A 2-year evaluation of moisture on microtensile bond strength and nanoleakage

A piezoelectric-driven nanoindentation system for scanning electron microscope with improved analog compensation method

This paper presents a novel piezoelectric-driven nanoindentation system for a scanning electron microscope (SEM) with an improved analog compensation (IAC) method. This system mainly consists of a piezoelectric-driven indenter head, a rectangle-shaped transducer, and a nanopositioner module. Compared with the state-of-the-art piezoelectric-driven nanoindentation system with a circle-shaped transducer, the proposed nanoindentation system is capable of multi-direction operation inside a SEM with a rectangle-shaped transducer. Self-matched semiconductor strain gauges are selected as the position sensor for the piezoelectric-actuator. The Wheatstone bridge output voltage cannot achieve a zero temperature coefficient because the temperature coefficients of self-matched semiconductor strain gauge pairs become significantly different from each other after installation in practice. An IAC method is proposed to compensate the temperature coefficients further. Compared with the existing analog compensation method, the IAC method solves the problem of amplifier saturation and improves the sensitivity of the self-matched semiconductor strain gauge pairs position sensor by 27%. The multi-direction operation results inside a standard SEM HITACHI SU5000 validate the advantage of the developed nanoindentation system.

Effect of irradiance and exposure time on the adhesive properties of universal adhesives after 2 years of storage

OBJECTIVE

This study aims to evaluate the effects of exposure time and irradiance on the dentin bonding properties (microtensile bond strength (μTBS) and nanoleakage (NL)) of the Clearfil Universal Bond Quick (CUQ) adhesive and Scotchbond Universal Adhesive (SBU) immediately and after 2 years of water storage.

MATERIAL AND METHODS

Hence, 128 human molars were randomly assigned to 16 groups based on adhesive strategy, irradiance/exposure times, and storage time for each universal adhesive tested. The adhesives were applied using the etch-and-rinse and self-etch strategies and were light-cured using four different irradiance/exposure times: 1400 mW/cm2 for 5 s (1400 × 5), 1400 mW/cm2 for 10 s (1400 × 10), 3200 mW/cm2 for 5 s (3200 × 5), and 3200 mW/cm2 for 10 s (3200 × 10). Then, each sample was restored and sectioned into a resin-dentin bonded stick to be tested for μTBS and NL (immediately and after 2 years of water storage). The mean μTBS and NL of all resin-dentin bonded sticks from the same hemi-tooth (factor time) were statistically analyzed using a three-way ANOVA and Tukey's test (a = 0.05).

RESULTS

Despite a significant decrease in the μTBS values for all groups after 2 years of water storage, the 3200 × 5 group showed higher μTBS values, whereas the 3200 × 10 group showed lower μTBS values for both universal adhesives tested. Although a significant increase in the NL values was observed for all groups after 2 years of water storage, the 3200 × 10 group showed higher NL values than the other groups (p < 0.001).

CONCLUSION

Results indicate that light-curing the adhesive layer with 14-16 J/cm2 led to an improvement in the stability of the resin-dentin adhesive interface. A longer exposure time (10 s) coupled with a higher irradiance (3200 mW/cm2) resulted in a greater degree of degradation of the adhesive interface.

CLINICAL SIGNIFICANCE

To guarantee better stability of the adhesive interface, clinicians could be preferred a light-cured universal adhesive layer with 14-16 J/cm2. Higher irradiances should be avoided.

Insight into the development of versatile dentin bonding agents to increase the durability of the bonding interface

Despite the huge improvements made in adhesive technology over the past 50 years, there are still some unresolved issues regarding the durability of the adhesive interface. A complete sealing of the interface between the resin and the dentin substrate remains difficult to achieve, and it is doubtful whether an optimal interdiffusion of the adhesive system within the demineralized collagen framework can be produced in a complete and homogeneous way. In fact, it is suggested that hydrolytic degradation, combined with the action of dentin matrix enzymes, destabilizes the tooth-adhesive bond and disrupts the unprotected collagen fibrils. While a sufficient resin–dentin adhesion is usually achieved immediately, bonding efficiency declines over time. Thus, here, a review will be carried out through a bibliographic survey of scientific articles published in the last few years to present strategies that have been proposed to improve and/or develop new adhesive systems that can help prevent degradation at the adhesive interface. It will specially focus on new clinical techniques or new materials with characteristics that contribute to increasing the durability of adhesive restorations and avoiding the recurrent replacement restorative cycle and the consequent increase in damage to the tooth.

Influence of Irradiance and Exposure Times on the Mechanical and Adhesive Properties of Universal Adhesives with Dentin

OBJECTIVES

This study evaluated the influence of irradiance/exposure time on the Knoop hardness (KHN) and polymer cross-linking density (PCLD), as well as microtensile bond strength (μTBS), nanoleakage (NL), and in situ degree of conversion (DC) of universal adhesives.

METHODS AND MATERIALS

Two universal adhesive systems, Clearfil Universal Bond Quick (CUQ) and Scotchbond Universal Adhesive (SBU), were light-cured using various irradiance/exposure times: 1400 mW/cm2 for 5 s (1400*5); 1400 mW/cm2 for 10 s (1400*10); 3200 mW/cm2 for 5 s (3200*5); and 3200 mW/cm2 for 10 s (3200*10). Adhesive disks from each group were used to measure PCLD by KHN. One hundred and twenty-eight human molars were randomly assigned to 16 groups according to the following variables: adhesive system vs adhesive strategies vs radiance/exposure times. After restoration, specimens were sectioned into resin-dentin sticks and tested for μTBS, NL, and DC. The data from PCLD (%), KHN, μTBS (MPa), NL (%), and DC (%) data were subjected to ANOVA and Tukey's test (α=0.05).

RESULTS

Significant reductions in KHN, μTBS, and DC (p=0.00001) values and an increase in NL and PCLD (p=0.00001) values were observed for 3200*10 when compared with other groups. Higher KHN, μTBS, and DC (p=0.000001) values were observed for 3200*5 in comparison with the other groups. The 1400*5 (7 J/cm2) and 1400*10 (14 J/cm2) groups showed intermediate values (p=0.000001).

