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Schulz-Kornas E, Tittel M, Schneider H, Bemmann M, Pellino M, Meissner T, Fuchs F, Hannig C, Tetschke F, Park KJ, Strumpski M, Haak R. Tooth-composite bond failure with a universal and an etch-and-rinse adhesive depending on mode and frequency of application. Dent Mater 2024; 40:359-369. [PMID: 38143188 DOI: 10.1016/j.dental.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To evaluate the effect of an additional layer of universal adhesive on the interfacial enamel/dentin-composite gap formation in relation to application mode and aging, via spectral domain optical coherence tomography (SD-OCT) and scanning electron microscopy (SEM). METHODS In vitro class V cavities in 114 caries-free premolars were restored by applying one or two layers of a universal adhesive (Scotchbond Universal, SBU) in self-etch (se) and etch-and-rinse (er) mode or the reference adhesive OptiBond FL (OFL-er). The restorations were imaged by SD-OCT (six groups, n = 8) and SEM (n = 3) directly after filling (t1), water storage (t2, 24 h), embedding (t3), and thermo-mechanical loading (t4, TCML). The interfacial gaps were quantified using 26 parameters and analyzed using principal component analysis and linear mixed effect models. RESULTS Gap formation at enamel and dentin was significantly influenced by the adhesive, the application mode and number of layers (p < 0.001). This was due to the influence of the SBU-er mode (p < 1e-05), which showed significantly more gap formation and a greater range of variation with double application when compared to SBU-se and OFL. The fewest interfacial gaps occurred with one or two applications of OFL-er and one layer of SBU-er. SIGNIFICANCE Adhesive application mode and the number of adhesive layers are relevant factors in the tooth-composite bond failure. Double application worsened the adaptation of SBU to freshly prepared dentin conditioned with phosphoric acid.
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Affiliation(s)
- Ellen Schulz-Kornas
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
| | - Mathilde Tittel
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Maximilian Bemmann
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Marco Pellino
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Tobias Meissner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Florian Fuchs
- Department of Prosthetic Dentistry and Dental Material Science, University of Leipzig, Leipzig, Germany
| | - Christian Hannig
- Policlinic of Operative Dentistry, Periodontology and Pediatric Dentistry, Faculty of Medicine Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Florian Tetschke
- Department of Clinical Sensoring and Monitoring, Faculty of Medicine Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Kyung-Jin Park
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Michaela Strumpski
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Scholz KJ, Tabenski IM, Vogl V, Cieplik F, Schmalz G, Buchalla W, Hiller KA, Federlin M. Randomized clinical split-mouth study on the performance of CAD/CAM-partial ceramic crowns luted with a self-adhesive resin cement or a universal adhesive and a conventional resin cement after 39 months. J Dent 2021; 115:103837. [PMID: 34624421 DOI: 10.1016/j.jdent.2021.103837] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 01/21/2023] Open
Abstract
Objectives To determine the clinical performance of partial ceramic crowns (PCCs) luted with a conventional resin cement combined with a universal adhesive without or with selective enamel etching or luted with a self-adhesive resin cement. Methods In a split-mouth design, each three CAD/CAM-PCCs (Vita Mark II, Cerec) were placed in 50 patients. Two PCCs were luted with a conventional resin cement (RelyX Ultimate) combined with a universal adhesive (Scotchbond Universal) without (SB-E) or with (SB+E) selective enamel etching. The third PCC was luted with a self-adhesive resin cement (RelyX Unicem 2; RXU). Chi-square tests (α≤0.05) were applied. Based on clinical failures (complete debonding or need for replacement of the restorations), Kaplan-Meier survival analysis was performed. Results 31 patients were evaluated clinically using FDI criteria at 39 months. Clinically acceptable results were detected over time, except for "fracture of material and retention" (inacceptable fractures and debondings). Within materials, statistically significant differences (p ≤ 0.003) between baseline and 39 months were found for "marginal adaptation" and "marginal staining". At 39-month, SB+E and SB-E showed significantly better results compared to RXU in "marginal adaptation"(p ≤ 0.021) and "marginal staining"(p ≤ 0.013). Kaplan-Meier analysis showed higher survival rates after 39 months for SB+E (96%) and SB-E (88%) compared to RXU (69%) with statistically significant differences between RXU vs. SB-E (p = 0.022) and RXU vs. SB+E (p ≤ 0.001). Conclusions After 39-months, PCCs luted with the self-adhesive resin cement exhibited a statistically significant inferior survival rate compared to restorations luted with the conventional resin cement combined with a universal adhesive without or with selective enamel etching. Clinical significance Currently, self-adhesive resin cements cannot be recommended for luting partial ceramic crowns. However, the standard adhesive luting procedure comprising a universal adhesive and luting composite yielded good clinical results for more than 3 years irrespectively of application of a selective enamel etching step.
