Water uptake of bonding systems applied on root dentin surfaces: a SEM and confocal microscopic study

Mapping water and monomer gradients in the adhesive/dentin interface with confocal micro-Raman imaging

OBJECTIVES

Water in the adhesive/dentin (a/d) interface plays a crucial role in the quality of the hybrid layer (HL). This study aims to directly measure depth profiles of water content and adhesive monomers within the HL and explore the relationship between adhesive hydrophilicity and water content under wet bonding conditions using two model adhesives.

METHODS

The occlusal one-third of the crown was removed from six unerupted human third molars. The exposed dentin surfaces were etched with 35 % phosphoric acid for 15 s, followed by the application of model adhesives with varying BisGMA/HEMA ratios (40/60 and 70/30) using the wet bonding technique. After light curing and 24 h of storage in water, the specimens were examined using a confocal Raman microscope under a 100x objective. Raman spectral imaging or mapping was performed at 1-micron intervals across the a/d interface in the Z direction. Reference spectra were obtained from model compounds, including type I collagen, BisGMA, HEMA, water, and the model adhesives, to generate calibration curves. These curves were then used to calculate the weight percentages of the components within the HL, which were subjected to statistical analysis (α = 0.05).

RESULTS

Raman imaging shows that the HL is not a uniform structure, exhibiting gradients in both adhesive penetration and dentin demineralization. However, water content consistently remains higher in the HL compared to both the adhesive and underlying dentin. The water content in the HL formed by the model adhesives varies between approximately 9 % and 24 %, depending on location. This water content is strongly influenced by the hydrophobicity of the adhesives, with greater water accumulation at the bottom of the HL when a more hydrophobic adhesive (BisGMA/HEMA = 70/30) is used.

SIGNIFICANCE

For the first time, the distribution of water, collagen, and adhesive within the HL has been quantified using confocal Raman microscopy combined with z-mapping. This technique allows for direct, nondestructive detection of the HL's interfacial structure and composition.

Simulated Hydrostatic Pulpal Pressure Effect on Microleakage-An Initial Study

PURPOSE

This study's purpose was to evaluate the effect of simulated in vitro hydrostatic pulpal pressure (HPP) on microleakage.

METHODS AND MATERIALS

Extracted third molars (n=12) were sectioned 5 mm below the cementoenamel junction, pulp tissue removed, and the sectioned crowns mounted on a Plexiglas plate penetrated by an 18-gauge stainless steel tube. The mounted specimen mesial surface received a 2×4×6 mm Class V preparation followed by restoration with a strongly acidic, one-step dental adhesive and a flowable microfilled resin, following all manufacturers' instructions. Restorations were finished to contour, and tubing was attached to a 20-cm elevated, 0.2% rhodamine G reservoir to the specimen steel tube for 48 hours. Specimens then received a nail polish coating to within 1 mm of the restoration margins and were placed in 2% methylene blue (MB) dye for 24 hours, followed by rinsing, embedding in epoxy resin, and sectioning into 1 mm slices using a diamond saw. Controls were intact molars (n=12) processed as above but without HPP. Specimen slices were evaluated using laser confocal microscopy with images exported to ImageJ software with microleakage assessed as the MB linear penetration as a percentage of the total interfacial wall length. Mean values were evaluated with the Kruskal Wallis/Dunn test at a 95% confidence level.

RESULTS

The control specimens demonstrated significantly greater (p<0.0001) MB penetration than experimental specimens with simulated HPP. Under this study's conditions, simulated HPP significantly decreased MB dye penetration.

CONCLUSION

Studies accomplished without simulated HPP may overestimate microleakage results.

