sodium hypochlorite (NaOCl) for 30 min followed by a final rinse with 17% ethylenediaminetetraacetic acid (EDTA) solution for 3 min; Group B: after pretreatment with NaOCl and EDTA, it is further treated with 5% sodium thiosulfate (Na₂S₂O₃) for 10 min; and Group C: after pretreatment with NaOCl and EDTA, it is further treated with 6.5% PA for 10 min. After drying the specimens, a bonding agent namely One Coat Bond SL (SwissTEC, Coltene) was applied to the pulp chamber dentin followed by a composite restoration (SwissTEC, Coltene). Each specimen was then tested under a universal testing machine at the dentin/resin interface to determine the shear bond strength.

Results:

Both the groups in which 5% Na₂S₂O₃ and 6.5% PA were used for 10 min showed bond strength that was found to be statistically higher than the positive control (P < 0.05).

Conclusion:

The use of Na₂S₂O₃ and PA can significantly increase the bond strength of composite resin to NaOCl/EDTA-treated dentin, allowing adhesive restorations to be immediately applied after endodontic treatment.

Effect of Two-minute Application of 35% Sodium Ascorbate on Composite Bond Strength following Bleaching

AIM

The aim of this study is to assess the effect of 35% sodium ascorbate on microtensile bond strength of dentin immediately after bleaching with 35% hydrogen peroxide.

MATERIALS AND METHODS

A total of 25 sound human 3^rd molars were collected. Teeth were randomly divided into five groups for different treatments: Group I [bleaching + immediate bonding (i.e., restoration)], group II (bleaching + delayed bonding), group III (bleaching + sodium ascorbate + immediate bonding), group IV (bleaching + sodium ascorbate + delayed bonding), and group V (bonding only). After bleaching, but before bonding, groups II and IV were stored for 1 week in deionized water at 37°C. All samples were bonded using OptiBoned FL (Kerr) and Filtek Supreme (3M/ESPE). Teeth were sectioned into 1 × 1 mm 2 bars, and microtensile bond strength was tested with a universal testing machine (Instron 8841) at a cross-head speed of 0.5 mm/minute.

RESULTS

Microtensile bond strength differed significantly across the five groups, with a significant reduction in microtensile bond strength observed for samples in group I relative to samples in any of the other treatment groups (p < 0.05).

CONCLUSION

The application of a high concentration of sodium ascorbate for a shorter time reversed the negative effect of 35% hydrogen peroxide bleaching on composite bonding strength to dentin.

CLINICAL SIGNIFICANCE

The negative effects of bleaching on composite bonding can be neutralized by the application of the reversing agent sodium ascorbate thus, increasing the efficiency of clinic chair time. This is clinically relevant for those patients requiring restorative treatment immediately after in-office bleaching.

Sodium Hypochlorite Irrigation and Its Effect on Bond Strength to Dentin

Effective shaping and cleaning of root canals are essential for the success of endodontic treatment. Due to the complex anatomy of root canal spaces, the use of various instrumentation techniques alone is not effective in producing bacteria-free root canal spaces. Irrigation, disinfectants, rinses, and intervisit medications are used in conjunction with the mechanical instrumentation to ensure the success of endodontic treatment. Sodium hypochlorite (NaOCl), a halogenated compound, is routinely used to irrigate the root canal during endodontic treatments. NaOCl has been known for its antibacterial action, proteolytic and dissolution capacity, and debridement properties. NaOCl, however, can alter the composition of dentin and hence its interaction with the adhesive resins used to bond the restorative materials to treated dentin. This review therefore covers in depth the action of NaOCl on dentin-adhesive resin bond strength including both enhancement and reduction, then mechanisms proposed for such action, and finally how the adverse action of NaOCl on dentin can be reversed.

Effect of synthetic and natural-derived novel endodontic irrigant solutions on mechanical properties of human dentin

This study aimed to evaluate the effects of different synthetic and natural-derived root canal irrigants (6% sodium hypochlorite [NaOCl], 6% calcium hypochlorite [Ca(OCl)₂] and 6.5% grape seed extract [GSE]) on dentin mechanical properties (flexural strength, ultimate tensile strength [UTS] and fracture resistance). Rectangular-shaped beams and hourglass-shaped sections obtained from mid-coronal and root dentin were treated with 6% NaOCl, 6% Ca(OCl)₂ or 6.5% GSE for 30 min. The irrigant solutions were replaced every 5 min. Then, the dentin specimens were rinsed with distilled water (DW) followed by incubation with 17% EDTA for 1 min, and thoroughly rinsed with DW again. Specimens from the control group were tested without prior irrigation. After treatment with the irrigants, dentin beams were used to assess the flexural strength (n = 10) while UTS was evaluated using the root dentin hourglass-shaped sections (n = 10). Similarly, roots with 1 mm of dentinal wall thickness were obtained from human teeth and treated with the same irrigant solutions (n = 10). A compressive loading was applied to the coronal surfaces of roots until fracture. The values of each mechanical test were statistically analyzed individually by one-way ANOVA followed by Tukey HSD test (P < 0.05). NaOCl significantly reduced the mechanical properties of dentin in all mechanical tests (P < 0.05) and no statistical difference was found among Ca(OCl)₂, GSE and control group (P > 0.05). It can be concluded that Ca(OCl)₂ and GSE may be alternative irrigant solutions, since they do not negatively affect the dentin mechanical properties.

Time of Application of Sodium Ascorbate on Bonding to Bleached Dentin

This study examined the effects of different application times of sodium ascorbate (SA) on the bond strength of composite resin to bleached dentin. Specimens with an exposed dentin surface were divided into 3 groups according to the type of bleaching agent used: Group A, mixture of sodium perborate (SP) and distilled water (DW); Group B, mixture of SP and hydrogen peroxide (HP); control group, no bleaching. Each group was classified into 10 subgroups. Subgroups IB and DB underwent immediate bonding and delayed bonding, respectively. 10% SA was applied to 3, 5, 10, and 30 minutes and 1, 24, 48, and 72 hours, respectively. Microtensile bond strength (μTBS) was measured after restoration, and the data was analyzed by one-way ANOVA and Scheffé's test. Before restoration, the dentin surfaces were examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). SEM showed that most dentin surfaces were filled with crystals when SA was applied to more than 24 hours. EDS revealed peaks of calcium, carbon, oxygen, and sodium. The application of SA for 5 minutes to 48 hours or for 30 minutes to 24 hours is suggested when a mixture of SP and DW or HP is used, respectively.