CONCLUSION

Although similar results in terms of hardness, polymer cross-linking density and nanoleakage were observed when 5 seconds at 3200 mW/cm2 and 10 seconds at 1400 mW/cm2 groups were compared, the use of higher irradiance (3200 mW/cm2) for only 5 seconds showed better results in terms of bond strength and degree of conversion for both universal adhesives to dentin. The prolonged exposure time (10 seconds) at the higher irradiance (3200 mW/cm2) showed the worst results.

Evaluation of composite restorations in primary molars subjected to selective caries removal associated with antimicrobial photodynamic therapy: A randomized controlled trial

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) has been used as an adjunct treatment of deep caries lesions; however, studies on the effects of aPDT on the longevity of restorations are still limited.

AIM

To evaluate the clinical performance of composite restorations in primary molars subjected to selective caries removal (SCR) associated with aPDT.

DESIGN

A randomized clinical trial was designed. Primary molars of patients (mean age 6.15 years) with deep caries lesions without signs and symptoms of pulpal involvement were selected. A total of 64 teeth were randomly divided into groups G1 (SCR, 32 teeth) and G2 (SCR + aPDT, 32 teeth) for treatment, restored with composite, and evaluated after a week (T₀ ), 6 months (T₁ ), and 12 months (T₂ ) according to the criteria of FDI. Groups were compared using the Rao-Scott chi-squared test and the logistic regression analysis for complex designs to account for multiple observations per subject (alpha = 0.05).

RESULTS

From all FDI criteria evaluated, the marginal adaptation for the SCR + aPDT group was significantly better in comparison with the SCR group at T0 and T2 in the logistic regression analysis (T0: OR = 0.151; 95% CI = 0.03-0.068, P = .015; and T2: OR = 0.201; 95% CI = 0.05-0.79, P = .022).

CONCLUSION

The marginal adaptation of primary molar resin restorations was positively affected by aPDT after 12 months of follow-up.

Does the Application of Additional Hydrophobic Resin to Universal Adhesives Increase Bonding Longevity of Eroded Dentin?

This paper evaluates the effect of an additional hydrophobic resin coat (extra HL) associated with universal adhesives on sound and eroded dentin and evaluated immediately or after 2 years of water storage to improve the microtensile bond strength (μTBS) and nanoleakage (NL) when compared to the use of universal adhesives only. Sixty-four molars were assigned to eight groups using the following combinations: 1. dentin substrate, including sound and eroded dentin; 2. treatment, including the control and extra HL and storage time (immediately and after two-years of storage). Two universal adhesives (Prime & Bond Active or Scotchbond Universal) were evaluated. Before restoration, half of the teeth were subjected to soft-drink erosion. Composite buildups were bonded; specimens were stored (37 °C/24 h), sectioned into resin−dentin bonded sticks and tested for microtensile bond strength and nanoleakage using SEM (immediately and after two-years of storage). Three-way ANOVA and Tukey’s test (α = 0.05%) were used. In the immediate testing, the application of extra HL did not increase microtensile bond strength values compared with the control group in either substrate (p > 0.05). However, extra HL significantly decreased nanoleakage values when applied to eroded and sound dentin (p = 0.0001). After two years, the application of extra HL produced significantly higher microtensile bond strength and lower nanoleakage values than the control group for both adhesives (p = 0.0001). In all cases, sound dentin showed higher microtensile bond strength and lower nanoleakage values than eroded dentin (p = 0.000001). An extra HL increased the bond strength and reduced nanoleakage in eroded dentin after two-years of storage.

Collagen cross-linking agents + dimethyl sulfoxide improving the adhesive properties of erosive lesion dentin

To investigate the effect of the dimethyl sulfoxide combined with cross-linking agents on microtensile bond strength, silver nitrate penetration and in situ degree of conversion analysis of adhesives to the erosive dentin treatment with Cola-based soft drink. One hundred and sixty-six molars were assigned to 20 groups: (1) Treatment: Sound dentin; Erosive dentin; Erosive dentin treated with primer of dimethyl sulfoxide; Erosive dentin treated with DMSO primer containing proanthocyanidin and rivoflavin; (2) Adhesive systems: iBond Universal and Scotchbond Universal; and (3) adhesive strategy: etch-and-rinse or self-etch strategy. After restoration, specimens were sectioned into sticks to be tested. The data from microtensile bond strength (MPa), silver nitrate penetration (%) and in situ degree of conversion (%) were analyzed by (three- and two-factor ANOVA; Tukey's test α=5%). The application of dimethyl sulfoxide combined of not with cross-linkers improved all properties evaluated when compared to only erosive dentin treatment with Cola-based soft drink. However, only when dimethyl sulfoxide was combined to cross-linkers, the values of the microtensile bond strength, silver nitrate penetration and in situ degree of conversion in erosive dentin treatment with Cola-based soft drink was similar to sound dentin, for both adhesives and adhesive strategies. The application of dimethyl sulfoxide combined with the collagen cross-linking agent contributed to increasing the bond strength and degree of conversion in erosive lesion dentin, at the same time that significantly reduction of nanoleakage in this substrate.

Dry bonding to dentin: Broadening the moisture spectrum and increasing wettability of etch-and-rinse adhesives

OBJECTIVE

To determine whether the effect of dentin moisture on the etch-and-rinse bonding may be minimized by dry-bonding protocols utilizing aqueous or ethanolic dimethyl sulfoxide (DMSO) pretreatments.

METHODS

H₃PO₄-etched mid-coronal dentin surfaces from human molars were randomly blot- or air-dried for 30 s and pretreated with DMSO/H₂O or DMSO/EtOH solutions. Untreated samples served as control. Moisture control was performed by either blot- or air-drying. Samples were bonded with a multistep etch-and-rinse adhesive. Restored crown segments (n = 8/group) were stored in distilled water for 24 h and sectioned for microtensile bond strength testing. Resin-dentin beams (0.8 mm²) were tested under tension until fracture (0.5 mm/min) after 24 h and two years of storage in artificial saliva at 37 °C. SEM nanoleakage evaluation was performed on aged samples. Collagen wettability was also measured by sessile drops of the hydrophilic and hydrophobic bonding resins (n = 8/group). Data were examined by factorial ANOVA followed by the Tukey test (α = 0.05).

