Effects of one versus two applications of an unfilled, all-in-one adhesive on dentine bonding

Degree of conversion and permeability of dental adhesives

The aim of this study was to analyse the extent of polymerization of different adhesive films in relation to their permeability. One adhesive of each class was investigated: OptiBond FL; One-Step; Clearfil Protect Bond; and Xeno III. Adhesive films were prepared and cured with XL-2500 (3M ESPE) for 20, 40 or 60 s. Polymerization kinetic curves of the adhesives tested were obtained with differential scanning calorimetry (DSC) and data were correlated with microhardness. The permeability of the adhesives under the same experimental conditions was evaluated on human extracted teeth connected to a permeability device and analysed statistically. The results showed that the extent of polymerization obtained from DSC exotherms was directly correlated with microhardness. An increased level of polymerization after prolonged light-curing was confirmed for all adhesives. Simplified adhesives exhibited a lower extent of polymerization and showed incomplete polymerization, even after 60 s. An inverse correlation was found between the degree of cure and the permeability. This study supports the hypothesis that the permeability of simplified adhesives is correlated with incomplete polymerization of resin monomers and the extent of light exposure. These adhesives may be rendered less permeable by using longer curing times than those recommended by the respective manufacturer.

Effect of double-application of all-in-one adhesives on dentin bonding

OBJECTIVES

To evaluate the effect of double-application of all-in-one adhesives using the micro-shear bond test.

METHODS

The occlusal surfaces of extracted human third molars were ground perpendicular to the long axis of each tooth to expose a flat dentin surface. Three commercially available and one experimental bonding system were used in this study: Adper Prompt L-Pop (APL, 3M ESPE), REACTMER BOND (RB, Shofu), XENO III (Xeno, Dentsply-Sankin) and newly developed OBF-2 (OB2, Tokuyama Dental). These adhesives were applied on the dentin surfaces by either the manufacturers' instructions or by an experimental method (single-application or double-application). Resin composite was then placed and light-cured for 40s. After 24h immersion in water, a micro-shear bond test was carried out and the fractured dentin surfaces were observed microscopically. The data were analyzed by one-way ANOVA and Tukey's HSD tests (p<0.05).

RESULTS

The mean bond strengths of APL, RB, Xeno and OB2 with single-application were 22.7, 28.3, 30.3 and 34.6MPa, respectively. The mean bond strengths of APL, RB, Xeno and OB2 with double-application were 29.5, 27.2, 29.6 and 32.5MPa, respectively. There were no statistically significant differences in micro-shear bond strengths between the single- and double-application methods for each adhesive system (p>0.05). The morphological observation of the fractured dentin surfaces revealed differences between the single- and double-application groups especially for APL and OB2.

CONCLUSIONS

Micro-shear bond strengths of all-in-one adhesives in this study showed no statistically significant differences between the single-application and the double-application method.

An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions

OBJECTIVE

In this intra-individual comparison (an 18-months' randomized, controlled prospective study), we evaluated the clinical performance of one self-etch and one "etch & rinse" adhesive in non-carious cervical lesions.

METHODS

Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated. Seventy-eight restorations were placed; 39 with etch & rinse (Single-Bond) and 39 with self-etch (Adper Prompt). Both adhesives were combined with the microfilled resin composite Filtek-A110. The restorations were evaluated at baseline, 6, 12, and 18 months according to slightly modified USPHS criteria. Statistical differences between the adhesives was tested with McNemar's test and clinical degradation over time for each material with the Fisher exact test (a=0.05).

RESULTS

Thirty pairs were evaluated at 12 and 18 months. Two self-etch restorations were lost after 18 months. Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months (p<0.05). Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration (p<0.05).

CONCLUSIONS

Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions. The self-etch adhesive showed a faster progressive marginal degradation.

Shear Bond Strengths of Two Composite Core Materials After Using All-in-One and Single-Bottle Dentin Adhesives

PURPOSE

The purpose of this study was to compare the shear bond strengths of 2 composite core materials after using all-in-one and single-bottle dentin bonding materials.