Effects of Epigallocatechin-3-gallate (EGCG) on the bond strength of fiber posts to Sodium hypochlorite (NaOCl) treated intraradicular dentin

This study was to evaluate the effect of Epigallocatechin-3-gallate (EGCG) on the bond strength of two adhesive systems to the Sodium hypochlorite (NaOCl) treated intraradicular dentin. The roots were accepted regular root canal treatments and post space preparations, and further divided into eight groups according to the four post space pretreatments and two dentin adhesives [Single Bond 2 (SB2) and Clearfil SE Bond (CSB)] used. The push-out strength before and after thermocycling in different root region (coronal and apical), DC of the adhesive and morphologic patterns of treated post space were evaluated. NaOCl + EGCG groups showed the highest push-out strength regardless of the adhesive type, root region and time (P < 0.05). NaOCl pretreatment significantly decreased the push-out strengths and DC of CSB (P < 0.05). EGCG could improve the bonding properties of both SB2 and CSB to NaOCl treated intraradicular dentin. The effect of NaOCl on bonding of a fiber post depended on the type of the adhesive.

Evaluating the effect of antioxidant agents on shear bond strength of tooth-colored restorative materials after bleaching: A systematic review

PURPOSE

The main objective of the present study was to make a systematic review of how antioxidant agents affect shear bond strength of tooth-colored restorative materials after bleaching.

DATA SOURCES

Electronic search was used to extract the related articles on the targeted key words such as "antioxidant", "dental bleaching" and "shear bond strength" (SBS) from MeSH, PubMed, Medline, and Cochrane electronic data bases. These articles were all published before 2016.

STUDY SELECTION

Inclusion criteria were restricted to English journal articles concerning humans, clinical trials, cohorts and case-control studies. Therefore, systematic reviews, case reports, letters to editors, editorials and congress abstracts were excluded from the analysis.

CONCLUSIONS

Most studies conducted on the issue have produced experimental data which are rather controversial, and there is no general agreement about the reported outcomes. As an illustration, most studies have not considered the relationship between the type of antioxidant materials and the shear bond strength. In point of fact, some researchers (e.g Kimyai et al.) have concluded that antioxidants like gel and solution leave similar effects on SBS. Alternatively, certain studies (e.g., Kunt et al.) have produced inconclusive data regarding the impact of one week postponement of the restorative process on SBS after the bleaching process. The results of the studies evaluating the role of various adhesive systems used after bleaching have demonstrated that regardless of the type of adhesive system used, applying antioxidants before restorative procedures can adversely affect the bleaching agents utilized for SBS. It has also been suggested that the type of the adhesive system used might be correlated with the magnitude of SBS. The results obtained from the systematic review of the articles under investigation reflected that the use of antioxidant agents, regardless of their type, form, concentration and duration of application, can improve SBS after bleaching.

The effects of endodontic substances and naturally reducing agents on the bond strength of epoxy resin-based sealer to root dentin

Aim:

To evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine (CHX), and two naturally derived reducing agents on the bond strength of epoxy resin-based sealer to root dentin.

Materials and Methods:

A total of 60 single-rooted human teeth were prepared using ProTaper (Dentsply Tulsa Dental Specialties, Johnson City, TN, USA) and an irrigation protocol including 5% NaOCl or 2% CHX gel, and ethylenediaminetetraacetic acid (EDTA), for smear layer removal. The following subgroups (n = 10) were also assessed according to the naturally derived reducing agent used: no agent (control group); grape seed extract (GSE); and green tea. Root canals were filled with gutta-percha and AH Plus (Dentsply DeTrey, Konstanz, Germany). Bond strength was measured using the push-out test, and statistical analyses were performed using ANOVA; failure patterns (modes) were classified as adhesive, cohesive, or mixed. The types of failure modes were evaluated using the Chi-squared test at α =0.05.

Results:

The irrigation protocols demonstrated similar bond strength values (P > 0.05). However, the Chi-squared test revealed significant differences in failure mode among the groups (P < 0.05). An increase in the incidence of adhesive failures was observed for the NaOCl and EDTA groups. The other groups demonstrated a prevalence of mixed and cohesive failures.

Conclusion:

The irrigation protocols and use of naturally derived reducing agents had no effect on the bond strength of the resin-based sealer to dentin; however, improvement was evident in the adhesion quality of AH Plus to NaOCl-treated root dentin, due to the prevalence of cohesive failure.

Shear Bond Strength of Two Types of Glass Ionomer to Bleached Dentin: Effect of Delayed Bonding and Antioxidant Agent

BACKGROUND

Studies have shown a reduction in bond strength of composites and glass ionomer to bleached enamel and dentin. Several methods have been proposed to reverse compromised bond strength.

OBJECTIVE

The aim of this study was to evaluate the effect of delayed bonding and application of antioxidant agent on the bond strength of reinforced self-cured (Fuji IX) and light-cured glass ionomers (Fuji II LC) to bleached dentin.

MATERIAL

Eighty extracted third molars were randomly divided into 8 groups. Buccal dentin surfaces received different treatments: Two control groups: no treatment + bonding Fuji IX or Fuji II LC. Two immediate bonding groups: bleaching + bonding Fuji IX or Fuji II LC. Two delayed bonding groups: bleaching + 7 days delay + bonding Fuji IX or Fuji II LC. Two sodium ascorbate application groups: Bleaching + application of 10% sodium ascorbate + bonding Fuji IX or Fuji II LC. All samples were tested for shear bond strength. Two-way analysis of variance (ANOVA) was used to compare the mean and standard deviations among groups, followed by the Tukey's test for significant interaction.