RESULTS

Dry bonding to untreated collagen produced inferior immediate and long-term bond strengths than wet bonding (p < 0.05). Regardless of initial hydration and moisture control, DMSO-dry bonding produced initially higher and stable bond strengths after aging (p < 0.05). DMSO-pretreated groups presented improved collagen wettability with lower silver uptake (p < 0.05).

SIGNIFICANCE

Despite the common belief that etch-and-rinse adhesives must be applied onto moist collagen, DMSO-dry bonding protocols not only improved bonding performance and hybrid layer integrity, but also brought more versatility to collagen hybridization by reducing overdrying-related issues.

Effect of epigallocatechin-3- gallate solutions on bond durability at the adhesive interface in caries-affected dentin

Hydrolytic and enzymatic degradation by matrix metalloproteinases (MMPs) reduces the durability of composite resin restorations on caries-affected dentin (CAD). The use of MMP inhibitors such as epigallocatechin-3-gallate (EGCG) could increase the longevity of the bond to dentin. This study aimed to evaluate the use of EGCG at different aqueous concentrations on the resin-dentin microtensile bond strength (μTBS), fracture pattern and nanoleakage (NL) in immediate (IM) time interval and after 12-months of water storage (1Y) when using a two-step etch-and-rinse adhesive system on CAD. Dentin surfaces of 40 human molars were submitted to a microbiological caries induction protocol and randomized into 5 groups (n = 8) (0.02% EGCG; 0.2% EGCG; 0.5% EGCG; 2% Chlorhexidine [CHX] and no treatment as Control Group - [NT]). After acid etching, the solutions were applied for 60 s followed by application of dental adhesive (Adper Single Bond 2, 3 M ESPE) to CAD surfaces. Subsequently, a resin composite (4 mm) block was built on the dentin. After 24 h, the teeth were sectioned into beam-shaped specimens (cross-sectional area of 1 mm² and 8-mm high). Half of the specimens were tested in IM and the other half after 1Y. Two samples per tooth were submitted to SEM for NL evaluation. Data were statistically analyzed by two-way ANOVA and Tukey tests (α = 0.05). The results showed that use of EGCG and CHX did not affect μTBS in IM (p > 0.05). After 1Y, there was a reduction in μTBS for all experimental groups (p < 0.05). Adhesive fractures predominated in IM in all groups, except for 0.05% EGCG and NT. After 1Y, there was an increase in these adhesive fractures in all groups. For NL, all agents applied reduced NL in comparison with CT (p < 0.001). CHX showed lower NL (p < 0.001), followed by 0.02% and 0.5% EGCG. NT showed highest NL for both time intervals (p < 0.001). Thus, although the use of EGCG at different concentrations and CHX reduced the NL, they were unable to reduce degradation of μTBS to CAD over time.

Three-Year Effects of Deproteinization on the In Vitro Durability of Resin/Dentin-Eroded Interfaces

Objective:

To evaluate the effect of sodium hypochlorite on the immediate and three-year bonding properties of a resin-eroded dentin interface produced by one of two adhesive strategies.

Methods and Materials:

Forty-eight molars were randomly assigned to six experimental groups, according to the combination of the adhesive strategy (etch-and-rinse and self-etch) and the dentin surface (control groups without erosion, eroded dentin surface [ED], and eroded dentin surface + NaOCl 5.2% [ED + NaOCl]). After completing restoration, specimens were stored in water (37°C) for 24 hours and then sectioned into resin–dentin beams (0.8 mm2) to be tested under tension (0.5 mm/min) immediately thereafter or after three years of water storage. To assess nanoleakage (NL), specimens were immersed in silver nitrate solution and examined by scanning electron microscopy at both time points. The dentin-etching pattern was examined under a scanning electron microscope. Data were subjected to appropriate statistical analysis (α=0.05)

Results:

In both strategies, a more pronounced and significant reduction of the microtensile bond strength (μTBS) values was observed for the ED groups (p=0.0001) after three years. However, in the ED + NaOCl group, μTBS values were maintained after three years of water storage. Furthermore, application of NaOCl to eroded dentin significantly reduced the immediate NL values and also preserved these values after three years of water storage for both adhesive strategies (p&gt;0.05). When considering the ED group, a superficial removal of the smear layer and enlarged lumen tubules in comparison to control were present. However, for ED + NaOCl, there was a total removal of the smear layer and significant numbers of collagen fibrils were exposed.

Conclusion:

The use of NaOCl may maintain the long-term stability of a resin-eroded dentin interface formed by etch-and-rinse and self-etch adhesives.

The role of copper nanoparticles in an etch-and-rinse adhesive on antimicrobial activity, mechanical properties and the durability of resin-dentine interfaces

OBJECTIVES

To evaluate the effect of addition of copper nanoparticles at different concentrations into an etch-and-rinse adhesive (ER) on antimicrobial activity, Knoop microhardness (KHN), in vitro and in situ degree of conversion (DC), as well as the immediate (IM) and 2-year (2Y) resin-dentine bond strength (μTBS) and nanoleakage (NL).

METHODS

Seven experimental ER adhesives were formulated according to the amount of copper nanoparticles incorporated into the adhesives (0 [control], 0.0075 to 1wt.%). We tested the antimicrobial activity of adhesives against Streptococcus mutans using agar diffusion assay after IM and 2Y. The Knoop microhardness and in vitro DC were tested after IM and 2Y. The adhesives were applied to flat occlusal dentine surfaces after acid etching. After resin build-ups, specimens were longitudinally sectioned to obtain beam-like resin-dentine specimens (0.8mm²), which were used for evaluation of μTBS and nanoleakage at the IM and 2Y periods. In situ DC was evaluated at the IM period in these beam-like specimens. Data were submitted to appropriate statistical analyses (α=0.05).

RESULTS

The addition of copper nanoparticles provided antimicrobial activity to the adhesives only in the IM evaluation and slightly reduced the KHN, the in vitro and in situ DC (copper concentrations of 1wt.%). However, KHN increase for all concentrations after 2Y. After 2Y, no significant reductions of μTBS (0.06 to 1% wt.%) and increases of nanoleakage were observed for copper containing adhesives compared to the control group.

