Current concepts on adhesion to dentin

Effects of the application sequence of calcium-containing desensitising pastes during etch-and-rinse adhesive restoration

OBJECTIVES

To evaluate the effects of different application sequence of calcium-containing desensitising pastes on bonding effectiveness and tubule occlusion during etch-and-rinse (E&R) adhesive restoration.

METHODS

Seventy molars were sectioned parallel to the occlusal plane, polished and randomly divided into seven groups (n=10). Group 1 was etched with 35% phosphoric acid for 15s. Groups 2-4 were treated with different calcium-containing desensitisers, including an arginine-calcium carbonate (Arg-CaCO3)-containing paste, a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-containing paste and a calcium-sodium phosphosilicate (Novamin)-containing paste, respectively. Afterward, these groups were etched with 35% phosphoric acid for 15s. Groups 5-7 were initially etched and then treated with Arg-CaCO3-, CPP-ACP- and Novamin-containing desensitisers, respectively. In each group, samples were equally distributed into two subgroups (n=5) to bond with either a two-step E&R adhesive Adper SingleBond 2 (SB) or a three-step E&R adhesive Adper ScotchBond Multi-Purpose (SBMP). The microtensile bond strengths (MTBS) were tested and fracture modes were analyzed by stereomicroscopy and field-emission scanning electron microscopy (FESEM). Eight additional dentine disks were prepared to evaluate tubule occlusion prior to bonding using FESEM.

RESULTS

The application sequence of calcium-containing desensitising pastes did not significantly affect MTBS irrespective of two-step SB (P>0.05) or three-step SBMP E&R adhesives (P>0.05). Effective dentinal tubule occlusion was observed in the mode of etching-desensitising.

CONCLUSIONS

Applying calcium-containing desensitisers (particularly Arg-CaCO3- and Novamin-based) after etching during E&R adhesive restoration could achieve effective tubule occlusion without affecting the bonding strength.

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.

Swelling equilibrium of dentin adhesive polymers formed on the water-adhesive phase boundary: experiments and micromechanical model

During their application to the wet, oral environment, dentin adhesives can experience phase separation and composition change, which can compromise the quality of the hybrid layer formed at the dentin-adhesive interface. The chemical composition of polymer phases formed in the hybrid layer can be represented using a ternary water-adhesive phase diagram. In this paper, these polymer phases are characterized using a suite of mechanical tests and swelling experiments. The experimental results were evaluated using a granular micromechanics-based model incorporating poro-mechanical effects and polymer-solvent thermodynamics. The variation in the model parameters and model-predicted polymer properties was studied as a function of composition along the phase boundary. The resulting structure-property correlations provide insight into interactions occurring at the molecular level in the saturated polymer system. These correlations can be used for modeling the mechanical behavior of the hybrid layer, and are expected to aid in the design and improvement of water-compatible dentin adhesive polymers.

Influence of powdered dentin on the shear bond strength of dentin bonding systems

This study evaluated the effect of different amounts of dentin powder (DP) mixed in Clearfil SE Bond (CSB) or Single Bond (SB) on adhesion to dentin. Human third molars (n=96) were sectioned to expose the mid-coronal dentin and divided into eight experimental groups (n=12 per group), namely, Group 1: CSB, Group 2: CSB+1.5 mg DP, Group 3: CSB+3 mg DP, Group 4: CSB+4.5 mg DP, Group 5: SB, Group 6: SB+1.5 mg DP, Group 7: SB+3 mg DP, and Group 8: SB+4.5 mg DP. Filtek Z250 composite was bonded onto dentin, and all specimens were subjected to shear bond strength test at a crosshead speed of 1 mm/min. Highest bond strength was obtained in Groups 1, 2, and 3 (15.1, 13.5, and 16.4 MPa respectively; p>0.05) and the lowest in Groups 6, 7, and 8 (5.5, 5.6, 4 MPa; p>0.05). DP addition, regardless of amount, adversely affected the bond strength of SB. Bond strength of CSB was not affected when 1.5 or 3 mg of DP was added.

Influence of chlorhexidine digluconate on the clinical performance of adhesive restorations: a 3-year follow-up

OBJECTIVES

The aim of this clinical study was to evaluate the long-term clinical performance of non-carious Class V restorations with and without application of chlorhexidine digluconate to acid-etched dentine.

METHODS

After the approval of the Ethics and Informed Consent Committee, 70 non-carious cervical lesions were selected and randomly assigned into two groups, according to the split mouth design. The control group was restored with a two-step etch-and-rinse adhesive (Adper Single Bond 2) following manufacturer's instructions; whereas in the experimental group 2% chlorhexidine digluconate solution was applied to acid etched dentine for 30s after etching and prior to the adhesive application. All lesions were restored with a nanofilled composite resin (Filtek Supreme XT) and polymerized with a light-curing unit operating at 600mW/cm(2). Clinical performance was recorded after 1 week, 6, 12, and 36 months using modified Ryge/USPHS criteria in terms of retention, marginal discoloration, marginal integrity, post-operative sensitivity, and secondary caries incidence. Data were analyzed using Chi-Square, Fisher's exact test and McNemar tests (α=.05).

RESULTS

After 36 months the control group showed a success rate of 88% in comparison to 76% of experimental group; however, no statistically difference between them was found (p=.463). Moreover, no statistical differences were observed between groups in the criteria post-operative sensitivity, marginal discoloration, marginal integrity, and secondary caries incidence between the two groups.

CONCLUSION

The addition of 2% chlorhexidine digluconate conditioning step does not improve the clinical durability of adhesive restorations.

