Reversal of compromised bonding to oxidized etched dentin

Effect of Ethylene diamine tetra acetic acid and sodium hypochlorite solution conditioning on microtensile bond strength of one-step self-etch adhesives

Background:

Attempts to improve bond strength of self-etch adhesives can enhance the durability of composite restorations.

Aims:

The aim of the present study was to evaluate the effect of collagen and smear layer removal with sodium hypochlorite solution (NaOCl) and EDTA on micro-tensile bond strength (μTBS) of self-etch adhesives to dentin.

Settings and Design:

It was an in-vitro study.

Materials and Methods:

Seventy-two teeth were divided into eight groups and their crowns were ground perpendicular to their long axis to expose dentin. The teeth were polished with silicon-carbide papers. The groups were treated as follows: No conditioning, 0.5-M EDTA conditioning, 2.5% NaOCl conditioning, NaOCl + EDTA conditioning. The surfaces were rinsed and blot-dried. Clearfil S3 and I-Bond were applied according to manufacturers’ instructions and restored with Z100 composite. After 500 cycles of thermo-cycling between 5°C and 55°C, the samples were sectioned and tested for μTBS.

Statistical Analysis:

Data were analyzed by two-way ANOVA and Tukey-HSD test.

Results:

The highest μTBS was recorded with Clearfil S3 + NaOCl + EDTA, and the lowest was recorded with I-Bond without conditioning. μTBS in EDTA-and EDTA + NaOCl-treated groups was significantly higher than the control and NaOCl-conditioned groups.

Conclusions:

Application of EDTA or EDTA + NaOCl before one-step self-etch adhesives increased μTBS.

Effective application duration of sodium ascorbate antioxidant in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth

OBJECTIVES

The aim of this study was to determine an appropriate application duration of sodium ascorbate (SA) antioxidant gel in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth.

MATERIALS AND METHODS

Eighty endodontically-treated human incisors were randomly divided into eight groups: control, no bleaching; IB and DB, immediate and delayed bonding after bleaching, respectively; S10m, S60m, S24h, S3d and S7d, bleaching + SA gel for 10 min, 60 min, 24 hr, 3 day and 7 day, respectively. For bleaching, a mixture of 30% hydrogen peroxide and sodium perborate was applied for 7 day. All access cavities were restored using One-Step adhesive (Bisco Inc.) and then Aelite LS Packable composite (Bisco Inc.). The bonded specimens were subjected to 500 thermal cycles, immersed in 1% methylene blue for 8 hr, and longitudinally sectioned. Microleakage was assessed with a 0 - 4 scoring system and analyzed using nonparametric statistical methods (α = 0.05).

RESULTS

Group IB showed a significantly higher microleakge than the control group (p = 0.006) and group DB a statistically similar score to the control group (p > 0.999). Although groups S10m, S60m, and S24h exhibited significantly higher scores than group DB (p < 0.05), the microleakage in groups S3d and S7d was statistically similar to that in group DB (p = 0.771, p > 0.999).

CONCLUSIONS

Application of SA gel for 3 day after nonvital bleaching was effective in reducing microleakage of composite restoration in intracoronally-bleached teeth.

Effect of endodontic irrigation and dressing procedures on the shear bond strength of composite to coronal dentin

This study aimed to evaluate the effects of three sodium hypochlorite (NaOCl)-endodontic irrigation procedures used alone or in combinations with two intermediate dressing materials on bond strengths of two adhesive composite systems to coronal dentin. Surfaces were treated with NaOCl or NaOCl–Glyde-File-Prep (H₂O₂ and EDTA) with or without chlorhexidine (CHX) as a final rinse. Intermediate dressing materials of calcium hydroxide (Ca(OH)₂) and sodium perborate (SP) were combined with surface treatments. Surface treatment groups (n = 10/group) included (1) distilled water (control), (2) 5.25% NaOCl (30 min), (3) NaOCl/Glyde (30 min), (4) NaOCl/Glyde (30 min) + CHX (2 min), (5) NaOCl/Glyde (30 min) + Ca(OH)₂ (5 days) + CHX (2 min), and (6) NaOCl/Glyde (30 min) + SP (9 days) + CHX (2 min). For each surface treatment group, dentin shear bond strengths of two different composite systems (Excite/Tetric Flow Chroma, [EX/TFC], and Clearfil Protect Bond/Protect Liner F [PB/PLF]) were evaluated. Median shear bond strengths (EX/TFC, PB/PLF) for each surface treatment group in MPa were (1) 21, 18; (2) 26, 18; (3) 21, 17; (4) 22, 16; (5) 17, 11; and (6) 14, 11, respectively. NaOCl significantly increased the bond strength of EX/TFC (p < 0.05), but did not significantly affect that of PB/PLF. The use of NaOCl/Glyde with CHX did not significantly affect EX/TFC (p > 0.05), whereas it significantly decreased PB/PLF (p < 0.05). Ca(OH)₂ and SP significantly decreased the bond strengths of both adhesive systems (p < 0.05). Adhesion to coronal dentin is dependent upon the irrigation regimen and the type of adhesive.