MATERIAL AND METHODS

The occlusal surfaces of 100 extracted, intact human third molars were ground to expose a flattened area of dentin and polished with 600-grit silicon carbide paper. Specimens were divided into 5 main groups (n= 20). Three all-in-one (AQ Bond, One-Up Bond, Xeno-CF Bond) and 2 single-bottle adhesives (Single Bond, One-Step Plus) were used. Each group was further divided into 2 subgroups. Ti-Core and Built-it F.R. core materials were applied using a translucent plastic ring (diameter: 3 mm, height: 5 mm). After storage in 37 degrees C water for 24 hours, shear bond strengths were measured using a Universal testing machine with a crosshead speed of 0.5 mm/min. Debonded dentin surfaces were examined with SEM. Two-way analysis of variance (ANOVA) and multiple comparison (Tukey) tests were used for statistical analysis of data.

RESULTS

Two-way ANOVA revealed that the type of core material did not significantly influence the shear bond strength (p > 0.05), whereas there were significant differences in shear bond strength among the types of bonding agents (p < 0.0001). Shear bond strengths for single-bottle adhesive systems were significantly higher than those for all-in-one adhesive systems (p < 0.05). Furthermore, the interaction of these 2 parameters was not significant (p > 0.05). The fracture modes were predominantly adhesive for all-in-one adhesives and cohesive for single-bottle adhesives.

CONCLUSION

Bonding of composite core materials with the newly developed all-in-one dentin adhesives produced lower shear bond strengths as compared with single-bottle adhesives.

Spatially resolved photopolymerization kinetics and oxygen inhibition in dental adhesives

A comparative study of three commercial dental adhesives was performed by (1)H nuclear magnetic resonance spectroscopy and Stray-Field magnetic resonance imaging. Spectroscopic evidence was found for the presence of solvent and unreacted methacrylate groups in photopolymerized adhesives. Spatially resolved photopolymerization kinetics and volumetric contraction (solvent evaporation and polymerization shrinkage) were obtained without solvent removal and in the presence of oxygen from the atmosphere. The oxygen and solvent inhibitor effects in the photopolymerization were found to be higher for water/ethanol based adhesives. However, was one of these adhesives that exhibited less spatially dependent irradiation time to start vitrification, higher concentration and a more uniform spatial distribution of rigid domains at the end of the photopolymerization.

Monomer-solvent phase separation in one-step self-etch adhesives

One-step adhesives bond less effectively to enamel/dentin than do their multi-step versions. To investigate whether this might be due to phase separation between adhesive ingredients, we characterized the interaction of 5 experimental and 3 commercial self-etch adhesives with dentin using transmission electron microscopy. All adhesives were examined for homogeneity by light microscopy. Bonding effectiveness to dentin was determined with the use of a micro-tensile bond-strength protocol. The lower bond strength of the one-step adhesives was associated with light-microscopic observation of multiple droplets that disappeared slowly. Interfacial analysis confirmed the entrapment of droplets within the adhesive layer. The prompt disappearance of droplets upon application of a small amount of HEMA (2-hydroxyethyl methacrylate) or a HEMA-containing bonding agent, as well as the absence of droplets at the interface of all HEMA-containing adhesives, strongly suggests that the adhesive monomers separate from water upon evaporation of ethanol/acetone. Upon polymerization, the droplets become entrapped within the adhesive, potentially jeopardizing bond durability. This can be avoided by strong air-drying of the adhesive, thereby removing interfacial water and thus improving bonding effectiveness.

Bond strengths of nine current dentine adhesive systems to primary and permanent teeth