Shear bond strength and ultrastructural interface analysis of different adhesive systems to Er:YAG laser-prepared dentin

The aim of this study was to evaluate the shear bond strength (SBS) of a microhybrid composite resin bonded with three different adhesive systems to Er:YAG laser- (EL) or bur-prepared dentin surfaces and to analyze the quality and ultrastructure of the adhesive-dentin interfaces by scanning electron microscopy (SEM). The specimens prepared for SBS test and SEM analysis were randomly assigned to eight groups (G1-G8): G1, EL (Fidelis PlusIII, Fotona) + Clearfil S3 Bond (C3S); G2, EL + AdperSE Plus (SE); G3, EL + laser etch + Adper Single Bond2 (SB2); G4, EL + acid etch + SB2; G5, EL + SB2 (no etching); G6, bur + acid etch + SB2; G7, bur + S3; G8, bur + SE. Laser was used in very short pulse mode at a setting of 200 mJ/20 Hz for dentin preparation and at 80 mJ/10 Hz for dentin etching. Bond strength test: 3.5 × 2.0 mm cylindrical molds were placed onto adhesives and filled with the composites. After 24 h in distilled water, SBS was tested at a crosshead speed of 0.5 mm/min. SEM analysis: The dentin-adhesive interfaces were evaluated for the ultrastructure of hybrid layer. Data of SBS (MPa) were statistically analyzed by ANOVA and Tukey HSD. ER:YAG laser-prepared dentin has demonstrated significantly more SBS (p < 0.01) for SE when compared to bur-prepared dentin. No significancies (p > 0.05) in SBS have been determined between the total-etch adhesive applied groups with regard to etching types. SEM analysis revealed that hybrid layers obtained in Er:YAG laser-irradiated dentin exhibited more irregular and non-homogeneous pattern than the conventionally prepared dentin. In conclusion, SE Bond demonstrated superior results in Er:YAG laser-ablated dentin compared to bur-prepared dentin.

Combined effect of smear layer characteristics and hydrostatic pulpal pressure on dentine bond strength of HEMA-free and HEMA-containing adhesives

OBJECTIVE

This study evaluated the combined effect of smear layer characteristics with hydrostatic pulpal pressure (PP) on bond strength and nanoleakage expression of HEMA-free and -containing self-etch adhesives.

METHODS

Flat dentine surfaces were obtained from extracted human molars. Smear layers were created by grinding with #180- or #600-SiC paper. Three HEMA-free adhesives (Xeno V, G Bond Plus, Beautibond Multi) and two HEMA-containing adhesives (Bond Force, Tri-S Bond) were applied to the dentine surfaces under hydrostatic PP or none. Dentine bond strengths were determined using the microtensile bond test (μTBS). Data were statistically analyzed using three- and two-way ANOVA with Tukey post hoc comparison test. Nanoleakage evaluation was carried out under a scanning electron microscope (SEM).

RESULTS

Coarse smear layer preparation and hydrostatic PP negatively affected the μTBS of HEMA-free and -containing adhesives, but there were no significant differences. The combined experimental condition significantly reduced μTBS of the HEMA-free adhesives, while the HEMA-containing adhesives exhibited no significant differences. Two-way ANOVA indicated that for HEMA-free adhesives, there were significant interactions in μTBS between smear layer characteristics and pulpal pressure, while for HEMA-containing adhesives, there were no significant interactions between them. Nanoleakage formation within the adhesive layers of both adhesive systems distinctly increased in the combined experimental group.

CONCLUSION

The combined effect of coarse smear layer preparation with hydrostatic PP significantly reduced the μTBS of HEMA-free adhesives, while in HEMA-containing adhesives, these effects were not obvious.

CLINICAL SIGNIFICANCE

Smear layer characteristics and hydrostatic PP would additively compromise dentine bonding of self-etch adhesives, especially HEMA-free adhesives.

Correlation between degree of conversion, resin-dentin bond strength and nanoleakage of simplified etch-and-rinse adhesives

OBJECTIVES

The aim of this study was to correlate the degree of conversion measured inside the hybrid layer (DC) with the microtensile resin-dentin bond strength (μTBS) and silver nitrate uptake or nanoleakage (SNU) for five simplified etch-and-rinse adhesive systems.

METHODS

Fifty-five caries free extracted molars were used in this study. Thirty teeth were used for μTBS/SNU [n=6] and 25 teeth for DC [n=5]. The dentin surfaces were bonded with the following adhesives: Adper Single Bond 2 (SB), Ambar (AB), XP Bond (XP), Tetric N-Bond (TE) and Stae (ST) followed by composite resin build-ups. For μTBS and SNU test, bonded teeth were sectioned in order to obtain stick-shaped specimens (0.8mm(2)), which were tested under tensile stress (0.5mm/min). Three bonded sticks, from each tooth, were not tested in tensile stress and they were immersed in 50% silver nitrate, photo-developed and analyzed by scanning electron microscopy. Longitudinal 1-mm thick sections were prepared for the teeth assigned for DC measurement and evaluated by micro-Raman spectroscopy.

RESULTS

ST showed lowest DC, μTBS, and higher SNU (p<0.05). All other adhesives showed similar DC, μTBS, and SNU (p>0.05), except for TE which showed an intermediate SNU level. The DC was positively correlated with μTBS and negatively correlated with SNU (p<0.05). SNU was also negatively correlated with μTBS (p<0.05).

SIGNIFICANCE

The measurement of DC inside the hybrid layer can provide some information about bonding performance of adhesive systems since this property showed a good correlation with resin-dentin bond strength and SNU values.

The effects of calcium hydroxide removal methods on bond strength of Epiphany SE with two irrigation protocols

OBJECTIVE

The purpose of this study was to compare the effects of five calcium hydroxide removal methods on the bond strength of Epiphany SE sealer after canal irrigation with NaOCl+EDTA or NaOCl+MTAD.

MATERIALS AND METHODS

The 120 roots were instrumented by using the ProTaper rotary system under irrigation with 2.5% sodium hypochlorite and randomly divided into two major groups according to the final irrigation: 1.3% NaOCl + MTAD and 5% NaOCl + 17% EDTA. For controls, 10 roots from each of the final irrigations with NaOCl + MTAD and NaOCl + EDTA (20 roots) were not filled with Ca(OH)2. The intra-canal paste, Ca(OH)2 was applied to each of the 100 remaining roots and stored at 37°C for 7 days. Each group was sub-divided into five sub-groups (n = 10) according to the removal technique for the intra-canal dressing: Group-1: recapitulation with size 30 K file + 3 ml of saline solution, Group-2: recapitulation with size 30 K file + 3 ml of 5% NaOCl, Group-3: using 5% NaOCl + 17% EDTA, Group-4: using 5%NaOCl + 15% citric acid, and Group-5: using 1.3% NaOCl + 5 ml MTAD. The root canals were filled with Resilon and Epiphany SE sealer. The bond strength was measured.