Evaluation of the effect of concentration and duration of application of sodium ascorbate hydrogel on the bond strength of composite resin to bleached enamel

Aim:

The effect of different concentrations of hydrogel of sodium ascorbate on bond strength of bleached enamel for varying periods of time and the mode of failure was evaluated.

Materials and Methods:

Seventy enamel surfaces were obtained from 35 human extracted premolars. Specimens were divided into four groups: no bleaching (control), bleaching with carbamide peroxide gel, bleaching and application of 10% / 20% sodium ascorbate hydrogel for 30, 60, 120 min. Surfaces were bonded with a total etch bonding system and composite resin. Specimens were tested for shear bond strength. Mode of failure was determined by stereomicroscope. Data were analyzed using a two-way analysis of variance, and Scheffe's post hoc test.

Results:

Sodium ascorbate hydrogel application following bleaching increased the resin-enamel bond strength and was directly proportional to its duration of application. However, there was no difference in bond strength with an increase in the concentration of sodium ascorbate hydrogel.

Conclusion:

Immediate bonding of composite resin to bleached enamel is possible after treatment with antioxidant sodium ascorbate hydrogel.

The Effect of Prophylaxis Method on Microtensile Bond Strength of Indirect Restorations to Dentin

The aim of this study was to evaluate the effect of different materials used for dentin prophylaxis on the microtensile bond strengths (μTBS) of adhesively cemented indirect composite restorations. Sixty bovine incisors had the buccal surface ground with wet #600-grit silicon carbide abrasive paper to obtain a flat exposed superficial dentin and were submitted to different prophylaxis protocols, as follows: 3% hydrogen peroxide (HydP); 0.12% chlorhexidine (Chlo); sodium bicarbonate jet (SodB); 50-μm aluminum oxide air abrasion (AirA); pumice paste (PumP), and control group–water spray (Cont). After prophylaxis protocols a resin composite block (3.0 mm × 5.0 mm × 5.0 mm) was adhesively cemented using dual resin cement (Rely X ARC). After 24 hours of water storage, specimens were serially sectioned perpendicular to the bonded interface into 1-mm-thick slices. Each specimen was trimmed with a diamond bur to an hourglass shape with a cross-sectional area of approximately 1.0 mm2 at the bonded area. Specimens were tested (μTBS) at 0.5 mm/min using a universal testing machine. Scanning electron microscopy was used to examine the effects of prophylaxis techniques on dentin. Bond strength data (MPa) were analyzed by one-way analysis of variance and failure mode by Fisher test (α=0.05). μTBS data, means (SD), were (different superscripted letters indicate statistically significant differences): AirA, 25.2 (7.2)a; PumP, 24.1 (7.8)a; Chlo, 21.5 (5.6)a; Cont, 20.6 (8.1)a; HydP, 15.5 (7.6)b; and SodB, 11.5 (4.4)c. The use of aluminum oxide air abrasion, pumice paste, and chlorhexidine before acid etching did not significantly affect μTBS to dentin; however, the use of hydrogen peroxide and sodium bicarbonate jet significantly reduced μTBS.