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Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.
| | - Isabelle M Tabenski
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Private practice, Regensburg, Germany
| | - Vanessa Vogl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Private practice, Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Department of Periodontology, University of Bern, Bern, Switzerland
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Marianne Federlin
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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Par M, Spanovic N, Marovic D, Attin T, Tarle Z, Tauböck TT. Rapid high-intensity light-curing of bulk-fill composites: A quantitative analysis of marginal integrity. J Dent 2021; 111:103708. [PMID: 34077801 DOI: 10.1016/j.jdent.2021.103708] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/01/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To investigate the effect of rapid high-intensity light-curing on the marginal integrity of four bulk-fill composites, including two materials specifically designed for high-intensity curing. METHODS Class V cavities were prepared on buccal surfaces of intact human molars with simulated pulpal pressure, filled in a single increment and light-cured using a conventional (10 s @ 1,340 mW/cm2) or high-intensity (3 s @ 3,440 mW/cm2) protocol. The restorations were subjected to thermo-mechanical loading (TML) comprising 1,200,000 mechanical loading cycles and 3,000 thermocycles. Quantitative margin analysis was performed before and after TML using a scanning electron microscope, and the marginal integrity was expressed as percentage of continuous margin (PCM). RESULTS All PCM values measured before TML were statistically similar regardless of the material and curing protocol (p>0.05). A statistically significant effect of the curing protocol (p = 0.021) was identified only after TML for one material. PCM was significantly diminished by TML (p<0.001) for most combinations of material and curing protocol. The PCM values of the sculptable composites after TML were statistically similar regardless of the curing protocol (p>0.05). Compared to these values, significantly lower PCM after TML was identified for the flowable composites cured with the high-intensity protocol (p = 0.001-0.045). CONCLUSION In most cases, high-intensity and conventional curing generally led to similar marginal integrity. Although all of the investigated composites initially performed similarly well, the flowable composites light-cured using the high-intensity protocol showed a significantly inferior marginal integrity compared to the sculptable composites after loading. CLINICAL SIGNIFICANCE Rapid high-intensity light-curing cannot be recommended for flowable bulk-fill composites since it may compromise the tooth-restoration interface.
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Affiliation(s)
- Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, Zagreb, Croatia.
| | | | - Danijela Marovic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, Zagreb, Croatia.
| | - Thomas Attin
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland.
| | - Zrinka Tarle
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, Zagreb, Croatia.
| | - Tobias T Tauböck
- Department of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland.
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Yamakami SA, Sehgal S, Taylor RH, Ohyama H. Decision tree protocol for demineralized gingival margin extension in class II composite cavity preparations. J Dent Sci 2021; 16:1050-1053. [PMID: 34141130 PMCID: PMC8189868 DOI: 10.1016/j.jds.2021.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/17/2021] [Indexed: 12/02/2022] Open
Abstract
This study proposed the development of a protocol for class-II preparations with demineralized gingival margins for the improvement of the longevity of restorations. Evidence sources such as location/color/surface hardness/width of demineralized gingival margin with enamel/demineralized enamel (DE)/dentin/cementum were reviewed based on methodological studies and systematic reviews. A decision tree protocol was developed with criteria (i) lesion location: demineralized gingival margins in enamel must be removed, but if close to cementoenamel-junction, color should be evaluated. (ii) Color: yellow/brown lesions must be removed, but if white/opaque, then the surface hardness should be evaluated. (iii) Surface hardness: soft/demineralized gingival margin must be removed, but if adequately hard, width should be evaluated. (iv) Width: lesions less than half-enamel thickness and impenetrable by an explorer, remineralization is possible and the lesion does not need to be removed. A decision tree protocol was set up with the current available literature. Further continued investigations will be needed for the appropriate protocol updates.
