Interfacial chemistry of class II composite restoration: structure analysis

Synthesis of an urushiol derivative and its use for hydrolysis resistance in dentin adhesive

Hydrolysis resistance is essential to the durability of the dentin bonding interface. Urushiol is a natural monomer that has been used in different fields over thousands of years but has the disadvantage of a long drying time. In this study, we evaluated a novel photocurable derivative of urushiol as the main monomer for polymerization in dentin adhesive and its effect on hydrolysis resistance. The derivative was characterized by Fourier transform infrared spectroscopy and ¹H nuclear magnetic resonance spectroscopy. Compared with the Adper Single Bond 2, the experimentally synthesized adhesives had higher contact angles. In particular, the water sorption/solubility of the experimental samples were significantly lower than that of Adper Single Bond 2. The microtensile bond strengths of the test groups were higher than that of the control group, even after 5000 thermocycles. Cytotoxicity test results showed that adhesives based on the original derivative induced low toxicity to L929 cells. The results of this study may shift the focus of future research to natural monomers and even their derivatives which may perform well in dentistry.

Chemometrics-Assisted Raman Spectroscopy Characterization of Tunable Polymer-Peptide Hybrids for Dental Tissue Repair

The interfaces that biological tissues form with biomaterials are invariably defective and frequently the location where failure initiates. Characterizing the phenomena that lead to failure is confounded by several factors including heterogeneous material/tissue interfaces. To seamlessly analyze across these diverse structures presents a wealth of analytical challenges. This study aims to develop a molecular-level understanding of a peptide-functionalized adhesive/collagen hybrid biomaterial using Raman spectroscopy combined with chemometrics approach. An engineered hydroxyapatite-binding peptide (HABP) was copolymerized in dentin adhesive and dentin was demineralized to provide collagen matrices that were partially infiltrated with the peptide-functionalized adhesive. Partial infiltration led to pockets of exposed collagen-a condition that simulates defects in adhesive/dentin interfaces. The spectroscopic results indicate that co-polymerizable HABP tethered to the adhesive promoted remineralization of the defects. The spatial distribution of collagen, adhesive, and mineral as well as crystallinity of the mineral across this heterogeneous material/tissue interface was determined using micro-Raman spectroscopy combined with chemometrics approach. The success of this combined approach in the characterization of material/tissue interfaces stems from its ability to extract quality parameters that are related to the essential and relevant portions of the spectral data, after filtering out noise and non-relevant information. This ability is critical when it is not possible to separate components for analysis such as investigations focused on, in situ chemical characterization of interfaces. Extracting essential information from complex bio/material interfaces using data driven approaches will improve our understanding of heterogeneous material/tissue interfaces. This understanding will allow us to identify key parameters within the interfacial micro-environment that should be harnessed to develop durable biomaterials.

Threats to adhesive/dentin interfacial integrity and next generation bio-enabled multifunctional adhesives

Nearly 100 million of the 170 million composite and amalgam restorations placed annually in the United States are replacements for failed restorations. The primary reason both composite and amalgam restorations fail is recurrent decay, for which composite restorations experience a 2.0-3.5-fold increase compared to amalgam. Recurrent decay is a pernicious problem-the standard treatment is replacement of defective composites with larger restorations that will also fail, initiating a cycle of ever-larger restorations that can lead to root canals, and eventually, to tooth loss. Unlike amalgam, composite lacks the inherent capability to seal discrepancies at the restorative material/tooth interface. The low-viscosity adhesive that bonds the composite to the tooth is intended to seal the interface, but the adhesive degrades, which can breach the composite/tooth margin. Bacteria and bacterial by-products such as acids and enzymes infiltrate the marginal gaps and the composite's inability to increase the interfacial pH facilitates cariogenic and aciduric bacterial outgrowth. Together, these characteristics encourage recurrent decay, pulpal damage, and composite failure. This review article examines key biological and physicochemical interactions involved in the failure of composite restorations and discusses innovative strategies to mitigate the negative effects of pathogens at the adhesive/dentin interface. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2466-2475, 2019.