The aim of this study was to compare the shear bond strength (SBS) of nine dentine bonding systems (DBS) of different classes to human primary and permanent dentine. Flat dentine occlusal surfaces were produced on human molars (100 primary, 100 permanent) by wet grinding on a 800-grit SiC paper. Nine DBS were applied following the manufacturers' instructions: One total etch multi-step system: Scotchbond Multipurpose Plus (3M/ESPE); Four total etch one-bottle system: Prime &Bond 2.1 (Dentsply), One Step (Bisco), Scotchbond 1 (3M/ESPE), and OptibondSolo Plus (Kerr); Three two-step self-etching primer systems: Clearfil Liner Bond 2 (Kuraray), Clearfil SE Bond (Kuraray), and Prime &Bond NT with NRC (Dentsply); An 'all-in-one' self-etching system: Prompt L-Pop (3M/ESPE). Composite (Z100; 3M/ESPE) cylinders (2 mm diameter, 3 mm high) were polymerized on the treated dentine surfaces and the specimens were stored at 37 degrees C for 24 h prior to testing. Twenty experimental groups were produced and tested. Statistical analysis revealed both a substrate and a bonding system effect. Two adhesive systems (One Step, Prime &Bond NT) had significantly higher bond strengths on permanent than on primary dentine. There was an effect of dentine bonding system on the mode of fracture. Although eight of the 10 DBS tested exhibited higher median SBS values on permanent dentine than on primary dentine, the dependent pairwise comparison identified a significant difference only for two groups. The use of simplified bonding systems does not necessarily result in improved bond strength to primary or to permanent dentine.

Pulpal responses following direct pulp capping of healthy dog teeth with dentine adhesive systems

OBJECTIVE

The aim of the present study was to evaluate the pulpal responses following direct pulp capping of mechanically exposed teeth with new dentine adhesive systems, in the preclinical model of dog teeth.

METHODS

Class V cavities (approximately 2.50 mm wide, 3.00 mm long, 1.5-2.0 mm deep) were prepared on the buccal surface of permanent maxillary and mandibulary molars, two rooted premolars, canines and third incisors. The cavities were assigned to five experimental groups, representing one control group treated with a Ca(OH)2-based material and four experimental groups where the adhesive systems Clearfil SE Bond, Prompt-L-Pop, Etch & Prime 3.0 and Single Bond were tested. The pulpal tissue responses to dentine adhesives were assessed at post-operative periods of 7, 21, 65 days.

RESULTS

Variable responses were recorded, which were characterized by moderate to severe inflammatory reactions, progressive extension of tissue necrosis with time and total absence of continuous hard tissue bridge formation after pulp capping with each of the four adhesive systems. Application of a Ca(OH)2-based material was characterized by inflammatory cell infiltration, limited tissue necrosis as well as partial to complete hard tissue bridging.

CONCLUSIONS

It seems evident that application of dentine adhesive systems in direct contact with the mechanically exposed pulp of healthy dog teeth cannot lead to acceptable repair of the dentine-pulp complex e.g. wound healing with tertiary dentine bridge formation.

Effect of smear layer thickness and acidity of self-etching solutions on early and long-term bond strength to dentin

OBJECTIVES

To evaluate the effect of smear layer thickness (SL) on early and 6-month bond strength (BS) of self-etching adhesives to dentin and to measure the ultimate microtensile strength (UTS) of the adhesives.

METHODS

Clearfil SE Bond; Optibond Solo Plus Self-Etch Primer; Tyrian Self Priming Etchant (TY) and as controls, Single Bond (SB) and Scotchbond Multi-Purpose Plus (SBMP) were applied on flat superficial dentin surface with thick and thin SL thicknesses. After adhesive's application (n=6) a resin build-up was made. After 24h, resin-dentin beams (0.8mm(2)) were prepared to be tested immediately and after 6-month (6M) at 0.5mm/min. For the UTS measurement, hour-glass specimens were prepared with the bonding resin alone or after mixing (1:1). BS values were analyzed by three-way repeated measures ANOVA and Tukey's multiple comparison tests. Two-way ANOVA (bonding resin and bonding resin+self-etching primer) and Tukey's test were used for the UTS values. The bonding resins were re-evaluated separately by a one-way ANOVA and Tukey's test, since Single Bond is a one-bottle adhesive (alpha=0.05).

RESULTS

The SL thickness was not significant (p=0.64). BS values were reduced after 6M, except for the SBMP. TY provided the lowest BS mean while SB and SBMP the highest BS. The UTS of the SBMP was the highest. TY yielded the lowest UTS. Regression analysis revealed a linear and significant relationship between the UTS of self-etch systems and the mean BS (R=0.95, p=0.02).

CONCLUSIONS

The performance of a self-etching system does not seem to be dependent on the SL thickness. The total-etch, three-step system provided the highest BS to dentin and maintained the BS stable over 6 months. The performance of the self-etching systems can be envisaged by their UTS.