Bonding efficacy of an acetone/based etch-and-rinse adhesive after dentin deproteinization

Objectives: to evaluate the effect of sodium hypochlorite (NaOCl) treatment on dentin bonding by means of shear bond strength (SBS) measurements when using Prime&Bond NT (PB NT) adhesive. Ultrastructure of the interfaces was examined by scanning electron microscopy (SEM). Study design: Extracted human third molars were sectioned and ground to expose flat surfaces of superficial or deep dentin. Specimens were randomly assigned to two equal groups, and bonded as follows: (1) according to the manufacturers’ directions, after 35% H3PO4 etching, (2) 5% NaOCl treated for 2 minutes, after 35% H3PO4 etching. Each sample was embedded in a Watanabe shear test assembly for a single plane lap shear. After PB NT bonding, specimens were stored in water for 24 h at 37ºC and thermocycled (500x). Samples were tested in shear to failure using a universal testing machine at 0.75 mm/min. Data were analyzed with ANOVA and Newman-Keuls multiple comparison test procedures. Two samples of each group were randomly selected to investigate the morphologic aspect of the resin/dentin interface with SEM. Results: After etching and after aqueous sodium hypochlorite (NaOClaq) application, SBS values were similar on superficial than deep dentin (p>0.05). SEM findings shows for H3PO4 etching conditioned samples a detectable hybrid layer and long resin tags; for NaOCl treated specimens, it may be observed a non apparent hybrid layer, and the adhesive contact directly with the neck of the cylindrical resin tags. Conclusions: The use of 5% NaOCl for 2 min after dentin demineralization when PB NT was employed did not improve the bond strength to dentin, probably due to nanofiller content and/or oxidative changes on collagen-depleted dentin.

Key words:Sodium hypochlorite, shear bond strength, SEM, Prime&Bond NT, superficial dentin, deep dentin.

Surface morphological changes in human enamel following bleaching: an in vitro scanning electron microscopic study

OBJECTIVE

The purpose of this study was to evaluate, using scanning electron microscopy (SEM), the morphological and structural changes of the enamel induced by three bleaching agents namely old McInnes solution, modified McInnes solution and 10% carbamide peroxide gel at different time intervals.

MATERIALS AND METHODS

Fifteen freshly extracted noncarious human central incisors with intact enamel surface were selected. The teeth were sectioned at the cementoenamel junction separating the crown portion from the root using a diamond separating disk. Following this, the samples were subjected to three different bleaching agents: Group 1: Old McInnes solution, group 2: modified McInnes solution and group 3: 10% carbamide peroxide for a period of 15, 30 and 60 minutes, 24 and 30 hours time interval. The sample stubs were subjected to scanning electron microscope and were photographed at 2000 and 10,000 magnifications.

CONCLUSION

The present study revealed no indication of either etching or significant change in surface morphology of enamel when evaluated under scanning electron microscope after 6 weeks treatment with various bleaching agents.

CLINICAL SIGNIFICANCE

Morphological alterations in bleached enamel are both concentration and time dependent.

Effect of 10% sodium ascorbate on the calcium: Phosphorus ratio of enamel bleached with 35% hydrogen peroxide: an in vitro quantitative energy-dispersive X-ray analysis

Objectives:

The study assessed quantitatively the calcium and phosphorous loss from the enamel surface following bleaching with 35% hydrogen peroxide and reversal with 10% sodium ascorbate using energy-dispersive X-ray analysis (EDAX).

Materials and Methods:

Eight non-carious, freshly extracted human permanent maxillary central incisors without any visible defects were used. Each specimen was bleached with 35% hydrogen peroxide activated by light and reversed with sodium ascorbate antioxidant gel. The calcium and phosphorous content in weight percent of sound, bleached and reversed enamel was acquired using EDAX. The Ca/P ratio was calculated from the obtained data. One-way ANOVA followed by Post Hoc Tukey test was used for comparing the Ca/P ratio of sound, bleached and reversed enamel.

Results:

All the samples subjected to bleaching using 35% hydrogen peroxide showed a statistically significant decrease in the Ca/P ratio as compared with samples in which no bleaching procedure was performed (P-value < 0.01). The striking finding was that there was a significant increase in the Ca/P ratio on application of sodium ascorbate antioxidant gel when compared with the bleached enamel (P-value < 0.01).

Conclusion:

The authors concluded that 35% hydrogen peroxide causes a significant decrease in the Ca/P ratio. This decrease in the Ca/P ratio can be restored by the application of 10% sodium ascorbate antioxidant gel.