Immobilization of quaternary ammonium based antibacterial monomer onto dentin substrate by non-thermal atmospheric plasma

Use of non-thermal atmospheric plasma (NTAP) brush on immobilization of dimethylaminohexadecyl methacrylate (DMAHDM) onto dentin bonding substrate, and resulting antibacterial activity against Streptococcus mutans were investigated. A bonding substrate with several-micron-demineralized layer was created from human dentin. DMAHDM was applied onto the demineralized layer with or without plasma exposure. Scanning electron microscopy (SEM) and Fourier transformed infrared (FTIR) spectroscopy were employed to verify immobilization/grafting of DMAHDM onto the substrate. Antibacterial activity of the resulting substrate was assessed by using colony-forming unit (CFU) and confocal scanning laser microscopy. Effects of saliva pellicle treatment and aging process on the above substrate were also evaluated. The SEM/FTIR results demonstrated that NTAP could induce DMAHDM immobilization onto dentin substrate, which was further verified via quantitative FTIR analysis. Comparing with non-plasma-treated, the plasmatreated substrate, with CFU 4 log lower, exhibited much stronger inhibitory effects, which were minimally affected by saliva or aging. The DMAHDM-immobilized dentin substrate showed effective and sustained antibacterial characteristics.

The Influence of Cold Atmospheric Plasma Irradiation on the Adhesive Bond Strength in Non-Demineralized and Demineralized Human Dentin: An In Vitro Study

Purpose:

While aiming at the use of Cold Atmospheric Plasmas (CAPs) in restorative dentistry, the present study intended to assess if plasma irradiation increases the Tensile Bond Strength (TBS) in non-demineralized and demineralized dentin.

Materials and Methods:

Forty-eight human dentin samples were assigned to three different treatment modalities: I: Plasma jet irradiation (CAP I); II: Dielectric barrier discharge plasma treatment (CAP II); and III: No plasma (control). In each group, half of the specimens had previously been demineralized. A fourth generation of adhesive and dental composite was applied to all of the samples. The testing of the TBS was performed after artificial aging.

Results:

In the non-demineralized dentin, the mean TBS values were significantly higher after using CAP II (16.95 MPa) than in the control samples (4.2 MPa; p = 0.001). Significantly higher TBS values were also obtained after irradiating the demineralized dentin with CAP I and CAP II (11.68 and 4.6 MPa) when compared to the control samples (0 MPa; p = 0.003 and 0.038). The differences between both of the plasma sources were only slightly significant (p = 0.05).

Conclusion:

CAPs can potentially enhance the adhesive/dentin interfacial bonding strength, whereby the underlying effects seem to depend on the type of plasma source and the degree of dentinal (de-) mineralization. In the non-demineralized dentin, after a complete caries excavation, dielectric barrier discharge devices might be favorable over the plasma jets, in order to improve the adhesive/dentin interfacial bonding. In contrast, the plasma jets could be more effective in the demineralized dentin after an incomplete caries excavation.

Engineered Peptide Repairs Defective Adhesive-Dentin Interface

Failure of dental composite restorations is primarily due to recurrent decay at the tooth-composite interface. At this interface, the adhesive and its bond with dentin is the barrier between the restored tooth and the oral environment. In vivo degradation of the bond formed at the adhesive/dentin (a/d) interface follows a cascade of events leading to weakening of the composite restoration. Here, a peptide-based approach is developed to mineralize deficient dentin matrices at the a/d interface. Peptides that have an inherent capacity to self-assemble on dentin and to induce calcium-phosphate remineralization are anchored at the interface. Distribution of adhesive, collagen, and mineral is analyzed using micro-Raman spectroscopy and fluorescence microscopy. The analysis demonstrates remineralization of the deficient dentin matrices achieved throughout the interface with homogeneous distribution of mineral. The peptide-based remineralization demonstrated here can be an enabling technology to design integrated biomaterial-tissue interfaces.

Degradation of resin-dentine bond of different adhesive systems to primary and permanent dentine

AIM

To evaluate the water storage degradation of resin-dentine bonds of different adhesive systems to primary and permanent human dentine.

METHODS

Flat occlusal human dentine surfaces of 15 primary molars and 15 permanent molars were randomly assigned according to adhesive systems: Adper Single Bond 2; Clearfil SE Bond and One Up Bond F Plus. After bonding procedures, the adhesives were applied according to the manufacturers' instructions and composite resin blocks were built. Restored teeth were sectioned rendering rectangular sticks (RS) (0.4 mm²). The RS were submitted to microtensile bond strength (µTBS) test according to the water storage time: 24 h, 1-year, and 2-years. Mean µTBS values were analysed by three-way analysis of variance (mixed design) and Tukey post hoc test (α = 0.05). The failure mode was analysed at 400× magnification.