Effect of cavity configuration and aging on the bonding effectiveness of six adhesives to dentin

OBJECTIVES

The purpose of this study was to determine the effect polymerization contraction stress may have on bond durability.

METHODS

Bonding effectiveness was assessed by micro-tensile bond strength testing (muTBS) and electron microscopy. The muTBS to flat dentin surfaces and in standardized cavities was determined (this after 1 day as well as 1 year water storage). Six adhesives representing all current classes were applied: two etch-and-rinse (OptiBond FL, Kerr; Scotchbond 1, 3M ESPE), two self-etch (Clearfil SE Bond, Kuraray; Adper Prompt, 3M ESPE) and two glass-ionomer (Fuji Bond LC, GC; Reactmer, Shofu) adhesives.

RESULTS

The conventional 3-step etch-and-rinse adhesive OptiBond FL bonded most effectively to dentin, and appeared insensitive to polymerization shrinkage stress and water degradation. The 2-step self-etch adhesive Clearfil SE Bond most closely approached this superior bonding effectiveness and only slightly lost bond strength after 1-year water exposure. The 2-step etch-and-rinse adhesive Scotchbond 1 and the 'strong' 1-step self-etch adhesive Adper Prompt appeared very sensitive to cavity configuration and water-aging effects. The 2-step resin-modified glass-ionomer adhesive Fuji Bond LC only suffered from shrinkage stress, but not from 1-year water-exposure. Remarkable also is the apparent repairability of the 'mild' 1-step glass-ionomer adhesive Reactmer when stored for 1 year in water, in spite of the very low 1-day muTBS.

SIGNIFICANCE

Simplified bonding procedures do not necessarily imply improved bonding performance, especially in the long term.

Adhesiveness of dental resin-based restorative materials investigated with atomic force microscopy

This study aimed to show that the polymerization contraction of dental methacrylate-based materials, when used as adhesives on hard substrate, produces voids at the material-substrate interface. This phenomenology is closely related with the nanoleakage and the sealing ability of these materials. One prime/bond system, three restorative composite resins, and one orthodontic bonding system were cured by using mirror-like glass slides as a compliance-free reference substrate. The adhesive surface was analyzed by atomic force microscopy, and the polymerization contraction of bulk material was tested by laser beam-scanning method. Nanoperiodic structure of three-dimensional (3D) images, section analysis, and roughness characteristics (R(a) and R(z)) indicated that polymerization contraction produced voids at the interface. When the adhesive surface was exposed to oral simulating fluids (water, ethanol, and lactic acid solutions), hydrolytic degradation involved some hundreds of nanometers in depth. In visible light-cured (VLC) materials, the interface porosity decreased when an irradiation pause ( approximately 2 min) was carried out during gelation.

Fluid movement across the resin-dentin interface during and after bonding

This study evaluated the extent of water penetration through resin-dentin interfaces before and after being sealed with adhesives. Four adhesive resin systems (2 total-etch adhesives and 2 self-etching primer adhesives) were used in this study. Dentin disks were placed in a split-chamber device, and in situ fluid movement across dentin was measured, with and without physiological pressure, during bonding procedures or 24 hrs after bonding. The fluid movement across dentin occurs via dentin tubules after acid-etching. Large outward or inward fluid shifts across dentin were observed during air-drying and light-curing for resin application. The amount of fluid movement across resin-bonded dentin when total-etch adhesives were used was significantly greater than that with self-etching adhesives. The milder acid-etching effects of self-etching primers may retain hybridized smear plugs within the tubules that reduce outward fluid flow, resulting in superior dentin sealing.

Effect of dentin perfusion on the sealing ability and microtensile bond strengths of a total-etch versus an all-in-one adhesive

OBJECTIVES

To test the null hypothesis that perfusion of dentin has no effect on the sealing or bond strength in Class V resin composite restorations using a two-step total-etch (Scotchbond 1), or a one-step self-etch (all-in-one) (Prompt L-Pop) adhesive.