RESULTS

The mean bond strength of Epiphany SE to root dentine irrigated with NaOCl + MTAD was lower than that of NaOCl + EDTA. The highest bond strengths were 3.31 ± 0.057 and 2.60 ± 0.054 in the NaOCl + citric acid group when Ca(OH)2 was applied to roots treated with NaOCl + EDTA and NaOCl + MTAD, respectively (p < 0.05).

CONCLUSION

For root canals treated with NaOCl + EDTA or NaOCl + MTAD, the use of NaOCl + chelating agent for Ca(OH)2 removal does not adversely affect the bond strength of Epiphany SE to dentin.

Evaluation of effect of three different dental unit waterline antimicrobials on the shear bond strength to dentin - An ex vivo study

BACKGROUND

In restorative treatment dental unit water is used while irrigating the cavity and also in the use of composite restorations to flush away the etchant to place bonding agent. These antimicrobials may influence the bond strength of the dentine bonding agent to the dentine.

AIM AND OBJECTIVE

To evaluate the effect of three different dental units waterline antimicrobials on the shear bond strength of dentin.

MATERIALS AND METHODS

Sixty freshly extracted human teeth were taken and the occlusal surfaces were sectioned to obtain a flat dentin surface. Then the teeth were randomized into 4 groups depending on the antimicrobial used: Group 1(Distilled water), Group 2 (Alpron), Group 3 (CitriSil), and Group 4 (Chlorhexidine). The dentine surface was prepared for bonding and composite resin was placed in two increments of 2 mm each. The specimens were stored in distilled water, thermo cycled after 7 days shear test was performed by using the universal testing machine.

RESULT

No significant difference between Group 1 and Group 2 with regard to shear bond strength. There was a significant difference in the SBS of Group 1 and Group 3 and Group 4. The SBS of group 2 was higher than Group 3 and Group 4 and the difference was statistically significant.

CONCLUSION

Citrisil and Chlorhexidine groups showed affected bond strength whereas Alpron did not vary with bond strength.

Shear bond strength of porcelain laminate veneers to enamel, dentine and enamel-dentine complex bonded with different adhesive luting systems

OBJECTIVES

The aim of this study was to evaluate the shear bond strength of porcelain laminate veneers to 3 different surfaces by means of enamel, dentine, and enamel-dentine complex.

METHODS

One hundred thirty-five extracted human maxillary central teeth were used, and the teeth were randomly divided into 9 groups (n=15). The teeth were prepared with 3 different levels for bonding surfaces of enamel (E), dentine (D), and enamel-dentine complex (E-D). Porcelain discs (IPS e.max Press, Ivoclar Vivadent) of 2mm in thickness and 4mm in diameter were luted to the tooth surfaces by using 2 light-curing (RelyX Veneer [RV], 3M ESPE; Variolink Veneer [VV], Ivoclar Vivadent) and a dual-curing (Variolink II [V2], Ivoclar Vivadent) adhesive systems according to the manufacturers' instructions. Shear bond strength test was performed in a universal testing machine at 0.5mm/min until bonding failure. Failure modes were determined under a stereomicroscope, and fracture surfaces were evaluated with a scanning electron microscope. The data were statistically analysed (SPSS 17.0) (p=0.05).

RESULTS

Group RV-D exhibited the lowest bond strength value (5.42±6.6MPa). There was statistically no difference among RV-D, V2-D (13.78±8.8MPa) and VV-D (13.84±6.2MPa) groups (p>0.05). Group VV-E exhibited the highest bond strength value (24.76±8.8MPa).

CONCLUSIONS

The type of tooth structure affected the shear bond strength of the porcelain laminate veneers to the 3 different types of tooth structures (enamel, dentine, and enamel-dentine complex).

CLINICAL SIGNIFICANCE

When dentine exposure is necessary during preparation, enough sound enamel must be protected as much as possible to maintain a good bonding; to obtain maximum bond strength, preparation margins should be on sound enamel.

SEM Analysis of Hybrid Layer and Bonding Interface After Chlorhexidine Use

More studies suggest that the bond between composite and dentin degrades over time because of the action of matrix metalloproteinase on collagen fibrils left unprotected by acid etching. Clinical actions should be taken to prevent this from happening and thus the failure of what should be a very long-term restoration.

Effect of conventional and resin-modified glass-ionomer liner on dentin adhesive interface of Class I cavity walls after thermocycling

OBJECTIVE

The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling.

MATERIALS AND METHODS

Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5°C-55°C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 mm × 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p<0.05).

RESULTS

There was no detectedstatistical difference on bond strength among groups (α<0.05). Confocal microscopy analysis showed a higher mean gap size in group 4 (12.5 μm) and a higher percentage of marginal gaps in the thermocycled groups. The RMGIC liner groups showed the lowest percentage of marginal gaps.

CONCLUSIONS

Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

Influence of hydrophobic layer and delayed placement of composite on the marginal adaptation of two self-etch adhesives

AIM

The purpose of this in vitro investigation was to evaluate the influence of hydrophobic layer and delay in placement of composite on marginal adaptation of two self-etch adhesive systems (XENO-III and ALL-BOND SE).

MATERIALS AND METHODS

Eighty class V cavities were prepared on intact, extracted human premolars and were divided into 4 groups of 10 teeth each. Group 1: Application of bonding agents as per manufacturer directions and immediate placement of composite; Group 2: Application of bonding agent and composite similar to group1, with hydrophobic layer curing before composite placement; Group 3: Application of bonding agent similar to group 1, with 2 min delay in composite placement; and Group 4: Application similar to group 2 with 2-min delay in composite placement. The specimens were restored and light cured. After thermocycling and immersion in 2% basic Fuchsin dye solution, the teeth were sectioned and dye penetration was observed under a stereomicroscope at 20x magnification. All the samples were scored and results were analyzed using Kruskal-Wallis and Mann-Whitney tests.