Application of a proanthocyanidin agent to improve the bond strength of root dentin treated with sodium hypochlorite

Aim:

The objective of this study was to analyze the application of PA agent that improves the bond strength of root dentin treated with NaOCl.

Materials and Methods:

Group 1: root canals were irrigated using 0.9% isotonic saline as an irrigant (negative control); Group 2: root canals were irrigated using 5.25% NaOCl (positive control); Group 3: root canals were irrigated with 5.25% NaOCl followed by 10% sodium ascorbate for 10 minutes; Group 4: root canals were irrigated with 5.25% NaOCl followed by 5% PA for 10 minutes. All the canals were then coated with self-etch dentin bonding agent, filled with resin cement, stored for one day in water, and then cross sectioned into three slabs of 2-mm thickness that were prepared and tested for microtensile bond strength.

Results:

The results demonstrated that 5.25% NaOCl caused significant reduction (P<0.05) in the bond strength, but this can be reversed by 5% PA significantly more than the 10% sodium ascorbate.

Effect of 10% sodium ascorbate hydrogel and delayed bonding on shear bond strength of composite resin and resin-modified glass ionomer to bleached enamel

OBJECTIVE

The aim of this study was to comparatively investigate the neutralizing effect of antioxidant treatment and delayed bonding after bleaching with hydrogen peroxide on the shear bond strength of a composite resin (CR) and resin-modified glass ionomer (RmGI) to enamel.

MATERIALS AND METHODS

Ninety-six freshly extracted human 3rd molars with flat enamel surfaces were divided into six experimental groups (n=12/group) and two control groups (n=12/group). After initial preparation, specimens in Groups 1 and 5 (control groups) were not bleached and the buccal enamel surface of specimens were bonded immediately with CR and RmGI. The samples of the remaining groups were all bleached six hours a day for seven days consecutively. Immediately after bleaching, groups two and six specimens were bonded with CR and RmGI. Groups 3 and 7 specimens were immersed in distilled water at 37°C for 7 days and the specimens in Groups 4 and 8 were treated with 10% sodium ascorbate as an antioxidant agent after bleaching. Specimens in Groups 3 and 4 were bonded with CR and Groups 7 and 8 specimens were bonded with RmGI immediately. After specimens were bonded, the shear bond strength (SBS) was measured. The SBS data analyses were subjected to one-way analysis of variance (ANOVA) followed by Tukey test for comparison of specific mean values.

RESULTS

The mean SBS value in Group 2 (immediately bonded with CR after bleaching) was significantly lower than other CR groups (P=0.045). RmGI did not bond to buccal enamel surface of specimens in group 6. There was no significant difference between other groups bonded with RmGI (P>0.05).

CONCLUSIONS

Applying 10% sodium ascorbate hydrogel and one week delay before bonding resulted in reversal of reduced bond strength of CR and RmGI to bleached enamel.

Effect of antioxidant treatment on the shear bond strength of composite resin to bleached enamel

INTRODUCTION

This study examined the antioxidant treatment on the shear bond strength of composite resin to enamel after bleaching with two different bleaching systems.

MATERIALS AND METHODS

Seventy flat enamel surfaces were prepared from freshly extracted human molars using a low speed diamond saw. Then the specimens were divided into seven random groups (n = 10) to apply different procedures; namely, bleaching with White Smile and bonding with composite resin (G1), bleaching with White Smile, treatment with ascorbic acid and bonding with composite resin (G2), bleaching with White Smile, immersing in artificial saliva for 2 weeks and bonding with composite resin (G3), bleaching with Opalesence and bonding with composite resin (G4), bleaching with Opalesence, treatment with ascorbic acid and bonding with composite resin (G5) and bleaching with Opalesence, immersing in artificial saliva for 2 weeks and bonding with composite resin (G6). Another group was used as a control group. Shear bond test was performed on all specimens and data were analyzed using one way ANOVA and Bonferroni's test (p < 0.05).

RESULTS

Bond strengths of bleached specimens were significantly lower than those of non-bleached specimens. No statistical difference was found in bond strength between the bleached and non-bleached groups when the antioxidant treatment was carried out.

CONCLUSION

Ten per cent ascorbic acid treatment was found to be an effective method to reverse the compromised bond strength.