CONCLUSION

Copper nanoparticles addition up to 0.5wt.% may provide antimicrobial properties to ER adhesives and prevent the degradation of the adhesive interface, without reducing the mechanical properties of the formulations.

Collagen cross-linkers on dentin bonding: Stability of the adhesive interfaces, degree of conversion of the adhesive, cytotoxicity and in situ MMP inhibition

OBJECTIVE

To investigate the effect of collagen cross-links on the stability of adhesive properties, the degree of conversion within the hybrid layer, cytotoxicity and the inhibition potential of the MMPs' activity.

METHODS

The dentin surfaces of human molars were acid-etched and treated with primers containing: 6.5wt% proanthocyanidin, UVA-activated 0.1wt% riboflavin, 5wt% glutaraldehyde and distilled water for 60s. Following, dentin was bonded with Adper Single Bond Plus and Tetric N-Bond; and restored with resin composite. The samples were sectioned into resin-dentin "sticks" and tested for microtensile bond strength (μTBS) after immediate (IM) and 18-month (18M) periods. Bonded sticks at each period were used to evaluate nanoleakage and the degree of conversion (DC) under micro-Raman spectroscopy. The enzimatic activity (P1L10 cross-linkers, P1L22 MMPs' activities) in the hybrid layer was evaluated under confocal microscopy. The culture cell (NIH 3T3 fibroblast cell line) and MTT assay were performed to transdentinal cytotoxicity evaluation. Data from all tests were submitted to appropriate statistical analysis (α=0.05).

RESULTS

All cross-linking primers reduced the degradation of μTBS compared with the control group after 18M (p>0.05). The DC was not affected (p>0.213). The NL increased after 18M for all experimental groups, except for proanthocyanidin with Single Bond Plus (p>0.05). All of the cross-link agents reduced the MMPs' activity, although this inhibition was more pronounced by PA. The cytotoxicity assay revealed reduced cell viability only for glutaraldehyde (p<0.001).

SIGNIFICANCE

Cross-linking primers used in clinically relevant minimized the time degradation of the μTBS without jeopardizing the adhesive polymerization, as well as reduced the collagenolytic activity of MMPs. Glutaraldeyde reduced cell viability significantly and should be avoided for clinical use.

Effect of Minocycline on the Durability of Dentin Bonding Produced with Etch-and-Rinse Adhesives

OBJECTIVES

To evaluate the effect of minocycline and chlorhexidine pretreatment of acid-etched dentin on the longevity of resin-dentin bond strength (μTBS) and nanoleakage of two-step etch-and-rinse adhesives.

METHODS

Before application of Prime & Bond NT and Adper Single Bond 2 in occlusal dentin, the dentin surfaces were treated with 37% phosphoric acid, rinsed, air-dried, and rewetted with water (control group), 2% minocycline, or 2% chlorexidine digluconate. Composite buildups were constructed incrementally, and specimens were longitudinally sectioned to obtain bonded sticks (0.8 mm²) to be tested in tension (0.5 mm/min) immediately or after 24 months of water storage. For nanoleakage, two specimens of each tooth/period were immersed in the silver nitrate solution, photo-developed, and polished with SiC paper for analysis under energy-dispersive X-ray spectroscopy/scanning electron microscopy.

RESULTS

Reductions of the μTBS and increases in the nanoleakage were observed for both adhesives when the rewetting procedure was performed with water. Stable bonds were observed for the 2% minocycline and 2% chlorexidine digluconate groups after 24 months.

CONCLUSIONS

The use of 2% minocycline as pretreatment of acid-etched dentin is one alternative to retard the degradation of resin-dentin interfaces over a 24-month period as well as 2% chlorexidine digluconate.

The effect of proanthocyanidin-containing 10% phosphoric acid on bonding properties and MMP inhibition

OBJECTIVES

This study evaluated the effect of etching using 2% proanthocynidin-containing 10% phosphoric acid 2% PA/10% PhA vs. 35% phosphoric acid 35% PhA on immediate (IM) and 6-months (6M) resin-enamel microshear bond strength (μSBS), resin-dentin microtensile bond strength (μTBS), nanoleakage (NL) and as well as in situ MMP inhibition potential.

METHODS

The dentin surface of human were exposed and then etched using 35% phosphoric acid for 15s or 2% PA/10% phosphoric acid for 30s. After rinsing with water, the dentin was bonded with Single Bond Plus (3M ESPE) and composite build-ups were constructed, followed by polymerization. The teeth were sectioned and the bonds were testing for microtensile bond strength (μTBS) and by SEM for NL analysis at IM and 6M. For MMP activity, resin-dentin slices were prepared for in situ zymography, and analyzed under confocal microscopy. For μSBS, others teeth had flattened enamel surfaces etched according the experimental groups and prepared to microshear procedure. The specimens were tested IM and after 6M by microshear bond strength. The data were submitted to two-way repeated measures ANOVA and Tukey's test (α=0.05).

RESULTS

Acid-etching using the 2% PA/10% phosphoric acid did not lower the μTBS in IM (p>0.05) compared to the control 35% phosphoric acid group. However, after 6M, only the 2% PA/10% PhA etched dentin had remained stable the resin-dentin bond strength (p<0.05). Bonds made with 35% PhA showed significant increase in NL% after 6M (p<0.05). Dentin bonds made with 2% PA/10% phosphoric acid showed no increase in NL% after 6 months. The MMP activity within the resin-dentin interface was almost completely reduced after 2% PA/10% PhA etching, while the 35% PhA exhibited intense MMP activity. For μSBS, the type of etchant and the storage period did not affect the resin-enamel bond strengths (p>0.05).

SIGNIFICANCE

Ten percent phosphoric acid containing 2% PA can produce stable resin-dentin and enamel-resin interfaces, without requiring additional steps in the bonding procedure. Future studies for longer evaluation time are required.

The effect of saliva decontamination procedures on dentin bond strength after universal adhesive curing

Objectives

The purpose of this study was to investigate the effectiveness of multiple decontamination procedures for salivary contamination after curing of a universal adhesive on dentin bond strength according to its etch modes.