RESULTS

In group 1, the microleakage along the both enamel and dentin margin was significantly higher than the other groups for both the adhesive systems. There is no significant difference between groups 2, 3 and 4.

CONCLUSION

The addition of a more hydrophobic resin layer and delay in composite placement significantly improves the marginal adaptation of self-etch adhesive resin systems.

Effect of mucoprotein on the bond strength of resin composite to human dentin

The purpose of this study was to test the bond strength and analyze the morphology of the dentin-adhesive interface of two etch and rinse and two self-etch adhesive systems with two kinds of artificial saliva (with and without 450 mg/L mucin) contamination under different conditions of decontaminating the interface. Bonded specimens were sectioned perpendicularly to the bonded surface in 1-mm thick slabs. These 1-mm thick slabs were remounted in acrylic blocks and sectioned in sticks perpendicular to the bonding interfaces with a 1-mm(2) area. Nine specimens from each condition were tested after 24 h on a testing machine (Instron) at a speed of 0.5 mm/min for a total of 360 specimens. Mean and standard deviations of bond strength (MPa) were calculated. ANOVA showed significant differences as well as Fisher's PLSD intervals (p < 0.05). The following values are the results for different groups: Control group 34-60 MPa, saliva without mucin 0-52 MPa, and saliva with mucin 0-57 MPa. Failure sites were mixed and adhesive failure was common for the low bond strength results. P&BNT with ideal conditions and following the manufacturer's instructions (control) had the highest bond strengths and the dentin-adhesive interface exhibited an ideal morphology of etch-and-rinse system. SEM gave complementary visual evidence of the effect in the dentin/adhesive interface structure with some contaminated conditions compared with their respective control groups. This in vitro artificial saliva model with and without mucin showed that an organic component of saliva could increase or decrease the bond strength depending on the specific bonding agent and decontamination procedure.

Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin

Objective

The aims of this study were to evaluate the tensile bond strengths between indirect composites and dentin of 3 recently developed self-adhesive resin cements and to determine mode of failure by SEM.

Material and Methods

Exposed dentin surfaces of 70 mandibular third molars were used. Teeth were randomly divided into 7 groups: Group 1 (control group): direct composite resin restoration (Alert) with etch-and-rinse adhesive system (Bond 1 primer/adhesive), Group 2: indirect composite restoration (Estenia) luted with a resin cement (Cement-It) combined with the same etch-and-rinse adhesive, Group 3: direct composite resin restoration with self-etch adhesive system (Nano-Bond), Group 4: indirect composite restoration luted with the resin cement combined with the same self-etch adhesive, Groups 5-7: indirect composite restoration luted with self-adhesive resin cements (RelyX Unicem, Maxcem, and Embrace WetBond, respectively) onto the non-pretreated dentin surfaces. Tensile bond strengths of groups were tested with a universal testing machine at a constant speed of 1 mm/min using a 50 kgf load cell. Results were statistically analyzed by the Student's t-test. The failure modes of all groups were also evaluated.

Results

The indirect composite restorations luted with the self-adhesive resin cements (groups 5-7) showed better results compared to the other groups (p<0.05). Group 4 showed the weakest bond strength (p>0.05). The surfaces of all debonded specimens showed evidence of both adhesive and cohesive failure.

Conclusion

The new universal self-adhesive resins may be considered an alternative for luting indirect composite restorations onto non-pretreated dentin surfaces.

Morphological and microtensile bond strength evaluation of three adhesive systems to caries-affected human dentine with chemomechanical caries removal

OBJECTIVES

To evaluate the influence of chemomechanical caries removal on bond strengths of three adhesive systems to caries-affected human dentine.

METHODS

45 extracted human third molars with occlusal moderate caries were used. One half of each cavity was prepared with chemomechanical method and the other half with bur as the control. Three adhesive systems, Prime&Bond NT (Dentsply, Germany) without any previous conditioning, an etch-and-rinse adhesive (One-Step, Bisco, USA) and a self-etching adhesive (Adper Prompt-L-Pop, 3M ESPE, USA), were applied. The compomer or resin crowns were, then, built up. The prepared specimens were sectioned for scanning electron microscopy (SEM) examination and microtensile bond strength (MTBS) testing. Data were analysed using two-way ANOVA with subsequent application of Student-Newman-Keuls test at p<0.05.

RESULTS

Opened dentinal tubules and less smear layer were visible by SEM after chemomechanical caries removal, whilst an obvious smear layer covering the dentine surface with occluded tubules was exhibited after bur excavation. Resin tags were seen only in specimens with chemomechanical excavation when Prime&Bond NT system was applied. Statistical analysis of the values of MTBS failed to show significant difference between caries removal methods. However, the values of MTBS for One-Step system achieved with two caries removal methods were both significant higher than other adhesive systems.

CONCLUSIONS

Chemomechanical caries removal did not influence the bond strengths of the adhesive systems used in this study to caries-affected human dentine. Highest bond strength was achieved with application of etch-and-rinse adhesive system.

In vitro enzymatic biodegradation of adhesive resin in the hybrid layer

Penetration of adhesives into the demineralized dentin surface and their subsequent conversion are critically important to longevity of the adhesive resin (AR)-dentin bond. The durability of the resin-dentin bond is investigated by monitoring the change of adhesive concentration within the hybrid layer (HL) of aged specimens using Raman spectroscopy. Absolute molar concentrations of Bis-GMA and HEMA were measured across the HL of resin-dentin specimens 24 h after photopolymerization and after 24-week storage in one of three media: artificial saliva (SAL), SAL containing cholesterol esterase to attack resin (EST), and SAL containing bacterial collagenase to attack collagen (COL). No significant difference among these groups for both Bis-GMA and HEMA molar concentrations at 24-h storage was found; however, concentrations decreased from the AR to the middle of the HL. Concentrations remained unchanged at any resin-dentin position after aging in SAL. In the HL, concentrations significantly decreased with aging in COL and tended to decrease in EST. While showing potential enzymatic biodegradative effects of endogenous matrix metalloproteinases and salivary esterases, this methodology may also prove to be a valuable assessment of new chemistries and future approaches to improve resin-dentin bond performance. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010.

