Immediate bonding properties of universal adhesives to dentine

Interfacial fracture toughness of universal adhesive systems treated with an antioxidant

Background

Secondary caries, degradation of the dentin-resin interface and fracture of the restoration are the most common forms of failure. The aim of this study was to assess the interfacial fracture toughness of three different adhesive approaches and to compare their fracture toughness after surface treatment with antioxidant.

Material and Methods

Seventy two dentin blocks with 3×4mm dimension and 3mm thickness were prepared and attached to precured 3×4×12mm composite blocks from both sides. Six adhesive groups (N=12), All-bond universal, Scotchbond universal and Clearfil SE bond with or without antioxidant treatment (Sodium Ascorbate 10% )were applied to dentin surfaces, a 160µ polyethylene paper formed the chevron in adhesive-dentin interfaces. Chevron-notched beam fracture toughness was measured following a modified ISO 24370 standard. The uniform composite-dentin-composite block was subjected to a 4-point test in universal machine. Data were analyzed by Kruskal-Wallis, Wilcoxon signed-rank and Mann-Whitney tests (α =0.05).

Results

Different adhesive approaches yielded different significant in fracture toughness rates. A significant increase of fracture toughness was observed between adhesive groups after antioxidant surface treatment. The difference in fracture toughness between Scotchbond universal and All-bond universal were significant.

Conclusions

The highest value of fracture toughness was reported for Clearfil SE bond and the lowest value was found for All-bond universal. Sodium ascorbate as antioxidant surface treatment had a significant effect in increasing the fracture toughness.

Key words:Chevron-notched beam fracture toughness, fracture toughness, dentin, adhesive, antioxidant.

Do universal adhesives promote bonding to dentin? A systematic review and meta-analysis

Objectives

The aims of this study were to conduct a systematic review of the microtensile bond strength (µTBS) of multi-mode adhesives to dentin and to perform a meta-analysis to assess the significance of differences in the µTBS of one of the most commonly used universal adhesives (Scotchbond Universal, 3M ESPE) depending on whether the etch-and-rinse or self-etch mode was used.

Materials and Methods

An electronic search was performed of MEDLINE/PubMed, ScienceDirect, and EBSCOhost. Laboratory studies that evaluated the µTBS of multi-mode adhesives to dentin using either the etch-and-rinse or self-etch mode were selected. A meta-analysis was conducted of the reviewed studies to quantify the differences in the µTBS of Scotchbond Universal adhesive.

Results

Only 10 studies fulfilled the inclusion criteria for the systematic review. Extensive variation was found in the restorative materials, testing methodologies, and failure mode in the reviewed articles. Furthermore, variation was also observed in the dimensions of the microtensile testing beams. The meta-analysis showed no statistically significant difference between the etch-and-rinse and self-etch modes for Scotchbond Universal adhesive (p > 0.05).

Conclusions

Multi-mode ‘universal’ adhesives can achieve substantial bonding to dentin, regardless of the used modes (either etch-and-rinse or self-etch).

Effect of different bonding protocols on degree of monomer conversion and bond strength between orthodontic brackets and enamel

The objective of the present study was to evaluate the effect of different surface treatments and polymerization protocols on the bond strength of brackets to enamel, and the degree of conversion of the bonding agents. 120 bovine crowns were embedded in acrylic resin blocks and sanded. Next, the blocks were randomly assigned into 12 groups. Metal brackets were bonded to enamel according to the "surface treatment" factor (A: Phosphoric Acid; ATxt: Phosphoric Acid + Transbond XT Primer®; Tse: Transbond Plus Self Etching Primer®; and SBU: Scotchbond Universal®) and "polymerization" factor (R20: Radii-Cal®/20 seconds; V20: Valo Cordless®/20 seconds; and V3: Valo Cordless®/3 seconds). All samples were stored for 6 months (water, 37ºC) and then subjected to a shear bond strength test (SBS). Bond failures were classified according to the Adhesive Remnant Index (ARI) and analyzed with the Kruskal-Wallis and Mann-Whitney tests (5%). Using the same factors, 120 resin discs were made to assess the degree of conversion (DC) of the monomer. Data from the SBS (MPa) and DC (%) were analyzed by analysis of variance (2 factors) and Tukey's test (5%). For the SBS, the factors "polymerization" (R20 = 8.1B; V20 = 13.2A; V3 = 5.2C, p = 0.0001) and "surface treatment" (A = 3.1C; ATxt = 13.6A; Tse = 12.3A; SBU = 6.3B, p = 0.0001) were statistically significant among groups. The highest adhesion value were found for the ATxt/V20 group (22.2A) and the lowest value for the A/R20 group (1.2E). Regarding ARI, score 2 was the most prevalent in groups A, ATxt, V20 and V3, while score 4 was the most prevalent in the Tse, SBU and R20 groups, with no significant difference between them (p = 1.0). Regarding DC, the factors "polymerization" (R20 = 66.6A; V20 = 58.4B; V3 = 45.1C, p = 0.0001) and "surface treatment" (A = 52B, ATxt = 59.7A, Tse = 51.4B, SBU = 63.8A, p = 0.0001) were statistically significant. Tse was more sensitive to the variations in polymerization protocols than the other surface treatments. Treatment A did not present suitable bond strength or degree of conversion.

Selective dentin etching: A potential method to improve bonding effectiveness of universal adhesives

OBJECTIVES

To evaluate whether selective dentin etching protocols using reduced phosphoric acid (H₃PO₄) etching-times would affect the resin-dentin interaction of a universal adhesive to improve long-term bonding effectiveness.

METHODS

Mid-coronal flat dentin surfaces were produced on sound third molars, selectively etched with 32% H₃PO₄ for 3, 5, 10 or 15 s and bonded with a universal adhesive (Scotchbond Universal, 3 M ESPE: SU). SU in self-etch mode and a three-step etch-and-rinse adhesive were used as control groups. Bonded specimens were stored in deionized water for 24 h and sectioned into beams (cross sectional area of 0.7 mm²). Micro-tensile bond strength test (n = 6) and nanoleakage evaluation were performed immediately, after thermocycling or 6-month storage in artificial saliva. Energy dispersive X-ray analysis (n = 6) was performed to determine the residual Ca-content ratio at the hybrid layers and scanning electron microscopy (SEM) was used to observe the micromorphology of the etched dentin surfaces before and after SU application. Data were analyzed by ANOVA and Tukey test (α = 0.05).