RESULTS

No statistically significant difference was detected in shear bond strength of Fuji IX to bleached or normal dentin. Although a significant reduction was found shear bond strength values of Fuji II LC to bleached dentin, no significant difference was observed between no bleaching group and those treated with 10% sodium ascorbate or 7 days of delay in bonding for both types of glass ionomer.

CONCLUSION

Bleaching had no significant effect on shear bond strength of Fuji IX to dentin; this type of GI can be used immediately after bleaching.

Effect of Two Antioxidants Agents on Microtensile Bond Strength to Bleached Enamel

Abstract This in vitro study evaluated the effect of sodium bicarbonate and sodium ascorbate on the microtensile bond strength of an etch-and-rinse system to bleached bovine enamel. Sixty bovine enamel blocks (4x4 mm) were flattened and randomly allocated into 5 groups: G1 (negative control): without treatment; G2 (positive control): bleached with 35% hydrogen peroxide (HP); G3: bleached and stored for 7 days in artificial saliva before restorative procedures; G4: bleached and treated with 10% sodium bicarbonate solution for 5 min; G5: bleached and treated with 10% sodium ascorbate hydrogel for 15 min. HP gel was applied twice (20 min each, except in G1) and the adhesive restorations were performed. After 24 h, the specimens were sectioned into sticks and submitted to microtensile bond strength testing with a crosshead speed of 0.5 mm/min (n=12). As a complementary visual observation, the enamel surfaces of the G1 and G2 specimens were evaluated with scanning electron microscopy. Data were analyzed by one-way ANOVA (p<0.05). The means (standard deviation) were: G1: 24.22±7.74; G2: 18.29±5.88; G3: 40.88±7.95; G4: 19.95±5.67 and G5: 24.43±6.43. Adhesive failures were predominant in all groups. The comparison between the treatments indicates that waiting 7 days after bleaching is still the most effective approach. When this waiting period is not possible, application of sodium ascorbate or sodium bicarbonate seems to be a good alternative. Therefore, the practicality of obtaining sodium bicarbonate in the bleaching kits and its higher stability enables its clinical use.

Correlation between antioxidant activity and bonding strength on bleached enamel

Objective: This study used the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) method to evaluate the percentage of antioxidant activity (%AA) of green tea (GT) and sodium ascorbate (SA) gel in three concentrations (10%, 20% and 30%), and the influence of these concentrations on the microshear bond strength (μ-SBT) values of bleached enamel, using 10% carbamide peroxide (CP).

Materials and methods: Eighty intact third molars were selected to perform the μ-SBT test, and were randomly divided into eight experimental groups: G1: positive control – no treatment; G2: negative control – bleached with CP; G3: PC +10% GT; G4: PC +20% GT; G5: PC +30% GT; G6: PC +10% SA; G7: PC +20% SA and G8: PC +30% SA. After applying the treatments, adhesive procedures were performed using Single Bond 2 and Filtek Z350XT. After 24 h, the samples were tested in a universal testing machine until fracture. The %AA was assessed in triplicate by DDPH method using a UV–VIS spectrophotometer.

Results: In the μ-SBT, ANOVA revealed no significant difference between the antioxidants evaluated (p = .625), but did reveal significant effects of the concentrations studied (p = .007). A negative correlation was observed between μ-SBT and solution concentrations. The values of %AA were from 90.58 to 96.75.

Conclusions: The reverse results occurred in μ-SBT values, only when the antioxidants were used in a 10% concentration and, %AA did not influence μ-SBT.

Bonding Effectiveness of Universal Adhesive to Intracoronal Bleached Dentin Treated with Sodium Ascorbate

Abstract This study evaluated the effect of restorative protocol with sodium ascorbate on the shear bond strength (SBS) of a universal adhesive to intracoronal bleached dentin. One hundred-and-twenty bovine dentin fragments were randomly divided into 12 groups (n=10), according to the bleaching procedure (unbleached and bleached) and restorative protocol (no treatment, 10% sodium ascorbate -10SA, 35% sodium ascorbate -35SA and two-step etch-and-rinse -ER or one-step self-etch -SE Scotchbond universal adhesive approaches). Four whitening sessions were performed using 35% hydrogen peroxide. The samples from control groups were kept in relative humidity at 37 °C. Immediately after bleaching procedures, the assigned antioxidant solution was applied on dentin and restorative procedures were performed following either the ER or the SE approach. After 24 h, the specimens were subjected to SBS test. Data (MPa) were analyzed by ANOVA and Tukey's test (?=0.05). Lower SBS values were found for bleached specimens (8.54 MPa) compared with those unbleached (12.13 MPa) (p<0.05). The bond strength of the sodium ascorbate-treated groups was higher than those untreated, regardless of the strategy employed (p<0.05). Groups restored without sodium ascorbate showed lower bond strength values for both ER (8.32 MPa) and SE (8.28 MPa) adhesive strategies. The group treated with 10SA submitted to ER approach (10.14 MPa) was similar to untreated groups (p>0.05). It may be concluded that bond strength of composite resin to intracoronal dentin was affected by restorative protocol and reduced by bleaching.

Modern Endodontic Principles Part 7: The Restorative Interface

The restoration of endodontically-treated teeth is a topic that has been extensively studied and yet remains controversial. The endodontically-treated tooth can be restored with a wide range of techniques of varying complexity. This article reviews the literature on this topic. Consideration is given to the ferrule and its importance in achieving success. Furthermore, consideration will be given to the use of endodontically-treated teeth as abutments for fixed and removable prostheses and the challenges this presents. Clinical recommendations are presented as guidelines to improve the predictability and outcome of treatment when restoring structurally compromised root-filled teeth. Clinical relevance: The prognosis of endodontically-treated teeth depends not only on the success of the endodontic treatment, but also on the type of reconstruction.

Comparative evaluation of superoxide dismutase, alpha-tocopherol, and 10% sodium ascorbate on reversal of shear bond strength of bleached enamel: An in vitro study

OBJECTIVE

The aim of this study was to investigate the neutralizer effect of antioxidant agents on the bond strength of bleached enamel.