RESULTS

All three factors isolated showed significant influences on µTBS, as did the cross-product interactions between material vs. storage time (p = 0.01) and substrate vs. storage time (p = 0.002). Bond strength means to primary dentine were lower than to permanent dentine (34.7 ± 10.1 and 45.8 ± 12.9 mPa, respectively) after 2-years of water storage. The one-step self-etch adhesive (One Up Bond F Plus) showed less stable bond strength after 2-years of water storage.

CONCLUSION

The resin-dentine bond of primary teeth was more prone to degradation over time compared to permanent dentine.

In vitro remineralization of hybrid layers using biomimetic analogs

Resin-dentin bond degradation is a major cause of restoration failures. The major aim of the current study was to evaluate the impact of a remineralization medium on collagen matrices of hybrid layers of three different adhesive resins using nanotechnology methods. Coronal dentin surfaces were prepared from freshly extracted premolars and bonded to composite resin using three adhesive resins (FluoroBond II, Xeno-III-Bond, and iBond). From each tooth, two central slabs were selected for the study. The slabs used as controls were immersed in a simulated body fluid (SBF). The experimental slabs were immersed in a Portland cement-based remineralization medium that contained two biomimetic analogs (biomineralization medium (BRM)). Eight slabs per group were retrieved after 1, 2, 3, and 4 months, respectively and immersed in Rhodamine B for 24 h. Confocal laser scanning microscopy was used to evaluate the permeability of hybrid layers to Rhodamine B. Data were analyzed by analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) tests. After four months, all BRM specimens exhibited a significantly smaller fluorescent area than SBF specimens, indicating a remineralization of the hybrid layer (P≤0.05). A clinically applicable biomimetic remineralization delivery system could potentially slow down bond degradation.

Light-Cured Self-Etch Adhesives Undergo Hydroxyapatite-Triggered Self-Cure

Light cure is a popular mode of curing for dental adhesives. However, it suffers from inadequate light delivery when the restoration site is less accessible, in which case a self-cure mechanism is desirable to salvage any compromised polymerization. We previously reported a novel self-cure system mediated by ethyl 4-(dimethylamino)-benzoate (4E) and hydroxyapatite (HAp). The present work aims to investigate if such self-cure phenomenon takes place in adhesives that underwent prior inadequate light cure and to elucidate if HAp released from the dental etching process is sufficient to trigger it. Model self-etch adhesives were formulated with various components, including bis[2-methacryloyloxy)ethyl]-phosphate (2MP) as acidic monomer and trimethylbenzoyl-diphenylphosphine oxide (TPO) as photoinitiator. In vitro evolution of degree of conversion (DC) of HAp-incorporated adhesives was monitored by infrared spectroscopy during light irradiation and dark storage. Selected adhesives were allowed to etch and extract HAp from enamel, light-cured in situ, and stored in the dark, after which Raman line mapping was used to obtain spatially resolved DC across the enamel-resin interface. Results showed that TPO+4E adhesives reached DC similar to TPO-only counterparts upon completion of light irradiation but underwent another round of initiation that boosted DC to ~100% regardless of HAp level or prior light exposure. When applied to enamel, TPO-only adhesives had ~80% DC in resin, which gradually descended to ~50% in enamel, whereas TPO+4E adhesives consistently scored ~80% DC across the enamel-resin interface. These observations suggest that polymerization of adhesives that underwent insufficient light cure is salvaged by the novel self-cure mechanism, and such salvaging effect can be triggered by HAp released from dental substrate during the etching process.

Durability of solvent-free one-step self-etch adhesive under simulated intrapulpal pressure

Background

There are different solvents presented in simplified adhesives. Bond-1 SF has been developed, which contains neither water nor organic solvents, in order to eliminate technical issues in terms of evaporation of solvents and concerns for the durability of resin-dentin bond. Thus this study was conducted to evaluate the microtensile bond strength (?TBS) of solvent-free and ethanol-based one-step self-etch adhesives to dentin under simulated intrapulpal pressure (IPP).