RESULTS

Selective dentin etching for 3 s improved the interaction depth of the tested universal adhesive without overexposing demineralized collagen or reducing Ca-content availability at the bonded interface. The improved immediate bond strengths of the selective etching protocol remained significantly higher (p < 0.05) after long-term aging producing hybrid layers without significant differences (p > 0.05) in silver uptake levels compared to those produced on non-etched dentin.

CONCLUSIONS

Despite the adjunctive conclusion that universal adhesives used in self-etch mode produce superior long-term dentin bonding compared to the etch-and-rinse mode, selective etching for 3 s with conventionally used H₃PO₄ improves dentin bonding effectiveness; nonetheless, longer etching times should be strictly avoided.

Bond Stability of a Universal Adhesive System to Eroded/Abraded Dentin After Deproteinization

OBJECTIVE

Erosive/abrasive challenges can potentially compromise bonding to dentin. Aiming to improve the quality and stability of bonding to this substrate, this study investigated the combined effect of erosion and toothbrush abrasion on the microtensile bond strength (μTBS) stability to dentin using a universal adhesive system in total and self-etching modes, associated or not associated with deproteinization.

METHODS

Bovine dentin specimens were divided into five groups according to the organic matrix condition (n=20): control (C); erosion (E); erosion + abrasion (EA); erosion + sodium hypochlorite (EH); erosion + abrasion + sodium hypochlorite (EAH). The groups were further divided (n=10) according to the mode of application (total or self-etching) of a universal adhesive. After the bonding procedure, composite blocks were built up, and the samples were cut to obtain sticks for μTBS testing. For each specimen, one-half of the sticks was immediately tested, and the other one-half was tested after artificial aging (5000 thermocycles, 5°C and 55°C).

RESULTS

Three-way analysis of variance (α=5%) showed a significant difference for the triple interaction ( p=0.0007). Higher μTBS means were obtained for the EH and EAH groups compared with the E and EA groups. The control group showed immediate μTBS values similar to that of the E and EA groups for both bond strategies.

CONCLUSIONS

Erosion and erosion/abrasion did not significantly influence the immediate μTBS to dentin. Artificial aging reduced μTBS values for the groups C, E, and EA using the total-etching mode. Deproteinization maintained the bond stability to artificially aged eroded and eroded/abraded dentin.

Eighteen-month Clinical Study of Universal Adhesives in Noncarious Cervical Lesions

OBJECTIVE

To evaluate the clinical performance of Scotchbond Universal (3M Oral Care) and Prime & Bond Elect (Dentsply Sirona) in the restoration of noncarious cervical lesions (NCCLs).

METHODS AND MATERIALS

This was a randomized controlled clinical trial involving 63 subjects. Two hundred and three NCCLs were restored using Scotchbond Universal and Prime & Bond Elect using both an etch-and-rinse and a self-etch technique. Lesions were notch-shaped NCCLs, and the restorations were placed without any mechanical retention. Restorations were finished immediately after placement and scored with regard to retention, marginal discoloration, marginal adaptation, and secondary caries. Similar assessment of the restorations was performed 18 months after placement. Logistic regression was performed for each outcome separately with a compound symmetric variance-covariance structure assumed to consider a correlation of restorations within subjects. All analyses were conducted using SAS version 9.4 (SAS Inc).

RESULTS

One hundred and fifty-eight teeth (77.8% of the restorations placed) in 46 subjects (73% of subjects enrolled) were available for the 18-month follow-up. A statistically significant difference was reached only for the comparison Scotchbond Universal/self-etch (SU_SE) and Prime & Bond Elect/etch-and-rinse (PBE_E&R) groups ( p=0.01), where a restoration with SU_SE was 66% less likely to maintain a score of Alpha for marginal discoloration than a restoration performed with PBE_E&R.

CONCLUSIONS

Scotchbond Universal and Prime & Bond Elect presented acceptable clinical performance after 18 months of clinical service. However, Scotchbond Universal, when applied with a self-etch approach, did demonstrate a relatively high level of marginal discoloration when compared to the other groups.

Influence of light activation of simplified adhesives on the shear bond strength of resin cements to a leucite-reinforced ceramic

Objective

This study aims to evaluate the influence of the light activation of simplified adhesives on the shear bond strength of resin cements to a glass-ceramic. Three factors were evaluated: (1) cement in two levels (light cured and dual cured); (2) adhesive in two levels (Single Bond 2 and Single Bond Universal), and (3) light activation in two levels (yes or no).

Materials and Methods

Thirty-two 1-mm thick slices of a leucite-reinforced glass-ceramic (IPS Empress CAD) were divided into eight groups according to adhesive (Single Bond 2 or Single Bond Universal), cement (AllCem Veneer or AllCem), and light activation of the adhesive before application of the cement (yes or no). Ceramic surfaces were etched for 60 s with 5% hydrofluoric acid, and adhesives were applied. Four cement cylinders were made over each ceramic slice (n = 16) and then submitted to shear bond strength tests.

Statistical Analysis

Data were analyzed with three-way ANOVA and Tukey (α = 0.05).

Results

There were significant differences between adhesives (P < 0.0001) and no differences between cements (P = 0.0763) and light activation (P = 0.4385). No interaction effect occurred (P = 0.05). Single Bond 2 showed higher bond strength than Single Bond Universal.

Conclusions

The light activation of the adhesive before the application of the resin cement did not influence the bond strength.

Adhesion performance of a universal adhesive in the root canal: Effect of etch-and-rinse vs. self-etch mode

PURPOSE

Universal adhesives are new systems that can be used in etch-and-rinse (ER) and self-etch (SE) modes. This in vitro study evaluated the bonding performance of a universal adhesive in ER mode and SE mode with two irrigants for luting fiber posts in the root canal.