The Effect of Different Condition of Pulpal Pressure on Microtensile Bond Strength of Several Dentin Bonding Agents on Deep and Superficial Dentin

The objective of this study was to examine the effect of different conditions of simulated hydrostatic pulpal pressure on the μTBS of HEMA-based and HEMA-free dentin bonding agents (DBAs). The influence of dentin location (deep and superficial) on μTBS was also evaluated. Flat coronal dentin surfaces of extracted human molars were prepared. Three groups of resin-bonded specimens were exposed to different pulpal pressures. Pulpal pressure was maintained for 20 min for each group. A flowable resin composite was used for coronal build-up. The bonded teeth were sectioned and, after 24 h of water storage, stressed to failure using the microtensile tester (μTBS). Failed samples were analyzed by SEM inspection. HEMA-based DBAs were much more sensitive to pulpal pressure conditions than non-HEMA-containing DBAs. Pulpal pressure had a greater influence in deep dentin. The HEMA-free DBA was insensitive to the presence or absence of pulpal pressure condition. SEM inspection confirmed a relationship between the presence of voids inside the HEMA-based DBAs layer and the lower μTBS results. HEMA-based DBAs are more sensitive to pulpal pressure conditions than HEMA-free DBAs. Interestingly, HEMA-free DBA showed a greater number of water droplets at resin–dentin interface in all tested conditions.

Effects of calcium-containing desensitizers on the bonding stability of an etch-and-rinse adhesive against long-term water storage and pH cycling

This study aimed to evaluate the effects of two calcium-containing desensitizing pastes on the bonding stability of an etch-and-rinse (E&R) adhesive to dentine. After dentine hypersensitivity model established, dentine surfaces were assigned one of the following pretreatment: Group 1, no desensitizer; Group 2, CPP-ACP; and Group 3, Novamin. Specimens were then bonded with an E&R adhesive. Beams from each tooth were randomly divided into three subgroups and then subjected to microtensile bond strength (MTBS) test after 24 h; 12 months of water storage; or 15 runs of pH cycling. Failure modes, nanoleakage, and tubule-occluding effectiveness were analyzed. Results showed that CPP-ACP- or Novamin-pretreated specimens mainly preserved the bonding strength after 12 months of water storage, while effective tubule occlusion could be observed. The results suggested that the calcium-containing desensitizers were compatible pretreatment for bonding with E&R adhesives to obtain reliable long-term bonding strength and prevention of post-operative sensitivity.

Self-Strengthening Hybrid Dental Adhesive via Visible-light Irradiation Triple Polymerization

A self-strengthening methacrylate-based dental adhesive system was developed by introducing an epoxy cyclohexyl trimethoxysilane (TS) which contains both epoxy and methoxysilyl functional groups. The experimental formulation, HEMA/BisGMA/TS (22.5/27.5/50, wt%), was polymerized by visible-light. Real-time Fourier transform infrared spectroscopy (FTIR) was used to investigate in situ the free radical polymerization of methacrylate, ring-opening cationic polymerization of epoxy, and photoacid-induced sol-gel reactions. Among the three simultaneous reactions, the reaction rate of the free radical polymerization was the highest and the hydrolysis/condensation rate was the lowest. With 40s-irradiation, the degrees of conversion of the double bond and epoxy groups at 600 s were 73.2±1.2%, 87.9±2.4%, respectively. Hydrolysis of the methoxysilyl group was initially <5%, and increased gradually to about 50% after 48 h dark storage. Photoacids generated through the visible-light-induced reaction were effective in catalyzing both epoxy ring-opening polymerization and methoxysilyl sol-gel reaction. The mechanical properties of copolymers made with TS concentrations from 5 to 35 wt% were obtained using dynamic mechanical analysis (DMA). In wet conditions, the storage moduli at 70 °C and glass transition temperature were significantly higher than that of the control (p<0.05); these properties increased with TS concentration and storage time. The post reaction of hydrolysis/condensation of alkoxysilane could provide persistent strengthening whether in a neutral or acidic environment and these characteristics could lead to enhanced mechanical properties in the oral environment. The cumulative amount of leached species decreased significantly in the TS-containing copolymers. These results provide valuable information for the development of dental adhesives with reduced leaching of methacrylate monomers and enhanced mechanical properties under the wet, oral environment.