Root canal irrigants

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ‘root canal irrigants’ and ‘endodontic irrigants.’ The reference lists of each article were manually checked for additional articles of relevance.

Effect of grape seed extract on the bond strength of bleached enamel

OBJECTIVE

This in vitro study assessed the neutralizing effect of grape seed extract (oligomeric proanthocyanidin complexes [OPCs]) on the bond strength of bleached enamel.

MATERIALS AND METHODS

Labial enamel surfaces of 70 extracted human maxillary central incisors were randomly divided into four groups based on the antioxidant used as follows: Group I (n=20): bleaching with 38% hydrogen peroxide gel for 10 minutes, without the use of an antioxidant; Group II (n=20): bleaching followed by the use of 10% sodium ascorbate solution; Group III (n=20): bleaching followed by the use of 5% proanthocyanidin solution; and Group IV (n=10): control group in which no bleaching was done. Groups I, II, and III were further subdivided into two subgroups of 10 teeth each, based on whether composite build-up was done immediately (subgroup A) or after a delay of 2 weeks (subgroup B) post bleaching. Shear bond strength of the specimens was tested under a universal testing machine. The data were tabulated and statistically analyzed.

RESULTS

Significantly higher shear bond strength values were observed in teeth treated with 10% sodium ascorbate (Group II) and 5% proanthocyanidin (Group III) as compared with the control group (Group IV). Among the antioxidants used, teeth treated with proanthocyanidin showed significantly higher shear bond strength values than those treated with sodium ascorbate.

CONCLUSION

It can be concluded that the use of grape seed extract prior to bonding procedures on bleached enamel completely neutralizes the deleterious effects of bleaching and increases the bond strength significantly.

Effect of reducing agents on bond strength to NaOCl-treated dentin

OBJECTIVE

The purpose of this study was to evaluate the effect of three antioxidant/reducing agents with different application times on microtensile bond strengths to sodium hypochlorite-treated dentin.

METHODS

The occlusal surfaces of 24 extracted human third molars were horizontally cut to expose sound dentin. The teeth were divided into eight groups. The dentin surfaces of the teeth were treated as follows: group 1, no treatment; group 2, treated with 6% sodium hypochlorite (NaOCl) for 30s; groups 3-8, applications of 10% sodium ascorbate solution, 100 μM rosmarinic acid solution or Accel for 5 or 10s after the same treatment as in group 2. All treated dentin surfaces were bonded with a 2-step self-etching adhesive system (Clearfil Protect Bond) and restored with a resin composite (Clearfil AP-X). After storage in water for 24h, the bonded specimens were subjected to the microtensile bond test at a crosshead speed of 1.0 mm/min. Data were analyzed by a one-way ANOVA and Tukey test (p<0.05).

RESULTS

The NaOCl-treated group had significantly lower bond strength than the control group (p<0.05). The application of sodium ascorbate solution for 5 or 10s did not significantly increase the compromised bonding to NaOCl-treated dentin (p>0.05). On the other hand, Accel and rosmarinic acid solution had significant reversal effects with the same application times (p<0.05).

SIGNIFICANCE

The reversal effect on compromised bonding to NaOCl-treated dentin depended upon the type of antioxidant within the short application time. Applying Accel or rosmarinic acid for 5 or 10s improved bond strengths to NaOCl-treated dentin.

Adjunctive use of an anti-oxidant agent to improve resistance of hybrid layers to degradation

OBJECTIVE

To determine the role of an anti-oxidant agent (ascorbic acid-AA) on resin-dentin bonds resistance to degradation of two adhesives.

METHODS

Flat dentin surfaces from 48 human molars were bonded as per manufacturer's instructions with: a two-step etch-and-rinse self-priming adhesive (Single Bond-SB) and a two-step self-etch adhesive (Clearfil SE Bond-CSE). Half of the specimens were bonded with the same adhesives, but after the addition of 10% AA into their formulation. Resin composite build-ups were constructed incrementally and sectioned into resin-dentin beams (1.0mm(2)) that were stored under four conditions: (1) water immersion for 24h; (2) water immersion for 1 year; (3) water immersion for 4 years; and (4) chemical challenging (immersion in 10% NaOCl for 5 h). Beams were pulled to failure in tension at 0.5mm/min. Mean microtensile bond strength (MTBS) data were analysed with ANOVA and multiple comparisons tests (P<0.05). Analysis of debonded dentin beams was performed by scanning electron microscopy (SEM).

