Influence of different etching modes on bond strength and fatigue strength to dentin using universal adhesive systems

Influence of Caries Eradication Techniques via Papacarie, and Er: YAG Laser With Different Adhesive Types Bonded to Composite Restoration in Primary Dentin. An SEM, μTBS, and Microleakage Assessment

Influence of different caries removal techniques using Papacarie and Erbium/yttrium-aluminum-garnet (Er: YAG) laser to different adhesives etch and rinse (ER) and self-etch (SE) restored via tooth-colored material on micro tensile bond strength (μTBS) and marginal leakage scores. Ninety-six extracted primary molars exhibiting moderate caries were allocated into three groups based on the caries removal technique. Group 1: Conventional bur, Group 2: Papacarie gel, and Group 3: Er: YAG laser. After caries removal, specimens from three groups were further allocated into two subgroups based on the type of adhesive used (n = 16). Two-step ER (A) and Two-step SE (B). Composite restoration was built and thermocycling was performed. Microleakage, μTBS, and failure mode were analyzed using a dye penetration test, a Universal testing machine, and a stereomicroscope respectively. Scanning electron microscopy (SEM) evaluation of the composite-CAD interface was performed. One-way ANOVA and the Tukey HSD test were utilized to compare microleakage and μTBS among investigated groups (p < 0.05). The lowest microlekage (13.56 ± 0.02) and highest μTBS (13.26 ± 0.11 MPa) was exhibited by Group 3B (Er: YAG laser-SE). However, the highest microleakage (45.62 ± 0.09) and lowest bond strength (9.34 ± 0.11 MPa) was exhibited by 1A (Conventional bur-ER) treated samples. For caries removal in primary dentition, the Er: YAG laser and Papacarié gel present themselves as appropriate alternatives. These non-invasive methods yield improved mechanical results when utilized with self-etch adhesive system.

The effect of different surface treatments and adhesive systems on shear bond strength in universal nanohybrid composite resin repair

BACKGROUND

The aim of this study is to evaluate the effect of different surface treatments and adhesives on shear bond strength (SBS) in the repair of composite resin restorations.

METHODS

In this study, 60 discs (2 mm x 10 mm) were prepared using a universal nanohybrid composite resin (GrandioSo, Voco, Germany). The discs were aged by exposure to 5000 thermal cycles between 5 and 55 °C for 30 s with an immersion procedure. Then samples were divided into 3 groups (n:20) according to the surface treatments (Group 1: no surface treatment, Group 2: roughening by bur, Group 3: roughening by Er, Cr: YSGG laser). Subsequently, the specimens were classified into two groups (n:10) according to the adhesive systems; a two-step self-etch adhesive (Clearfil SE bond (SE)), or a universal adhesive (Scotchbond Universal Plus (SB)). After surface treatments and adhesive applications, the same universal nanohybrid composite resin with a height of 2 mm and a diameter of 3 mm was placed in the center of the samples. The samples were then submitted to the SBS test using universal testing equipment (Autograph AGS-X; Shimadzu, Kyoto, Japan) with a crosshead speed of 1 mm/min. The failure modes were examined using a stereomicroscope. The surface topography of the roughened and fractured surfaces resin composite (n = 1) was assessed using scanning electron microscopy (SEM). Analyses were performed using IBM SPSS 25 programme (p < 0.05).

RESULTS

The highest bond strength was observed in the laser + SE group (22.69 ± 4.49), while the lowest was recorded in the control + SE group (14.12 ± 3.00). In the SE adhesive group, no significant difference was found between the laser + SE and bur + SE groups (p > 0.05). Similarly, in the SB adhesive group, there were no significant differences among the surface roughening procedures (p = 0.078). Additionally, no significant differences were observed between the adhesives according to various surface roughening procedures. The failure mode was predominantly cohesive in old composites.

CONCLUSION

The bond strength can be improved by surface treatments such as diamond burs, Er, Cr: YSGG laser application for better bonding strategies in the repair of nanohybrid resin composite restorations. There was no statistically significant difference in bond strength between the adhesives tested in this study.

Clinical evaluation of single bond universal adhesive in non-carious cervical lesions: a 36-month retrospective study

OBJECTIVE

To evaluate the 36-month clinical performance of Single Bond Universal Adhesive (SBU; 3M ESPE, Germany) in non-carious cervical lesions (NCCLs) using different modes of adhesion according to the FDI criteria. The primary outcome was the retention loss of the restorations, while the secondary outcomes included marginal staining, marginal adaptation, post-operative sensitivity and tooth vitality, recurrence of caries erosion and abfraction, and tooth integrity, all evaluated according to the FDI criteria.

MATERIALS AND METHODS

In this study, the SBU Adhesive was applied to 246 NCCLs of 25 patients using different modes of adhesion: Self-etch (SE), selective-enamel-etching (SLE), and etch-and-rinse (ER). All lesions were restored with the same nanohybrid resin composite. The restorations were evaluated at the 1st, the 6th, 12th, 18th, and 36th month using the FDI criteria. The differences between SE, SLE, and ER groups were tested using the Kruskal-Wallis and Mann-Whitney U tests where a value of p < 0.05 was accepted as a criterion for statistical significance.

RESULTS

After 36-month the recall rate was 96%. The retention loss rates were 29.33% for SE, 16.66% for SLE, and 3.89% for ER modes. Interactions between time periods and adhesive modes were found to be statistically significant (p < 0.05) for all FDI criteria. ER mode performed significantly better than SE mode for marginal staining, marginal adaptation and recurrence of caries, erosion and abfraction criteria after the 36th month (p < 0.05). There was no statistically significant difference between SE and SLE mode (p > 0.05), nor between SLE and ER mode (p > 0.05).

CONCLUSIONS

After the 36-month evaluation of all adhesive modes used in the study, restorations performed with the ER adhesion mode were clinically good (2), while those performed with the SE adhesion mode and SLE adhesion mode were clinically satisfactory (3) according to the FDI criteria. The primary outcome, retention loss, was significantly lower in the ER mode compared to SE and SLE modes. For secondary outcomes, the ER mode showed better performance in marginal staining, marginal adaptation, and the recurrence of caries, erosion, and abfraction highlighting its clinical advantages for mid-term success in non-carious cervical lesions.

CLINICAL RELEVANCE

Restorations performed with the SE adhesion mode of universal adhesives exhibit clinically acceptable behavior after 36 months of evaluation, although with less success than those performed with the ER adhesion mode.

CLINICAL TRIAL REGISTRATION

Clinical trials number- NCT06227715, Clinical trials link: https://clinicaltrials.gov/study/NCT06227715.

The effect of different treatment protocols on shear bond strength in resin composite restoration repair

BACKGROUND

It was aimed to investigate the effect of sandblasting and laser surface treatment on shear bond strength in composite restoration repair in vitro.

METHODS

A micro-hybrid composite (Filtek Z250, 3 M-ESPE, USA) was used to prepare 120 samples. The samples were subjected to a thermal cycle test 5,000 times between 5 and 55 0C, and they were randomly divided into 12 groups (n = 10). No surface treatment was performed in Groups 1 to 4, which were designed as control groups. The surfaces of the samples in Groups 5 to 8 were sandblasted with a Cojet device, and the surfaces of the samples in Groups 9 to 12 were applied Er, Cr: YSGG laser. After the sample surfaces were divided into groups with and without acid etching, universal adhesive was applied, and the repair process was performed using Filtek Z250 or nano-filled resin composite (Filtek Ultimate, 3 M-ESPE, USA). The thermal cycle test was repeated 5,000 times between 5 and 55 0C on all repaired samples. The repair shear bond strength of the samples was measured using a universal testing device (Shimadzu IG-IS, Kyoto, Japan). The fracture types were evaluated by optical microscopy and scanning electron microscopy (SEM). Statistical analyses of the findings were evaluated by the Kruskal Wallis test and Mann Whitney U test at 0.05 significance degree.