Materials and Methods

Forty-two extracted bovine incisors were trimmed by exposing the labial dentin surfaces and embedded in cylindrical molds. A universal adhesive (All-Bond Universal, Bisco) was used. The teeth were randomly divided into groups according to etch mode and decontamination procedure. The adhesive was applied according to the manufacturer's instructions for a given etch mode. With the exception of the control groups, the cured adhesive was contaminated with saliva for 20 sec. In the self-etch group, the teeth were divided into three groups: control, decontamination with rinsing and drying, and decontamination with rinsing, drying, and adhesive. In the etch-and-rinse group, the teeth were divided into four groups: control, decontamination with rinsing and drying, decontamination with rinsing, drying, and adhesive, and decontamination with rinsing, drying, re-etching, and reapplication of adhesive. A composite resin (Filtek Z350XT, 3M ESPE) was used for filling and was cured on the treated surfaces. Shear bond strength was measured, and failure modes were evaluated. The data were subjected to one-way analysis of variation and Tukey's HSD test.

Results

The etch-and-rinse subgroup that was decontaminated by rinse, drying, re-etching, and reapplication of adhesive showed a significantly higher bond strength.

Conclusions

When salivary contamination occurs after curing of the universal adhesive, additional etching improves the bond strength to dentin.

Influence of a hydrophobic resin coating on the immediate and 6-month dentin bonding of three universal adhesives

OBJECTIVE

To test the influence of a hydrophobic resin coating (HC) on the immediate (24h) and 6-month (6m) microtensile dentin bond strengths (μTBS) and nanoleakage (NL) of three universal adhesives applied in self-etch (SE) or in etch-and-rinse (ER) mode.

METHODS

Sixty caries-free extracted third molars were assigned to 12 experimental groups resulting from the combination of the factors "adhesive system" (Scotchbond Universal Adhesive [SBU], 3M ESPE; All-Bond Universal [ABU], Bisco Inc.; and G-Bond Plus [GBP], GC Corporation); "adhesive strategy" (SE or ER); "hydrophobic resin coating" [HC] (with or without Heliobond, Ivoclar Vivadent); and "storage time" (24h or 6m). Specimens were prepared for μTBS testing - (24h) half of the beams were immediately tested under tension; and (6m) the other half was stored in distilled water (37°C) for 6m prior to testing. For each tooth, two beams were randomly selected for NL evaluation for both evaluation times. Data were analyzed for each adhesive system using three-way ANOVA and Tukey's post-hoc test (α=0.05).

RESULTS

μTBS: (24h): In SE mode, HC resulted in statistically greater mean μTBS for all adhesives. (6m): When HC was not used the mean μTBS for SBU/ER, ABU/ER, GBP/ER and SBU/SE decreased significantly. NL: (24h): SBU/ER, ABU/ER and GBP/SE resulted in a significant reduction in NL when HC was applied. (6m): No significant reduction was observed for SBU/ER or for SBU/SE regardless of the use of HC.

SIGNIFICANCE

The application of a hydrophobic resin coating improved the 24h and the 6m performances of all three adhesives systems in SE mode.

In vitro longevity of bonding properties of universal adhesives to dentin

PURPOSE

To evaluate the immediate and 6-month resin-dentin bond strength (μTBS) and nanoleakage (NL) of universal adhesives that contain or do not contain methacryloyloxydecyl dihydrogen phosphate (MDP) and are used in the etch-and-rinse and self-etch strategies.

METHODS AND MATERIALS

Forty caries-free extracted third molars were divided into eight groups for μTBS (n=5). The groups were bonded with the Clearfil SE Bond (CSE) and Adper Single Bond 2 (SB) as controls; Peak Universal, self-etch (PkSe) and etch-and rinse (PkEr); Scotchbond Universal Adhesive, self-etch (ScSe) and etch-and-rinse (ScEr); and All Bond Universal, self-etch (AlSe) and etch-and-rinse (AlEr). After composite restorations, specimens were longitudinally sectioned to obtain resin-dentin bonded sticks (0.8 mm(2)). The μTBS of the specimens was tested immediately (IM) or after 6 months of water storage (6M) at 0.5 mm/min. Some sticks at each storage period were immersed in silver nitrate and photo developed, and the NL was evaluated with scanning electron microscopy. Data were analyzed with two-way repeated-measures analysis of variance and Tukey test (α=0.05).

RESULTS

At the IM period, PkSe and PkEr showed μTBS similar to the control adhesives (p>0.05) but increased NL pattern and lower μTBS after 6M (p<0.05). ScSe and ScEr showed intermediary μTBS values at the IM period but remained stable after 6 months (p>0.05). AlSe showed the lowest μTBS (p<0.05), but μTBS and NL remained stable after 6M (p>0.05). AlEr showed higher IM μTBS but showed higher degradation after 6M (p<0.05).

CONCLUSIONS

Universal adhesives that contain MDP showed higher and more stable μTBS with reduced NL at the interfaces after 6 months of water storage.

Short-and long-term bond strengths of a gold standard two-step self-etch adhesive system to dentin: a preliminary study

Purpose:

The aim of this study was to investigate the micro tensile bond strength of a self-etch adhesive system following 1 year storage in water.

Materials and Methods:

10 sound human molar teeth were used for micro tensile bond strength test. Twostep self-etch dentin adhesive (Clearfil SE Bond®) was applied to the flat dentin surfaces according to the manufacturer’s instructions. Composite blocks (Z- 250; 3M ESPE) of 5 mm in height have been prepared by using layering technique. Teeth were stored in water for 24 hours at 37°C and longitudinally sectioned to obtain dentin sticks of 1 mm2.Randomly selected samples from half of the teeth were immediately subjected to micro tensile test and. Remaining specimens were tested after 1 year storage in water. Bond strengths were calculated in megapascal (MPa).

Results:

Means and standard deviations of the Clearfil SE Bond® micro tensile bond strength values were, respectively, 37.31 ± 13.77 MPa and 24.78 ± 2.99 MPa after 24 h and 1 year of storage in water. The difference was statistically significant (p=0.031).