MATERIALS AND METHODS

After separation of the roots from the crowns of 56 maxillary central incisors and endodontic treatment, 10-mm post space was prepared. The roots were divided into seven groups according to irrigant/adhesive protocol used for cementation of posts: 1) sodium hypochlorite (NaOCl) irrigant + acid etching + One-Step Plus, 2) NaOCl + Clearfil SE Bond (CSE) and 3) EDTA + CSE as controls; 4) NaOCl + All-Bond Universal (AB) in ER mode, 5) NaOCl + AB in SE mode, 6) EDTA + AB in SE mode, 7) distilled water + AB in SE mode. Posts were luted using Duo-link. The bonded roots were sectioned into microslices. After push-out bond strength (PBS) testing, data in MPa were analyzed with two-way ANOVA and Tukey test (α = 0.05).

RESULTS

PBS was significantly affected by irrigation/adhesive protocol and root region (P<0.05), with no significant interaction of these factors. PBS of ABU in ER mode with NaOCl and in SE mode with NaOCl or EDTA was comparable to that in the respective controls. The highest and lowest PBSs were recorded for ABU in the SE mode with EDTA (15.38 ± 4) and NaOCl (10.17 ± 3.5), respectively. PBS of AB in ER and SE modes was similar when distilled water was used in the SE mode.

CONCLUSION

Adhesive performance of AB in the ER mode was comparable to or different from the SE mode, depending on the irrigant used to prepare post space in SE approach. AB could behave as a reliable bonding for post cementation.

Effects of different etching modes on the nanoleakage of universal adhesives: A systematic review and meta-analysis

PURPOSE

The aim of this systematic review was to evaluate how etching modes affect the nanoleakage of universal adhesive from in vitro studies.

MATERIALS AND METHODS

PubMed/MEDLINE, Web of Science, Scopus and Science Direct electronic databases were searched for in vitro studies that evaluated the nanoleakage of universal adhesives. A total of 511 (after duplicate removal) potentially relevant records were identified in the literature search. The titles and abstracts of the retrieved studies were screened by two independent researchers according to the main concept. Subsequently, the full text of potentially relevant studies was screened using the exclusion criteria. Thirteen studies were subjected to qualitative analysis, and 5 of them were selected for a detailed meta-analysis.

RESULTS

Seven universal adhesives were evaluated in this review. The meta-analysis demonstrated that the etch-and-rinse technique significantly reduced the nanoleakage of the Peak Universal and G-Bond Plus adhesives, whereas the self-etch mode reduced the nanoleakage of All-Bond Universal. In comparison, the etching technique did not significantly alter the nanoleakage of either Prime&Bond Elect or Scotchbond Universal which was characterized by the smallest nanoleakage.

CONCLUSIONS

Etching modes significantly, in various ways, influence the nanoleakage of universal adhesives.

CLINICAL SIGNIFICANCE

Contrary to the drive to simplify bonding technologies, an appreciation of their adhesive components and how these perform according to bonding technique could yield a knowledge-based practical approach that ultimately improves the longevity of direct composite restorations.

Degradation of Multimode Adhesive System Bond Strength to Artificial Caries-Affected Dentin Due to Water Storage

The purpose of this study was to evaluate the influence of water storage on bond strength of multimode adhesive systems to artificially induced caries-affected dentin. One hundred twelve sound bovine incisors were randomly assigned to 16 groups (n=7) according to the dentin condition (sound; SND, artificially induced caries-affected dentin; CAD, cariogenic challenge by pH cycling for 14 days); the adhesive system (SU, Scotchbond Universal Adhesive; AB, All-Bond Universal; PB, Prime & Bond Elect; SB, Adper Single Bond 2; and CS, Clearfil SE Bond), and the etching strategy (etch-and-rinse and self-etch). All adhesive systems were applied under manufacturer's instructions to flat dentin surfaces, and a composite block was built up on each dentin surface. After 24 hours of water storage, the specimens were sectioned into stick-shaped specimens (0.8 mm2) and submitted to a microtensile test immediately (24 hours) or after six months of water storage. Bond strength data (MPa) were analyzed using three-way repeated-measures analysis of variance and post hoc Tukey test (α=5%), considering each substrate separately (SND and CAD). The etching strategy did not influence the bond strength of multimode adhesives, irrespective of the dentin condition. Water storage only reduced significantly the bond strength to CAD. The degradation of bond strength due to water storage was more pronounced in CAD, regardless of the etching strategy.

Bond Strength and Cytotoxicity of a Universal Adhesive According to the Hybridization Strategies to Dentin

Abstract This study evaluated application protocol (etch-and-rinse/ER and self-etching/SE) and dentin wettability (wet and dry) on microtensile bond strength (μTBS) and transdentinal cytotoxicity of ScotchbondTM Universal (SU) adhesive system. The μTBS values and fracture mode were registered 24 h after adhesive system application and resin composite block build-up (n=5). For analysis of transdentinal cytotoxicity, odontoblast-like MDPC-23 cells were seeded on pulpal surface of dentin discs (0.4 mm thick) adapted to artificial pulp chambers (n=8). The adhesive system was applied to occlusal surface, followed by 24-h incubation time. Cell viability (Alamar Blue) and morphology (SEM) were assessed. Adper Single Bond 2 and Clearfil SE Bond were used as positive controls of the ER and SE application protocols, respectively. No treatment was performed on negative control (NC) group. Data were analyzed by ANOVA and Tukey’s tests (α=5%). Higher μTBS values were found for ER mode in comparison with SE protocol (p<0.05). Dentin wettability had no effect on bond strength of SU in both the ER and SE techniques (p>0.05). Most fractures involved hybrid layer and/or adhesive layer. Neither variable prevented the intense toxic effects of adhesive systems on MDPC-23 cultured cells, since intense reduction in cell viability (±88%) and severe alterations in cell morphology were observed for all groups compared to NC, with no differences among them (p>0.05). Therefore, it was concluded that application of SU following the ER protocol had better adhesive performance. However, this adhesive system featured intense transdentinal cytotoxicity to pulp cells, regardless of application protocol and dentin wettability.