Dentin surface treatment using a non-thermal argon plasma brush for interfacial bonding improvement in composite restoration

The objective of this study was to investigate the treatment effects of non-thermal atmospheric gas plasmas on dentin surfaces used for composite restoration. Extracted unerupted human third molars were prepared by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. The dentin surfaces were treated using a non-thermal atmospheric argon plasma brush for various periods of time. The molecular changes of the dentin surfaces were analyzed using Fourier transform infrared spectrophotometry/attenuated total reflectance (FTIR/ATR), and an increase in the amount of carbonyl groups was detected on plasma-treated dentin surfaces. Adper Single Bond Plus adhesive and Filtek Z250 dental composite were applied as directed. To evaluate the dentin/composite interfacial bonding, the teeth thus prepared were sectioned into micro-bars and analyzed using tensile testing. Student-Newman-Keuls tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s of plasma treatment. However, the bonding strength to plasma-treated inner dentin did not show any improvement. It was found that plasma treatment of the peripheral dentin surface for up to 100 s resulted in an increase in the interfacial bonding strength, while prolonged plasma treatment of dentin surfaces (e.g. 5 min) resulted in a decrease in the interfacial bonding strength.

Effect of dentine smear layer on the performance of self-etching adhesive systems: A micro-tensile bond strength study

This study aimed to evaluate the effect of the smear layer on the micro-tensile bond strength when two self-etching adhesives were used with different techniques. Flat dentine surfaces were prepared using either medium grit diamond burs or tungsten carbide burs. Ten specimens from each prepared surfaces were subjected for smear layer evaluation under SEM. Forty specimens from each of the prepared surfaces were further divided into two groups, bonded with either Clearfil SE Bond (SE) or Clearfil S(3) Bond (S3) using one of four applications (as manufacturer's instructions, agitation, reapplication, and increased application time), restored with composites and subjected to a micro-tensile bond strength test. Smear layers created with diamond burs were thicker than those created with tungsten carbide burs. Surfaces prepared with tungsten carbide burs produced a higher bond strength than those prepared with diamond burs and the same type of adhesive resin. SE demonstrated a higher bond strength than S3 for all surfaces. S3 applied with the agitation technique demonstrated a higher bond strength to dentine prepared with tungsten carbide and diamond burs than that applied with other techniques. SE applied with increased time on dentine treated with carbide burs produced the highest bond strength. In conclusion, a thick smear layer decreased bond strength to dentine, and this might be improved by modification of application technique.

Adhesive/Dentin interface: the weak link in the composite restoration

Results from clinical studies suggest that more than half of the 166 million dental restorations that were placed in the United States in 2005 were replacements for failed restorations. This emphasis on replacement therapy is expected to grow as dentists use composite as opposed to dental amalgam to restore moderate to large posterior lesions. Composite restorations have higher failure rates, more recurrent caries, and increased frequency of replacement as compared to amalgam. Penetration of bacterial enzymes, oral fluids, and bacteria into the crevices between the tooth and composite undermines the restoration and leads to recurrent decay and premature failure. Under in vivo conditions the bond formed at the adhesive/dentin interface can be the first defense against these noxious, damaging substances. The intent of this article is to review structural aspects of the clinical substrate that impact bond formation at the adhesive/dentin interface; to examine physico-chemical factors that affect the integrity and durability of the adhesive/dentin interfacial bond; and to explore how these factors act synergistically with mechanical forces to undermine the composite restoration. The article will examine the various avenues that have been pursued to address these problems and it will explore how alterations in material chemistry could address the detrimental impact of physico-chemical stresses on the bond formed at the adhesive/dentin interface.

Antibacterial effects of 4-META/MMA-TBB resin containing chlorhexidine

This study evaluated the antibacterial effects of 4-acryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butylborane (4-META/MMA-TBB) resin containing chlorhexidine (CHX) digluconate. The CHX was incorporated into the resins at varying concentrations from 0.0 (control) to 3.0%. The antibacterial effect of each resin against seven microorganisms was examined using agar diffusion tests. Growth inhibition of two streptococci was also tested in brain heart infusion (BHI) liquid broth containing each resin. Release of CHX was analyzed using HPLC, and enamel and dentin bond strengths of each resin were measured. In the agar diffusion tests, growth of all the microorganisms was inhibited by the resin specimens containing CHX at 1.0% or higher except for Enterococcus faecalis. There was greater sensitivity in Streptococcus mutans and Streptococcus sobrinus than in the other bacteria tested. Complete growth inhibition of these two streptococci was observed in BHI liquid broth containing 1.0-1.5% or greater CHX-incorporated resin. According to HPLC analysis, 1.0% and 1.5% CHX-containing resins released means of 3.63 and 8.59 microg/mL of CHX, respectively. Specimens with 0.5-1.5% and 0.5-2.0% CHX exhibited no significant reduction in enamel and dentin bond strengths, respectively, when compared to the control (p > 0.05). This in vitro study suggested that incorporation of 1.0-1.5% CHX digluconate into the 4-META resin is optimal in terms of antibacterial effects and bond strength to the tooth.

Bond strength of adhesives to dentin contaminated with smoker's saliva

The purpose of this study was to determine the effects of contamination with smoker's and non-smoker's saliva on the bond strength of resin composite to superficial dentin using different adhesive systems. The interfacial structure between the resin and dentin was evaluated for each treatment using environmental scanning electron microscopy (ESEM). Freshly extracted human molars were ground with 600-grit SiC paper to expose the superficial dentin. Adhesives [One-Up-Bond-F-Plus (OUFP) and Adper-Prompt-L-Pop (APLP)] and resin composite (TPHSpectrum) were bonded to the dentin (n = 8/group, 180 total specimens) under five surface conditions: control (adhesive applied following manufacturers' instructions); saliva, then 5-s air dry, then adhesive; adhesive, saliva, 5-s air dry; adhesive, saliva, 5-s water rinse, 5-s air dry (ASW group); and adhesive, saliva, 5-s water rinse, 5-s air dry, reapply adhesive (ASWA group). After storage in water at 37 degrees C for 24 h, the specimens were debonded under tension at a speed of 0.5 mm/min. ESEM photomicrographs of the dentin/adhesive interfaces were taken. Mean bond strength ranged from 8.1 to 24.1 MPa. Fisher's protected least significant difference (P = 0.05) intervals for critical adhesive, saliva, and surface condition differences were 1.3, 1.3, and 2.1 MPa, respectively. There were no significant differences in bond strength to dentin between contamination by smoker's and nonsmoker's saliva, but bond strengths were significantly different between adhesive systems, with OUFP twice as strong as APLP under almost all conditions. After adhesive application and contamination with either smoker's or nonsmoker's saliva followed by washing and reapplication of the adhesive (ASWA group), the bond strength of both adhesive systems was the same as that of the control group.