RESULTS

The highest mean shear bond strength values were obtained from the samples sandblasted with CoJet, followed by Er, Cr: YSGG laser, and the control group. It was determined that there was a significant difference between the mean shear bond strength values obtained from the control group and the other surface treatment groups (p < 0.05). In general, significantly higher mean shear bond strength values were obtained when the universal adhesive was applied in total-etch mode compared to the application in self-etch mode (p < 0.05). Additionally, it was determined that higher shear bond strength values were obtained with Filtek Ultimate compared to Filtek Z250 (p < 0.05).

CONCLUSION

Within the limitations of this study, it can be concluded that the use of universal adhesive in total-etch mode, in addition to surface treatments on the resin composite surface in the repair protocol and the use of nano-filled resin composite as repair material can increase the mean shear bond values in repair.

Influence of luting strategies on dentin bond performance of self-adhesive resin luting cement in combination with a universal adhesive

OBJECTIVES

This study aimed to evaluate the dentin bond performance of various resin luting cement (RLC) systems combined with universal adhesives in different luting strategies.

MATERIALS AND METHODS

Three self-adhesive resin luting cements (SRLCs) were used with universal adhesives as primers. Twelve specimens per group were prepared to measure shear bond strength (SBS) under distinct luting strategies in etch-&-rinse and self-etch modes. Regarding luting strategies, the bonded specimens were categorized into four groups based on tooth primer application and the curing mode of the SRLC paste: (i) with light irradiation of the tooth primer (wL) + dual-cure mode (DC) of the SRLC paste, (ii) wL + self-cure mode (SC) of the SRLC paste, (iii) without light irradiation of the tooth primer (woL) + DC mode of the SRLC paste, and (iv) woL + SC mode of the SRLC paste. Specimens were also subjected to different storage conditions: 24 h in water (baseline condition) and 10,000 cycles of thermal cycling.

RESULTS

Luting strategy, storage condition, and SRLC system type significantly influenced dentin SBS values in both etching modes. Notably, certain SRLCs exhibited significantly higher dentin SBS when the primer was light-irradiated compared with no primer irradiation.

CONCLUSION

Most SRLCs demonstrated higher dentin bond strength with light-irradiated primers, suggesting potential enhancement of dentin bond performance via primer light irradiation.

Scanning electron microscopy observation of dentin bond interfaces in different types of resin luting cements

This study aimed to observe and compare the resin luting cement (RLC)/dentin interfaces of different types of RLC systems with scanning electron microscopy (SEM). This study evaluated six self-adhesive resin luting cement systems (SARLCs), four systems combining a SARLC with a tooth primer (SARLCPs), and six conventional resin luting cement systems (CVRLCs). Cured resin composite rods were bonded to bovine dentin using RLCs in different etching modes. The morphological features at the interfaces were observed using SEM. Although all RLCs in etch-&-rinse (ER) mode showed a clear hybrid layer, most SARLCs had a thinner and more porous hybrid layer than the SARLCPs and CVRLCs. All SARLCPs with primer and CVRLCs showed a thin high-density layer below the primer layer in both etching modes. CVRLCs and SARLCPs with primer treatment systems may be more versatile and reliable when compared to simplified RLC systems.

Comparing Various Resin Luting Cement Systems in Different Etching Modes Through Bond Durability and Morphological Features

OBJECTIVES

This study aimed to investigate bond performance of various resin luting cement (RLC) systems on enamel and dentin in different etching modes and to compare the RLC-tooth interface morphology using scanning electron microscopy (SEM).

METHODS AND MATERIALS

The self-adhesive RLC systems used in combination with universal adhesives were as follows: Scotchbond Universal Adhesive Plus + RelyX Universal (3M Oral Care) and Clearfil Universal Bond Quick ER + SA Luting Multi (Kuraray Noritake Dental). These RLC systems were also used alone as self-adhesive RLC systems without universal adhesives (self-adhesive mode). The conventional RLC systems for comparison materials were as follows: BeautiBond Xtream + ResiCem EX (Shofu) and Tooth Primer + Panavia V5 (Kuraray Noritake Dental). Twelve specimens were prepared for each group to measure shear bond strength (SBS) in different etching modes. A stainless-steel rod was used as a substitute for indirect restorations. Bonded specimens were allocated to baseline (stored for 24 hours) and artificially aged (thermocycling [TC] for 10,000 cycles) groups. Representative treated tooth surfaces and RLC-tooth interfaces were observed using SEM.

RESULTS

Three-way analysis of variance (ANOVA) revealed that all the factors (etching mode, storage period, and RLC system) had a significant influence on the enamel SBS values (p<0.05). Enamel SBS was significantly higher in etch-&-rinse (ER) mode than in self-etch (SE) mode, regardless of RLC system or storage period. Three-way ANOVA showed that all the factors had a significant influence on the dentin SBS values (p<0.001). Most RLC systems showed significantly higher dentin SBS in SE mode than in ER mode, regardless of storage period. However, the combination with Scotchbond Universal Adhesive Plus and RelyX Universal showed no significant difference in SBS values between etching modes at the baseline and showed a significantly higher SBS value in ER mode than in SE mode after TC.

CONCLUSIONS

The self-adhesive RLC systems with universal adhesives tended to show higher enamel and dentin bond performance than the self-adhesive RLC systems alone. The morphology of treated tooth surfaces and resin cement-tooth interfaces were dependent on the RLC system and etching mode used. The RLC systems with primer application showed a thin, high-density layer above the intact dentin in both etching modes, suggesting chemical interaction.

Tooth-composite bond failure with a universal and an etch-and-rinse adhesive depending on mode and frequency of application

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.

Influence of different curing modes on the bonding effectiveness of self-adhesive resin luting cements in combination with universal adhesives

OBJECTIVES

This study aimed to investigate the immediate dentin bond performance and bond durability of self-adhesive resin luting cements (RLCs) in combination with universal adhesives in different curing modes.

METHODS

Two self-adhesive RLCs were used with universal adhesives as primers. They were also used alone as self-adhesive RLCs. Two multiple-step RLC systems were used as comparison materials. To measure the shear bond strength (SBS) in different curing modes, 12 specimens were prepared for each group. Stainless-steel rods were bonded to bovine dentin, and the bonded specimens were assigned to the baseline group (stored for 24 h) and artificially aged group (thermal cycling [TC], 10,000 cycles). After each storage period, the SBS of the bonded specimens was measured. The Knoop hardness number (KHN) of the cured RLCs was measured with or without primer application in different curing modes at 24 h and after 10,000 TC. The representative RLC/dentin interfaces were observed using scanning electron microscopy (SEM).

RESULTS

Dentin SBS was significantly influenced by the RLC system but not by the curing mode. Self-adhesive RLCs alone showed significantly lower SBS values than self-adhesive RLCs with primer regardless of the curing mode or storage period. The storage period, curing mode, and RLC system significantly influenced the KHN.

SIGNIFICANCE

The use of universal adhesives as a primer may help enhance the immediate dentin bond performance and bond durability of self-adhesive RLCs.

The Classification and Selection of Adhesive Agents; an Overview for the General Dentist

Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords "adhesive agents", "classification", "dentin", "enamel", "universal", "self-etch", "etch-and-rinse", and "bonding". The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or "multi-mode" according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.

Long-Term In Vitro Adhesive Properties of Two Universal Adhesives to Dentin

The composition of universal adhesives, as well as the adhesive strategy, may influence bonding effectiveness and durability. This study aimed to evaluate the microtensile bond strength (µTBS) and nanoleakage (NL), immediately and after 6-month aging, and in situ degree of conversion (DC), of two universal adhesives (Scotchbond Universal Adhesive, SBU; Xeno Select, XEN) applied with etch-and-rinse (ER) and self-etch (SE) strategies, in comparison with a two-step SE adhesive (Clearfil SE Bond, CSE). Dentin surfaces of fifty human third molars were randomly assigned to the following adhesives: two universal adhesives, SBU and XEN, applied in ER or SE mode and CSE, used as control. Teeth were sectioned into beams to be tested under µTBS, half of them after 24 h, and the rest after 6 months of water aging. Selected beams from each tooth were used for NL evaluation and in situ DC quantification. SBU and CSE showed significantly higher mean µTBS and lower nanoleakage than XEN, regardless of the evaluation time and adhesion strategy. XEN-SE yielded the lowest degree of conversion. Therefore, adhesive properties of universal adhesives to dentin are material dependent, regardless of the adhesion strategy, exhibiting XEN a significantly worse performance than SBU.