Limitations in bonding to dentin and experimental strategies to prevent bond degradation

The limited durability of resin-dentin bonds severely compromises the lifetime of tooth-colored restorations. Bond degradation occurs via hydrolysis of suboptimally polymerized hydrophilic resin components and degradation of water-rich, resin-sparse collagen matrices by matrix metalloproteinases (MMPs) and cysteine cathepsins. This review examined data generated over the past three years on five experimental strategies developed by different research groups for extending the longevity of resin-dentin bonds. They include: (1) increasing the degree of conversion and esterase resistance of hydrophilic adhesives; (2) the use of broad-spectrum inhibitors of collagenolytic enzymes, including novel inhibitor functional groups grafted to methacrylate resins monomers to produce anti-MMP adhesives; (3) the use of cross-linking agents for silencing the activities of MMP and cathepsins that irreversibly alter the 3-D structures of their catalytic/allosteric domains; (4) ethanol wet-bonding with hydrophobic resins to completely replace water from the extrafibrillar and intrafibrillar collagen compartments and immobilize the collagenolytic enzymes; and (5) biomimetic remineralization of the water-filled collagen matrix using analogs of matrix proteins to progressively replace water with intrafibrillar and extrafibrillar apatites to exclude exogenous collagenolytic enzymes and fossilize endogenous collagenolytic enzymes. A combination of several of these strategies should result in overcoming the critical barriers to progress currently encountered in dentin bonding.

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.

A systematic method for predetermined scanning electron microscope analysis in dental science

Scanning electron microscope evaluation could be criticized if the method adopted to correct for bias is not specified in the study design. Observers can draw conclusions from images unconsciously chosen to best support their research hypotheses, impairing the basic research principle of operator's impartiality. In this study, a systematic observation method has been described and verified for repeatability. The number and the observation points on a certain specimen have been predetermined using a scheme along with observation rules previously established in the research protocol. When our instrument is used at an operating magnification between 500x and 1,000x (corresponding to a frame of 250x190 micro and 120x90 micro, respectively), the method allowed 100% repeatable observation frames, with linear frame errors in finding an observation point of 12.5% in length and 16.8% in height. With modifications to accommodate research objective and statistical requirements, the method could be applied to many SEM observation study.

Application of hydrophobic resin adhesives to acid-etched dentin with an alternative wet bonding technique

Hydrophilic dentin adhesives are prone to water sorption that adversely affects the durability of resin-dentin bonds. This study examined the feasibility of bonding to dentin with hydrophobic resins via the adaptation of electron microscopy tissue processing techniques. Hydrophobic primers were prepared by diluting 2,2-bis[4(2-hydroxy-3-methacryloyloxy-propyloxy)-phenyl] pro- pane/triethyleneglycol dimethacrylate resins with known ethanol concentrations. They were applied to acid-etched moist dentin using an ethanol wet bonding technique that involved: (1) stepwise replacement of water with a series of increasing ethanol concentrations to prevent the demineralized collagen matrix from collapsing; (2) stepwise replacement of the ethanol with different concentrations of hydrophobic primers and subsequently with neat hydrophobic resin. Using the ethanol wet bonding technique, the experimental primer versions with 40, 50, and 75% resin exhibited tensile strengths which were not significantly different from commercially available hydrophilic three-step adhesives that were bonded with water wet bonding technique. The concept of ethanol wet bonding may be explained in terms of solubility parameter theory. This technique is sensitive to water contamination, as depicted by the lower tensile strength results from partial dehydration protocols. The technique has to be further improved by incorporating elements of dentin permeability reduction to avoid water from dentinal tubules contaminating water-free resin blends during bonding.

Assessment of in vitro methods used to promote adhesive interface degradation: a critical review

One factor that has a great influence on clinical performance of dental restorations is their resistance to degradation. Morphological changes in the structure of tooth-restoration interface aged in the oral environment have been reported. However, even though the in vivo performance is the ultimate testing environment for predicting the behavior of restorations because of the complexity of intraoral conditions, in vitro models such as thermocycling, mechanical loading, pH cycling, and aging of materials in distilled water, NaOCl, and food-simulating solutions may provide important information about the fundamental mechanisms involved in resin-tooth interface degradation. Most recently, the effect of host-derived enzymes and the storage in deproteinizing solutions (such as aqueous NaOCl) on the degradation of resin-dentin bonds has also been described. This review considers the importance of these in vitro methods on bond durability interface in an attempt to understand the behavior of restoratives over time. The first section is focused on the mechanism of in vivo biodegradation, whereas the second looks at studies that have described the influence of water storage, NaOCl storage, host-derived matrix metalloproteinases, thermocycling, mechanical loading, pH cycling, and food-simulating solutions on the degradation of the adhesive interface. It is obvious that these methodologies do not occur separately in the oral cavity, but that each one has a specific importance in the mechanisms of bond degradation.