Effect of rubbing force magnitude on bond strength of universal adhesives applied in self-etch mode

This study investigated the effect of rubbing force magnitude on dentin bond strengths of multi-mode adhesives applied in self-etch mode. Seventy-two extracted human molar teeth were used. Two different universal adhesives Single Bond Universal (SB) and Clearfil Universal (CL) were applied onto dentin surfaces in three different modes: without rubbing (NR), rubbing with 40 gf (gram-force) (40) or 80 gf (80) load. Teeth were restored with a resin composite. Half of the specimens were subject to thermal aging (10,000 cycles). Microtensile bond strength was measured and data were statistically analyzed with two-way analysis of variance and Tukey's test (α=0.05). Baseline bond strength values for CL adhesive were improved by rubbing (40 and 80 gf) as compared to no rubbing (p<0.05). Rubbing did not significantly improve bond strength values for SB, regardless of aging (p>0.05). Rubbing improves bonding performance of some universal adhesives to dentin when applied in self-etch mode.

Influence of different smear layers on bond durability of self-etch adhesives

OBJECTIVE

The purpose of this study was to determine the influence of different smear layers on enamel and dentin bond durability of various types of self-etch adhesives.

METHODS

Two universal adhesives, Scotchbond Universal (SU) and Prime & Bond elect (PE); a conventional single-step self-etch adhesive, G-ænial Bond (GB); and two two-step self-etch adhesives, Optibond XTR (OX) and Clearfil SE Bond (SE) were used in this study. Shear bond strengths (SBS) and shear fatigue strengths (SFS) to human enamel and dentin were determined with different smear layer conditions. The prepared specimens were divided into three groups. The bonding surfaces were prepared by grinding with either (1) #180, (2) #600, or (3) #4000-SiC papers before making the bonded assemblies. For each group, 15 specimens were prepared for the SBS and 30 specimens for the SFS.

RESULTS

The two-step self-etch adhesives showed significantly higher SFS values than the single-step self-etch adhesives, regardless of the smear layer condition or substrate. Although most of the tested adhesives showed no significant differences in enamel SFS values among the smear layer groups, SU, GB, and SE showed significantly lower SFS values in the #180 in dentin groups than the #600 and #4000 groups.

CONCLUSION

The influence of different smear layer conditions on bond durability was adhesive dependent. Furthermore, the smear layers generated on different substrates also influenced the bond quality of the self-etch adhesives.

SIGNIFICANCE

Smear layer conditions of enamel and dentin influence the bond durability of universal adhesives and conventional single and two-step self-etch adhesives.

Effect of caries-affected dentin on one-step universal and multi-step etch-and-rinse adhesives’ bond strength

Abstract Objective To evaluate the influence of caries-affected dentin on bond strength of a universal one-step and a multi-step etch-and-rinse adhesive system. Material and method Enamel of 60 third human molars with and without caries was removed to expose dentin. The teeth were randomly assigned to six groups: Single Bond Universal (3M ESPE, St. Paul, MN, USA) in etch-and-rinse and in self-etch mode and Prime & Bond NT (Dentsply Co, Konstanz, Germany), all on sound and caries-affected dentin. Smear layer of the 30 sound dentin specimens was standardized by polishing with 600-grit SiC paper under water cooling. Residual infected dentin of the 30 caries-affected specimens was removed with a number 4 CA carbide bur until no caries smooth tissue was detectable by tactile-visual inspection. Cylinders of a light cured composite resin (Filtek Z350 XT, 3M ESPE) were built up using starch tubes and microshear test was performed until failure. The data was analyzed by one-way ANOVA and Tukey’s post hoc test. Result Significant differences in microshear bond strength (μSBS) were observed for the caries-affected groups, but not for sound dentin. The μSBS of Single Bond Universal were not influenced by the application protocol on sound dentin, however they were lower in the caries-affected group with both application protocols. The μSBS for Prime & Bond NT was not influenced by the dentin conditions. Conclusion Caries-affected dentin decrease in bond strength of Single Bond Universal in comparison to sound dentin. The bond strength of Prime & Bond NT was not altered by substrate conditions.

Does laser diode irradiation improve the degree of conversion of simplified dentin bonding systems?

Simplified dentin-bonding systems are clinically employed for most adhesive procedures, and they are prone to hydrolytic degradation.

Protective Effect of Adhesive Systems associated with Neodymium-doped Yttrium Aluminum Garnet Laser on Enamel Erosive/Abrasive Wear

AIM

This study evaluated the efficacy of self-etching adhesive systems associated or not associated with the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser on the protection against enamel erosive/abrasive wear.

MATERIALS AND METHODS

Bovine enamel specimens were demineralized with 0.3% citric acid (5 minutes). The samples were randomly assigned to eight groups (n = 20): SB - Single Bond Universal (3M/ESPE); SB+L - Single Bond Universal + laser (80 mJ/10 Hz); FB - Futurabond U (Voco); FB+L -Futurabond U + laser; GEN - G-aenial bond (GC); GEN+L -G-aenial bond + laser; L - laser irradiation; and C - no treatment. The laser was applied before light curing. The samples were subjected to erosive/abrasive challenges (0.3% citric acid - 2 minutes and tooth brushing four times daily for 5 days). Enamel surface loss was recovered profilometrically by comparison of baseline and final profiles. The adhesive layer thickness, retention percentage of the protective layer, and microhardness of cured adhesive were measured. Data were analyzed using one-way analysis of variance and Tukey's test (5%).

RESULTS

There were significant differences for all parameters (p = 0.0001). Mean values ± SD and results of the Tukey's test were: Surface wear: GEN - 4.88 (±1.09)a, L - 5.04 ± 0.99)a, FB - 5.32 (±0.93)ab, GEN + L - 5.46 (±1.27)abc, SB + L - 5.78 (±1.12)abc, FB + L - 6.23 (±1.25)bc, SB - 6.35 (±1.11)c, and C - 6.46 (±0.61)c; layer thickness: GEN - 15.2 (±8.63)c, FB - 5.06 (±1.96)a, GEN + L - 13.96 (±7.07)bc, SB + L - 4.24 (±2.68)a, FB + L - 9.03 (±13.02)abc, and SB - 7.49 (±2.80)ab; retention: GEN - 68.89 (±20.62)c, FB - 54.53 (±24.80)abc, GEN + L - 59.90 (±19.79)abc, SB + L - 63.37 (±19.30)bc, FB + L - 42.23 (±17.68) a, and SB - 47.78 (±18.29)ab; microhardness: GEN - 9.27 (±1.75)c; FB - 6.99 (±0.89)b; GEN + L - 6.22 (±0.87)ab; SB + L - 15.48 (±2.51)d; FB + L - 10.67 (±1.58)c; SB - 5.00 (±1.60)a.

