Influence of glutaraldehyde priming on bond strength of an experimental adhesive system applied to wet and dry dentine

Theaflavin -3,3'-digallate/ethanol: a novel cross-linker for stabilizing dentin collagen

Objectives

To study the ability of theaflavin-3,3'-digallate (TF3)/ethanol solution to crosslink demineralized dentin collagen, resist collagenase digestion, and explore the potential mechanism.

Methods

Fully demineralized dentin blocks were prepared using human third molars that were caries-free. Then, these blocks were randomly allocated into 14 separate groups (n = 6), namely, control, ethanol, 5% glutaraldehyde (GA), 12.5, 25, 50, and 100 mg/ml TF3/ethanol solution groups. Each group was further divided into two subgroups based on crosslinking time: 30 and 60 s. The efficacy and mechanism of TF3's interaction with dentin type I collagen were predicted through molecular docking. The cross-linking, anti-enzymatic degradation, and biomechanical properties were studied by weight loss, hydroxyproline release, scanning/transmission electron microscopy (SEM/TEM), in situ zymography, surface hardness, thermogravimetric analysis, and swelling ratio. Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy were utilized to explore its mechanisms. Statistical analysis was performed using one and two-way analysis of variance and Tukey's test.

Results

TF3/ethanol solution could effectively crosslink demineralized dentin collagen and improve its resistance to collagenase digestion and biomechanical properties (p < 0.05), showing concentration and time dependence. The effect of 25 and 50 mg/ml TF3/ethanol solution was similar to that of 5% GA, whereas the 100 mg/mL TF3/ethanol solution exhibited better performance (p < 0.05). TF3 and dentin type I collagen are mainly cross-linked by hydrogen bonds, and there may be covalent and hydrophobic interactions.

Conclusion

TF3 has the capability to efficiently cross-link demineralized dentin collagen, enhancing its resistance to collagenase enzymatic hydrolysis and biomechanical properties within clinically acceptable timeframes (30 s/60 s). Additionally, it exhibits promise in enhancing the longevity of dentin adhesion.

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.

Bonding strategies to deal with caries-affected dentin using cross-linking agents: Grape seed extract, green tea extract, and glutaraldehyde - An in vitro study

Aim

This study evaluated the effect of three collagen cross-linking agents - proanthocyanidins (grape seed extract [GSE] and green tea extract [GTE]) and glutaraldehyde [GA] on microshear bond strength (μSBS) of caries-affected dentin (CAD)-resin complex.

Materials and Methods

Freshly extracted 96 teeth with caries up to the middle third of dentin were sectioned through the deepest part of the occlusal fissure, perpendicular to the long axis of the crown. Caries was excavated with large round bur until firm dentin was obtained, confirmed by visual inspection and tactile examination. Flat occlusal dentin surfaces were treated as follows: Group-1 - 6.5% GSE (n = 30), Group-2 - 2% GTE (n = 30), Group-3 - 5% Glutaraldehyde (n = 30), Group-4 - control group (no agents) (n = 6). Each group was further divided into Subgroup A - Etch-N-Rinse 15s, Subgroup B - Etch-N-Rinse 45s, and Subgroup C - Self-etch. Two increments of 1.5-mm thick composite (Tetric-N-Ceram - Ivoclar Vivadent) with a 1-mm diameter were built-up. Each sample was subjected to μSBS test in Universal Testing Machine. Student's t-test was done for intragroup comparison and one-way ANOVA for intergroup comparison.

Results

Statistically significant difference was present in mean μSBS, with Group 1B showing the best results and Group 4C, the least.

Conclusions

Thus, the application of these collagen cross-linkers, to CAD, increases μSBS and promises a new approach to improve dentin bond strength.

Effect of Nd:YAG, Er,Cr:YSGG Laser Irradiation, and Adjunctive Photodynamic Therapy on Push-Out Bond Strength of Zirconia Posts to Radicular Dentin