Material and Methods

Occlusal surfaces of human molars were prepared to expose mid-dentin depth. Bond-1SF Solvent-Free SE [SF] and AdperTM easy one adhesives [AE] were applied on dentin specimens. Resin composite build up was done in increments. Then specimens were stored under simulated IPP 20 mmHg, immersed in artificial saliva at 37 ºC for 24 hours (24h) and 6 months (6m). Specimens were sectioned into sticks of (1 mm²) to be tested for (?TBS) using a universal testing machine. Both fractured sections of each stick were inspected using a stereomicroscope at 40× magnification to determine the mode of failure. Data were statistically analyzed by Two-way ANOVA of Variance.

Results

There was no statistically significant difference between the mean ?TBS of both [SF] and [AE] adhesives at both aging periods, 24h and 6m (p< 0.1103) and (p< 0.7148) respectively. Only for [AE] there was statistical significance for aging periods (p< 0.0057*). The most represented modes of failure were adhesive failure at tooth side.

Conclusions

Under simulated IPP solvent-free adhesive [SF] had comparable performance as ethanol-based adhesive [AE] when bonded to dentin substrate.

Key words:Bond strength, dentin, simulated intrapulpal pressure, self-etch adhesives, solvents.

Effect of crosslinking density of polymers and chemical structure of amine-containing monomers on the neutralization capacity of dentin adhesives

OBJECTIVES

Neutralization of the acidic micro-environment at the tooth/material interface is expected to provide enhanced durability for dental composite restorations. The objective of this study is to explore the effect of amine-containing monomer formulations and the crosslinking density of the resultant polymers on the neutralization capacity.

MATERIALS AND METHODS

The co-monomer system was varied systematically to obtain different proportions of Bisphenol A glycerolate dimethacrylate (BisGMA) and 2-hydroxyethyl methacrylate (HEMA), while maintaining a constant amount of amine-containing methacrylate monomer. A series of amine-containing monomers covering a range of pKa values were examined. Crosslinking density of formed copolymers was controlled by adjusting the weight content of the dimethacrylate monomer BisGMA. Lactic acid (LA) was used as a probe to analyze the effectiveness of the basic polymers to neutralize acid. The neutralization capacity of each amine-containing crosslinked copolymer was characterized by measuring pH as a function of time when the specimens were soaked in 1-mM LA solution, and the results were compared to the control formulations composed solely of BisGMA and HEMA. Polymer surfaces were examined using the methyl orange (MO) assay to quantify the amount of accessible amine groups.

RESULTS

For each amine-containing crosslinked co-polymer, the neutralization capacity is enhanced by decreasing crosslinking density (e.g., by reducing BisGMA concentration in the formulation). In addition, more amine groups were accessible when crosslinking density was decreased. For different amine-containing polymers with the same BisGMA concentration, the neutralization capacity is higher when the amino monomers with higher pKa values were used in the formulations.

SIGNIFICANCE

This is the first time that the neutralization capacity based on crosslinked dental polymers has been studied. The information is important for future development of durable dentin adhesives.

Synthesis and evaluation of novel siloxane-methacrylate monomers used as dentin adhesives

OBJECTIVES

The objectives of this study were to synthesize two new siloxane-methacrylate (SM) monomers for application in dentin adhesives and to investigate the influence of different functionality of the siloxane-containing monomers on the adhesive photopolymerization, water sorption, and mechanical properties.

METHODS

Two siloxane-methacrylate monomers (SM1 and SM2) with four and eight methacrylate groups were synthesized. Dentin adhesives containing BisGMA, HEMA and the siloxane-methacrylate monomers were photo-polymerized. The experimental adhesives were compared with the control adhesive (HEMA/BisGMA, 45/55, w/w) and characterized with regard to degree of conversion (DC), water miscibility of the liquid resin, water sorption and dynamic mechanical analysis (DMA).

RESULTS

The experimental adhesives exhibited improved water miscibility as compared to the control. When cured in the presence of 12 wt% water to simulate the wet environment of the mouth, the SM-containing adhesives showed DC comparable to the control. The experimental adhesives showed higher rubbery modulus than the control under dry conditions. Under wet conditions, the mechanical properties of the formulations containing SM monomer with increased functionality were comparable with the control, even with more water sorption.