CONCLUSION

The application of Futurabond U and G-aenial bond on enamel surface, as well as the Nd:YAG laser irradiation alone, was able to reduce the enamel wear. The use of laser after the adhesive systems did not improve their efficacy.

CLINICAL SIGNIFICANCE

Erosive/abrasive wear is a prevalent condition in clinical practice affecting many patients. The association of adhesive systems and Nd:YAG laser is of considerable clinical interest because it assesses new treatments to reduce the erosive/abrasive wear that would help dentists in clinical treatment decisions to reduce enamel wear and achieve a successful treatment.

Comparison of microleakage of Scotchbond™ Universal Adhesive with methacrylate resin in Class V restorations by two methods: Swept source optical coherence tomography and dye penetration

Background:

One of the most important factors in restoration failure is microleakage at the restoration interface. Furthermore, a new generation of bonding, Scotchbond Universal (multi-mode adhesive), has been introduced to facilitate the bonding steps. The aim of this study was to compare the microleakage of Class V cavities restored using Scotchbond™ Universal with Scotchbond Multi-Purpose in two procedures.

Materials and Methods:

Eighteen freshly extracted human molars were used in this study. Thirty-six standardized Class V cavities were prepared on the buccal and lingual surfaces. The teeth were divided into three groups: (1) Group A: Scotchbond Universal with “self-etching” procedure and nanohybrid composite Filtek Z350. (2) Group B: Scotchbond Universal with “total etching” procedure and Filtek Z350. (3) Group C: Scotchbond Multi-Purpose and Filtek Z350. Microleakage at enamel and dentinal margins was evaluated after thermocycling under 5000 cycles by two methods of microleakage assay: swept source optical coherence tomography (OCT) and dye penetration. Wilcoxon's signed-rank test and Kruskal–Wallis test were used to analyze microleakage.

Results:

In silver nitrate dye penetration method, group A exhibited the minimum microleakage at dentin margins and group C exhibited the minimum microleakage at enamel margins (P < 0.05). Furthermore, in OCT method, group C demonstrated the minimum microleakage at enamel margins (P = 0.047), with no difference in the microleakage rate at dentin margins.

Conclusion:

Scotchbond Universal with “self-etching” procedure at dentin margin exhibited more acceptable performance compared to the Scotchbond Multi-Purpose with the two methods.

Self-etch or etch-and-rinse mode did not affect the microshear bond strength of a universal adhesive to primary dentin

This study evaluated the microshear bond strength (µSBS) of resin composite to primary dentin using a universal adhesive in etchand-rinse mode or self-etch mode. Flat ground dentin surfaces were created on forty extracted human primary incisors and randomly assigned into four groups (n=10): Adper Single Bond II (ASB), Clearfil SE Bond (CSE), Single Bond Universal etch-and-rinse (SBUER) and Single Bond Universal self-etch (SBU-SE). Adhesive was applied on the dentin surface, which was subsequently bonded with a resin composite. The µSBS test was performed using a universal testing machine at a crosshead speed of 1 mm/min. The ASB group generated a lower mean µSBS (19.1±3.4 MPa) than those of the other groups [SBU-ER (24.3±2.7 MPa), SBU-SE (25.1±2.4 MPa), and CSE (25.3±2.7 MPa)]. Adhesive failure was the most common failure mode in each group. In conclusion, SBU used in etch-and-rinse or self-etch mode resulted in similar bond strength to primary dentin.

Bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin irradiated with a novel CO2 9.3 μm short-pulsed laser for dental restorative procedures

The objective of this study was to evaluate the influence of CO₂ 9.3 μm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO₂ 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa).

Classification review of dental adhesive systems: from the IV generation to the universal type

Adhesive dentistry has undergone great progress in the last decades. In light of minimal-invasive dentistry, this new approach promotes a more conservative cavity design, which relies on the effectiveness of current enamel-dentine adhesives. Adhesive dentistry began in 1955 by Buonocore on the benefits of acid etching. With changing technologies, dental adhesives have evolved from no-etch to total-etch (4^th and 5^th generation) to self-etch (6^th, 7^th and 8^th generation) systems. Currently, bonding to dental substrates is based on three different strategies: 1) etch-and-rinse, 2) self-etch and 3) resin-modified glass-ionomer approach as possessing the unique properties of self-adherence to the tooth tissue. More recently, a new family of dentin adhesives has been introduced (universal or multi-mode adhesives), which may be used either as etch-and-rinse or as self-etch adhesives. The purpose of this article is to review the literature on the current knowledge for each adhesive system according to their classification that have been advocated by many authorities in most operative/restorative procedures. As noted by several valuable studies that have contributed to understanding of bonding to various substrates helps clinicians to choose the appropriate dentin bonding agents for optimal clinical outcomes.

Effect of prior silane application on the bond strength of a universal adhesive to a lithium disilicate ceramic

STATEMENT OF PROBLEM

Universal adhesives combine silane and various monomers in a single bottle to make them more versatile. Their adhesive performance is unclear.

PURPOSE

The purpose of this in vitro study was to assess the effects of an additional silane application before using a universal adhesive on the adhesion between a disilicate glass ceramic and a composite resin by using a microshear bond strength test (μSBS) and fracture analysis immediately and after thermocycling.

MATERIAL AND METHODS

One hundred lithium disilicate glass ceramic disks were divided into 10 groups for bond strength testing according to the following 3 surface treatments: silane application (built-in universal adhesive or with additional application), adhesive (Adper Single Bond Plus [SB, 3M ESPE], Scotchbond Universal Adhesive [U, 3M ESPE], and mixed U with Dual Cure Activator [DCA, 3M ESPE]); or thermocycling (half of the specimens were thermocycled 10000 times). After surface treatment, 5 resin cylinders were bonded to each disk and submitted to a μSBS test. The failure mode was analyzed under a stereomicroscope and evaluated by scanning electron microscope and energy-dispersive x-ray spectroscopy. Data from the μSBS test were analyzed by 3-way ANOVA followed by the Tukey HSD post hoc test (α=.05).

RESULTS

An additional silane application resulted in a higher μSBS result for all adhesive groups (P<.05).