MATERIALS AND METHODS

Sixty enamel slabs were prepared from 60 freshly extracted maxillary central incisors and were divided into six groups. The negative control group received no bleaching treatment and the other groups were bleached with 35% carbamide peroxide (Opalescence Quick; Ultradent, South Jordan, USA). In Group II, composite was built immediately after bleaching and cured without any antioxidants. In Group III, bleached specimens received composite build ups delayed by 1 week. In Groups IV, V, and VI bleached specimens received applications of superoxide dismutase (SOD), sodium ascorbate (SA), and tocopherol solutions, respectively, for 10 min. Following composite bonding, the micro shear bond strength (μSBS) was measured at a speed of 1 mm/min in universal testing machine.

STATISTICAL ANALYSIS USED

The μSBS values of all the groups were analyzed using the analysis of variance followed by Tukey honestly significant difference post-hoc test.

RESULTS

Bonding of composites to unbleached group (Group I) exhibited the highest mean SBS values and among the antioxidant-treated groups, the highest SBS values were seen with SOD (Group IV) treated samples (23.0040 ± 4.30565 MPa).

CONCLUSIONS

Application of SA, alpha-tocopherol, and SOD can effectively reverse the bond strength with bleached enamel. SOD gave a comparatively more promising reversal of bond strength than SA and alpha-tocopherol, and deserves further studies.

Effect of sodium ascorbate on the bond strength of all-in-one adhesive systems to NaOCl-treated dentin

BACKGROUND

Ascorbic acid and its salts are low-toxicity products, which are routinely used in food industries as antioxidants. The aim of the present study was to evaluate the effect of 10% sodium ascorbate on the bond strength of two all-in-one adhesive systems to NaOCl-treated dentin.

MATERIAL AND METHODS

After exposing the dentin on the facial surface of 90 sound human premolars and mounting in an acrylic resin mold, the exposed dentin surfaces were polished with 600-grit SiC paper under running water. Then the samples were randomly divided into 6 groups of 15. Groups 1 and 4 were the controls, in which no surface preparation was carried out. In groups 2 and 5 the dentin surfaces were treated with 5.25% NaOCl alone for 10 minutes and in groups 3 and 6 with 5.25% NaOCl for 10 minutes followed by 10% sodium ascorbate for 10 minutes. Then composite resin cylinders, measuring 2 mm in diameter and 2 mm in height, were bonded on the dentin surfaces in groups 1, 2 and 3 with Clearfil S3 Bond and in groups 4, 5 and 6 with Adper Easy One adhesive systems according to manufacturers' instructions. The samples were stored in distilled water for 24 hours at 37°C and then thermocycled. Finally, the samples underwent shear bond strength test in a universal testing machine at a strain rate of 1 mm/min. Data were analyzed with two-way ANOVA and post hoc Tukey tests at α=0.05.

RESULTS

The differences between groups 1 and 2 (P=0.01), 1 and 5 (P=0.003). 1 and 6 (P=0.03) and 4 and 5 (P=0.03) were statistically significant. Two-by-two comparisons did not reveal any significant difference between other groups (P>0.05).

CONCLUSIONS

Use of 10% sodium ascorbate for 10 minutes restored the decreased bond strength of the adhesive systems to that of the control groups.

KEY WORDS

Sodium ascorbate, adhesive systems, all-in-one, bond strength, sodium hypochlorite.

Effect of Different Anti-Oxidants on Shear Bond Strength of Composite Resins to Bleached Human Enamel

INTRODUCTION

The bond strength of the composite to the bleached enamel plays a very important role in the success and longevity of an aesthetic restoration.

AIM

The aim of this study was to compare and evaluate the effect of Aloe Vera with 10% Sodium Ascorbate on the Shear bond strength of composite resin to bleached human enamel.

MATERIALS AND METHODS

Fifty freshly extracted human maxillary central incisors were selected and divided into 5 groups. Group I and V are unbleached and bleached controls groups respectively. Group II, III, IV served as experimental groups. The labial surfaces of groups II, III, IV, V were treated with 35% Carbamide Peroxide for 30mins. Group II specimens were subjected to delayed composite bonding. Group III and IV specimens were subjected to application of 10% Sodium Ascorbate and leaf extract of Aloe Vera following the Carbamide Peroxide bleaching respectively. Specimens were subjected to shear bond strength using universal testing machine and the results were statistically analysed using ANOVA test. Tukey (HSD) Honest Significant Difference test was used to comparatively analyse statistical differences between the groups. A p-value <0.05 is taken as statistically significant.

RESULTS

The mean shear bond strength values of Group V showed significantly lower bond strengths than Groups I, II, III, IV (p-value <0.05). There was no statistically significant difference between the shear bond strength values of groups I, II, III, IV.

CONCLUSION

Treatment of the bleached enamel surface with Aloe Vera and 10% Sodium Ascorbate provided consistently better bond strength. Aloe Vera may be used as an alternative to 10% Sodium Ascorbate.

Effect of 10% sodium bicarbonate on bond strength of enamel and dentin after bleaching with 38% hydrogen peroxide

AbstractIntroductionBy-products of hydrogen peroxide degradation released during dental bleaching influence the polymerization of adhesive systems and composite resins, causing a reduction in shear bond strength to the tooth.Objectivethe aim of this article was to evaluate the effect of 10% sodium bicarbonate (SB), applied for different lengths of time, on the shear bond strength to enamel and dentin after bleaching.Material and methodEnamel and dentin blocks were divided into groups (n=10): (1) control: no bleaching; (2) immediate: bleaching immediately followed by restoration; (3) 14-day: bleaching, restoration 14 days later; (4) SB for 10 minutes: bleaching, SB gel for 10 minutes, immediately followed by restoration; (5) SB for 20 minutes: bleaching, SB gel for 20 minutes, immediately followed by restoration. A 38% hydrogen peroxide gel (Opalescence Boost/Ultradent) was used. After application of the adhesive system, composite resin cylinders were mounted on the surface of the substrates in order to test shear bond strength. Result: ANOVA and Tukey tests showed significantly higher mean enamel bond strength values for the 14-day follow-up group and without significant differences for control group. Mean bond strength values obtained for the other groups were intermediate. When testing dentin, the Tukey test revealed a significantly higher mean bond strength value for the 14-day follow-up group when compared with application of SB for 20 minutes.ConclusionSB gel applied was unable to reverse the low bond strength to enamel and dentin after bleaching treatment.