SIGNIFICANCE

The concentration and functionality of the newly synthesized siloxane-methacrylate monomers affected the water miscibility, water sorption and mechanical properties of the adhesives. The experimental adhesives show improved water compatibility compared with the control. The mechanical properties were enhanced with an increase of the functionality of the siloxane-containing monomers. The results provide critical structure/property relationships and important information for future development of durable, versatile siloxane-containing dentin adhesives.

Posterior composite restoration update: focus on factors influencing form and function

Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient’s caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of posterior composite restorations, the emphasis must remain on advancing our understanding of the clinical variables that impact the formation of a durable seal at the restoration–tooth interface. This paper presents an update of existing technology and underscores the mechanisms that negatively impact the durability of posterior composite restorations in permanent teeth.

BisGMA/TEGDMA dental nanocomposites containing glyoxylic acid-modified high-aspect ratio hydroxyapatite nanofibers with enhanced dispersion

The purpose of this research was to investigate the influence of the glyoxylic acid (GA) modification of hydroxyapatite (HAP) nanofibers on their dispersion in bisphenol A glycidyl methacrylate (BisGMA)/triethylene glycol dimethacrylate (TEGDMA) dental composites and also to investigate the mechanical properties, water absorption and water solubility of the resulting dental resins and composites. Scanning/transmission electron microscopy images showed that microsized HAP nanofiber bundles could be effectively broken down into individual HAP nanofibers with an average length of ∼15 µm after the surface modification process. Fourier transform infrared spectroscopy, x-ray photoelectron spectroscopy and thermal gravimetric analysis characterization confirmed that GA was chemically grafted on the HAP nanofiber surface, hypothetically by reacting with the amine group on the HAP nanofiber surface. The enhanced dispersion of HAP nanofibers in the dental matrix led to increased biaxial flexural strength (BFS) compared with the corresponding dental resins and composites filled with untreated HAP nanofibers. In addition, impregnation of small mass fractions of the GA-modified HAP nanofibers into the BisGMA/TEGDMA dental resins (5 wt%, 10 wt%) or composites (2 wt%, 3 wt%) could also substantially improve the BFS in comparison with the controls (pure resins or dental composites filled with silica particles alone). Larger mass fractions could not increase the mechanical property further or even degraded the BFS values. Water behavior testing results indicated that the addition of the GA-modified HAP nanofibers resulted in higher water absorption and water solubility values, which are not preferred for clinical application. In summary, well-dispersed HAP nanofibers and their dental composites with enhanced mechanical properties have been successfully fabricated, but the water absorption and water solubility of such dental composites need to be further improved.

Characterization of micro- and nanophase separation of dentin bonding agents by stereoscopy and atomic force microscopy

The aim was to study the effect of solvents on the phase separation of four commercial dental adhesives. Four materials were tested: Clearfil™ SE Bond (CSE), Clearfil Protect Bond (CPB), Clearfil S3 Bond (CS3), and One-Up Bond F Plus (OUB). Distilled water or ethanol was used as a solvent (30 vol%) for microphase separation studies, by stereoscopy. For nanophase images, the mixtures were formulated with two different solvent concentrations (2.5 versus 5 vol%) and observed by atomic force microscopy. Images were analyzed by using MacBiophotonics ImageJ to measure the area of bright domains. Macrophase separations, identified as a loss of clarity, were only observed after mixing the adhesives with water. Nanophase separations were detected with all adhesive combinations. The area of bright domains ranged from 132 to 1,145 nm² for CSE, from 15 to 285 nm² for CPB, from 149 to 380 nm² for CS3, and from 26 to 157 nm² for OUB. In water-resins mixtures, CPB was the most homogeneous and OUB showed the most heterogeneous phase formation. In ethanol-resin mixtures, CSE attained the most homogeneous structure and OUB showed the most heterogeneous phase. Addition of 5 vol% ethanol to resins decreased the nanophase separation when compared with the control materials.