Conclusion:

Long-term storage in water decreased the micro tensile bond strength values of the twostep self-etch adhesive which has been accepted as the gold standard in bond strength tests.

Potential role of surface wettability on the long-term stability of dentin bonds after surface biomodification

Degradation of the adhesive interface contributes to the failure of resin composite restorations. The hydrophilicity of the dentin matrix during and after bonding procedures may result in an adhesive interface that is more prone to degradation over time. This study assessed the effect of chemical modification of the dentin matrix on the wettability and the long-term reduced modulus of elasticity (Er) of adhesive interfaces. Human molars were divided into groups according to the priming solutions: distilled water (control), 6.5% Proanthocyanidin-rich grape seed extract (PACs), 5.75% 1-ethyl-3-[3-dimethylaminopropyl] carbodiimide hydrochloride/1.4% n-hydroxysuccinimide (EDC/NHS) and 5% Glutaraldehyde (GA). The water-surface contact angle was assessed before and after chemical modification of the dentin matrix. The demineralized dentin surface was treated with the priming solutions and restored with One Step Plus (OS) and Single Bond Plus (SB) and resin composite. Er of the adhesive, hybrid layer and underlying dentin was evaluated after 24h and 30 months in artificial saliva. The dentin hydrophilicity significantly decreased after application of the priming solutions. Aging significantly decreased Er in the hybrid layer and underlying dentin of control groups. Er of GA groups remained stable over time at the hybrid layer and underlying dentin. Significant higher Er was observed for PACs and EDC/NHS groups at the hybrid layer after 24h. The decreased hydrophilicity of the modified dentin matrix likely influence the immediate mechanical properties of the hybrid layer. Dentin biomodification prevented substantial aging at the hybrid layer and underlying dentin after 30 months storage.

A comprehensive laboratory screening of three-step etch-and-rinse adhesives

OBJECTIVES

This study evaluated several bonding (microtensile bond strengths [μTBS], nanoleakage [NL], and in situ degree of conversion [ISDC] on dentin) and mechanical properties (ultimate tensile strength [UTS], degree of conversion [DC], water sorption [WS], and solubility [SL] in water) of four three-step etch-and-rinse adhesives in the short term.

METHODS

A total of 28 molars were used in this study. The dentin surfaces were bonded with the following adhesives: All-Bond 3 (ALB3); Fusion Duralink (FSDL); Optibond FL (OBFL), and Scotchbond Multi-Purpose (SBMP). After each adhesive-system application, composite resin build-ups were added. For bonding tests, specimens were sectioned in order to obtain bonded sticks. The sticks were divided to be tested for μTBS (0.5 mm/min), for NL (n=2), and ISDC (n=2). For NL, they were immersed in 50% silver nitrate and analyzed by scanning election microscopy. For ISDC, the hybrid layer was evaluated by micro-Raman spectroscopy. An hourglass-shaped matrix (UTS) or disk-shaped matrix (WS and SL) was filled with primer and adhesive (1:1 ratio) and light-polymerized. For UTS evaluation, the specimens were tested under tension. For WS and SL, specimens were desiccated and stored in distilled water to evaluate water diffusion kinetics over a 28-day period. The DC of the adhesives was evaluated by Fourier transformed infrared spectroscopy. The data from each test were analyzed by appropriate statistical methods.

RESULTS

OBFL resulted in the highest μTBS, lower NL, higher ISDC and DC, and higher UTS than other adhesives (p<0.05), as well as lower WS (similar to ALB3 and FSDL) and SL (similar to ALB3 and SBMP) (p>0.05). ALB3 showed a higher NL and the lowest DC value. FSDL showed the highest NL and SL and the lowest ISDC. SBMP showed the lowest pattern of WS (p<0.05)CONCLUSION: OBFL showed the best results in all the properties evaluated, and it can be considered the gold standard of the three-step etch-and-rinse adhesive systems.

Correlation between degree of conversion, resin-dentin bond strength and nanoleakage of simplified etch-and-rinse adhesives

OBJECTIVES

The aim of this study was to correlate the degree of conversion measured inside the hybrid layer (DC) with the microtensile resin-dentin bond strength (μTBS) and silver nitrate uptake or nanoleakage (SNU) for five simplified etch-and-rinse adhesive systems.

METHODS

Fifty-five caries free extracted molars were used in this study. Thirty teeth were used for μTBS/SNU [n=6] and 25 teeth for DC [n=5]. The dentin surfaces were bonded with the following adhesives: Adper Single Bond 2 (SB), Ambar (AB), XP Bond (XP), Tetric N-Bond (TE) and Stae (ST) followed by composite resin build-ups. For μTBS and SNU test, bonded teeth were sectioned in order to obtain stick-shaped specimens (0.8mm(2)), which were tested under tensile stress (0.5mm/min). Three bonded sticks, from each tooth, were not tested in tensile stress and they were immersed in 50% silver nitrate, photo-developed and analyzed by scanning electron microscopy. Longitudinal 1-mm thick sections were prepared for the teeth assigned for DC measurement and evaluated by micro-Raman spectroscopy.

RESULTS

ST showed lowest DC, μTBS, and higher SNU (p<0.05). All other adhesives showed similar DC, μTBS, and SNU (p>0.05), except for TE which showed an intermediate SNU level. The DC was positively correlated with μTBS and negatively correlated with SNU (p<0.05). SNU was also negatively correlated with μTBS (p<0.05).

SIGNIFICANCE

The measurement of DC inside the hybrid layer can provide some information about bonding performance of adhesive systems since this property showed a good correlation with resin-dentin bond strength and SNU values.

Overview of Clinical Alternatives to Minimize the Degradation of the Resin-dentin Bonds

The incorporation of hydrophilic and acidic resin monomers substantially improved the initial bonding of contemporary etch-and-rinse (ER) and self-etch (SE) adhesives to intrinsically wet dental substrates, providing quite favorable immediate results, regardless of the bonding approach used. However, in the long term, the bonding effectiveness of most simplified ER and SE adhesives drop dramatically. This review examines the fundamental processes that are responsible for the aging mechanisms involved in the degradation of the resin-bonded interfaces and some possible clinical approaches that have been effective in minimizing or even preventing the degradation of the adhesive interfaces produced with simplified adhesives. The incorporation of some of the feasible approaches - described in this review - may improve the quality of the adhesive restorations performed in clinical practice, while manufacturers develop bonding materials that are less susceptible to the aging mechanisms present in the oral environment.