Bond durability of a two-step adhesive with a universal-adhesive-derived primer in different etching modes under different degradation conditions

This study investigated the enamel and dentin bond durability of a two-step adhesive system, using a universal adhesive-derived primer (G2-Bond Universal [GU]), and compared it with the two conventional, two-step, self-etch adhesive systems (Clearfil SE Bond 2 [CS] and OptiBond XTR [OX]) under thermal cycling (TC) and long-term water storage (WS). The shear bond strengths to bovine enamel and dentin were determined using the etch-and-rinse and self-etch modes. Twelve specimens per test group were prepared and further divided into the following subgroups: 1) subjected to TC, 2) long-term WS, and 3) WS for 24 h (baseline). The enamel and dentin bond durability of GU was superior to those of CS and OX in different etching modes and under different degradation conditions. The latest two-step adhesive system, which utilizes universal adhesives' benefits in its primer, might offer durable clinical bonding performances and can be widely used in a clinical setting.

Primer application technique and remaining dentin thickness affected microtensile bond strength of contemporary dentin adhesives under simulated pulp pressure

OBJECTIVES

To evaluate the effect of application techniques, type of adhesives and remaining dentin thicknesses on microtensile bond strength (µTBS) of 3 adhesive systems.

MATERIALS AND METHODS

112 flat occlusal dentinal surfaces of third molar were randomly allocated into 16 groups based on 2 remaining dentin thicknesses (RDT), 2 application techniques, and 3 adhesive systems (Optibond FL, OFL; Clearfil SE Bond, CSE; and Single Bond Universal, SB); SB was applied in either etch-and-rinse (ER) or self-etch (SE) mode. Simulated pulpal pressure was performed during restorative procedure and water storage. The stick-shaped specimens from each tooth underwent µTBS testing. The data were evaluated using a paired t test and ANOVA followed by a post hoc test. The fractured specimens were evaluated for mode of failure using a stereomicroscope.

RESULTS

The mean µTBS values were significantly affected by RDT, application technique, and types of adhesives. Neither RDT nor application technique affected µTBS of SB in ER mode, whereas application technique affected both conventional and universal self-etch adhesives. RDT also influenced µTBS of OFL.

CONCLUSIONS

RDT and application technique differently affected the µTBS of dentin bonding which was product-related. Etch-and-rinse systems had higher bond strength to superficial than to deep dentin, whereas self-etch systems were more sensitive to both RDT and application technique.

CLINICAL RELEVANCE

The universal adhesive is less sensitive to intrinsic wetness and can be used according to manufacturer's instructions.

Which self-etch acidic composition may result in higher dental bonds at the long-term? A network meta-analysis review of in vitro studies

OBJECTIVES

This review evaluated the effects of the acidic composition of self-etch (SE) adhesives at the long-term bond strengths to dentin and enamel.

DATA

The review followed the PRISMA Extension Statement for network meta-analysis. Studies were identified by a systematic search in PubMed, Web of Science, and Scopus databases.

STUDY SELECTION

The inclusion criteria were in vitro studies that evaluated bond strength data of samples analyzed at both immediate and long-term (after aging simulation) periods and that were bonded to sound dentin/enamel using SE adhesives, with at least one group of adhesives being based on 10-MDP (10-methacryloyloxy-decyl-dihydrogen-phosphate; control) and the other group being comprised of alternative acidic monomers. Statistical analyses were conducted using two methods: standard pairwise meta-analysis (SPMA) and Bayesian network meta-analysis (NMA). Heterogeneity was assessed by using the Cochran Q test and I2 statistics.

RESULTS

From 5220 studies identified, 87 met the eligibility criteria and 83 were meta-analyzed. Seventeen adhesives were based on 10-MDP and 44 systems were based on alternative acids. The resin-dentin/enamel bonds were predominantly reduced after aging (∼84% of cases). From the SPMA findings, the following acidic compositions showed lower bond strength values (effect size: mean difference [MD] with 95% confidence interval [95% CI]) than 10-MDP: 4-META (MD -4.99, 95% CI: -7.21, -2.78; p<0.001); sulfonic acids (MD -9.59, 95% CI -12.19, -6.98; p<0.001); unspecified phosphate esters (MD -8.89, 95% CI -17.50, -0.28; p = 0.04); or mixed acids (MD -11.0, 95% CI -13.62, -8.38; p<0.001). The dental bonds were benefited from the presence of 10-MDP upon longer aging (>6 months). From the NMA probabilistic findings, adhesives based on 10-MDP and phosphonic acids ranked as having the best and the worst bonding potential to dentin, respectively. More than one composition (phosphonic acids and mixed acids) ranked similarly to 10-MDP in enamel. The studies scored as having moderate risk of bias (58.6%), followed by low (39.1%) and high (2.3%) risk of bias.

CONCLUSION

10-MDP is an outstanding acidic monomer that contributes to higher bonds to dentin at the long-term. In enamel, there is no evidence that one acidic composition prevails over the other.

CLINICAL SIGNIFICANCE

The acidic composition of SE adhesives affects the resistance of dental bonds after simulated aging, with 10-MDP playing a significant role in the adhesion to dentin but not to the enamel.

REGISTRATION NUMBER

This report is registered at the Open Science Framework (osf.io/urtdf).

Effect of immediate dentin sealing procedure using different universal adhesive systems on the shear bond strength of self-adhesive resin cement

Objective: The aim of this in vitro study was to investigate the effect of immediate dentin sealing (IDS) procedure using different universal adhesive systems on the shear bond strength (SBS) of dual-cure self-adhesive luting cement. Materials and Method: Sixty sound human molar teeth were used. The coronal dentin surfaces were exposed with model trimmer device and ground with 600-grit silicon carbide paper under water cooling to obtain standard smear layers. Specimens were randomly divided into 4 groups according to the different types of universal adhesive systems used (n=15): Group 1 (control; C): no immediate dentin sealing; Group 2: Clearfil Universal Bond Quick (UBQ); Group 3: Single Bond Universal (SBU); Group 4: OptiBond Universal (OBU). Adhesive systems were applied in self-etch mode according to the manufacturers’ instructions. Then, self-adhesive luting cement (Nova Resin Cement) was bonded using cylinder-shaped silicone mold (diameter: 3 mm, height: 2 mm). The specimens were stored in distilled water for 24 h and subjected to SBS test at a crosshead speed of 1 mm/min using universal testing machine. Debonded surfaces were observed with a stereomicroscope under 15× magnification to determine the failure mode. Data were statistically analyzed with Kruskal Wallis and Dunn test (p&lt;0.05). Results: Control group showed statistically lower shear bond strength than IDS-treated groups (p&lt;0.05). Group 2 (UBQ) showed statistically higher SBS than Group 3 (SBU) (p&lt;0.05). IDS-treated groups showed predominantly mixed failures while control group showed adhesive failure patterns. Conclusion: IDS procedures using universal adhesive systems improved the SBS of the self-adhesive luting cement. Besides, the highest shear bond strengths were obtained with Clearfil Universal Bond Quick which contains MDP and amide monomers.

Interactions of two phosphate ester monomers with hydroxyapatite and collagen fibers and their contributions to dentine bond performance

OBJECTIVES

To evaluate the interactions of two phosphate ester monomers [10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) and dipentaerythritol penta-acrylate phosphate (PENTA)] with hydroxyapatite and collagen and understand their influence on dentine bonding.

METHODS

Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, nuclear magnetic resonance, ultraviolet-visible, and molecular docking were applied for separately evaluating the interactions of two monomers with hydroxyapatite and collagen. Hydrophilicity tests and morphological observation were employed to characterize pretreated dentine. Microtensile bond strength (μTBS) and nanoleakage were investigated to evaluate the bonding performance. Hydroxyproline assay, in situ zymography, and matrix metalloproteinase-9 (MMP-9) activity assay were used to confirm the MMP inhibition.