Effect of bromelain enzyme for dentin deproteinization on bond strength of adhesive system

Aims:

To assess the deproteinizing effect of bromelain enzyme and compare it with 5% sodium hypochlorite (NaOCl) on shear bond strength before application of the adhesive system.

Materials and Methods:

A total of 30 extracted human premolars were divided into three groups, each one consisted of 10 teeth. The occlusal surface was wet ground to expose superficial dentin. In Group 1, teeth were etched; in Group 2, teeth were etched and deproteinized with bromelain enzyme; in Group 3, teeth were etched and deproteinized with 5% NaOCl. Upon completion of the adhesive procedures, resin composite was inserted into the plastic tube and light-polymerized. All specimens were stored at 37°C in water for 24 h, and the specimens were transferred to the universal testing machine, and then subjected to shear bond strength analysis at a crosshead speed of 1.0 mm/min.

Statistical Analysis Used:

Data were statistically analyzed using one-way analysis of variance and unpaired t-test at a significance level of 0.05. The statistical analysis was performed using SPSS version 12.0.1 for Windows (SPSS Inc., Chicago, IL, USA).

Results:

The bond strength results were significantly influenced by the application of bromelain enzyme. Statistically significant differences were not demonstrated in control group and NaOCl-treated group. The highest bond strength was seen in bromelain enzyme-treated group.

Conclusions:

Within the limitations of the present study, it was concluded that removal of unsupported collagen fiber with bromelain enzyme after acid etching results in improved bond strength.

The Effect of 3% Phosphate Ascorbyl Gel on Bond Strength of Composite Resin to Enamel treated with 35% Hydrogen Peroxide

OBJECTIVE

To evaluate the effect of 3% phosphate ascorbyl gel (PA) in different times onto the microshear bond strength of composite resin (CR) to bovine enamel treated with 35% hydrogen peroxide (HP).

MATERIALS AND METHODS

Thirty enamel blocks of bovine incisors were made and divided into 5 groups (n = 6) with three specimens per group (n = 18), according to treatment: G1= No bleaching + CR; G2 = HP + CR after 15d; G3 = HP + CR after 24 hours; G4 = HP + PA (15 min) + CR after 24 hours; G5 = HP + PA (2 hours) + CR after 24 hours. The resin cylinders were made by Tygon matrices. Microshear bond strength test was performed using universal testing machine with a 50N load at a speed of 0.5 mm/min. Fracture modes were assessed by a stereomicroscope 40 ×. Microshear bond strength values were submitted to the analysis of variance (ANOVA) one-way and Tukey test (p < 0.05).

RESULTS

G1 had significant results when compared to G3 and G5 (p < 0.01). However, G2, G3, G4 and G5 have showed no significant differences among groups (p > 0.05). Failure modes were categorized into adhesive (90%) and mixed (10%).

CONCLUSION

The use of 3% phosphate ascorbyl gel for 15 minutes was able to improve bond strength of composite resin to bleached bovine enamel, but when 3% phosphate ascorbyl gel was applied during 40 minutes it negatively interfered in the adhesion of the resin to bleached bovine enamel.

Antioxidants in Endodontics: A Strategic Review

Over the past few decades, the free radicals and antioxidants have attracted tremendous importance in the field of dentistry. Depending on the level of free radicals in the body, they can either be harmful or helpful. Antioxidants are the substances that interact with and stabilize free radicals thereby protecting cells from the damage caused by free radicals. The indigenous antioxidants may be useful in preventing the harmful effects of oxidative stress. The present article presents a review on the free radicals formation, their role in disease pathogenesis, antioxidants and their potential role in endodontics.

Effect of three different antioxidants on the shear bond strength of composite resin to bleached enamel: An in vitro study

Objective:

The effect of 10% sodium ascorbate, 10% grape seed extract, and 10% pine bark extract on the shear bond strength of composite resin to bleached enamel was evaluated.

Materials and Methods:

Ninety recently extracted human premolars were divided into six groups of 15 teeth each. Except Group I (negative control), the labial enamel surface of all specimens in the other groups were bleached with 37.5% hydrogen peroxide. After bleaching, Group II specimens were stored in artificial saliva for 3weeks before composite bonding. Immediately following bleaching; Groups III, IV, and V specimens were treated with antioxidants 10% sodium ascorbate, 10% grape seed extract, and 10% pine bark extract, respectively, for 10 min and bonded with composite resin. In Group VI (positive control), the composite bonding was done immediately after bleaching. All specimens were stored in deionized water for 24 h at 37΀C before shear bond strength testing. The data obtained were tabulated and statistically analyzed using analysis of variance (ANOVA) and Duncan's multiple range test.

Results:

The unbleached teeth showed the highest shear bond strength followed by the bleached teeth treated with the antioxidant 10% pine bark extract.

Conclusion:

Within the limitations of this study, it was observed that the use of antioxidants effectively reversed the compromised bond strength of bleached enamel. Among the antioxidants, 10% pine bark extract application after bleaching showed better bond strength.

Effect of antioxidants on push-out bond strength of hydrogen peroxide treated glass fiber posts bonded with two types of resin cement

Objectives

Hydrogen peroxide (H₂O₂) surface treatment of fiber posts has been reported to increase bond strength of fiber posts to resin cements. However, residual oxygen radicals might jeopardize the bonding procedure. This study examined the effect of three antioxidant agents on the bond strength of fiber posts to conventional and self-adhesive resin cements.