This study is aimed at assessing the influence of Nd:YAG, Er,Cr:YSGG laser irradiation, and adjunctive photodynamic therapy (aPDT) on the bond strength of zirconia posts to radicular dentin. Eighty extracted anterior teeth were randomly categorized into 4 groups (n = 20) based on varying laser irradiation treatments, i.e., conventional cleaning and shaping (CCS), Nd:YAG, Er,Cr:YSGG, and aPDT group, respectively. Using a cutting machine, the samples were prepared for push-out bond strength analysis; 4 sections (2 on each apical and cervical) of around 1 mm thickness were sectioned for all roots at a right angle to the long axis of the post. After making the space for the post, they were incorporated into the root system and were subjected to different laser treatments. The universal testing machine was utilized to assess the push-out bond strength, which had a defined 1 mm/minute crosshead speed until the failure was encountered. Specimens in the aPDT group (8.20 ± 2.14 MPa) demonstrated the highest mean push-out bond strength, whereas the lowest was shown by samples in the CCS group (7.08 ± 1.11 MPa). According to the independent t-test, the mean push-out bond strength scores of the cervical segments were higher as compared to the apical segments in research groups (p < 0.05). Overall, the adhesive type was the most frequently encountered failure mode in all of the experimental groups, with the least number of failures observed in aPDT treated teeth samples. In conclusion, the push-out bond strength to radicular dentin was not much influenced by Nd:YAG, Er,Cr:YSGG laser, and aPDT in comparison with CCS. Although statistically not significant, however, the application of aPDT provided better outcomes as compared to other research groups.

Inhibition of matrix metalloproteinases: a troubleshooting for dentin adhesion

Matrix metalloproteinases (MMPs) are enzymes that can degrade collagen in hybrid layer and reduce the longevity of adhesive restorations. As scientific understanding of the MMPs has advanced, useful strategies focusing on preventing these enzymes' actions by MMP inhibitors have quickly developed in many medical fields. However, in restorative dentistry, it is still not well established. This paper is an overview of the strategies to inhibit MMPs that can achieve a long-lasting material-tooth adhesion. Literature search was performed comprehensively using the electronic databases: PubMed, ScienceDirect and Scopus including articles from May 2007 to December 2019 and the main search terms were “matrix metalloproteinases”, “collagen”, and “dentin” and “hybrid layer”. MMPs typical structure consists of several distinct domains. MMP inhibitors can be divided into 2 main groups: synthetic (synthetic-peptides, non-peptide molecules and compounds, tetracyclines, metallic ions, and others) and natural bioactive inhibitors mainly flavonoids. Selective inhibitors of MMPs promise to be the future for specific targeting of preventing dentin proteolysis. The knowledge about MMPs functionality should be considered to synthesize drugs capable to efficiently and selectively block MMPs chemical routes targeting their inactivation in order to overcome the current limitations of the therapeutic use of MMPs inhibitors, i.e., easy clinical application and long-lasting effect.

Effect of different laser types on bonding strength of CAD/CAM-customized zirconia post to root canal dentin: an experimental study

In clinical dentistry, the strength of bonding zirconia posts to root canal dentinal walls currently needs enhancement, and laser application can be an important contribution owing to its features that accommodate adjustable modifications on dental materials. Herein, the effect of different laser treatments applied to dentin surfaces on the strength of bonding zirconia posts to root canal dentinal walls is evaluated by using the pull-out bond strength test in a laboratory setting. A total of 40 single-rooted permanent mandibular premolar teeth that were freshly extracted were used here. The root canal preparation steps were performed using the crown-down technique. Custom-made zirconia posts were produced using CAD/CAM technology. Prior to the application of resin cement, the internal surfaces of the root canals were irradiated using Nd:YAG, Er:YAG, and KTP lasers. Pull-out tests were performed on each specimen by using a universal testing machine. One-way analysis of variance and Tukey post hoc tests were used to compare the pull-out bond strength data. The bond strengths of the laser-treated specimens were greater than those of the untreated controls (p < 0.05). While the value of the pull-out bond strength after Nd:YAG laser treatment was significantly higher than the values obtained after the applications of the Er:YAG and KTP lasers (p < 0.05), the pull-out bond strength after Er:YAG laser treatment was considerably greater than that after KTP laser treatment (p < 0.05). The bond strength between the root canal dentin and the CAD/CAM custom-made zirconia post was improved upon using all the laser modalities in current laboratory settings, among which, application of the Nd:YAG laser was the most successful.

The Significance and Utilisation of Biomimetic and Bioinspired Strategies in the Field of Biomedical Material Engineering: The Case of Calcium Phosphat-Protein Template Constructs

This review provides a summary of recent research on biomimetic and bioinspired strategies applied in the field of biomedical material engineering and focusing particularly on calcium phosphate-protein template constructs inspired by biomineralisation. A description of and discussion on the biomineralisation process is followed by a general summary of the application of the biomimetic and bioinspired strategies in the fields of biomedical material engineering and regenerative medicine. Particular attention is devoted to the description of individual peptides and proteins that serve as templates for the biomimetic mineralisation of calcium phosphate. Moreover, the review also presents a description of smart devices including delivery systems and constructs with specific functions. The paper concludes with a summary of and discussion on potential future developments in this field.