Comparing microleakage and the layering methods of silorane-based resin composite in wide Class II MOD cavities

OBJECTIVE

This in vitro study compared the effects of different layering techniques and different monomer-based composites on microleakage.

METHOD AND MATERIALS

Thirty-two freshly extracted caries-free human third molars were used. A wide mesio-occlusal-distal (MOD) cavity was prepared in each third molar, with the occlusal dimension being approximately two-thirds of the intercuspal dimension, and the cervical limit of one proximal box was stopped 1 mm below and the other 1 mm above the cementoenamel junction. The cavities were filled with a methacrylate-based nanohybrid composite (Grandio, VoCo) and a silorane-based microhybrid composite (Filtek Silorane, 3M ESPE). All samples were subjected to 1000 thermal cycles of 5 degrees C/55 degrees C in water with a 30-second dwell time and, after the procedure, the teeth were immersed in a 0.5% basic fuchsin dye at 23 degrees C for 24 hours. Sectioned samples were examined under a stereomicroscope (Leica MZ12, Leica Microsystems), and microleakage scores were statistically analyzed using the Kruskal-Wallis and the Mann-Whitney U tests.

RESULTS

No microleakage was observed for silorane-based resin composite restorations. The nanohybrid-based resin composite restorations showed different levels of leakage. Statistical analysis of microleakage scores showed differences only at the enamel margins for nanohybrid material for both layering techniques (p < 0.05). The nanohybrid-based resin composite restorations showed better results with the vertical layering technique for enamel margins.

Five-year clinical evaluation of 300 teeth restored with porcelain laminate veneers using total-etch and a modified self-etch adhesive system

This study evaluated the long-term clinical performance of porcelain laminate veneers luted with hybrid composite in combination with total-etch and self-etch adhesive systems. The study was performed on 30 patients ranging in age between 28 and 54 years. Ten veneers were performed per patient in the maxillary arch. In Group 1, 150 teeth were treated with porcelain veneers, using a total-etch adhesive system (Scotchbond Multi-Purpose Plus, 3M ESPE). In Group 2, 150 teeth were bonded with a self-etch adhesive system (AdheSE, Ivoclar-Vivadent). All the veneers were luted with a light-cured hybrid composite (Z100, 3M ESPE). The patients were recalled after 1, 2 and 5 years. Modified United States Public Health Service (USPHS) criteria were utilized to evaluate the porcelain laminate veneers in terms of marginal adaptation, cavo-surface marginal discoloration, secondary caries, postoperative sensitivity, satisfaction with restoration shade and gingival tissue response. Data were analyzed using the Chi-Square test (p < 0.05). There was no statistically significant difference between the total-etch and self-etch groups in terms of USPHS criteria (p > 0.05). Porcelain veneers exhibited successful clinical performance with both total-etch and two-step self-etch adhesives at the end of five-years.

Characterization of interfacial chemistry of adhesive/dentin bond using FTIR chemical imaging with univariate and multivariate data processing

Fourier transform infrared (FTIR) chemical imaging can be used to investigate molecular chemical features of the adhesive/dentin interfaces. However, the information is not straightforward and is not easily extracted. The objective of this study was to use multivariate analysis methods, principal component analysis, and fuzzy c-means clustering and to analyze spectral data in comparison with univariate analysis. The spectral imaging data collected from both the adhesive/healthy dentin and adhesive/caries-affected dentin specimens were used and compared. The univariate statistical methods such as mapping of intensities of specific functional group do not always accurately identify functional group locations and concentrations because of more or less band overlapping in adhesive and dentin. Apart from the ease with which information can be extracted, multivariate methods highlight subtle and often important changes in the spectra that are difficult to observe using univariate methods. The results showed that the multivariate methods gave more satisfactory, interpretable results than univariate methods and were conclusive in showing that they can discriminate and classify differences between healthy dentin and caries-affected dentin within the interfacial regions. It is demonstrated that the multivariate FTIR imaging approaches can be used in the rapid characterization of heterogeneous, complex structure.

Push-out stress for fibre posts luted using different adhesive strategies

The influence of thermocycling on the bond strength of fibre posts cemented with different luting approaches was investigated. A total of 84 human incisors were selected for the study. Sixty teeth were assigned to one of the following adhesive/cement combinations for push-out bond-strength evaluation: group 1, XP Bond/CoreXFlow + DT Light-Post; group 2, Panavia F 2.0 + Tech 21; or group 3, RelyX Unicem + RelyX. Bonded specimens were cut into 1-mm-thick slabs and either thermocycled (40,000 cycles) or stored in artificial saliva (control specimens) before push-out bond-strength testing. Additional specimens were processed for quantitative interfacial nanoleakage analysis. Thermocycling decreased the bond strength in specimens of groups 2 and 3, but did not affect the specimens from group 1. No difference was observed among luting approaches in control specimens. Thermocycling resulted in increased silver nitrate deposition (i.e. interfacial nanoleakage) in all groups. Within the limitations of the study, the use of an etch-and-rinse adhesive in combination with a dual-cure cement to lute fiber posts is the most stable luting procedure if compared with a self-etch resin-based cement or a self-adhesive cement, as assayed by thermocycling of the bonded specimens.