Materials and Methods

Post spaces were prepared in forty human maxillary second premolars. Posts were divided into five groups of 8 each: G1 (control), no pre-treatment; G2, 10% H₂O₂ pre-treatment; G3, G4 and G5. After H₂O₂ application, Hesperidin (HES), Sodium Ascorbate (SA) or Rosmarinic acid (RA) was applied on each group respectively. In each group four posts were cemented with Duo-Link conventional resin cement and the others with self-adhesive BisCem cement. Push-out test was performed and data were analyzed using 2-way ANOVA and tukey's post-hoc test (α = 0.05).

Results

There was a statistically significant interaction between the cement type and post surface treatment on push-out bond strength of fiber posts (p < 0.001, F = 16). Also it was shown that different posts' surface treatments significantly affect the push-out bond strength of fiber posts (p = 0.001). H₂O₂ treated posts (G2) and control posts (G1) cemented with Duo-link showed the highest (15.96 ± 5.07MPa) and lowest bond strengths (6.79 ± 3.94) respectively.

Conclusions

It was concluded that H₂O₂ surface treatment might enhance the bond strength of fiber posts cemented with conventional resin cements. The effect of antioxidants as post's surface treatment agents depends on the characteristics of resin cements used for bonding procedure.

Bacterial leakage in root canals filled with AH Plus and dentine bonding agents

OBJECTIVE

The aim of this study was to compare the efficacy of different dentine adhesives in delaying the coronal bacterial leakage of Enterococcus faecalis in filled root canals. Materials and methods. Ninety-five lower incisors of patients >65 years of age were instrumented using the ProTaper system and were irrigated with 1 mL of 2.5% sodium hypochlorite (NaOCl) alternated with 1 mL 17% EDTA between each file change. Final irrigation was performed with 5 mL of 17% EDTA and then flushed with 5 mL of distilled water. The teeth were randomly divided into five experimental groups (n = 15/group) and one of the following dentine adhesives was applied: (1) AdheSE; (2) Excite DSC; (3) Clearfil Protect Bond; (4) One Coat 7.0; or (5) Control group without adhesive. After filling the root canals, the samples were mounted on a double chamber device to evaluate the bacterial filtration of E. faecalis during a period of 240 days. The results underwent non-parametric Kaplan-Meier survival analysis and comparisons among groups were done using the Log-Rank test.

RESULTS

At 240 days, E. faecalis was detected in samples of all groups in the lower chamber. The highest survival value was obtained by One Coat 7.0, giving statistically significant differences from the other groups, whereas Clearfil Protect Bond, AdheSE and Excite DSC showed similar behaviours, likewise similar to the Control group.

CONCLUSIONS

One Coat 7.0 adhesive system provides the longest survival value to delay E. faecalis coronal leakage in filled root canals.

Effects of applying antioxidants on bond strength of bleached bovine dentin

Objectives

Some antioxidants are believed to restore dentin bond strength after dental bleaching. This study was done to evaluate the influence of antioxidants on the bond strength of bleached bovine dentin.

Materials and Methods

Thirty incisors were randomly assigned to 10 groups (two unbleached control and eight bleached groups: immediate bonding IB, 4 wk delayed bonding DB, 10% sodium ascorbate treated SA, 10% α-tocopherol treated TP groups). Teeth in half of groups were subjected to thermal stress, whereas the remaining groups were not. Resin-dentin rods with a cross-sectional area of 2.25 mm² were obtained and microtensile bond strength was determined at a crosshead speed of 1 mm/min. Fifteen specimens were prepared for SEM to compare the surface characteristics of each group. The change in dentin bond strength from thermal stress and antioxidant treatment was evaluated using two-way analysis of variance (ANOVA) and Sheffe's post hoc test at a significance level of 95%.

Results

The control group exhibited the highest bond strength values, whereas IB group showed the lowest value before and after thermocycling. The DB group recovered its bond strength similar to that of the control group. The SA and TP groups exhibited similar bond strength values with those of the control and DB groups before thermocycling. However, The TP group did not maintain bond strength with thermal stress, whereas the SA group did.

Conclusions

Applying a 10% sodium ascorbate solution rather than 10% α-tocopherol solution for 60 sec is recommended to maintain dentin bond strength when restoring non-vitally bleached teeth.

Effects of Green Tea Application Time on Bond Strength after Enamel Bleaching

This study evaluated the effect of green tea application time on the bond strength of enamel after enamel bleaching. Enamel samples were obtained from 80 third molars and randomly divided into 7 experimental groups (G1-G7) and 1 group without treatment (G8): G1, bleached with 10% carbamide peroxide (CP); G2, CP + 10% sodium ascorbate gel (SA) for 15 min; G3, CP + SA for 30 min; G4, CP + SA for 60 min; G5, CP + 10% green tea gel (GT) for 15 min; G6, CP + GT for 30 min; G7, CP + GT for 60 min. The CP was applied onto the enamel surface for 8 h for 14 days. The SA was applied in groups 2, 3 and 4, and the GT was applied in groups 5-8 according to the above described application times. Immediately after treatment, the specimens were bonded with Adper Single Bond 2 and Filtek Z350XT. The specimens were prepared to microtensile bond strength analysis. Fracture mode analysis was performed using a stereoscopic loupe. The data were statistically analyzed by two-way analysis of variance, the Tukey's and Dunnett's tests (=5%). The means (standard deviation) were: G1, 23.3 (3.2); G2, 25.2 (3.9); G3, 26.4 (5.4); G4, 30.2 (4.5); G5, 26.6 (3.4); G6, 22.0 (5.4); G7, 31.4 (3.3); G8, 31.4 (3.2). All groups had a high percentage of adhesive failures. In conclusion, the bond strength values were higher than the value in the bleached group only when the antioxidants were applied for 60 min.

Adhesive bonding to pulp chamber dentin after different irrigation regimens

AIM

The aim of the present study was to determine the effect of ethylenediaminetetraacetic acid (EDTA) and NaOCl irrigation on the microleakage and interfacial morphology of adhesives bonded to pulp chamber dentin.