Effect of Baicalein on Matrix Metalloproteinases and Durability of Resin-Dentin Bonding

OBJECTIVE

In an attempt to increase resin-dentin bonding quality, this study used baicalein as a preconditioner in an etch-and-rinse adhesive to evaluate its effect on matrix metalloproteinases (MMPs) and adhesive durability.

METHODS

As a MMP inhibitor and potential collagen cross-linking agent, baicalein was used as a preconditioner in an etch-and-rinse adhesive system. The degree of conversion was evaluated by Fourier-transform infrared spectroscopy. EnzChek gelatinase/collagenase assay kits were then used to detect the MMP inhibitory effect of different concentrations of baicalein (0.1, 0.5, 2.5, and 5.0 μg/mL) on dentin powders. During in vitro bonding procedures, flat dentin surfaces on sound third molars were preconditioned with 2.5 μg/mL baicalein after being acid-etched; this step was followed by continuation of adhesive processes and build-up of resin composite. After resin-dentin stick preparation, bonding strength, failure mode, and interface nanoleakage were respectively evaluated via microtensile testing, stereomicroscopy, and field emission scanning electron microscopy either immediately or after storage in artificial saliva for three or six months. Data were analyzed by two-way analysis of variance and Tukey test (α=0.05).

RESULTS

Baicalein at a concentration of 0-5.0 μg/mL did not influence the conversion of adhesives. However, it inhibited the activities of dentin-bond gelatinase and collagenase, especially at a concentration of 2.5 μg/mL, while effectively increasing microtensile bonding strength and decreasing nanoleakage in vitro, both immediately and after aging.

CONCLUSIONS

Baicalein used as preconditioner in an etch-and-rinse adhesive system has an anti-MMP function and effectively improves resin-dentin bonding durability in vitro, which has potential value in clinical bonding procedures.

Effects of Collagen Crosslinkers on Dentine: A Literature Review

This aim of this review is to explore the current research related to crosslinking agents used on dentine. A systematic search of publications in PubMed and Web of Science databases was performed. Further retrieval was conducted using the search terms of specific names of crosslinkers. Reviews, conference abstracts, dissertation and theses, non-English articles, studies of intrinsic crosslinking of dentine, studies of adhesives without specific crosslinker components, studies of crosslinker applications in other collagenous tissues or tooth-like structures and irrelevant studies were excluded. Manual screening was conducted on the bibliographies of remaining papers to identify other relevant articles. One hundred and one articles were included in this systematic review and full texts were retrieved. Both synthetic and naturally derived crosslinkers have been found to exhibit significant effects in biomodification of dentine via their multiple interactions with the dentine matrix. A stable matrix network or a durable hybrid layer in dentine bonding could be achieved, where the dentine collagen fibrils show improved biochemical and biomechanical properties and enzymatic biodegradation is reduced. Although no crosslinkers have been tested in clinical trials, extensive research has been conducted in laboratory studies to investigate their potential applicability for inhibition of demineralisation and/or promotion of remineralisation, caries prevention as well as improvement of bonding performance of adhesive systems. Further studies are needed to develop the feasibility for clinical use, reduce side effects as well as explore mechanisms of action and long-term effectiveness.

Bonding resin thixotropy and viscosity influence on dentine bond strength

OBJECTIVES

To investigate the influence of bonding resin thixotropy and viscosity on dentine tubule penetration, blister formation and consequently on dentine bond strength as a function of air-blowing pressure (air-bp) intensity.

METHODS

Two HEMA-free, acetone-based, one-bottle self-etch adhesives with similar composition except disparate silica filler contents and different bonding resin viscosities were investigated. The high-filler-containing adhesive (G-Bond) featured a lower viscous bonding resin with inherent thixotropic resin (TR) properties compared to the low-filler-containing adhesive (iBond) exhibiting a higher viscous bonding resin with non-thixotropic resin (NTR) properties. Shear bond strength tests for each adhesive with low (1.5bar; 0.15MPa; n=16) and high (3.0bar; 0.30MPa; n=16) air-bp application were performed after specimen storage in distilled water (24h; 37.0±1.0°C). Results were analysed using a Student's t-test to identify statistically significant differences (p<0.05). Fracture surfaces of TR adhesive specimens were morphologically characterised by SEM.

RESULTS

Statistically significant bond strength differences were obtained for the thixotropic resin adhesive (high-pressure: 24.6MPa, low-pressure: 9.6MPa). While high air-bp specimens provided SEM images revealing resin-plugged dentine tubules, resin tags and only marginally blister structures, low air-bp left copious droplets and open dentine tubules. In contrast, the non-thixotropic resin adhesive showed no significant bond strength differences (high-pressure: 9.3MPa, low-pressure: 7.6MPa).