RESULTS

After 24 h, SB and CSE performed equally, regardless of AA incorporation. Inclusion of AA on CSE formulation decreased MTBS following one-year water storage, but maintained SB bond strength values even after four years of water storage. NaOCl challenge diminished MTBS for both adhesives, but when AA was added to SB, this reduction was significantly lower.

CONCLUSIONS

The inclusion of AA on adhesive's formulation exerts a protective role on resin-dentin bonds resistance to degradation when SB is used. Bonding durability of CSE may be compromised by the addition of sodium ascorbate.

Effect of 10% sodium ascorbate on bleached bovine enamel surface morphology and microhardness

Sodium ascorbate has recently been suggested to compensate decreased bond strength of composite resin to bleached tooth surfaces. The aim of present study was to evaluate the effect of 10% sodium ascorbate on bleached bovine enamel morphology and microhardness considering the possibility of its effect on enamel surface characteristics. A total of 69 bovine enamel slabs were prepared and mounted in acrylic resin. Subsequent to polishing, they were randomly divided into 3 groups of 23 specimens each; 3 for Scanning Electron Microscopy (SEM) analysis and 20 for hardness test. In group 1 the specimens were immersed in distilled water as control group; in group 2 the specimens were bleached with 35% carbamide peroxide for 30 min a week for 3 consecutive weeks; and in group 3 the specimens were exposed to 10% sodium ascorbate for 30 min subsequent to bleaching similar to group 1. After 3 weeks Vickers hardness of the specimens was measured at 3 points with equal distances from each other under a force of 50 g. The mean of the hardness values of each specimen was calculated and data was analyzed by one-way ANOVA (P < 0.05). The highest and lowest microhardness values were observed in group 1 and group 2, respectively. However, there were no statistically significant differences in microhardness between the groups (P = 0.12). The use of 35% carbamide peroxide alone or with 10% sodium ascorbate does not affect bovine enamel hardness. SEM analysis showed a network of sodium ascorbate adsorbed to the bleached enamel surface.

Influence of endodontic irrigants on bond strength of a self-etching adhesive

The aim of this in vitro study was to evaluate the bond strength of a self-etching adhesive system to dentine irrigated with sodium hypochlorite (NaOCl), chlorhexidine solution (CX) and ethylene diamine tetra acetic acid (EDTA) by microtensile testing. Sixty human third molars were sectioned 3 mm below the occlusal level and then randomly divided into six groups: G1(control), without irrigant solution; G2, 1% NaOCl; G3, 1% NaOCl followed by the application of 17% EDTA; G4, 2% CX; G5, 2% CX followed by the application of 17% EDTA and G6, 17% EDTA. The specimens received the self-etching adhesive system were restored with composite resin, then sectioned and trimmed to obtain four hourglass-shaped slabs from each tooth. The specimens were submitted to the microtensile test in a Universal Testing Machine at a crosshead speed of 0.5 mm min(-1) until fracture. The results were submitted to statistical analysis by anova /Newman-Keuls. The means and standard deviations (MPa) were: G1, 26.88 (±3.81); G2, 19.08 (±3.89); G3, 18.16 (±2.21); G4, 18.14 (±4.32); G5, 34.30 (±3.32); G6, 13.61 (±1.21). It was concluded that the application of 2% CX followed by the application of 17% EDTA resulted in increasing the bond strength of the self-etching adhesive system to dentine, when compared with the results obtained for the other tested groups.

Transdentinal protective role of sodium ascorbate against the cytopathic effects of H2O2 released from bleaching agents

OBJECTIVES

The objectives of this study were to evaluate the transdentinal cytotoxicity of 10% and 16% carbamide peroxide gel (CP), as well as the ability of the antioxidant, 10% sodium ascorbate (SA), to protect the odontoblasts in culture.