CLINICAL SIGNIFICANCE

The in vitro methods used to simulate bond degradation may describe important points related to the clinical performance of restorations. This article evaluates the mechanism of the in vivo biodegradation of adhesive interfaces as well as the influences that various testing methods have on these bonds.

Effects of water content and initiator composition on photopolymerization of a model BisGMA/HEMA resin

AIMS

The purpose of this study was to evaluate the effects of photoinitiator type and water content on the polymerization rate (Rp) and degree of conversion (DC) of a model BisGMA/HEMA-based resin.

MATERIALS AND METHODS

The comonomer mixture consisted of BisGMA/HEMA (60/40 by weight). Different two- or three-component photoinitiator systems were incorporated. Two-component systems were 0.5% CQ (camphorquinone) and 0.5% DMAEMA (2-(dimethylamino) ethyl methacrylate) or 0.5% CQ and 0.5% 4E (ethyl 4-dimethylaminobenzoate). The three-component systems were added 1% DPIHP (diphenyliodonium hexafluorophosphate) to the above systems. Each system was tested as made, or after addition of 5, 10, 15wt% water. When cured under a conventional dental light, the Rp and DC of each formulation was determined using time-resolved attenuated total reflection (ATR)-Fourier transform infrared (FTIR) spectroscopy.

RESULTS

For mixtures containing two-component initiator systems, when the hydrophobic initiator CQ was used in combination with hydrophilic DMAEMA, Rps and DCs were dramatically decreased as a function of water content. The Rps and DCs of the hydrophobic CQ/4E system were higher than those of the CQ/DMAEMA system in the presence of water. For three-component initiator systems, incorporation of DPIHP enhanced the polymerization of all mixtures in the presence of water compared to their counterpart two-component initiators. Interestingly, the CQ/DMAEMA caused greater DC and Rp when DPIHP was used.

SIGNIFICANCE

The hydrophobicity/hydrophilicity of photoinitiator components significantly affects both the DC as well as Rp when in the presence of water. The results indicate that formulation of photoinitiator components should be based on the effectiveness of the bonding systems under both dry and wet conditions.

Effect of simulated pulpal pressure on dentin permeability and adhesion of self-etch adhesives

OBJECTIVES

Dentin bonds made with one-bottle etch-and-rinse and self-etch adhesives are affected by the formation of interfacial blisters, porosities and deterioration. The first objective of this study was to evaluate the fluid flow through resin-dentin interfaces created by self-etching adhesives applied to deep dentin using a replica technique and by directly measuring dentin permeability (P). The second objective was to examine the effect of intrapulpal pressure on the microtensile bond strength of these adhesives.

METHODS

A fluid-transport model was used to measure the fluid permeability (%P) through different adhesives. Impressions of bonded dentin were taken with a polyvinylsiloxane impression material to monitor fluid transudation from the surface of the adhesive. Positive replicas were fabricated for SEM examination. Two groups of resin-bonded specimens (pulpal pressure versus no pulpal pressure) were created for microtensile bond strength evaluation. Adhesive application was performed under 0 cm H(2)O. Pulpal pressure group was submitted to 20 cm H(2)O of pulpal pressure during build-up procedures.

RESULTS

Clearfil Protect Bond exhibited the lowest permeability and fewest numbers of fluid droplets over the surface of the bonded dentin. G-Bond and Clearfil-S3 Bond were more permeable than Clearfil Protect Bond. One Up Bond F was the most permeable adhesive. A highly significant correlation was observed between the relative permeability of these adhesives (%P) and the number of fluid droplets on the adhesive surfaces. The application of pulpal pressure significantly reduced bond strength.

SIGNIFICANCE

Resin-dentin bonds created by contemporary self-etch adhesives are susceptible to fluid permeation induced by pulpal pressure. HEMA-based adhesives showed the largest reductions in bond strengths after pulpal pressure application.