CONCLUSIONS

Ceramic surface treatment influenced the performance of adhesives, which may be improved with an additional silane application.

The effect of double-coating and times on the immediate and 6-month dentin bonding of universal adhesives

OBJECTIVE

The purpose of this study was to evaluate the effect of double-application coats and times on microtensile bond strength (μTBS) and adhesive-dentin interfaces created by dentin adhesive systems after 6 months of storage in water.

MATERIALS AND METHODS

Two-hundred sixteen extracted non-carious human third molars were selected for the study. Single-Bond Universal (SU) and All-Bond Universal (AU), Adper Easy One (Eo) Self-Etch adhesive and Adper Single-Bond 2 (Sb) etch-and-rinse adhesive were applied to a flat dentin surface using three methods (1): dentin adhesives were applied as recommended by the manufacturers; (2): two consecutive coats of dentin adhesives were applied before photo-polymerization; and (3): a single coat of adhesive was applied but with twice the manufacturers recommended application time. Microtensile bond strength was determined either immediately or after 6 months of water storage. Data were analyzed using one-way analysis of variance and Tukey's post-hoc tests.

RESULTS

At 24 h, groups 1, 2, and 3 exhibited statistically similar results for all dentin adhesive systems. For AU-Er, group 3 showed significantly higher bond strength than all group of AU-Se after 6 months.

CONCLUSION

Universal adhesives seemed more stable against water degradation than traditional two-step etch-and-rinse and all-in-one systems within the 6-month period.

Effect of water storage on ultimate tensile strength and mass changes of universal adhesives

Background

The aim of the present study was to evaluate the influence of water storage on micro tensile strength (µTS) and mass changes (MC) of two universal adhesives.

Material and Methods

10 disk-shaped specimens were prepared for each adhesive; Scotchbond Universal (SCU) All-Bond Universal (ABU) and Adper Single Bond 2 (SB2). At the baseline and after 1 day and 28 days of water storage, their mass were measured and compared to estimate water sorption and solubility. For µTS test, 20 dumbbell shaped specimens were also prepared for each adhesive in two subgroups of 1 day and 28 days water storage.

Results

MC was significantly lower for SCU and ABU than SB2 (P < 0.05) at both time intervals. In all three adhesives, the MC was significantly lower at 28 days compared to that at 1 day (P < 0.05). Similarly, µTS was significantly higher for SCU and ABU than SB2 at both storage intervals (P < 0.05). After 28 days, µTS increased significantly for universal adhesives (P < 0.05).

Conclusions

MC and µTS of adhesives were both material and time dependent when stored in water; both universal adhesives showed less water sorption and higher values of µTS than the control group.

Key words:Absorption, dental adhesives, dentin-bonding agents, solubility, tensile strength.

Initial and long-term bond strengths of one-step self-etch adhesives with silane coupling agent to enamel-dentin-composite in combined situation

This study evaluated the effect of adding silane coupling agent on initial and long-term bond strengths of one-step self-etch adhesives to enamel-dentin-composite in combined situation. Cervical cavities were prepared on extracted molars and filled with Clearfil AP-X. After water-storage for one-week, the filled teeth were sectioned in halves to expose enamel, dentin and composite surfaces and then enamel-dentin-composite surface was totally applied with one of adhesive treatments (Clearfil SE One, Clearfil SE One with Clearfil Porcelain Bond Activator, Beautibond Multi, Beautibond Multi with Beautibond Multi PR Plus and Scotchbond Universal). After designed period, micro-shear bond strengths (µSBSs) to each substrate were determined. For each period of water-storage, additive silane treatments significantly increased µSBS to composite (p<0.001). On the other hand, they significantly decreased µSBS to dentin (p<0.001), although did not have adverse effect on µSBS to enamel (p>0.05). Moreover, the stability of µSBS was depended on materials and substrates used.

Do matrix metalloproteinase inhibitors improve the bond durability of universal dental adhesives?

The aim of this study was to evaluate the effects of matrix metalloproteinases (MMPs) inhibitors on the microtensile bond strength (μTBS) and the adhesive-dentin interface of two universal dentin bonding agents, Single Bond Universal and All Bond Universal, after 12 months of water storage. Seventy extracted, caries-free, human third molars were used in this study. Of these, 50 were used for μTBS testing and 20 were used for scanning electron microscopy. The two bonding agents were applied to flat dentin surfaces in five different ways: self-etch mode, etch-and-rinse mode with 37% phosphoric acid, etch-and-rinse mode with phosphoric acid containing 1% benzalkonium chloride, etch-and-rinse mode with phosphoric acid and 2% chlorhexidine, and etch-and-rinse mode with 0.5 M ethylenediaminetetraacetic acid (EDTA) (n = 5 for each bonding agent in each group; N = 50). Half the specimens were subjected to μTBS tests at 24 h, while half were subjected to the tests after 12 months of water storage. For each bonding agent, inhibition, storage, and their interaction effects were tested by two-way analysis of variance and Bonferroni tests. For Single Bond Universal, the benzalkonium chloride (p = 0.024) and chlorhexidine groups (p = 0.033) exhibited significantly higher μTBS values at 24 h compared with the self-etch group. For All Bond Universal, all groups displayed similar bond strengths at 24 h (p > 0.05). After 12 months of water storage, the μTBS values decreased significantly in the benzalkonium chloride group for Single Bond Universal (p = 0.001) and the self-etch (p = 0.029), chlorhexidine (p = 0.046), and EDTA (p = 0.032) groups for All Bond Universal. These results suggest that the immediate dentin bond strength increases when universal bonding systems are applied in the etch-and-rinse mode, although the durability decreases. The use of chlorhexidine and EDTA can increase the bond durability of mild adhesives such as Single Bond Universal. SCANNING 38:535-544, 2016. © 2016 Wiley Periodicals, Inc.

Influence of Different Etching Modes on Bond Strength to Enamel using Universal Adhesive Systems

INTRODUCTION

The adhesive systems and the techniques currently used are designed to provide a more effective adhesion with reduction of the protocol application. The objective of this study was to evaluate the bond strength of universal adhesive systems on enamel in different etching modes (self-etch and total etch).