STUDY DESIGN

Human dentin discs of 0.5-mm thickness were obtained and were placed into artificial pulp chambers. MDPC-23 odontoblastlike cells were seeded on pulp surface of the discs and the following groups were established: G1-No Treatment (control), G2-10% SA/6hs, G3-10%/CP6hs, G4-10%SA/6hs+10%CP/6hs, G5-16%CP/6hs, and G6-10%SA/6hs+16%CP/6hs. The cell viability was measured by the MTT assay.

RESULTS

In groups where 16% CP was used, decreased cell viability was observed. Conversely, the application of 10% SA on the dentin discs, before the use of the CP, reduced the cytotoxic effects of these products on cells.

CONCLUSIONS

The 16% CP cause a significant decrease in MDPC-23 cell viability and 10% SA was able to partially prevent the toxic effects of CP.

The endo-restorative interface: current concepts

Successful endodontic treatment depends on the restorative treatment that follows. The connection between endodontic treatment and restorative dentistry is well accepted, but the best restorative approaches for endodontically treated teeth have always been somewhat controversial. A plethora of information from various sources contributes to the controversy and much of it is contradictory. With the emergence of implants in mainstream dentistry, there has been more emphasis on long-term outcomes and on evaluating the "restorability" of teeth prior to endodontic treatment. The long-term viability of endodontically treated teeth is no longer a "given" in the implant era. In consequence, some teeth that might have received endodontic treatment in the past are now extracted and replaced with implant-supported prostheses if they are marginally restorable or it makes more sense in the overall treatment plan. As it is not possible to review here all the literature on the restoration of endodontically treated teeth, this article focuses primarily on current concepts based on the literature from the past 10 years or so, and provides treatment guidelines based on that research.

Long-term bond strength of adhesive systems applied to etched and deproteinized dentin

The aim of this study was to evaluate the early and 12-month bond strength of two adhesive systems (Single Bond-SB and One Step-OS) applied to demineralized dentin (WH) and demineralized/NaOCl-treated dentin (H). Twenty flat dentin surfaces were exposed, etched, rinsed and slightly dried. For the H groups, a solution of 10% NaOCl was applied for 60 s, rinsed (15 s) and slightly dried. The adhesives were applied according to the manufacturer's instructions and composite resin crowns were incrementally constructed. After 24 h (water-37 degrees C), the specimens was sectioned in order to obtain resin-dentin sticks (0.8 mm(2)). The specimens were tested in microtensile (0.5 mm/min) immediately (IM) or after 12 months of water storage (12M). The data (MPa) were subjected to ANOVA and Tukey's test (a=0.05). Only the main factors adhesive and time were significant (p=0.004 and p=0.003, respectively). SB (42.3+/-9.1) showed higher bond strengths than OS (33.6+/-11.6). The mean bond strength for IM-group (42.5+/-8.7) was statistically superior to 12M (33.3+/-11.8). The use of 10% NaOCl, after acid etching, did not improve the immediate and the long-term resin-dentin bond strength.

The effect of endodontic irrigants on the microtensile bond strength of dentin adhesives

INTRODUCTION

The purpose of this study was to evaluate the microtensile bond strength of a total etch (XP-Bond) and a self-etch (Clearfil SE Bond) adhesive system to dentine surfaces treated using endodontic irrigants.

METHODS

Twenty-four freshly extracted third molars were used. After creating a smear layer on the coronal midthird portion of the crowns, the teeth were divided into three groups and surfaces were irrigated with distilled water, 5.25% NaOCl + 17% EDTA, and 1.3% NaOCl + BioPure MTAD, respectively. Each group was divided into two subgroups, and a self-etching adhesive and an etch-and-rinse adhesive were applied respectively. The teeth were restored with a composite material and sectioned to produce sticks for microtensile bond testing.

RESULTS

The microtensile bond strength of the MTAD + Clearfil SE group was found to be significantly lower than the microtensile bond strength of the distilled water + Clearfil SE Bond group and the NaOCl, EDTA, + Clearfil SE Bond group (p = 0.0001, p = 0.009).

CONCLUSIONS

Because of the significant reduction of Clearfil SE Bond to coronal dentine after MTAD application, an etch-and rinse adhesive such as XP-Bond may be preferred if this irrigant has been chosen during endodontic treatment.