RESULTS

Chemoanalytic characterization confirmed the interactions of 10-MDP and PENTA with hydroxyapatite and collagen. The interactions of PENTA were weaker than 10-MDP. PENTA possessed better dentine tubule sealing after etching than 10-MDP. Dentine treated with PENTA was more hydrophilic than 10-MDP. 10-MDP and PENTA treating significantly increased the initial μTBS than the control group without primer conditioning. μTBS decreased significantly during aging, and the decrease was more severe in the PENTA group than 10-MDP. The 10-MDP and PENTA groups exhibited relatively less fluorescence than the control. The relative inhibition percentages of MMP-9 decreased in the order of 10-MDP-Ca salt, 10-MDP and PENTA. The 10-MDP, PENTA, and 10-MDP-Ca salt groups showed significantly lower hydroxyproline contents than the control.

CONCLUSIONS

Although PENTA adsorbed on hydroxyapatite, it did not form a stable calcium salt. The interactions of 10-MDP with hydroxyapatite and collagen are different than those of PENTA.

CLINICAL SIGNIFICANCE

The sealing of dentinal tubules by PENTA and the inhibition of MMP by 10-MDP and its calcium salts contribute to improving the dentine bonding durability.

Five-year Randomized Clinical Trial on the Performance of Two Etch-and-rinse Adhesives in Noncarious Cervical Lesions

OBJECTIVES

To evaluate the 5-year clinical performance of two-step etch-and-rinse adhesives in noncarious cervical lesions (NCCL).

METHODS AND MATERIALS

The sample comprised 35 adults with at least two similar-sized NCCL. Seventy restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months and 5 years using some items of the FDI criteria. The differences in the ratings of the two materials after 6 months, 18 months, and 5 years were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05).

RESULTS

Five patients did not attend the 60-month recall. No significant differences were observed between the materials for any criteria evaluated. Twenty-one restorations failed (12 for SB and 9 for AM) after 60 months. Thus, the retention rate for SB at 60 months were 55.6% for SB and 71% for AM (p=0.32). After 60 months, 12 restorations (6 for SB and 6 AM) showed some loss of marginal adaptation (p=1.0). Slight marginal discoloration was observed in 10 restorations (6 for SB and 4 AM; p=0.91). Five restorations (2 for SB and 3 for AM) showed recurrences of caries (p=1.0).

CONCLUSIONS

Both two-step etch-and-rinse adhesives-Adper Single Bond 2, a polyalkenoic acid-containing adhesive, and Ambar, a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing adhesive-showed acceptable clinical performance after 60 months.

Universal Adhesives and Adhesion Modes in Non-Carious Cervical Restorations: 2-Year Randomised Clinical Trial

This prospective, double-blind, six-arm parallel randomised controlled trial aimed to compare the performance of two universal adhesives (UAs) in non-carious cervical lesions (NCCLs), using the FDI criteria, and analysed if participants/NCCLs’ characteristics influenced the outcome. Thirty-eight 18- to 65-year-old participants were seeking routine dental care at a university clinic. At baseline, 210 NCCLs were randomly allocated to six groups (35 restorations’ each). The UAs tested were FuturabondU (FBU) and AdheseUniversal (ADU) applied in either etch-and-rinse (ER) and self-etch (SE) modes. FuturabondDC (FBDC) in SE and in SE with selective enamel etching (SE-EE) modes were controls. NCCLs were restored with AdmiraFusion. The analysis included nonparametric tests, Kaplan-Meier and log-rank tests (α = 0.05). At 2-years, of 191 restorations, ten were missed due to retention loss (all groups, p > 0.05). FBDC (p = 0.037) and FBU (p = 0.041) performed worse than ADU in SE mode. FBDC and FBU also showed worse functional success rate (p = 0.012, p = 0.007, respectively) and cumulative retention rates (p = 0.022, p = 0.012, respectively) than ADU. Some participants/NCCLs’ characteristics influenced (p < 0.05) the outcomes. FBU did not perform as well as ADU, especially in SE mode and due to functional properties. Participants’ age and NCCLs’ degree of dentin sclerosis and internal shape angle influenced FBU performance.

Does Multi-Fiber-Reinforced Composite-Post Influence the Filling Ability and the Bond Strength in Root Canal?

The purpose of the present in vitro study was to investigate the bond strength of root canal dentin and the filling ability of a new multi-fiber-reinforced composite post (mFRC) compared to a conventional single fiber-reinforced-composite post (sFRC). Twenty-eight freshly maxillary first permanent single-rooted premolars were instrumented and divided into groups (n = 14). Group 1: single-fiber-reinforced composite (sFRC), group 2: multi-fiber-reinforced composite (mFRC). Bonding procedures were performed using a dual-cure universal adhesive system and resin cement. All specimens were sectioned so that seven discs of 1 mm of thickness were obtained from each root. An optical microscope was used before the push-out test to measure the total area of the voids and to determine the length of the smaller/bigger circumferences. The push-out bond strength (PBS) test was performed using an Instron universal testing machine. Data were then compared by one-way ANOVA on ranks (α = 0.05). The dentin–cement–post interface was observed using scanning electron microscopy (SEM). At the coronal third, a significantly higher bond strength (p < 0.05) was obtained in the sFRC group (44.7 ± 13.1 MPa) compared to the mFRC group (37.2 ± 9.2 MPa). No significant difference was detected between the groups at the middle third (sFRC group “33.7 ± 12.5 MPa” and mFRC group “32.6 ± 12.4 MPa”) (p > 0.05). Voids were significantly lower in the mFRC compared to those observed in the sFRC group (p < 0.05) at the coronal third. Whereas, no significant difference was found at the middle third (p > 0.05) between the tested groups. Filling ability was overall improved when employing mFRC, although such technique might have characteristic limitations concerning the bond strength to dentin.

Comparison of bond strength of universal adhesives using different etching modes: A systematic review and meta-analysis

This review aims to evaluate whether the etch-and-rinse or self-etch mode is the better protocol for dentin adhesion by universal adhesives. A total of 15 articles were included in the meta-analysis. Two reviewers performed a literature search up to October 2020in four databases: PubMed, Web of Science, Embase, and the Cochrane Library. Without considering the difference in aging mode, the analysis of the immediate and long-term bond strength of dentin showed that there was no statistical significance between the etch-and-rinse and self-etch mode of universal adhesive, and the long-term bond strength decreased relative to the immediate. In vitro studies suggest that prior acid etching did not improve bond performance. Whether from the perspective of long-term bonding performance or simplifying operating procedures, the self-etch mode is preferred.

Bonding Performance of Universal Adhesives Applied to Nano-Hydroxyapatite Desensitized Dentin Using Etch-and-Rinse or Self-Etch Mode

The study assessed the bonding performance of three universal adhesives on desensitized dentin with etch-and-rinse mode or self-etch mode after nano-hydroxyapatite (nHAp)-based desensitizers application. Simulated sensitive dentin specimens were prepared and separated into four groups: no treatment as the negative control, groups desensitized by Biorepair toothpaste, Dontodent toothpaste, or nHAp paste. Three universal adhesives of All-Bond Universal, Single Bond Universal, and Clearfil Universal Bond with etch-and-rinse or self-etch mode were bonded to the desensitized dentin specimens separately, followed by resin composite build-ups. Micro-tensile bond strength was measured using a micro-tensile tester. The wettability of desensitized dentin was evaluated by the contact angle of the adhesives. Resin infiltration was observed by confocal laser scanning microscopy. Dentin tubular occlusion and nanoleakage were observed by scanning electron microscope. The results showed that the etch-and-rinse or self-etch mode of each adhesive showed similar bond strength when bonding to nHAp-based desensitized dentin. The dentin surface was partially covered by desensitizers after desensitization. Compared with the self-etch mode, stronger demineralization and more reopened dentin tubules were observed in the etch-and-rinse mode after acid etching; longer resin tags and more nanoleakage in the resin-dentin interface were observed when using the etch-and-rinse mode. When bonding to nHAp-based desensitized dentin with universal adhesives, no significant difference in bond strength was found between self-etch mode or etch-and-rinse mode; while the latter produced more nanoleakage in the resin-dentin interfaces.