MATERIALS AND METHODS

The mesial and distal halves of 52 bovine incisors, healthy, freshly extracted, were used and divided into seven experimental groups (n = 13). The enamel was treated in accordance with the following experimental conditions: FUE-Universal System - Futurabond U (VOCO) with etching; FUWE - Futurabond U (VOCO) without etching; SB-Total Etch System - Single Bond 2 (3M); SBUE-Universal System - Single Bond Universal (3M ESPE) with etching; SBUWE - Single Bond Universal (3M ESPE) without etching; CLE-Self-etch System - Clearfil SE Bond (Kuraray) was applied with etching; CLWE - Clearfil SE Bond (Kuraray) without etching. The specimens were made using the composite spectrum TPH (Dentsply) and stored in distilled water (37 ± 1°C) for 1 month. The microshear test was performed using the universal testing machine EMIC DL 2000 with the crosshead speed of 0.5 mm/minute. The bond strength values were analyzed using statistical tests (Kruskal-Wallis test and Mann-Whitney test) with Bonferroni correction.

RESULTS

There was no statistically significant difference between groups (p < 0.05), where FUE (36.83 ± 4.9 MPa) showed the highest bond strength values and SBUWE (18.40 ± 2.2 MPa) showed the lowest bond strength values. The analysis of adhesive interface revealed that most failures occurred between the interface composite resin and adhesive.

CONCLUSION

The universal adhesive system used in dental enamel varies according to the trademark, and the previous enamel etching for universal systems and the self-etch both induced greater bond strength values.

CLINICAL SIGNIFICANCE

Selective enamel etching prior to the application of a universal adhesive system is a relevant strategy for better performance bonding.

Six-month Follow-up of Cervical Composite Restorations Placed With a New Universal Adhesive System: A Randomized Clinical Trial

Purpose: The objective of this double-blind, randomized clinical trial was to evaluate the six-month clinical performance of a new universal adhesive (Xeno Select, Dentsply) in noncarious cervical lesions (NCCLs) using two evaluation criteria: World Dental Federation (FDI) and the US Public Health Service (USPHS).

Methods and Materials: A total of 124 restorations were randomly placed in 31 patients according to the following groups: ER-D = etch-and-rinse/dry dentin; ER-M = etch-and-rinse/moist dentin; SE-et = selective enamel etching; and SET = self-etch. The composite resin EVOLUX (Dentsply) was placed incrementally. The restorations were evaluated after one week (baseline) and at six months using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α=0.05).

Results: Fifteen restorations were lost or fractured at six months (one for ER-D, three for ER-M, five for SE-et, and six for SET) (p&gt;0.05 at six-month recall). When ER (ER-D and ER-M) was compared with SE (SE-et and SET) there was a significant difference in the retention rate after six months (p=0.001). Marginal staining and postoperative sensitivity to air were only observed in three (one for ER-M and two for SET) and two restorations (two for ER-D) in both evaluation criteria (p&gt;0.05), respectively. Forty-seven restorations were considered to have minor discrepancies in marginal adaptation at the six-month recall using the FDI criteria (13 for ER-D, 10 for ER-M, 11 for SE-et, and 13 for SET; p&gt;0.05 between groups). However, for all groups, a significant difference was detected when baseline and six-month data were compared (p&lt;0.05).

Conclusions: The six-month clinical behavior of Xeno Select Universal Adhesive depends on the bonding strategy used. The universal adhesive did not fulfill the American Dental Association criteria for full approval when used in the self-etch mode.

Influence of Conditioning Time of Universal Adhesives on Adhesive Properties and Enamel-Etching Pattern

OBJECTIVES

To evaluate the effect of application protocol in resin-enamel microshear bond strength (μSBS), in situ degree of conversion, and etching pattern of three universal adhesive systems.

METHODS AND MATERIALS

Sixty-three extracted third molars were sectioned in four parts (buccal, lingual, and proximals) and divided into nine groups, according to the combination of the main factors-Adhesive (Clearfil Universal, Kuraray Noritake Dental Inc, Tokyo, Japan; Futurabond U, VOCO, Cuxhaven, Germany; and Scotchbond Universal Adhesive, 3M ESPE, St Paul, MN, USA)-and enamel treatment/application time (etch-and-rinse mode [ER], self-etch [SE] application for 20 seconds [SE20], and SE application for 40 seconds [SE40]). Specimens were stored in water (37°C/24 h) and tested at 1.0 mm/min (μSBS). The degree of conversion of the adhesives at the resin-enamel interfaces was evaluated using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a scanning electron microscope. Data were analyzed with two-way analysis of variance and Tukey test (α=0.05).

RESULTS

In general, the application of the universal adhesives in the SE40 produced μSBS and degree of conversion that were higher than in the SE20 (p<0.01) and similar to the ER mode. The deepest enamel-etching pattern was obtained in the ER mode, followed by the SE40.

CONCLUSIONS

The active and prolonged application of universal adhesives in the SE mode may be a viable alternative to increase the degree of conversion, etching pattern, and resin-enamel bond strength.

Effect of an extra layer of hydrophobic resin on the microleakage of Cl V composite resin restorations with a universal adhesive system

AIM

The aim of the present study was to evaluate the effect of the application of a hydrophobic resin on the microleakage of Cl V composite resin restorations using a universal adhesive system applied in the self-etch (SE) and etch-and-rinse (ER) modes.

METHOD

Cl V cavities were prepared on the buccal surfaces of 64 human premolar teeth and divided into four groups (n = 16): ER, ER with hydrophobic resin (ERH), SE, and SE with hydrophobic resin (SEH). Microleakage at occlusal and gingival margins was evaluated using 0.5% methylene blue dye penetration technique under stereomicroscope at 40 × magnification. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests (P < 0.05).

RESULTS

At the enamel margins, the ER group had significantly less microleakage than the SE and SEH groups (P < 0.001), but had no significant difference compared with the ERH group (P > 0.05). There was also no statistically-significant difference between the SE and SEH groups (P > 0.05). At the dentinal margins, the SE group had significantly less microleakage compared with the ER (P < 0.001) and ERH groups (P = 0.005). Furthermore, microleakage of the SEH group was significantly less than the SE group (P < 0.001).

CONCLUSION

Applying an extra layer of hydrophobic resin significantly decreased microleakage in the SE mode at the dentinal margin, but had no significant effect in the ER mode.