METHODS

The pulp chamber roof of 72 extracted permanent molars was removed. Samples were equally divided into six groups. Pulp chamber dentin was bonded with either Adper Easy One (group 1), Adper Prompt L-Pop (group 2), or Adper Single Bond 2 (Group 3), after irrigation with either normal saline (groups 1a, 2a, 3a) or 17% EDTA and 5.25% NaOCl (groups 1b, 2b, 3b). Composite resin restorations were placed in the pulp chamber. Ten samples per group were subjected to microleakage test and scanning electron microscopic analysis was done in two samples from each group. Data were statistically analyzed using Mann-Whitney and Kruskal Wallis tests at a significance level of P < 0.05.

RESULTS

EDTA and NaOCl irrigation of the pulp chamber significantly reduced microleakage in Adper Easy One. However, it had no significant effect on the microleakage of Adper Prompt L-Pop and Adper Single Bond 2.

CONCLUSIONS

EDTA and NaOCl irrigation of the pulp chamber was not deleterious to the bonding of any of the adhesives tested. While this irrigation regimen had no significant effect on the microleakage of Adper Prompt L-Pop and Adper Single Bond 2, it significantly reduced the microleakage scores in Adper Easy One.

Microleakage evaluation of adhesive systems following pulp chamber irrigation with sodium hypochlorite

Background and aims. This in vitro study evaluated the effect of delaying composite resin restorative procedures bonded with total-etch and self-etch adhesive systems on microleakage following root canal irrigation with sodium hy-pochlorite (NaOCl) solution. Materials and methods. The roofs of pulp chambers and roots (1&ndash;2 mm below furcation) of 40 human first molar teeth were cut and pulp tissues completely removed. The teeth were randomly divided into two main groups (n = 20). Group E (experimental) was irrigated with 5% NaOCl and group C (control) was left untreated. For the experimental group, after obturation of root canals with gutta-percha and sealing the cavity with Cavit, the specimens were stored in artificialsaliva for two weeks. Then each group was divided into two subgroups according to the total-etch or self-etch adhesive application protocol: Scotchbond Multi-Purpose and Clearfil SE Bond. The specimens were restored with composite resin using each bonding agent: Z250 and Clearfil Photo Core, respectively. Fluid filtration method was used for evaluation of microleakage. Data was analyzed using two-way ANOVA ( α= 0.05). Results. Two types of dentin adhesive systems showed no statistically significant differences in microleakage (P = 0.77). NaOCl-treated groups demonstrated significantly higher microleakage values compared to the non-NaOCl-treated groups (P= 0.001). The interaction between the two factors was not significant (P = 0.78). Conclusion. Differences in inlay temperature had no effect on microleakage. CAD/CAM inlays had lower cement thick-ness than laboratory-made inlays, but this was not related to their microleakage.

Effects of antioxidants on the microleakage of composite resin restorations after external tooth bleaching

OBJECTIVE

To compare the effects of three antioxidants (sodium ascorbate, sodium ascorbate combined with a surfactant, and catalase) on the microleakage of composite resin restorations after external tooth bleaching with 10% carbamide peroxide.

MATERIALS AND METHODS

Buccal cavities were prepared on the surface of 60 intact premolars, which were randomly divided into six groups. All cavities were filled with composite resin. In group 1, teeth were not bleached; in group 2, cavities were filled immediately after bleaching; in group 3, cavities were delay-filled for 3 weeks; in group 4, cavities were treated with sodium ascorbate after bleaching and then filled; in group 5, cavities were treated with sodium ascorbate combined with surfactant after bleaching and then filled; and in group 6, cavities were treated with catalase after bleaching and then filled. Microleakage of the restorations was measured from sections using a stereomicroscope.

RESULTS

Group 1 displayed the least amount of microleakage, while group 2 showed the greatest amount of microleakage (P < 0.05). Groups 3 and 4 were similar to group 2 (P > 0.05). However, groups 5 and 6 showed a significantly lower amount of microleakage compared to group 2 (P < 0.05).

CONCLUSION

Microleakage increased significantly after external bleaching with 10% carbamide peroxide, and decreased when the bleached teeth were treated with sodium ascorbate combined with Tween(®) 80, or with catalase. Catalase was more effective in decreasing microleakage, while delayed filling or treatment with sodium ascorbate alone did not effectively decrease the microleakage.

Immediate shear bond strength of resin cements to sodium hypochlorite-treated dentin

INTRODUCTION

The purpose of this in vitro study was to evaluate the immediate shear bond strength of different categories of resin cements on sodium hypochlorite (NaOCl)-treated dentin and to evaluate if the bond was improved by a subsequent treatment with 10% sodium ascorbate before adhesive procedures.

METHODS

This study tested immediate shear bond strengths to human dentin of 5 resin cements: Variolink II (Ivoclar Vivadent, Schaan, Liechtenstein), Multilink (Ivoclar Vivadent), Clearfil Esthetic Cement EX (Kuraray, Tokyo, Japan), SpeedCEM (Ivoclar Vivadent), and Clearfil SA Cement (Kuraray). All cements were tested with no NaOCl pretreatment of the dentin (negative control) and with a 20-minute exposure of the dentin to 6% NaOCl before bonding procedures. The cements found to have decreased bond strengths to NaOCl-treated dentin were tested with the dentin exposed to 10% sodium ascorbate after NaOCl exposure. The sodium ascorbate exposure times tested were 5 seconds and 1 minute.

RESULTS

The mean and standard deviation values for immediate shear bond strength (MPa) for the negative control group were as follows: Variolink II, 18.8 ± 4.2; Multilink, 29.1 ± 7.1; Clearfil Esthetic Cement EX, 20.7 ± 4.9; SpeedCEM, 17.8 ± 4.2; and Clearfil SA Cement, 7.2 ± 2.8. The results for the NaOCl exposure group were as follows: Variolink II, 24.0 ± 6.7; Multilink, 34.1 ± 6.1; Clearfil Esthetic Cement EX, 20.7 ± 6.8; SpeedCEM, 0.0 ± 0.0; and Clearfil SA Cement, 0.1 ± 0.1. The results for the 5-second sodium ascorbate group were the following: SpeedCEM, 8.5 ± 2.6, and Clearfil SA Cement, 4.3 ± 2.0. The following results were found for the 1-minute sodium ascorbate group: SpeedCEM, 12.2 ± 3.2, and Clearfil SA Cement, 4.8 ± 1.0.