Phenolic extract of Libidibia ferrea inhibits dentin endogenous enzymatic activity depending on the adhesive system strategy

This study evaluated the influence of Libidibia ferrea (Lf) extract used as dentin pretreatment on the resin-dentin bond strength stability and dentin endogenous enzymatic activity. The phytochemical profile (PP) of the Lf extract was evaluated by liquid chromatography; particle size, polydispersity index (PdI), and zeta potential (ZP) were evaluated by dynamic light scattering. The tested groups were ER-Scotchbond Universal (SBU) in the etch-and-rinse (ER) mode; ERLf-SBU in the ER mode + Lf after etching; SE- SBU in the self-etch (SE) mode; and LfSE-Lf before SBU in the SE mode. Sticks were obtained for microtensile bond strength tests and failure mode (24 hr and 12 months). The hybrid layer was evaluated using scanning electron microscopy. The endogenous enzymatic activity of the underlying dentin was analyzed by in situ zymography with the same treatments. The PP showed the presence of quercetin (2.6% w/w). Lf particles were considered large after the analysis of the PdI. The ZP remained stable over time. The ER and ERLf groups had lower bond strength after 12 months, but SE and LfSE remained stable. The predominant failure mode was adhesive for both times. ER and ERLf had longer resin tags and a thicker hybrid layer. The ER and LfSE groups showed higher enzymatic activity than the ERLf and SE groups after 12 months. The Lf extract may contribute to inhibit the dentin endogenous enzymatic activity when associated with an adhesive system in the ER mode.

The effect of immediate dentin sealing with chlorhexidine pretreatment on the shear bond strength of dual-cure adhesive cement

The purpose of this in vitro study was to evaluate the effect of immediate dentin sealing (IDS) with and without chlorhexidine (CHX) pretreatment on the shear bond strength (SBS) of dual-cure adhesive resin cement. Mid-coronal dentin surfaces were obtained from 75 human molars. They were randomly allocated into five groups in accordance to type of IDS [etch&rinse/ER (Adper Single Bond2) and universal/U adhesive systems (Single Bond Universal)] and presence of CHX application (n = 15): Group ER; Group ER + CHX; Group U; Group U + CHX; and Group C (no IDS). Dual-cure adhesive resin cements were bonded with a cylinder-shaped Teflon mold. The SBS was measured using a universal test machine. Fracture type was evaluated with stereomicroscope. The resin/dentin interfaces were examined with an environmental scanning electron microscope. Data were statistically analyzed with two-way analysis of variance and Bonferroni tests (p < .05). Regarding the IDS treatment groups with/without CHX, there were no significant differences in SBS (p > .05). Group U + CHX showed significantly higher SBS than Group C (p < .05). Regarding the presence of CHX, no significant differences in SBS were found (p > .05). The prevalent failure mode was the mixed type for most of the groups. Group C exhibited an intact and regular hybrid layer with no resin tag, whereas longer and clear resin-tag formation was visible for Group U + CHX. CHX pretreatment improved the bond strength between adhesive resin cement and dentin when IDS treatment was performed with a universal adhesive system.

Micro Push-Out Bond Strength of Resin Composite to Dentin in Primary Dentition Using Three Universal Adhesives with Different pH: An In Vitro Study

To evaluate the bond strength of different universal adhesives on deciduous tooth dentineand their relationship with the composition and potential of hydrogen (pH). Methods: An in vitromicro push-out test on 150 samples (n = 50) per group per adhesive, namely, Adhese Universal(ADH; Ivoclar Vivadent), Futurabond U (FUT; Voco GmbH) (Test), and Scotchbond Universal withpre-conditioning (SCO; 3M) (Control), to record bond strength (BS) and type of adhesive failure.Results: The results of the different adhesives (megapascals (MPa)) varied, showing no statisticalsignificance. The corresponding averages are in MPa: ADH, 13.66 2.81; FUT, 14.48 2.88; SCO,14.98 3.96. Additionally, the frequency of type of failure was as follows: mixed (60.7%), adhesive(27.3%), and cohesive (12%). Conclusions: SCO, with a pH of 2.7, showed greater resistance tofracture, while FUT, with a pH of 2.3 and no pre-conditioning, approached the same values, being aone-step adhesive. No relationship was found between failure and type of adhesive.

Influence of Low-Level Laser Modification and Adhesive Application Mode on the Bonding Efficiency of Universal Adhesives to Er:YAG Laser-Ablated Dentin

Introduction: Erbium laser ablation as a method of tooth preparation and conditioning has shown promising results. Although previous studies have adopted various combinations of different laser parameters and several dentin adhesive systems, very few have investigated combining high-level and low-level ER:YAG lasers with Universal adhesives. This study aimed to assess the impact of using low-energy irradiation on the surface micro-topography and shear bond strength (SBS) of universal adhesive (UA) to the erbium:yttrium-aluminum-garnet (Er:YAG) laser-ablated dentin substrate, bonded in etch-and-rinse or self-etch adhesive mode. Methods: Eighty-seven extracted molars were sectioned to expose flat occlusal dentin surface; 60 teeth were divided equally into three groups according to the surface treatment; bur-cutting (B), Er:YAG high-energy laser cutting (L₁ - 200 mJ, 20 Hz, 50 μs pulse), or L₁ followed by low-energy laser modification (L₁ /L₂ - 80 mJ, 10 Hz, 50 μs pulse). Then each group was equally divided into two groups (n=10) according to the mode of application of the universal adhesive; either etch-and-rinse (ER) or self-etching (SE). The samples were subjected to thermocycling (5000 cycle between 5°C and 55°C), and SBS was tested. Two-way ANOVA and Tukey post hoc test were used to analyze the results. The remaining 27 samples were used to investigate the effect of the treatment on the topography of the treated dentin surfaces using a scanning electron microscope (SEM). Results: B/SE recorded the highest SBS (25.48 ± 2.6 MPa) followed by B/ER (23.20 ± 6.8 MPa) and L₁ /L₂ /SE (22.94 ± 4.1 MPa) and with no statistically significant difference between these groups (P >0.05). The lowest SBS results (P <0.05) were recorded for L₁/SE (12.22 ± 3 MPa). No statistical differences were found between the SBS of L₁ /L₂ /ER and L₁ /ER groups or between the SBS of L₁ /L₂ / ER and L₁ /L₂ /SE groups. Conclusion: A subsequent treatment of the Er:YAG laser-ablated dentin with low-energy laser modification mode (LMM) enhances the SBS of the tested UA when applied in SE mode.

Flexural properties and dentin adhesion in recently developed self-adhesive bulk-fill materials

PURPOSE

This study investigated the flexural properties, shear bond strength (SBS) and interface to dentin of three recently developed self-adhesive bulk-fill materials.

METHODS

Bars of Surefil One (SO), Cention N (CN), Activa BioActive Restorative (AB) and EQUIA Forte HT Fil (EQUIA) were tested for flexural strength and flexural modulus in self-curing and light-curing modes. In addition, SBS to dentin was tested in specimens without pretreatment and after application of universal adhesive (Scotchbond Universal). EQUIA was used as the control material.

RESULTS

The flexural properties were significantly better in light-curing mode for all materials except CN. CN had the highest SBS values after universal adhesive application (33.8 MPa), and SO had the highest SBS without pretreatment (20.9 MPa).

CONCLUSION

The mechanical and adhesive properties of these new materials varied widely.

Universal adhesives and dual-cured core buildup composite material: adhesive properties

Dual-cured buildup composites and simplified light-cured adhesive systems are mixed with a chemical activator to prevent the incompatibility between them.

Comparison of different etch-and-rinse adhesive systems based on shear fatigue dentin bond strength and morphological features the interface

OBJECTIVES

The aim of this study was to investigate dentin bonding durability of different etch-and-rinse (ER) adhesive systems under fatigue stress and to compare morphological features of resin/dentin interfaces using SEM.

METHODS

Two three-step ER adhesives, a two-step ER adhesive, and a universal adhesive in ER mode were evaluated. Before application of either primer or adhesive, phosphoric acid etching of human dentin was completed. Fifteen bonded specimens for each adhesive system were stored in distilled water at 37 °C for 24 h, then subjected to a shear bond strength (SBS) test. Bonding durability was assessed from the perspective of biomechanical stress. 25 bonded specimens for each adhesive system were subjected to shear fatigue strength (SFS) testing with a repeated subcritical load at a frequency of 20 Hz for 50,000 cycles or until failure.