Pre-treating dentin with chlorhexadine and CPP-ACP: self-etching and universal adhesive systems

Objective: The aim of the present study was to compare the effect of pre-treating dentin with chlorhexidine, at concentrations of 0.2% and 2%, and remineralizing paste containing CPP-ACP (MI Paste - GC) on the bond strength of adhesive systems. Material and methods: In total, 80 slides of dentin were used. These slides were 2 mm thick and were obtained from bovine incisors. Standard cavities were created using diamond bur number 3131. In the control groups, a Scotchbond Universal Adhesive (SUA) self-etching adhesive system of 3M ESPE and a Clearfil SE Bond (CSE) adhesive system of Kuraray were applied, following the manufacturer's instructions. In the other groups, dentin was pretreated with chlorhexidine (0.2% and 2%) for 1 min and with MI Paste for 3 min. The cavities were restored with Z350 XT resin (3M ESPE). After 24 h of storage, the push-out test was applied at a speed of 0.5 mm/min. Results: The different dentin pretreatment techniques did not affect the intra-adhesive bond strength. There was a difference between treatment with MI Paste and chlorhexidine 0.2% in favor of the SUA, with values of 15.22 and 20.25 Mpa, respectively. Conclusions: The different pretreatment methods did not alter the immediate bond strength to dentin. Differences were only recorded when comparing the adhesives.

Bonding of flowable resin composite restorations to class 1 occlusal cavities with and without cyclic load stress

To examine the bonding of flowable resin composite restorations (F-restoration) to class 1 occlusal cavities with and without cyclic load stress, compared with that of a universal resin composite restoration (U-restoration). Two flowable composites and one universal composite (control) were applied with an adhesive system to 42 standardized class 1 occlusal cavities. The restored specimens were subjected to cyclic load stress and no stress modes. The microtensile bond strength (μ-TBS) of the dentin floor was measured. The U-restoration did not show pretesting failure. The F-restorations exhibited pretesting failure, regardless of the stress mode. The μ-TBS was not significantly different among the three restorations, regardless of the stress mode. The cyclic load stress did not influence the μ-TBS of the F-restorations; however, it significantly reduced μ-TBS in the U-restoration. The bonding reliability of the F-restorations was inferior to that of the U-restoration, for both stress modes.

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.

An in situ evaluation of the polymerization shrinkage, degree of conversion, and bond strength of resin cements used for luting fiber posts

STATEMENT OF PROBLEM

The behavior and magnitude of the deformations that occur during polymerization and the behavior of the luting agents of glass fiber posts inside the root canal require quantification.

PURPOSE

The purpose of this in vitro study was to investigate the in situ polymerization shrinkage, degree of conversion, and bond strength inside the root canal of resin cements used to lute fiber posts.

MATERIAL AND METHODS

Thirty maxillary canines were prepared to lute fiber posts. The teeth were randomly divided into 2 groups (n=15) according to the cementation system used, which included ARC, the conventional dual-polymerized resin cement RelyX ARC, and the U200 system, a self-adhesive resin cement, RelyX U200. Two fiber optic sensors with recorded Bragg gratings (FBG) were attached to each post before inserting the resin cement inside the root canal to measure the polymerization shrinkage (PS) of the cements in the cervical and apical root regions (με). Specimens were sectioned (into cervical and apical regions) to evaluate bond strength (BS) with a push-out test and degree of conversion (DC) with micro-Raman spectroscopy. Data were statistically analyzed with 2-way ANOVA and the Tukey honestly significant difference post hoc test (α=.05).

RESULTS

The ARC and U200 system showed similar PS values (-276.4 ±129.2 με and -252.1 ±119.2 με, respectively). DC values from ARC were higher (87.5 ±2.7%) than those of U200 (55.9 ±9.7%). The cervical region showed higher DC values (74.8 ±15.2%) and PS values (-381.6 ±53.0 με) than those of the apical region (68.5 ±20.1% and -146.9 ±43.5 με, respectively) for both of the resin cements. BS was only statistically different between the cervical and apical regions for ARC (P<.05).

CONCLUSIONS

The ARC system showed the highest PS and DC values compared with U200; and for both of the resin cements, the PS and DC values were higher at the cervical region than at the apical region of the canal root. BS was higher in the cervical region only for ARC.

Collagen cross-linkers on dentin bonding: Stability of the adhesive interfaces, degree of conversion of the adhesive, cytotoxicity and in situ MMP inhibition

OBJECTIVE

To investigate the effect of collagen cross-links on the stability of adhesive properties, the degree of conversion within the hybrid layer, cytotoxicity and the inhibition potential of the MMPs' activity.

METHODS

The dentin surfaces of human molars were acid-etched and treated with primers containing: 6.5wt% proanthocyanidin, UVA-activated 0.1wt% riboflavin, 5wt% glutaraldehyde and distilled water for 60s. Following, dentin was bonded with Adper Single Bond Plus and Tetric N-Bond; and restored with resin composite. The samples were sectioned into resin-dentin "sticks" and tested for microtensile bond strength (μTBS) after immediate (IM) and 18-month (18M) periods. Bonded sticks at each period were used to evaluate nanoleakage and the degree of conversion (DC) under micro-Raman spectroscopy. The enzimatic activity (P1L10 cross-linkers, P1L22 MMPs' activities) in the hybrid layer was evaluated under confocal microscopy. The culture cell (NIH 3T3 fibroblast cell line) and MTT assay were performed to transdentinal cytotoxicity evaluation. Data from all tests were submitted to appropriate statistical analysis (α=0.05).

RESULTS

All cross-linking primers reduced the degradation of μTBS compared with the control group after 18M (p>0.05). The DC was not affected (p>0.213). The NL increased after 18M for all experimental groups, except for proanthocyanidin with Single Bond Plus (p>0.05). All of the cross-link agents reduced the MMPs' activity, although this inhibition was more pronounced by PA. The cytotoxicity assay revealed reduced cell viability only for glutaraldehyde (p<0.001).

SIGNIFICANCE

Cross-linking primers used in clinically relevant minimized the time degradation of the μTBS without jeopardizing the adhesive polymerization, as well as reduced the collagenolytic activity of MMPs. Glutaraldeyde reduced cell viability significantly and should be avoided for clinical use.