Synthesis and evaluation of novel dental monomer with branched aromatic carboxylic acid group

A new glycerol-based dimethacrylate monomer with an aromatic carboxylic acid, 2-((1,3-bis(methacryloyloxy)propan-2-yloxy)carbonyl)benzoic acid (BMPB), was synthesized, characterized, and proposed as a possible dental co-monomer for dentin adhesives. Dentin adhesives containing 2-hydroxyethyl methacrylate (HEMA) and 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (BisGMA) in addition to BMPB were formulated with water at 0, 5, 10, and 15 wt % to simulate wet, oral conditions, and photo-polymerized. Adhesives were characterized with regard to viscosity, real-time photopolymerization behavior, dynamic mechanical analysis, and microscale 3D internal morphologies and compared with HEMA/BisGMA controls. When formulated under wet conditions, the experimental adhesives showed lower viscosities (0.04-0.07 Pa s) as compared to the control (0.09-0.12 Pa s). The experimental adhesives showed higher glass transition temperature (146-157°C), degree of conversion (78-89%), and rubbery moduli (33-36 MPa), and improved water miscibility (no voids) as compared to the controls (123-135°C, 67-71%, 15-26 MPa, and voids, respectively). The enhanced properties of these adhesives suggest that BMPB with simple, straightforward synthesis is a promising photocurable co-monomer for dental restorative materials.

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

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

Effect of photoinitiator system and water content on dynamic mechanical properties of a light-cured bisGMA/HEMA dental resin

The selection of an appropriate photoinitiator system is critical for efficient polymerization of dental resins with satisfactory mechanical and physical properties. The purpose of this study was to evaluate the influence of adding an iodonium salt to two-component photoinitiator systems. Four photoinitiator systems were included in a model bisGMA/HEMA resin and used to prepare samples at different water contents; the dynamic mechanical properties and the final degree of conversion of the samples were then characterized. Addition of the iodonium salt to the two-component photoinitiator systems increased the final degree of conversion, glass transition temperature, rubbery modulus, and crosslink density. The photoinitiator system containing ethyl-4-(dimethylamino) benzoate as a coinitiator and the iodonium salt exhibited the highest rubbery modulus. The enhanced properties in the presence of the iodonium salt can be attributed to the production of an active phenyl radical with regeneration of the original camphorquinone, which may increase the compatibility between monomers and initiators, especially in the presence of water. The results support the hypothesis that a photoinitiator system containing an iodonium salt can increase both mechanical properties and final conversion of model resin polymerized in the presence of water.

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

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

Enzyme-catalyzed hydrolysis of dentin adhesives containing a new urethane-based trimethacrylate monomer

A new trimethacrylate monomer with urethane-linked groups, 1,1,1-tri-[4-(methacryloxyethylamino-carbonyloxy)-phenyl]ethane (MPE), was synthesized, characterized, and used as a comonomer in dentin adhesives. Dentin adhesives containing 2-hydroxyethyl methacrylate (HEMA, 45% w/w) and 2,2-bis[4(2-hydroxy-3-methacryloyloxy-propyloxy)-phenyl] propane (BisGMA, 30% w/w) in addition to MPE (25% w/w) were formulated with H(2)O at 0 (MPE0), 8 (MPE8), and 16 wt % water (MPE16) to simulate the wet demineralized dentin matrix and compared with controls [HEMA /BisGMA, 45/55 w/w, at 0 (C0), 8 (C8), and 16 wt % water (C16)]. The new adhesive showed a degree of double bond conversion and mechanical properties comparable with control, with good penetration into the dentin surface and a uniform adhesive/dentin interface. On exposure to porcine liver esterase, the net cumulative methacrylic acid (MAA) released from the new adhesives was dramatically (p < 0.05) decreased relative to the control, suggesting that the new monomer improves esterase resistance.

Dynamic mechanical analysis and esterase degradation of dentin adhesives containing a branched methacrylate

A study of the dynamic mechanical properties and the enzymatic degradation of new dentin adhesives containing a multifunctional methacrylate are described. Adhesives contained 2-hydroxyethyl methacrylate, 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]-propane, and a new multifunctional methacrylate with a branched side chain-trimethylolpropane mono allyl ether dimethacrylate (TMPEDMA). Adhesives were photopolymerized in the presence of 0, 8, and 16 wt % water to simulate wet bonding conditions in the mouth and compared with control adhesives. The degree of conversion as a function of irradiation time was comparable for experimental and control adhesives. In dynamic mechanical analysis, broad tan delta peaks were obtained for all samples, indicating that the polymerized networks are heterogeneous; comparison of the full-width-at-half-maximum values obtained from the tan delta curves indicated increased heterogeneity for samples cured in the presence of water and/or containing TMPEDMA. The experimental adhesive showed higher T(g) and higher rubbery modulus indicating increased crosslink density when compared with the control. The improvement in esterase resistance afforded by adhesives containing the TMPEDMA is greater when this material is photopolymerized in the presence of water, suggesting better performance in the moist environment of the mouth. The improved esterase resistance of the new adhesive could be explained in terms of the densely crosslinked network structure and/or the steric hindrance of branched alkyl side chains.