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Affiliation(s)
- Shelyn Akari Yamakami
- Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, Brazil
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, United States
| | - Shaan Sehgal
- Harvard School of Dental Medicine, Boston, United States
| | - Russell Haywood Taylor
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, United States
| | - Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, United States
- Corresponding author. Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, United States. Fax: 617 432 0901.
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Impact of Different Etching Strategies on Margin Integrity of Conservative Composite Restorations in Demineralized Enamel. MATERIALS 2020; 13:ma13204500. [PMID: 33050594 PMCID: PMC7600983 DOI: 10.3390/ma13204500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/04/2020] [Accepted: 10/09/2020] [Indexed: 12/28/2022]
Abstract
Good margin integrity with a tight seal of the adhesive interface is considered one of the key factors for the clinical success of composite restorations. This study investigated the effect of enamel etching with phosphoric acid on the margin integrity of self-etch bonded composite restorations in demineralized enamel. Crowns of bovine incisors were assigned into 14 groups (n = 10 per group) of which ten groups (groups 1–5 and 8–12) were demineralized (21 days, acid buffer, pH 4.95) to create artificial carious lesions. Standardized Class V cavities were prepared in all specimens. Demineralized groups were either etched with phosphoric acid for 10, 30, 60, or 120 s (groups 2–5 and 9–12), or no etching was performed (groups 1 and 8). The non-demineralized (sound) groups were etched for 10 s (groups 7 and 14) or remained non-etched (groups 6 and 13). Resin composite restorations were then placed using either a one-step (iBond Self Etch, groups 1–7) or two-step self-etch adhesive (Clearfil SE Bond, groups 8–14). Margin integrity of the restorations was assessed after thermocycling (5000×, 5–55 °C) using scanning electron microscopy, and the percentage of continuous margins (%CM) was statistically analyzed (α = 0.05). Phosphoric acid etching significantly increased %CM in both demineralized and sound enamel. For iBond Self Etch, a significant increase in %CM in demineralized enamel was observed with increased etching times. All etched groups treated with Clearfil SE Bond and those etched for 60 or 120 s and treated with iBond Self Etch showed similar %CM in demineralized enamel as in etched sound enamel, and significantly higher %CM than in non-etched sound enamel. In conclusion, enamel etching with phosphoric acid improves margin integrity of composite restorations in demineralized enamel when bonded with the examined adhesives.
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Lührs AK, Jacker-Guhr S, Günay H, Herrmann P. Composite restorations placed in non-carious cervical lesions-Which cavity preparation is clinically reliable? Clin Exp Dent Res 2020; 6:558-567. [PMID: 32924312 PMCID: PMC7545222 DOI: 10.1002/cre2.310] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 11/09/2022] Open
Abstract
The purpose of this in-vivo study was to evaluate the clinical performance of restorations placed in non-carious cervical lesions (NCCLs), using different cavity preparation designs, after 7.7 years. A total of 85 NCCLs with coronal margins in enamel and cervical margins in dentin were randomly assigned to the following treatment protocols: dentin surface cleaning, dentin surface roughening with round bur plus flowable composite, dentin surface roughening/cervical groove preparation with round bur, dentin surface roughening/cervical groove preparation with round bur plus flowable composite. After enamel beveling and selective enamel etching, the defects were restored with composite. The restorations were assessed by two independent, calibrated and blinded investigators, using modified USPHS criteria. At 7 years (7.7 (± 0.35)), a total of 64 restorations (75.3%) were available for follow-up examination. The total retention rate, irrespective of the test groups, was 82.8%. Restorations placed without any preparation showed the highest loss rate (27.8%). Esthetic appearance, marginal adaptation, anatomic form and marginal discoloration did not differ significantly between the groups. Composites are long-term stable materials for restoring NCCLs. Restorations placed without any dentin preparation (cavity cleaning only) showed the highest loss rate.
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Affiliation(s)
- Anne-Katrin Lührs
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Silke Jacker-Guhr
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Hüsamettin Günay
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
| | - Peggy Herrmann
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
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