RESULTS

Mean SBS and SFS values ranged from 33.3 to 41.2 MPa, and from 18.3 to 20.3 MPa, respectively. Three-step adhesives showed higher SBS and SFS values than the other adhesive systems. Under SEM, resin tags in different adhesive systems showed similar features, but morphology below the hybrid layer was material dependent. The universal adhesive in ER mode showed an obvious thin, high-density reaction layer below the hybrid layer.

SIGNIFICANCE

Three-step adhesives showed higher dentin bond durability than the other ER adhesives; no significant differences in SFS were found between the universal adhesive in ER mode and the three-step ER adhesives. The results of this in vitro study indicate that some ER adhesives might establish chemical bonding with intact dentin below the hybrid layer in addition to micromechanical retention.

Optical changes of human dentin after non-vital bleaching and effect of Er,Cr:YSGG laser on micro-shear bond strength of a self-etch and an etch-and-rinse adhesive system

The aim was to evaluate the optical changes of bleached human dentin and the efficacy of Er,Cr:YSGG laser on micro-shear bond strength (μSBS) of two adhesive systems for immediate and delayed applications. Seventy-two human dentin specimens (1 mm) were obtained. Colour measurements of 30 specimens (control and bleaching groups) were made at baseline, after bleaching and a 7-day delay. Differences at colour (ΔE₀₀), translucency (ΔTP₀₀) and whiteness (ΔWI_D) were calculated by recorded data. Forty-two specimens were used to compare μSBS of a self-etch (Clearfil SE Bond [SE]) and an etch-and-rinse (Prime&Bond NT [PBNT]) adhesive to bleached dentin. Additional to a negative group, six groups were contemplated for each adhesive, considering the time of composite application (immediate, delayed) and whether additional surface treatment by laser (1 W, 2 W) or not. Colour and μSBS data were statistically analysed. For optical analysis, only ΔE₀₀ and ΔWI_D calculated for the difference between baseline and bleaching were found significantly different for control and bleaching groups. Whiteness of bleached specimens was remarkably decreased after a 7-day delay. Despite immediate applications of SE showing lower μSBS than negative control, delayed applications showed no significant differences except that of the 2 W laser etching. For PBNT, laser etching increased μSBS for both of the immediate and delayed applications, and no significant difference was observed from negative control. Related with the preferred adhesive system, Er,Cr:YSGG laser etching can be an alternative for optimal bond strength of immediate restorations, but the clinicians should always keep in mind that perceived colour and whiteness will change by the passing time which can affect the shade match.

Influence of Acid Etching and Universal Adhesives on the Bond Strength to Dentin

Abstract The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey’s post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures.

Effect of double-layer application on the early enamel bond strength of universal adhesives

OBJECTIVES

The present study aimed to investigate the changes in the enamel bond strengths of universal adhesives in the early phase of specimen creation and evaluate the effect of double-layer application on enamel bond effectiveness using different etching modes.

METHOD

Four universal adhesives, namely Clearfil Universal Bond Quick, G-Premio Bond, Scotchbond Universal, and Tokuyama Universal Bond, were used. Clearfil SE Bond two-step self-etch adhesive system was used as a comparison. Fifteen specimens per group were used for determining the shear bond strength (SBS) to bovine enamel in the etch-and-rinse or self-etch mode. The adhesive was applied to specimens in accordance with the manufacturers' instructions (single-layer application), or the adhesive was applied twice (double-layer application). The bonded specimens were stored in distilled water at 37 °C for 5 min or 1, 6, 12, or 24 h before SBS testing. The flexural properties of the resin composite Clearfil AP-X were measured for the same storage periods.

RESULTS

All universal adhesives exhibited increased SBS values with prolonged storage periods regardless of the application technique or etching mode used. Double-layer application was associated with higher SBS values than single-layer application for most universal adhesives over the same storage period.

CONCLUSION

Phosphoric acid pre-etching and double-layer application of universal adhesives resulted in increased enamel bond strength in the early phase of specimen bonding.

CLINICAL RELEVANCE

Care should be taken when using universal adhesives in the self-etch mode for enamel bonding because the enamel adhesion is sensitive to the duration after filling.

Microshear Bond Strength of Different Adhesive Systems to Dentin

Objectives:

The aim of this study was to compare the microshear bond strength (μSBS) of various adhesive systems to dentin.

Materials and Methods:

In this in vitro experimental study, 60 sound human third molars were divided into four groups. Dentin discs were prepared of middle-third dentin measuring 4 mm in diameter and 2 mm in thickness. Dentin surfaces were bonded with one of the four types of adhesives: (A) Single Bond (3M ESPE), Scotchbond Universal (3M ESPE) in etch and rinse (B) and self-etch (C) modes and (D) Clearfil SE Bond (Kuraray Noritake Dental). After the application of adhesive systems according to the manufacturers’ instructions, composite cylinders (Vit-l-escence) were bonded to dentin surfaces. The μSBS test was performed using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with one-way ANOVA and Tukey’s test (α=0.05).

Results:

The μSBS was the highest in self-etch Scotchbond Universal (15.8±6.08 MPa) followed by Clearfil SE Bond (15.24±4.6 MPa), etch and rinse Scotchbond Universal (11.68±4.07MPa) and Single Bond (11.24±3.74 MPa). A significant difference was only found between Single Bond and etch and rinse Scotchbond Universal groups (P=0.04).

Conclusion:

Based on the results of this study, application of Scotchbond Universal in self-etch mode provides a reliable bond to dentin.

Comparison of dentin bond durability of a universal adhesive and two etch-and-rinse adhesive systems

OBJECTIVE

This study aimed to compare dentin bond durability under different degradation conditions between two etch-and-rinse (ER) systems and a universal adhesive in ER mode.

METHOD

This study used a universal adhesive [Scotchbond Universal (SU)], a three-step ER adhesive [Scotchbond Multi-Purpose Plus (SM)], and a two-step ER adhesive [Single Bond Plus (SB)]. A phosphoric acid-etching agent was applied to bovine dentin prior to the application of either a primer or the adhesive. After acid etching, bonding procedures were conducted. The specimens were divided into three group classes: (1) subjected to 10,000, 30,000, or 50,000 thermal cycles (TC); (2) stored in distilled water at 37 °C for 6 months or 1 year (WS); and (3) stored in distilled water for 24 h (baseline). Shear bond strength (SBS) tests were conducted.

RESULTS

SB showed a higher baseline SBS than the other adhesives. Defining the baseline SBS value for each adhesive system as 100%, TC groups ranged from 56.1 to 70.3% for SM, from 98.4 to 103.7% for SB, and from 120.3 to 126.7% for SU. WS groups ranged from 66.2 to 71.4% for SM, from 98.1 to 103.3% for SB, and from 102.5 to 118.1% for SU.

CONCLUSIONS

Although SB showed relatively stable dentin bond performance under all degradation conditions, SM showed decreased dentin SBS with prolonged degradation. SU did not show any significant decrease in SBS from the baseline under any degradation condition.

CLINICAL RELEVANCE

The universal adhesive showed comparable adhesive performance with the two-step ER adhesive.