METHODS

Dentin permeability in Class V cavity preparations cut into extracted human third molars was measured in a fluid transport setup. Resin composites were placed using either Scotchbond 1, or Prompt L-Pop with or without dentin perfusion at 1.47 kPa. Permeability was re-measured, and the reduction in permeability was calculated as a percentage of the initial value. Additionally, microtensile bond strength (microTBS) to dentin was measured.

RESULTS

Whereas the ability of Scotchbond 1 to seal dentin was significantly decreased due to dentin perfusion (p = 0.00025), that of Prompt L-Pop was not affected (p = 0.099). Scotchbond 1 produced significantly less dentinal seal than Prompt L-Pop only in the restorations carried out with perfusion (p = 0.0003), in the absence of perfusion, however, the difference was not significant (p = 0.343). Dentin perfusion significantly decreased the microTBS of Scotchbond 1 to dentin (p = 0.001). Due to excessive premature failure during sectioning, microTBS test could not be performed with Prompt L-Pop.

SIGNIFICANCE

Dentinal fluid flow may have detrimental effects on the sealing ability of dental adhesives depending on the type of adhesive used. Studies aiming to rank adhesives in relation to their sealing ability in vitro should not disregard dentin perfusion.

In vitro microleakage of adhesive-sealed dentin with lactic acid and saliva exposure: a radio-isotope analysis

OBJECTIVES

The aim of this study was to evaluate the dentin-protective potential of two dentin-bonding systems (Syntac and Clearfil SE Bond) on artificial saliva and lactic acid exposure.

METHODS

Radiochemical analysis in combination with polarization-microscopy was used in the current study. Different applications in MOD preparations in irradiated human molars were compared. Untreated cavities and cavities covered with flowable resin served as controls. Forty-eight specimens were immersed in artificial saliva (pH 7.5), 48 in lactic acid (pH 4). Activity of (32)P was measured between days 1 and 21 and loss of mineralized tissue was estimated.

RESULTS

In lactic acid, cavities sealed with single bond, double bond or bond plus cavity sealer application resulted in significantly lower mineralized tissue loss compared to negative controls (p < 0.05). Upon both saliva and lactic acid exposure, bonding plus sealer application proved to be the most protective treatment (p < 0.05).

CONCLUSIONS

Based on these in vitro findings it may be advisable to use a filled cavity sealer or a flowable resin to protect dentin from demineralization. The radiochemical analysis appeared to be valuable in evaluating the protective potential of bonding agents against dentin demineralization.

Microtensile bond strength of total-etch and self-etching adhesives to caries-affected dentine

OBJECTIVES

To evaluate the microtensile bond strength of total-etch or self-etch adhesives to caries-affected versus normal dentine, and to correlate these bond strengths with DIAGNOdent laser fluorescence and Knoop microhardness (KH) measurements of the substrates.

METHODS

Extracted carious human molars were ground to expose flat surfaces where the caries lesion was surrounded by normal dentine. Surfaces were bonded with either Prime & Bond NT, Scotchbond 1, Clearfil SE Bond or Prompt L-Pop, according to manufacturers' recommendations. A crown was built up using resin composite (Tetric Ceram). After storage in water (37 degrees C, 24 h), teeth were vertically serially sectioned into 0.7 mm thick slabs and trimmed to yield 1 mm(2) test area that contained either caries-affected or normal dentine. Samples were tested in tension in an Instron machine at 1 mm/min. The quality of the dentine just beneath each fractured specimen was measured by laser fluorescence and KH.

RESULTS

Total-etch adhesives yielded higher bond strengths than self-etching systems. Significantly lower results were obtained with Prompt L-Pop. All the adhesives attained higher strengths in normal than in caries-affected dentine, but the differences were only significant for Prime & Bond NT and Clearfil SE Bond. Higher laser fluorescence values and lower KH (p<0.001) were recorded in caries-affected dentine compared to normal dentine.

CONCLUSIONS

The total-etch adhesives evaluated produced higher bond strengths to normal and caries-affected dentine than self-etching systems. Laser fluorescence measurements discriminated caries-affected dentine from normal dentine, and were strongly correlated with KH. However, laser fluorescence and KH did not permit high correlations with resin-dentine bond strengths in caries-affected dentine.