Effect of photoinitiators on the in vitro performance of a dentin adhesive exposed to simulated oral environment

OBJECTIVES

Our previous study showed poor mechanical durability and nano-sized heterogeneities in cross-linked dentin adhesives cured in the presence of water. To further explore the relationship between nano-scale heterogeneities and the long-term mechanical properties of dentin adhesives, the properties of model dentin adhesives polymerized using hydrophilic photoinitiators were compared with those of adhesives polymerized using hydrophobic camphorquinone-based photoinitiators.

METHODS

The model adhesives consisted of HEMA and bisGMA with a mass ratio of 45/55 and were photopolymerized in the presence of 8.3 mass% water. The photo-polymerization of the model adhesives during irradiation was monitored in situ using a Perkin-Elmer Spectrum One FTIR in the ATR sampling mode. The tensile properties were determined for all samples after dry storage at room temperature, or after aqueous storage in distilled deionized water.

RESULTS

There was a continuous decline of mechanical properties for the specimens cured in the presence of water during 3 months aqueous storage, especially for the specimens that contained hydrophobic photoinitiators. The multi-component systems containing hydrophilic photoinitiators were shown to produce superior model dental adhesives when these materials are cured in the presence of water.

SIGNIFICANCE

Designing initiator systems to perform in this heterogeneous environment may improve the mechanical performance of dentin adhesives, as the results presented here indicate.

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

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

In vitro performance of nano-heterogeneous dentin adhesive

Water is ubiquitous in the mouths of healthy individuals and routinely interferes with efforts to bond restorations to dental tissues. Our previous studies using tapping-mode atomic force microscopy (TMAFM) have shown that nanophase separation is a general feature of cross-linked polymethacrylates photocured in the presence of water. To explore the relationship between nanophase separation in dentin adhesives and their long-term mechanical properties, we evaluated model adhesives after 3 months of aqueous storage. The degree of contrast in the TMAFM phase image depended on the formulations used, ranging from 'not observable' to 'very strong'. Correspondingly, the mechanical properties of these model adhesives varied from 'minimal change' to 'significant depreciation'. The results support the hypothesis that a high degree of heterogeneity at the nano-scale is associated with poor mechanical durability in these model adhesives.

Effect of solvent content on resin hybridization in wet dentin bonding

With wet bonding techniques, the channels between the demineralized dentin collagen fibrils are filled with debris, solvent, and water. Commercial adhesives include solvents such as ethanol or acetone to facilitate resin-infiltration into this wet substrate. Under in vivo conditions, the solvent may be diluted because of repeated exposure of the material to the atmosphere, or concentrated because of separation of the bonding liquids into layers within the bottle. The purpose of this study was to investigate the effect of different concentrations of ethanol (10-50%) on infiltration of the adhesive resin and collagen fibril encapsulation in the adhesive/dentin interface using light microscopy, micro-Raman spectroscopy, and scanning electron microscopy. The results indicated that under wet bonding conditions the hybridization process was highly sensitive to the initial solvent concentration in the adhesive system. The staining and scanning electron microscopy results showed that the quality of the interfacial hybrid layer was poor at the lower (10%) or higher (50%) ethanol content. Micro-Raman analysis indicated that there was a distinct difference in the degree of adhesive penetration among adhesives containing different concentrations of ethanol. Adhesives containing 10 or 50% ethanol did not realize effective penetration; the penetration of the adhesive monomers increased dramatically when the initial ethanol content was 30%. The amount of solvents are essential for achieving effective bonding to dentin.