The Effects of Aluminablasting on Bond Durability Between Universal Adhesives and Tooth Substrate

The aim of this study was to determine the effect of aluminablasting on the bond durability of universal adhesives and adherent surface characteristics. Adhese Universal (Ivoclar Vivadent), All-Bond Universal (Bisco), Bondmer Lightless (Tokuyama Dental), G-Premio Bond (GC), and Scotchbond Universal (3M ESPE) were used in self-etch mode. The prepared bovine enamel and dentin specimens were divided into two groups based on whether they received an aluminablasting prior to application of the universal adhesives. The resin composite bonded specimens were stored in distilled water at 37°C for 24 hours, following which the shear bond strength (SBS) of half of the specimens was measured (24-hour group). The other half was subjected to 30,000 thermal cycles between 5 and 55°C before SBS measurement (TC group). Surface roughness (Ra) and surface free energy (SFE) of the adherent surfaces were also measured, and scanning electron microscopy observation and scanning electron microscopy/energy-dispersive X-ray analysis were carried out. Most of the adhesives did not show any significant differences in enamel SBS values between the two pretreatment groups, regardless of the storage condition. However, the dentin SBS values were significantly lower in specimens that underwent aluminablasting compared with those that did not, irrespective of their storage conditions. Significantly higher Ra and SFE values were observed in the enamel and dentin of specimens that underwent aluminablasting. Although aluminablasting increased the Ra and SFE values of enamel and dentin, its effect on the SBS value was dependent on the tooth substrate. In addition to C, O, Na, Mg, P, and Ca, the element Al was detected in the enamel and dentin of samples that had undergone aluminablasting. These results suggest that although aluminablasting of the tooth surface is thought to be effective for modification of the adherent surface, it may not enhance enamel bond performance and may also adversely affect the dentin bond effectiveness of the universal adhesives.

SEM observation of novel characteristic of the dentin bond interfaces of universal adhesives

OBJECTIVE

The aim of this study was to observe the resin/dentin interfaces of universal adhesives by using scanning electron microscopy (SEM), and to compare their morphologies with conventional etch & rinse (ER) and self-etch (SE) adhesive systems.

METHODS

Two three-step and one two-step ER adhesives and two two-step and two single-step SE adhesives were used for comparison with seven universal adhesives in ER mode and SE mode, respectively. Bonded surfaces with bovine teeth were longitudinally sectioned and mirror-polished. Half of the samples were treated with HCl and NaOCl solutions. The interfaces were subjected to argon ion beam etching and then observed by scanning electron microscopy.

RESULTS

The thickness of the adhesive layer (AL) of most of the seven universal adhesives and single-step SE adhesives was similar. Universal adhesives in SE mode formed a hybrid smear layer as a high-density zone between the AL and dentin. The thickness of the hybrid layer (HL) of the universal adhesives in ER mode was ∼1-2μm, with a high-density zone (reaction layer [RL]) below the HL.

CONCLUSION

The morphological features of most universal adhesives in SE mode and single-step SE adhesives are similar. Although resin-dentin interfaces of universal adhesives in ER mode resemble those of ER adhesives, universal adhesives have a distinctive feature, an RL.

SIGNIFICANCE

The RL might be a sign of chemical bonding even when using universal adhesives in ER mode.

Multi-Mode adhesives performance and success/retention rates in NCCLs restorations: randomised clinical trial one-year report

Aim: Compare clinical performance and success/retention rates of two multi-mode (MM) adhesives, applied in self-etch (SE) or etch-and-rinse (ER) modes, with SE-all-in-one adhesive (SE/SE with enamel etching) in NCCL restorations at one-year follow-up.

Material and methods: Prospective, double-blind RCT approved by the University Fernando Pessoa and the National-Clinical-Research-Ethics Committees (CEIC-20150305), ClinicalTrials.gov registered (NCT02698371), in 38 participants with 210 restorations (AdmiraFusion^®) randomly allocated to six groups (Adhesives_Adhesion mode), each with 35 restorations: G1-Control Futurabond^®DC_SE; G2-Control Futurabond^®DC_SE with enamel etching; G3-Futurabond^®U_ER; G4-Futurabond^®U_SE; G5-Adhese^®Universal_ER; G6-Adhese^®Universal_SE. Restorations evaluated at baseline and one-year by three calibrated examiners (ICC ≥0.952) using FDI criteria and statistical analysis with nonparametric tests (alpha = 0.05).

Results: At one-year recall 36 participants, 199 restorations were available for examination; five (2.5%) restorations (G1 n = 2; G2, G3, G4 n = 1) were lost due to retention (p > .05); G1 showed less satisfying marginal adaptation (p < .05) than G2 and MM adhesives groups, particularly G6. Overall success rates (p > .05) were: 93.9% (G1), 97.0% (G2; G3; G4) and 100.0% (G5; G6).

Conclusions: MM adhesives (Futurabond^®U and Adhese^®Universal) showed similar and acceptable performance/success rates but also better clinical outputs than the SE-all-in-one adhesive (Futurabond^®DC), particularly in SE mode. Success and retention rates were similar and not dependent on materials or adhesion modes.

Influence of Application Time on Dentin Bond Performance in Different Etching Modes of Universal Adhesives

We attempted to determine the effect of universal adhesive application time on dentin bond performance in different etching modes based on shear bond strength (SBS) tests and surface free energy (SFE) measurements. The five universal adhesives used were Adhese Universal (AU), Clearfil Universal Bond Quick (CQ), G-Premio Bond (GP), Scotchbond Universal (SU), and Tokuyama Universal Bond (TU). Bovine dentin specimens were divided into four groups of 10 for each adhesive. SBS and SFE were determined after applying the following surface treatments: 1) self-etch (SE) mode with immediate air blowing after adhesive application (IA treatment), 2) SE mode with prolonged application time (PA treatment), 3) etch-and-rinse (ER) mode with IA treatment, and 4) ER mode with PA treatment. Bonded specimens were subjected to SBS testing. The SFE of adhesive-treated dentin surfaces was measured after rinsing with acetone and water. Three-way analysis of variance revealed that dentin SBS values (p<0.001) were significantly influenced by the factors of adhesive type and application duration, but the factor of pre-etching was not significant (p=0.985). The manufacturer's instructions require longer application times for AU and SU, which showed significantly lower SBS values in IA than in PA treatment in both etching modes. However, the difference in the other adhesives was not significant between the IA and PA treatments in either etching mode. The total SFE (γ_S) was dependent on the adhesive and etching mode. The γ_S value of the initial group (SiC paper ground group) at baseline was 69.5 (mN·m^-1) and that of the pre-etching group at baseline was 30.6 (mN·m^-1). For all the adhesives, γ_S in SE mode showed significantly higher values than in ER mode, regardless of the application time. In SE mode, almost all universal adhesives tested showed lower γ_S values in PA treatment than in IA treatment. For ER mode, all the adhesives showed significantly higher γ_S values than those of the pre-etching baseline, regardless of the application time. Most adhesives did not show any significant differences in γ_S values between IA and PA treatments, regardless of etching mode.

Evaluation of Fracture Resistance and Microleakage of Endocrowns with Different Intracoronal Depths and Restorative Materials Luted with Various Resin Cements

The aim of this study was to determine the effect of restoration design on the fracture resistance of different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics and investigate the marginal leakage of endocrowns according to different types of cement. In total, 96 extracted mandibular first premolars were used for fabrication of endocrowns; 48 of the endocrowns were divided into 6 groups (n = 8) according to intracoronal cavity depth (2 and 3 mm) and CAD/CAM ceramics (lithium disilicate IPS e.max-CAD, zirconia-reinforced glass-ceramic Vita Suprinity, and poly-ether-ether-ketone (PEEK)). Teeth were subjected to a fracture resistance test with a universal test machine following thermo-cycling. Failure modes were determined by stereomicroscope after the load test. The rest of the endocrowns (n = 48) were produced by Vita Suprinity ceramic and divided into 6 groups (n = 8) according to the cement used (Panavia V5, Relyx Ultimate, and GC cement) with intracoronal cavity depths of 2 and 3 mm. Microleakage tests were performed using methylene blue with stereomicroscope after thermo-cycling. Numerical data for both fracture resistance and microleakage tests were obtained and evaluated by three-way ANOVA. PEEK endocrowns had higher fracture resistance compared to lithium disilicate and Vita Suprinity. Panavia V5 cement had the lowest degree of microleakage, while GC cement had the highest. Different intracoronal cavity depths had no correlation with fracture resistance and microleakage.