CONCLUSIONS

A pressure-dependent distinct influence of bonding resin thixotropy and viscosity on dentine bond strength has been demonstrated. Stronger adhesion with high air-bp application is explained by improved resin fluidity and facilitated resin penetration into dentine tubules.

CLINICAL SIGNIFICANCE

Filler particles used in adhesive systems may induce thixotropic effects in bonding resin layers, accounting for improved free-flowing resin properties. In combination with high air-bp this effect allows an easy plugging of dentine tubules and elimination of blister structures, both resulting in superior dentine bond strength.

A rapid, efficient, and facile solution for dental hypersensitivity: The tannin-iron complex

Dental hypersensitivity due to exposure of dentinal tubules under the enamel layer to saliva is a very popular and highly elusive technology priority in dentistry. Blocking water flow within exposed dentinal tubules is a key principle for curing dental hypersensitivity. Some salts used in "at home" solutions remineralize the tubules inside by concentrating saliva ingredients. An "in-office" option of applying dense resin sealants on the tubule entrance has only localized effects on well-defined sore spots. We report a self-assembled film that was formed by facile, rapid (4 min), and efficient (approximately 0.5 g/L concentration) dip-coating of teeth in an aqueous solution containing a tannic acid-iron(III) complex. It quickly and effectively occluded the dentinal tubules of human teeth. It withstood intense tooth brushing and induced hydroxyapatite remineralisation within the dentinal tubules. This strategy holds great promise for future applications as an effective and user-friendly desensitizer for managing dental hypersensitivity.

Effect of Desensitizing Agents on the Bond Strength of Mild and Strong Self-etching Adhesives

BACKGROUND

Desensitizing agents are used, almost as routine practice, in many adhesive restorative procedures. There is still debate as to their effect in dentin bonding, particularly with self-etching adhesives. The present study aimed to evaluate the effect of different desensitizing agents on the bond strength of mild and strong self-etching adhesive systems to dentin.

MATERIALS AND METHODS

One hundred twenty recently extracted, noncarious human molars were used to obtain superficial dentin substrate for bonding. No desensitizer was used in the control groups. The experimental groups were pretreated with Gluma Desensitizer, MicroPrime B, and Dentin Desensitizer immediately prior to bonding with self-etching adhesives Optibond XTR, Xeno IV, and iBond. A bonding jig was used to fabricate composite cylinders, which were stored for either 24 hours or three months, after which the shear bond strength (SBS) was evaluated using a notched-edge testing device at a crosshead speed of 1 mm/min. Failure mode distribution was also evaluated at 24 hours and three months. A two-way analysis of variance, Tukey test, and Student t-test, with a significance level of p<0.05, were used for data analysis.

RESULTS

At 24 hours, there was no significant difference in SBS when the same adhesive was used with any of the experimental desensitizing agents compared with the control group without desensitizer. However, at three months, Dentin Desensitizer bonded with Optibond XTR demonstrated significantly lower SBS (p<0.001), while Gluma bonded with iBond showed significantly higher SBS values (p=0.034) relative to their corresponding control group. Only MicroPrime B bonded with Xeno IV and iBond with no desensitizer demonstrated a significant reduction in SBS after three months (p=0.034 and p=0.002, respectively). The most prevalent type of failure was adhesive.

CONCLUSION

Desensitizing agents can be used in combination with self-etching adhesives to control hypersensitivity without adversely affecting their bond strength to dentin.

Riboflavin-ultraviolet-A-induced collagen cross-linking treatments in improving dentin bonding

OBJECTIVES

To evaluate the collagen cross-linkers, riboflavin-ultraviolet-A (RF/UVA) and glutaraldehyde, with regard to their efficacy in cross-linking the dentinal collagen and improving dentin bonding.

METHODS

Glutaraldehyde and different RF/UVA protocols (0.1%RF/1-minUV, 0.1%RF/2-minUV, and 1%RF/1-minUV) were first evaluated by gel electrophoresis to determine their abilities of collagen cross-linking. The mechanical properties of acid-etched dentin receiving these cross-linking treatments were examined in either dry or wet condition by a nanoindentation test. Fifteen teeth with exposed occlusal dentin received the microtensile bond strength (μTBS) test. The teeth were primed either with RF/UVA or glutaraldehyde, followed by adhesive treatment and composite restorations, and then cut into resin-dentin microbeams. Half of the microbeams received the μTBS test after 24h, and the other half received test after 5000 thermocycles. Nanoleakage at the bond interface was examined under TEM. The alignments of collagen fibrils in the hybrid layers were also defined by an image analysis.