Root dentin body moisture changes caused by ascorbic acid

OBJECTIVES

To quantify in vitro the root dentin moisture (DM) when soaked in 10% ascorbic acid solution (Group A) and distilled water (Group B) for up to 14 days.

METHODS

Forty-four extracted human mandibular single-rooted teeth were sectioned perpendicular to the long axis at the CEJ to access the root dentin. The samples were divided into Groups A and B. Baseline (day 0) DM was measured using a digital grain moisture meter. One sample was placed in each tube, which was then filled with solution. All tubes were kept at 37 degrees C and 100% humidity. DM was measured after 1, 3, 7, and 14 days. The baseline DM value was used as a covariate in the generalized estimating equation (GEE) analysis to account for the difference in the baseline DM between the two groups.

RESULTS

The mean DM (%) values+/-standard deviation on days 0, 1, 3, 7, and 14 were 11.4+/-1.08, 17.1+/-0.87, 18.2+/-0.76, 18.4+/-0.77, and 17.9+/-0.90 in Group A, and 10.2+/-0.95, 12.8+/-0.90, 13.3+/-0.95, 13.0+/-0.91, and 13.2+/-0.89 in Group B, respectively. Group A had significantly higher baseline DM than Group B (p=0.006). After adjusting for differences in the baseline, the GEE analysis indicated that, on average, Group A had a significantly higher increase in DM than Group B, with means+/-standard deviation of 4.35+/-0.26.

CONCLUSIONS

The moisture increase in the ascorbic acid group was greater than that in the distilled water group. Soaking root dentin in the unreplenished ascorbic acid solution or distilled water beyond 3 days did not further increase DM.

Effect of 10% Sodium Ascorbate and 10% α-tocopherol in Different Formulations on the Shear Bond Strength of Enamel and Dentin Submitted to a Home-use Bleaching Treatment

A significant reduction in bond strength of restorative materials to dentin and enamel after home-use bleaching treatment has been reported. Antioxidizing agents may be a procedure to increase bond strength values. Although no reversal of bond strength values was found for sodium ascorbate, alpha-tocopherol formulated in solution resulted in a significant increase in bond strength of bleached enamel.

Effects of direct and indirect bleach on dentin fracture toughness

There are concerns that tooth-whitening procedures irreversibly damage tooth structure. We investigated the hypothesis that dental bleaches significantly affect dentin structural integrity. The objective was to evaluate the effects of peroxide bleaches on dentin fracture toughness. Compact test specimens, composed of human dentin, were used (n = 10/group). Bleach (16% or 10% carbamide peroxide or 3% hydrogen peroxide) or control material, containing 0.1% sodium fluoride, was applied directly or indirectly to dentin through enamel (6 hrs/day) for 2 or 8 weeks. Fracture toughness results were analyzed by ANOVA and Fisher's LSD test (p < 0.05). There were significant decreases in mean fracture toughness after two- and eight-week direct (19-34% and 61-68%, respectively) and indirect (up to 17% and 37%, respectively) bleach application. The in vitro reduction in dentin fracture toughness caused by the application of peroxide bleaches was greater for the direct application method, longer application time, and higher bleach concentration.

Adhesion of Epiphany and AH Plus sealers to human root dentin treated with different solutions

This study evaluated comparatively the adhesion of Epiphany and AH Plus endodontic sealers to human root dentin treated with 1% NaOCl and 1% NaOCl+17% EDTA, using the push-out test. Sixty root cylinders obtained from maxillary canines had the canals prepared and were randomly assigned to 3 groups (n=20), according to root dentin treatment: GI - distilled water (control), GII - 1% NaOCl and GIII - 1% NaOCl+17% EDTA. Each group was divided into 2 subgroups (n=10) filled with either Epiphany or AH Plus. Bond strength push-out test data (kN) were obtained and analyzed statistically by ANOVA and Tukey's post-hoc test. There was statistically significant difference between sealers (AH Plus: 0.78 ± 0.13; Epiphany: 0.61 ± 0.19; p<0.01) and among root dentin treatments (distilled water: 0.58 ± 0.19; 1% NaOCl: 0.71 ± 0.12; 1% NaOCl+17% EDTA: 0.80 ± 0.17; p<0.05). In conclusion, AH Plus sealer presented greater adhesion to dentin than Epiphany, regardless of the treatment of root canal walls.