Papain-based gel for biochemical caries removal: influence on microtensile bond strength to dentin

This study investigated the influence of a papain-based gel (Papacárie) for chemo-mechanical caries removal on bond strength to dentin. Human molars were assigned to the following groups: Group 1: sound teeth were flattened to expose dentin; Group 2: after flattening of surfaces, the papain-based gel was applied on the sound dentin; Group 3: overlying enamel from carious teeth was removed and mechanical excavation of dentin was conducted; Group 4: chemo-mechanical excavation of carious dentin was conducted using the papain-based gel. The Prime&Bond NT or Clearfil SE Bond adhesive systems were used for restorative procedures. A microtensile bond strength test was performed, and the modes of failure were determined under SEM. The data were submitted to two-way ANOVA and Tukey's test (p < or = 0.05). No significant differences were observed between the sound dentin groups. For both excavation methods, Clearfil presented a significantly higher bond strength than Prime&Bond NT. Also, for Clearfil, the mechanically excavated samples disclosed a significantly higher bond strength than the chemo-mechanically ones. For Prime&Bond NT, no significant differences were detected between the excavation methods. Predominance of mixed failures for the sound substrate and of adhesive failures for the carious dentin one was detected. The bond strength to carious dentin of the self-etching system was negatively affected by chemo-mechanical excavation using the papain-based gel.

Influence of microleakage, surface roughness and biofilm control on secondary caries formation around composite resin restorations: an in situ evaluation

This study was carried out to evaluate in situ the influence of microleakage, surface roughness and biofilm control on caries formation around composite resin restorations. During 28 days, 12 volunteers wore palatal devices containing bovine enamel slabs restored with composite resin. Restorations were made without leakage, when the adhesive system was applied, or with leakage, when adhesive system was omitted. Half of the restorations in each group were finished and the remaining were finished and polished. In one side of the palatal device, biofilm was left to accumulate over the restored slabs, and in the other side dental slabs were brushed, to allow biofilm removal. There was an extraoral application of 20% sucrose solution (8x/day) over the enamel slabs. The formation of caries lesions (white spots) was evaluated by visual inspection under stereomicroscopy. Additionally, the dental slabs were sectioned and observed under polarized light microscopy. Data were submitted to Kruskal-Wallis test and Spearman's correlation test at 5% significance level. Polishing and bonding were not significant factors regarding white spot formation (p>0.05). Biofilm control (brushing) was associated with reduction of caries formation close to the restorations (p<0.01). Polarized light microscopy confirmed the visual inspection findings. These results suggest that while microleakage and surface roughness did not influence caries lesion formation, biofilm control may prevent the enamel demineralization.

Microleakage and scanning electron microscopy evaluation of all-in-one self-etch adhesives and their respective nanocomposites prepared by erbium:yttrium-aluminum-garnet laser and bur

The aim of this study was to evaluate the microleakage of all-in-one self-etch adhesives and their respective nanocomposites in class V cavities prepared by erbium:yttrium-aluminum-garnet (Er:YAG) laser and bur. Class V cavities were prepared on both buccal and lingual surfaces of 72 premolars by Er:YAG laser or bur and divided into six groups (n = 24). The occlusal margins were enamel and the cervical margins were cementum. The groups were as follows: group 1 Er:YAG laser preparation (E) + Xeno V (X) + CeramX (C); group 2 bur preparation (B) + X + C; group 3 E + AdheSE One (A) + Tetric EvoCeram (T); group 4 B + A + T; group 5 E + Clearfil S3 Bond (CSB) + Clearfil Majesty Esthetic (CME); group 6 B + CSB + CME. All teeth were stored in distilled water at 37 degrees C for 24 h, then thermocycled 500 times (5-55 degrees C). Ten teeth from each group were chosen for the microleakage investigation and two teeth for the scanning electron microscopy (SEM) evaluation. The teeth that were prepared for the microleakage test were immersed in 0.5% basic fuchsin dye for 24 h. After immersion, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Bur-prepared cavities presented less microleakage in all groups for enamel (P < 0.05); however, in cervical margins, there were no differences between laser-prepared and bur-prepared cavities in the Xeno V + CeramX and AdheSE One + Tetric EvoCeram groups (P > 0.05). SEM observations of restorative material-dentin interfaces seemed to correspond with those of the microleakage test. Microleakage at the cervical interfaces was greater than that at the occlusal interfaces. Er:YAG laser-prepared class V cavities yielded more microleakage in occlusal margins with all-in-one self-etch adhesives and the respective manufacturer's nanocomposites.

Enzymatic biodegradation of HEMA/bisGMA adhesives formulated with different water content

Dentin adhesives may undergo phase separation when bonding to wet demineralized dentin. We hypothesized that adhesives exhibiting phase separation will experience enhanced biodegradation of methacrylate ester groups. The objective of this project was to study the effect of enzyme-exposure on the release of methacrylic acid (MAA) and 2-hydroxyethyl methacrylate (HEMA) from adhesives formulated under conditions simulating wet bonding. HEMA/bisGMA(2,2-bis[4(2-hydroxy-3-methacryloyloxy-propyloxy)-phenyl] propane), 45/55 w/w ratio, was formulated with different water content: 0 Wt % (A00), 8 wt % (A08), and 16 wt % (A16). After a three day prewash, adhesive discs were incubated with/without porcine liver esterase (PLE) in phosphate buffer (PB, pH 7.4) at 37 degrees C for 8 days. Supernatants were collected daily and analyzed for MAA and HEMA by HPLC. For all formulations, daily MAA release in the presence of PLE was increased compared to MAA release in PB. HEMA release in the presence of PLE was not detected while HEMA release was consistently measured in PB. A08 and A16 released significantly larger amounts of HEMA compared to A00. Analysis of the cumulative release of analytes showed that the leachables in PLE was significantly increased (p < 0.05) as compared with that released in PB indicating that MAA release was not only formed from unreacted monomers but from pendant groups in the polymer network. However, the levels of analytes HEMA in PB or MAA in PLE were increased in A08 and A16 as compared with A00, which suggests that there could be a greater loss of material in HEMA/bisGMA adhesives that experience phase separation under wet bonding conditions.