CONCLUSIONS

The resin cements tested varied in their capacity to adhere to NaOCl-treated dentin. Some resin cements exhibited equal or improved bond strengths (P < .05), whereas others exhibited significantly decreased bond strengths (P < .05). For the susceptible resin cements, a rinse of 10% sodium ascorbate provided an immediate restoration of at least 50% of the original bond strength (P < .05). The efficacy of sodium ascorbate may vary among resin cements.

Effect of Sodium Ascorbate on Dentin Bonding After Two Bleaching Techniques

The purpose of this study was to analyze the influence of 10% sodium ascorbate (SA) on the hybrid layer, resin tag length, and bond strength to dentin after bleaching. Six groups were tested: G C, control; G SA, sodium ascorbate (SA) + restoration; G CP, bleaching with carbamide peroxide (CP) + restoration; G CP+SA, bleaching with CP + SA+ restoration; G HP, bleaching with 35% hydrogen peroxide (HP) + restoration; and G HP+SA, HP + SA + restoration. After dental bleaching, the dentin was exposed and the antioxidant solution was applied to groups G SA, G CP+SA, and G HP+SA, before bonding procedures. The teeth were sectioned in the mesiodistal direction. One section was decalcified, and the specimens were embedded in paraffin and sectioned in the longitudinal direction with a thickness of 6 μm. Fifteen slices of each specimen were selected according to a systematic sample of slices with an interval proportional to the total number of slices obtained for each tooth. The specimens were stained using the Brown & Brenn method, and an optic microscope was used to analyze the hybrid layer thickness and resin tag length. The remaining tooth segment was sectioned into stick-shaped specimens and used for microtensile bond strength testing (0.5 mm/min). Statistical analysis was performed using two-way analysis of variance and Fisher test. The results for hybrid layer + tag formation (in micrometers) were G C, 13.27 Aa; G SA, 11.85 Ba; G CP, 6.84 Bb; G CP+SA, 9.02 Ab; G HP, 7.28 Bb; and G HP+SA, 9.22 Ab; bond strength results (in MPa) were G C, 49.5 Aa; G SA, 51.7 Aa; G CP, 37.16 Bb; G CP+SA, 47.69 Aa; G HP, 32.39 Ab; and G HP+SA, 39.67 Ab. Tooth bleaching with CP or HP impairs the formation of the hybrid layer and resin tags and reduces the microtensile bond strength. Statistically, the use of SA significantly increases the hybrid layer thickness and resin tag length. The microtensile bond strength values for carbamide peroxide increased, but the microtensile bond strength for hydrogen peroxide was not affected.

Effect of blood contamination and decontamination protocols on acetone-based and ethanol-based total etch adhesive systems

STATEMENT OF THE PROBLEM

The efficacy of various decontamination protocols to reverse the effect of blood contamination after acid-etching may depend on the type of adhesive.

OBJECTIVES

To compare the effect of blood contamination and various decontamination protocols on acetone-based and ethanol-based total-etch adhesive systems.

METHODS

Occlusal dentin of 64 human molars was etched and contaminated with fresh human blood. The samples were assigned to two groups as per adhesive used: Prime & Bond NT (acetone-based) and Adper Single Bond 2 (ethanol-based) and then subdivided into eight groups: (1) control, (2) no decontamination, (3) water rinsing, (4) re-etching, (5) sodium hypochlorite, (6) sodium hypochlorite/sodium ascorbate, (7) hydrogen peroxide, and (8) ethanol. Adhesives were applied and specimens were prepared for μTBS after composite buildup. The data were subjected to analysis of variance followed by post hoc Tukey test.

RESULTS

Blood contamination significantly reduced μTBS of both the adhesives. Re-etching and NaOCl/Asc were effective in restoring μTBS to the level of control for both the adhesives whereas NaOCl was effective only for Prime & Bond NT.

CONCLUSION

Both re-etching and NaOCl can be used for regaining μTBS of blood-contaminated acid-etched dentin. NaOCl/Asc yields better results than NaOCl alone, specifically for ethanol-based adhesive.

CLINICAL SIGNIFICANCE

Knowing the adverse effects of prolonged acid-etching, other alternatives for decontamination of etched dentin after blood contamination should be considered. NaOCl alone or NaOCl followed by sodium ascorbate may prove to be good alternatives. These choices also may determine the type of adhesive system.

Effect of Sodium Ascorbate on Resin Bonding to Sodium Perborate–bleached Dentin

This was an in vitro study to evaluate the effect of sodium ascorbate on the microshear bond strength (MSBS) of resin composite to sodium perborate–bleached dentin. Molar dentin sections were divided into six groups: 1) control, 2) sodium perborate (SP) bleach and immediate bonding, 3) SP and 30 second sodium ascorbate (SA); 4) SP and 1 minute SA; 5) SP and 2 minute SA; and 6) SP and 7 day delay before bonding. They were further divided into two-step self-etching (Clearfil SE Bond) or all-in-one self-etching (Xeno IV) adhesive systems. Resin composite microtubes were bonded according to dentin location—center, pulp horn, and peripheral positions—and an MSBS test was carried out. Failure mode was determined using light microscopy and scanning electron microscopy. There were no significant differences between the treatment types/groups. MSBSs were significantly higher for two-step self-etching adhesive compared with all-in-one self-etching adhesive (p=0.028). For the all-in-one adhesive, MSBSs at the center and pulp horn positions were significantly lower than the peripheral positions (p&lt;0.001). All-in-one groups had significantly more adhesive failures than two-step adhesive groups (p=0.015). The odds of adhesive failure were higher at the pulp horn position than the peripheral position (p=0.004). Sodium perborate bleaching of dentin had no effect on MSBS or mode of failure for either two-step or all-in-one self-etching adhesives; therefore, the effect of sodium ascorbate was negligible. The two-step adhesive groups demonstrated the highest MSBS, and the all-in-one groups, when bonded to center and pulp horn dentin, exhibited the lowest MSBS.