The role of dentin moisture in the degradation of resin-dentin interfaces under clinical and laboratory conditions

BACKGROUND

The authors conducted a study to evaluate the influence of dentin moisture on the degradation of the resin-dentin interface in primary teeth under clinical and laboratory conditions.

METHODS

The authors prepared 40 Class I restorations (five teeth per group) by using a cylindrical diamond bur, leaving a flat dentin surface on the pulpal floor. They vigorously rubbed two coats of a simplified etch-and-rinse adhesive on either dry or wet demineralized dentin under clinical or laboratory conditions. After performing restorative procedures, the authors extracted teeth prepared under clinical conditions after 20 minutes (immediately) or the teeth exfoliated after six months. The authors also tested the teeth prepared under laboratory conditions immediately or after six months of being stored in water. They sectioned the teeth to obtain resin-dentin bonded specimens for microtensile testing and for silver nitrate uptake (SNU) under scanning electron microscopy. They performed a three-way analysis of variance and Tukey test (α = .05) on the SNU bond strength data.

RESULTS

Statistically higher bond strength values (megapascals [standard deviation]) were observed when bonding was performed under laboratory conditions (clinical = 25.2 [3.6] MPa versus laboratory = 28.5 [4.4] MPa; P < .05). Degradation occurred only in the wet dentin groups under both experimental conditions (immediately = 31.3 [4.5] MPa versus after six months = 21.3 [2.1] MPa; P < .05). SNU occurred in all groups and was statistically higher after six months of clinical function or water storage (immediately = 13.9 [4.9 SD] percent versus after six months = 34.1 [4.5 SD] percent; P < .05).

CONCLUSIONS

The bonding of adhesives to dry demineralized dentin produces adhesive interfaces that are more resistant to degradation regardless of the bonding condition.

CLINICAL IMPLICATIONS

Resin-dentin bond strengths produced under laboratory conditions in primary teeth may be higher than those obtained under clinical circumstances, although both conditions (clinical and laboratory) seemed to yield similar results. Bonding to dry demineralized primary tooth dentin produced resin-dentin interfaces that were more resistant to degradation.

Bond durability of adhesives containing modified-monomer with/without-fluoride after aging in artificial saliva and under intrapulpal pressure simulation

OBJECTIVE

To evaluate the dentin bond strength durability of adhesives containing modified-monomer with/without-fluoride after storage in artificial saliva and under intrapulpal pressure simulation (IPPS).

MATERIALS AND METHODS

The occlusal enamel of 48 freshly extracted teeth was trimmed to expose midcoronal dentin. Roots were sectioned to expose the pulp chamber and to connect the specimens to the pulpal-pressure assembly. Specimens were assigned into four groups (n=12) according to adhesive system utilized: a two-step etch-and-rinse adhesive system (SB, Adper Single Bond 2, 3M ESPE), a two-step self-etch adhesive system (CSE, Clearfil SE Bond, Kuraray Medical Inc), and two single-step self-etch adhesives with the same modified monomer (bis-acrylamide)-one with fluoride (AOF, AdheSE One F, Ivoclar-Vivadent) and the other without (AO, AdheSE One, Ivoclar-Vivadent). Bonding was carried out while the specimens were subjected to 15-mm Hg IPPS. Resin composite (Valux Plus, 3M ESPE) buildups were made. After curing, specimens were aged in artificial saliva and under 20-mm Hg IPPS at 37°C in a specially constructed incubator either for 24 hours or six months prior to testing. Bonded specimens (n=6/group) were sectioned into sticks (n=24/group) with a cross section of 0.9 ± 0.01 mm(2) and subjected to microtensile bond strength (μTBS) testing using a universal testing machine. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA tests, and a t-test (p<0.05). Failure modes were determined using a scanning electron microscope.

RESULTS

The μTBS values of SB and CSE fell significantly after six-month storage in artificial saliva and under IPPS, yet these values remained significantly higher than those for the other two adhesives with modified monomers. There was no significant difference in the bond strength values between fluoride-containing and fluoride-free self-etch adhesive systems (AOF and AO) after 24 hours or six months. Modes of failure were mainly adhesive and mixed.

CONCLUSIONS

Based on the results of this study, 1) Fluoride addition did not affect dentin bond durability; and 2) despite the fact that the single-step adhesive system with modified monomer showed stability, bond strengths associated with these systems remained lower than those of multistep adhesive systems.

The Influence of Time and Cement Type on Push-Out Bond Strength of Fiber Posts to Root Dentin

A self-adhesive resin cement can provide a significantly stronger bond than a three-step etch-and-rinse adhesive and resin cement when used to lute fiber posts.

Inhibition of MMPs by alcohols

OBJECTIVES

While screening the activity of potential inhibitors of matrix metalloproteinases (MMPs), due to the limited water solubility of some of the compounds, they had to be solubilized in ethanol. When ethanol solvent controls were run, they were found to partially inhibit MMPs. Thus, the purpose of this study was to compare the MMP-inhibitory activity of a series of alcohols.

METHODS

The possible inhibitory activity of a series of alcohols was measured against soluble rhMMP-9 and insoluble matrix-bound endogenous MMPs of dentin in completely demineralized dentin. Increasing concentrations (0.17, 0.86, 1.71 and 4.28 mol/L) of a homologous series of alcohols (i.e. methanol, ethanol, propanols, butanols, pentanols, hexanols, the ethanol ester of methacrylic acid, heptanols and octanol) were compared to ethanediol, and propanediol by regression analysis to calculate the molar concentration required to inhibit MMPs by 50% (i.e. the IC(50)).

RESULTS

Using two different MMP models, alcohols were shown to inhibit rhMMP-9 and the endogenous proteases of dentin matrix in a dose-dependent manner. The degree of MMP inhibition by alcohols increased with chain length up to 4 methylene groups. Based on the molar concentration required to inhibit rhMMP-9 fifty percent, 2-hydroxyethylmethacrylate (HEMA), 3-hexanol, 3-heptanol and 1-octanol gave the strongest inhibition.