Chemical profile of adhesive/caries-affected dentin interfaces using Raman microspectroscopy

In clinical practice, dentists must frequently bond adhesives to caries-affected dentin substrates, but the bond that characteristically forms with these substrates does not provide the durability necessary for long-term clinical function. The purpose of this study was to characterize and compare the interfacial chemistry of adhesive with caries-affected and noncarious dentin using micro-Raman spectroscopy. The results indicated that the differences in the Raman spectra between noncarious and caries-affected dentin could not be accounted for by simple decreased mineralization. Both the structure of collagen and mineral in the caries-affected dentin has been altered by the caries process. The differences in structure and composition not only interfered with acid-etching process but also subsequent resin monomer penetration. It was shown that the interface between the adhesive and caries-affected dentin was wider and more complicated than that of the adhesive and noncarious dentin. As a result of adhesive phase separation, a structurally integrated hybrid layer did not form at the interface with either caries-affected or noncarious dentin. Using chemical imaging techniques, this study provides the direct evidence of adhesive phase separation at the interface with caries-affected dentin. Although our group previously reported adhesive phase separation at the interface with noncarious dentin, the chemistry of caries-affected dentin leads to greater variability and a more highly irregular composition along the length and breadth of the interface.

Relationship of solvent to the photopolymerization process, properties, and structure in model dentin adhesives

The ratio of the double-bond content of monomer to polymer, i.e. degree of conversion (DC) has been used frequently as a convenient means of comparing the behavior and properties of dental composites and adhesives. The purpose of this investigation was to study the relationship of photopolymerization processes, bulk properties, and structure using model dentin adhesives cured in the presence of different ethanol content as an example. There was little difference in the DC of model BisGMA-based adhesives cured in the presence of ethanol concentrations ranging from 0 to 40 wt %, but there were substantial differences in the mechanical properties. Ultimate tensile strength (UTS) and modulus of elasticity decreased with an increase in ethanol content. Polymer structure was revealed by thermal behavior in the glass transition temperature (Tg) region; these measurements were obtained by modulated temperature differential scanning calorimetry (MTDSC) technology, which removes the competing irreversible effects associated with release of volatiles and residual curing. Glass transition temperature of model adhesives decreased substantially with an increase in ethanol content. The DC based on the quantity of remaining double bond has been used extensively to characterize and provide a relative assessment of the quality of dentin adhesives and dental composites. Since polymers differing in linearity, and therefore crosslink density, may have a similar degree of conversion, the measurement of monomer/polymer conversion does not necessarily provide complete representation of the quality or durability of the polymer structure.

Effects of a solubility enhancer on penetration of hydrophobic component in model adhesives into wet demineralized dentin

AIMS

The purpose of this study was to evaluate the effects of a polymerizable solubility enhancer, poly (ethylene glycol) dimethacrylate (PEGDMA) in BisGMA/HEMA model adhesives on adhesive phase separation, adhesive penetration and structural integrity of adhesive/dentin (a/d) interfaces.

MATERIALS AND METHODS

The occlusal one-third of the crown was removed from 10 unerupted human third molars, each tooth was separated in half by cutting perpendicular to the acid conditioned dentin surface and treated with BisGMA/HEMA model adhesives with and without PEGDMA. Five-micron-thick sections of adhesive/dentin interface specimens were cut and stained with Goldner's trichrome for light microscopy. Companion slabs were analyzed with micro-Raman spectroscopy and scanning electron microscopy (SEM). The macrophase separation in the model adhesives with/without PEGDMA was also detected using cloud point measurements in the presence of water.

RESULTS

The addition of PEGDMA enhanced the water solubility/compatibility of the BisGMA/HEMA model adhesives. Micro-Raman spectral analysis of the dentin/adhesive interface indicated that there was a gradual decrease in penetration of BisGMA component for model adhesive without PEGDMA, while homogeneous distribution of the hydrophobic BisGMA component was noted in the interface with adhesive containing PEGDMA. The addition of PEGDMA dramatically facilitated infiltration of the hydrophobic monomers into the wet demineralized dentin. The SEM and staining results showed that the addition of PEGDMA would also improve the integrity at the interface between pure adhesive and hybrid layers.

SIGNIFICANCE

The addition of PEGDMA could reduce phase separation, enhance the infiltration of BisGMA-based adhesives into the wet, demineralized dentin substrates, and promote homogeneous distribution of the hydrophobic component throughout the interface.