Reactivity and Bond Strength of Universal Dental Adhesives with Co-Cr Alloy and Zirconia

The aim of this study was to evaluate (a) the reactivity of six universal dental adhesives with polished cobalt-chrome (Co-Cr) alloy and zirconia (3Y-TZP) surfaces; and (b) to assess the shear bond strength (SBS) of a resin composite with polished and alumina-blasted surfaces as mediated by these adhesives. The products tested were Adhese Universal (AD), All-Bond Universal (AB), Clearfill Universal Bond (CB), G-Premio Bond (GP), Prelude One (PO) and Scotchbond Universal (SB). The reactivity on polished substrates was evaluated by reflection infrared microscopy (RFTIRM). The roughness parameters of polished and 50 μm alumina grit-blasted surfaces were assessed by optical profilometry. The SBS of the composite bonded to the substrates treated with each adhesive (n = 10/product) was evaluated after 1 week of storage (H₂O/37 °C) by Weibull statistics. Evidence of phosphate interaction with polished substrates was obtained by FTIRM, with higher peaks on the alloy. Alumina-blasting increased all roughness parameters with higher values on the alloy. AD, CB were the strongest (σ₀) treatments on alloy surfaces and AD, CB, AB, SB on zirconia. GP was the weakest on both substrates and the least reliable (β) on alloy. On polished alloy GP, PO performed better (σ₀), whereas on zirconia there were no significant differences. All adhesives showed more prominent reaction with the Co-Cr alloy than with 3Y-TZP.

Effect of Active Application on Bond Durability of Universal Adhesives

The purpose of this study was to determine the effect of different adhesive application methods and etching modes on the dentin bond durability of universal adhesives under thermal cycling (TC). All-Bond Universal (Bisco), Adhese Universal (Ivoclar Vivadent), and Scotchbond Universal (3M ESPE) were used as adhesives. In total, 600 bovine teeth with exposed dentin were divided into 12 groups according to the type of adhesive and subjected to the following bonding procedures: 1) etch-and-rinse mode with active application; 2) etch-and-rinse mode with inactive application; 3) self-etch mode with active application; and 4) self-etch mode with inactive application. Bonded specimens were stored in distilled water at 37°C for 24 hours and then subjected to 5000, 10,000, 30,000, or 50,000 TC between 5°C and 55°C before shear bond strength (SBS) testing, creating a division into a total of five different storage conditions. Baseline specimens were stored in distilled water at 37°C for 24 hours. The SBS test was performed at a cross-head speed of 1.0 mm/min. Three-way analysis of variance revealed that all the factors of application mode, adhesive, and thermal cycle period significantly influenced the SBS values (p&lt;0.001), regardless of the etching mode. In the baseline groups, all of the tested adhesives with active application had higher SBS values than those with inactive application, regardless of etching mode. In the TC groups, significantly lower SBS values were observed at 50,000 TC with inactive application compared to those with active application, regardless of the etching mode. From the scanning electron microscopy observation of demineralized and deproteinized resin/dentin interfaces, dense resin tags longer than 50 μm were observed in the etch-and-rinse with active application group. On the other hand, the resin tags in self-etch mode were sparse, thin, and much shorter than those in etch-and-rinse mode. Comparing the penetration status of the resin tags with active and inactive application in self-etch mode, the resin tag penetration with inactive application was much lower than that with active application. Active application is effective in enhancing the dentin bond durability of universal adhesives. When using universal adhesives with different etching modes, practitioners should select the optimal etching mode and appropriate application method in accordance with the cavity conditions.

Effect of Reduced Universal Adhesive Application Time on Enamel Bond Fatigue and Surface Morphology

Objective:

The purpose of this study was to evaluate the effect of reduced application times of universal adhesives on enamel bond fatigue and surface morphology of the treated enamel with constant force atomic force microscopy (AFM).

Methods:

Four universal adhesives—Adhese Universal (AU), Clearfil Universal Bond Quick (CU), G-Premio Bond (GP), and Scotchbond Universal Adhesive (SU)—were evaluated in a laboratory for their ability to adhesively bond resin composite to enamel. Shear bond strengths were initially determined using 15 specimens per test group for each adhesive. Shear fatigue strengths were then determined using 20 specimens per test group for each the adhesives. The fatigue specimens were loaded using a sine wave at a frequency of 20 Hz for 50,000 cycles or until failure occurred. AFM observations, surface Ra roughness measurements, and geometric surface area evaluations of enamel surface treated with the adhesive agents were also conducted.

Results:

A strong relationship was found between the initial shear bond strength and shear fatigue strength for enamel surface Ra roughness but not for geometric surface area. The initial shear bond strength and shear fatigue strength of CU and GP were not influenced by different application times, unlike those of AU and SU. While the surface area of enamel treated with the adhesive agents was not significantly influenced by different application times and type of adhesive, surface Ra roughness of the enamel in the AU and SU groups significantly increased with increasing application time, unlike CU and GP.

Conclusions:

The results of this study suggest that universal adhesives, used with reduced application times, have adequate Ra surface roughness to provide sufficient resistance to enamel bond fatigue at application times from &lt;1 second to 20 seconds, while the geometric surface area of adhesive-treated enamel did not show any significant changes at these different application times.

Bond strength assessment of a universal adhesive system in etch-and-rinse and self-etch modes

Abstract Introduction Modern dentistry is reflected in the insertion of new materials with different adhesion forms in dental structures, such as the Universal adhesive system. Objective To evaluate the bond strength of the universal dentin adhesive system, in the form of self-etching and conventional application, compared with a simplified conventional adhesive system, in two distinct periods: 1 week and 6 months. Material and method 48 bovine incisors separated into 6 groups, stored for 7 days, were selected. Worn out the buccal enamel until dentin exposure. Adper Single Bond 2 (3M Espe) or SingleBond Universal (3M Espe) adhesives were applied, and catheters filled with Opallis Flow (FGM) composite were placed. After photoactivation, the catheters were removed and the specimens (n = 48), stored in distilled water at 37 °C for one week and six months, were exposed. The specimens were fixed to a universal testing machine (EMIC DL 2000) with a speed of 0.5 mm / min. Bond strength (BS) was calculated in MPa, and data were statistically analyzed by Anova and Tukey test at 5% significance level. Result For Adper Single bond, the BS was equivalent in the times tested; for Universal conventional and self-conditioning time influenced the BS, with a decrease in the results. At 1 week, all stickers were different from each other, with higher BS for Universal conventional mode, followed by universal self-etching mode and then Adper Single bond. Conclusion The best results were achieved with universal adhesive in conventional mode for both tested times.

Effect of chlorhexidine on the durability of a new universal adhesive system

Background

The effect of chlorhexidine on bond durability of universal adhesives is not clear. The aim of this study was to evaluate the effect of chlorhexidine on 6-month water storage bond strength of adhesive systems.

Material and Methods

72 freshly sound human extracted molars were selected. In each tooth both buccal and lingual sides were prepared by bur to reach superficial dentin and randomly divided into 6 groups and 12 sub-groups and bonded with Scotchbond Universal (SBU) or Scotchbond Multi-purpose (SBMP) with/without chlorhexidine (CHX) usage. Group 1: SBU, group2: SBU+CHX, group3: Etch+SBU, group4: Etch+CHX+SBU, group5: Etch+SBMP, group6: Etch+CHX+SBMP. After composite curing, water storage and thermocycling was done. Each group was divided into two subgroups. One was tested immediately, and the other was thermocycled for 5000 cycles (5-55 °C) (it was equivalent to 6 months of storage in distilled water). Shear bond strength test was done and failure modes were determined by Stereomicroscope. The data were analyzed by one-way ANOVA, Tukey post-hoc test and Paired Two test with P<0.050 as the level of significance.

Results

Shear bond strength in late SBU (Self etch) was significantly lower than late SBU [Etch and rinse (ER)], P value= 0.0001, also shear bond strength in late SBU [self-etch (SE)] was significantly lower than immediate SBU (SE), P value= 0.01. There were no significant differences between other sub-groups and conditions. The most failure mode was adhesive in all the groups.

Conclusions

Long term bonding durability of SBU(ER) was better than SBU (SE). CHX usage had prevented bond strength decrease in SBU and SBMP in long term. CHX usage did not have any effect on immediate shear bond strength of SBU and SBMP. Immediate and late shear bond strength of SBMP with/without CHX usage was similar to SBU(SE, ER). Key words:Dentin Bonding, Shear Bond Strength, chlorhexidine, 6-month storage.