SIGNIFICANCE

The results indicate that alcohols with 4 methylene groups inhibit MMPs more effectively than methanol or ethanol. MMP inhibition was inversely related to the Hoy's solubility parameter for hydrogen bonding forces of the alcohols (i.e. to their hydrophilicity).

Biomimetic remineralization as a progressive dehydration mechanism of collagen matrices--implications in the aging of resin-dentin bonds

Biomineralization is a dehydration process in which water from the intrafibrillar compartments of collagen fibrils are progressively replaced by apatites. As water is an important element that induces a lack of durability of resin-dentin bonds, this study has examined the use of a biomimetic remineralization strategy as a progressive dehydration mechanism to preserve joint integrity and maintain adhesive strength after ageing. Human dentin surfaces were bonded with dentin adhesives, restored with resin composites and sectioned into sticks containing the adhesive joint. Experimental specimens were aged in a biomimetic analog-containing remineralizing medium and control specimens in simulated body fluid for up to 12 months. Specimens retrieved after the designated periods were examined by transmission electron microscopy for the presence of water-rich regions using a silver tracer and for collagen degradation within the adhesive joints. Tensile testing was performed to determine the potential loss of bond integrity after ageing. Control specimens exhibited severe collagen degradation within the adhesive joint after ageing. Remineralized specimens exhibited progressive dehydration, as manifested by silver tracer reduction and partial remineralization of water-filled microchannels within the adhesive joint, as well as intrafibrillar remineralization of collagen fibrils that were demineralized initially as part of the bonding procedure. Biomimetic remineralization as a progressive dehydration mechanism of water-rich, resin-sparse collagen matrices enables these adhesive joints to resist degradation over a 12-month ageing period, as verified by the conservation of their tensile bond strength. The ability of the proof of concept biomimetic remineralization strategy to prevent bond degradation warrants further development of clinically relevant delivery systems.

Slow progression of dentin bond degradation during one-year water storage under simulated pulpal pressure

OBJECTIVES

To evaluate the dentin bond durability of simplified adhesives after one-year (1 y) under water storage and simulated pulpal pressure.

METHODS

Class I cavities were prepared in sixty human third molars with the pulpal wall located in mid-coronal dentin. The roots were cut off to expose the pulpal chamber, and the teeth were assembled in a pulpal pressure simulator device. A two-step etch-and-rinse adhesive (Single Bond 2/SB), a two-step self-etch adhesive (Clearfil SE Bond/CSE), a three-step self-etch adhesive (Adper Scotchbond SE/SSE) and three all-in-one adhesives (Adper Easy Bond/EB, Clearfil S(3) Bond/S3 and Adhese One/AO) were applied according to manufacturers instructions. No enamel pre-etching was used for the self-etch systems. The cavities were filled with a composite (Z250, 3M ESPE) in four to five horizontal increments and individually cured. Immediately after the final cure, pulpal pressure was set to 15 cm H(2)O. After 24 h and 1 y under simulate pulpal pressure the teeth were cut following a 'nontrimming' microtensile test technique (n=30) and tested in tension. Kruskall-Wallis and post hoc multiple comparisons were used at alpha=0.05. Weibull statistics was applied to SB, CSE and EB. Fractographic analysis of debonded specimens was performed using scanning electron microscopy.

RESULTS

At 24 h and 1 y periods, SB showed higher bond strength means than all the others adhesives tested. CSE was not statistically different from EB at 24 h and from EB and SB at 1 y. EB showed bond strength statistically higher than the other three self-etch adhesives, which were not statistically different from each other at 24 h. AO showed significantly lower bond strength than all tested materials after 1 y. For all adhesives the mean bond strength at 1 y were not statistically different from the values measured at 24 h (p>0.05). Shifts in failure mode patterns and Weibull modulus decrease indicate some degree of bond degradation after the 1 y storage period.

CONCLUSION

One-year of simulated pulpal pressure did not affect dentin bond strength of simplified adhesives in Class I restorations. Signs of degradation were only revealed by fractographic analysis and reliability parameters.

A review--micromorphological evidence of degradation in resin-dentin bonds and potential preventional solutions

Resin adhesion to dentin was first achieved in 1982 through mechanical hybridization between resin and collagen fibrils using an adhesive resin containing a functional monomer. Over the last 2 decades, newly developed adhesive resins have attempted to improve the bond strength at least in the first 24 h after bonding. Although much is known about the initial bond strength, learned through morphological analysis, the long-term durability of bonds has not yet been established analytically. However, numerous recent studies have shown chemical biodegradation of resin-dentin bonds under various testing regimes. In general, studies have shown that dentin bond strength decreases over time due to degradation of the resin and the collagen fibrils within the bonds. Furthermore, crystal formation around cured bonding resins has been reported in a number of adhesives after long-term water storage. However, the extent and process of degradation or crystallization is adhesive type specific. This review mainly summarizes the most recent and state of the art work in degradation of the bonding of dental restorative compounds with dentin based on micromorphological data of scanning and transmission electron microscopy.

The use of warm air stream for solvent evaporation: effects on the durability of resin-dentin bonds

This study evaluated the effect of a warm (W) or cold (C) air-dry stream for solvent evaporation on the immediate (IM) and six-month (6M) resin-dentin bond strength (microTBS) and silver nitrate uptake pattern (SNU) of two-step etch-and-rinse adhesive system (Adper Single Bond [SB] and Prime & Bond 2.1 [PB]). The adhesives were applied on demineralized dentin surfaces and a warm or cold air-dry stream (10 seconds) was applied followed by light-activation (10 seconds). After 24-hours of water storage, the specimens were serially sectioned in the "x" and "y" directions to obtain bonded sticks around 0.8 mm2 to be tested immediately or after six months of water storage. The specimens at each period were immersed in a 50% solution of silver nitrate, photodeveloped and analyzed by SEM for SNU. Higher IM microTBS values were observed for SB under W conditions. Both adhesives showed reductions in microTBS after 6M in both air temperatures. Regarding SEM, a low silver nitrate uptake was observed in the W groups either in IM or 6M for both adhesives.