Effect of surface treatments and aging in water on bond strength to zirconia

The current study evaluated the effects of various pretreatments and aging in water on the bond strength to hot isostatic pressed yttrium-oxide partially stabilized zirconia. Sixty zirconia ceramic specimens (Denzir) were randomly divided into three groups of 20. One group of specimens (n=10) was then bonded to each other using a resin composite cement (RelyX Unicem), the second group (n=10) was bonded with RelyX Unicem and a metal primer (Metal Primer II), while the third group (n=10) was bonded with RelyX Unicem and a ceramic primer (Ceramic Primer). The specimens were then subjected to shear force before and after sandblasting and before and after aging in water for 180 days. Before aging, no significant differences (p > 0.05) were seen within the different groups, either before or after sandblasting. Sandblasting and pretreatment with the metal (p < 0.01) or ceramic (p < 0.001) primers significantly improved the bond strength compared to that of the non-treated specimens. After aging, the bond strength of the sandblasted specimens with metal primer was significantly higher than that of the sand-blasted specimens with ceramic primer (p < 0.01) and the specimens with no primer (p < 0.001). For the specimens that were sandblasted and pretreated with the metal primer, the bond strength was not significantly affected after aging (p > 0.05), whereas, for those specimens with the ceramic primer (p < 0.001) and no primer (p < 0.05), the bond strength significantly decreased. Thus, air abrasion and pretreatment with a metal primer seems to be an appropriate method for improving bond strength.

Chlorhexidine release and water sorption characteristics of chlorhexidine-incorporated hydrophobic/hydrophilic resins

OBJECTIVES

The aim of this study was to evaluate chlorhexidine release from unfilled non-solvated methacrylate-based resins of increasing hydrophilicity and to examine relationships among Hoy's solubility parameters, water sorption, solubility and the rate of chlorhexidine release.

METHODS

Resin discs were prepared from light-cured, experimental resin blends (R1, R2, R3, R4 and R5) containing 0.0, 0.2, 1.0 and 2.0 wt.% chlorhexidine diacetate (CDA). Discs were immersed in distilled water at 37 degrees C, and mass changes were recorded at different periods. Spectral measurements were made to follow change in optical densities of storage solution to examine chlorhexidine release kinetics. After a 28-day period, water sorption, solubility, and the cumulative chlorhexidine release were obtained. Additionally, antibacterial study was performed by observing the presence of inhibition zone against Streptococcus mutans.

RESULTS

The most hydrophilic resin (R5) exhibited the highest chlorhexidine release rate. The most hydrophobic resin (R1) exhibited the lowest rate. However, no inhibition zone was produced by any specimens stored in water for 2 weeks. The addition of CDA increased solubility significantly but had no effect on water sorption. Significant positive correlations were seen between water sorption and the cumulative chlorhexidine release.

SIGNIFICANCE

Chlorhexidine release from resins may be related to water-induced swelling, which in turn is enhanced by the hydrophilicity of cured polymer matrix.

Shear bond strength of four resin cements used to lute ceramic core material to human dentin

PURPOSE

This study evaluated the effect of four resin cements on the shear bond strength of a ceramic core material to dentin.

MATERIALS AND METHODS

One hundred twenty molar teeth were embedded in a self-curing acrylic resin. The occlusal third of the crowns were sectioned under water cooling. All specimens were randomly divided into four groups of 30 teeth each according to the resin cement used. One hundred twenty cylindrical-shaped, 2.7-mm wide, 3-mm high ceramic core materials were heat-pressed. The core cylinders were then luted with one of the four resin systems to dentin (Super-Bond C&B, Chemiace II, Variolink II, and Panavia F). Half of the specimens (n = 15) were tested after 24 hours; the other half (n = 15) were stored in distilled water at 37 degrees C for 1 day and then thermocycled 1000 times between 5 degrees C and 55 degrees C prior to testing. Shear bond strength of each specimen was measured using a universal testing machine at a crosshead speed of 1 mm/min. The bond strength values were calculated in MPa, and the results were statistically analyzed using a two-way analysis of variance (ANOVA) and Tukey HSD tests.

RESULTS

The shear bond strength varied significantly depending on the resin cement used (p < 0.05). The differences in the bond strengths after thermocycling were not remarkable as compared with the corresponding prethermal cycling groups (p > 0.05). Significant interactions were present between resin cement and thermocycling (p < 0.05). After 24 hours, the specimens luted with Variolink II (5.3 +/- 2.2 MPa) showed the highest shear bond strength, whereas the specimens luted with Chemiace II (1.6 +/- 0.4 MPa) showed the lowest. After thermocycling, the bond strength values of specimens luted with Chemiace II (1.1 +/- 0.1 MPa) and Super-Bond C&B (1.7 +/- 0.4 MPa) decreased; however, this was not statistically significant (p > 0.05). The increase in the shear bond strength values in the Panavia F (4.5 +/- 0.7 MPa) and Variolink II (5.5 +/- 2.1 MPa) groups after thermocycling was also not statistically significant (p > 0.05).

CONCLUSION

Variolink II and Panavia F systems showed higher shear bond strength values than Chemiace II and Super-Bond C&B. They can be recommended for luting ceramic cores to dentin surfaces.

Comparison of operative procedure variables on pulpal viability in an ex vivo model

AIM

To measure and compare the responses of pulp tissue to cavity preparation and restoration variables using a novel tooth slice culture model.

METHODOLOGY

Experimental cavities (265) were continuously cut, under carefully controlled conditions, into the dentine of the labial aspect of 28-day-old Wistar rat incisors, and slices of these teeth maintained in organ culture for up to 2 weeks. The experimental variables examined were: the preparation method, remaining dentine thickness, coolant, drill speed, conditioning with EDTA and filling materials. The reactions of the dentine-pulp complex to the experimental variables were measured using pathohistometric analysis and the correlations between variables were determined using analysis of variance statistical tests.

RESULTS

In rank order of surgically induced restorative pulpal injury, from the most to the least injurious were: remaining dentine thickness, absence of coolant during cavity preparation, bur speed, cavity conditioning treatments and the filling material.

CONCLUSIONS

To reduce pulp injury and to promote pulpal repair activity, the correct use of appropriate materials are important. However, of relatively greater importance is the operative technique adopted, the need to avoid the excess removal of dentine and to minimize trauma during preparation.