RESULTS

Gel electrophoresis showed that glutaraldehyde induced strong collagen gelation, while RF/UVA generated milder collagen cross-linking. Glutaraldehyde, 0.1%RF/2-min-UVA, and 1%RF/1-minUV showed higher stiffness compared to untreated and 0.1%RF/1-minUV in wet condition. All the crosslinking treatments improved early μTBS, but 0.1%RF/2-minUVA treatment maintained high μTBS after theromocycles. Under TEM, glutaraldehyde-treated dentin showed dense and enclosed collagen network on the adhesive interface. 0.1%RF/2-minUVA showed the least nanoleakage, and this could be associated with the suspended collagen fibrils in the hybrid layer.

SIGNIFICANCE

0.1%RF/2-minUVA treatment enhanced resin-dentin bond possibly through enhancing the stiffness and maintaining the expanding collagen matrix in the hybrid layer.

Biomodification to dentin by a natural crosslinker improved the resin-dentin bonds

OBJECTIVES

Transient collagen cross-linking treatment by proanthocyanidins (PA), a natural crosslinker, was proved to increase the cross-linking degree and ultimate tensile strength of demineralised dentin. The present study aimed to investigate whether transient pretreatment by PA-based preconditioner can improve the resin-dentin bonds of various etch and rinse adhesives. The influence of solvent type, PA concentration and treatment duration were examined.

METHODS

PA-based preconditioners were prepared by adding powdered grape seed extract, rich in PA, to various solvents at different concentrations. They were used on demineralised dentin before the application of the bonding agent. Bond strength, failure modes and degree of conversion were evaluated via microtensile testing, field emission scanning electron microscopy and Fourier transform infrared spectroscopy, respectively.

RESULTS

Collagen cross-linking treatment by PA-based preconditioners presented a concentration- and time-dependent increase in dentin bond strength even in reduced, clinically applicable treatment duration. PA preconditioning improved bond strength of the tested water/ethanol-based adhesive better than the water/acetone-based system. Mixed fracture was the most prevalent failure mode happened on the top of the hybrid layer in PA-pretreated specimens, whilst at the bottom in non-treated controls. The degree of conversion was not significantly affected by PA pretreatment.

CONCLUSIONS

Transient PA preconditioning improved resin-dentin bonds without compromise on the curing behaviours of the tested adhesives.

Critical appraisal. Current usage of glutaraldehyde/HEMA

The use of glutaraldehyde/2-hydroxyethylmethacrylate (HEMA) combinations has been recommended for routine use in restorative dentistry by many authors and opinion leaders. Clinical restorative sites are colonized by bacteria that can contribute to postoperative sensitivity or recurrent caries. The structure of dentin allows for fluid conductance, which has been identified by Brännström as the cause of dentin sensitivity and as well, its water content challenges short- and long-term adhesion. The glutaraldehyde/HEMA combination is stated to be antimicrobial, a flocculating agent that strengthens collagen, and an agent that can create tubular occlusion, thereby reducing postoperative sensitivity by limiting fluid movement without affecting the strength of bonding or adhesive cements. This Critical Appraisal reviews five publications that deal with the various issues and clinical challenges described above, and provides suggestions for additional reading. A Bottom Line summary is provided.

The effect of transient proanthocyanidins preconditioning on the cross-linking and mechanical properties of demineralized dentin

Proanthocyanidin-based preconditioners were prepared by adding powdered proanthocyanidins-rich grape seed extract to various solvents at different concentrations. Demineralized dentin specimens were preconditioned for 20, 30, 60 or 120 s, followed by the evaluation of their cross-linking degree, mechanical properties and micromorphology. The cross-linking degree of the demineralized dentin collagen exhibited concentration- and time- dependent increase after preconditioning treatment, irrespective of the preconditioner and the solvent. When treated for the same exposure time, specimens after 15% proanthocyanidins preconditioning resulted in the highest mean ultimate tensile strength compared with all the other groups tested. Five percent glutaraldehyde control group produced the highest cross-linking degree, but the ultimate tensile strength was lower than that of 15% proanthocyanidins group. The field emission scanning electron microscopy confirmed that the demineralized dentin collagen was in a homogeneous and regular arrangement after preconditioning and maintained expanding, regardless of the surface moisture conditions.

Long-term nano-mechanical properties of biomodified dentin-resin interface components

Failures of dental composite restorative procedures are largely attributed to the degradation of dentin-resin interface components. Biomodification of dentin using bioactive agents may improve the quality and durability of the dentin-resin bonds. The aim of this study was to nanomechanically assess the reduced modulus of elasticity (Er) and nano-hardness (H) of major components of the dentin-resin interface (hybrid layer, adhesive layer and underlying dentin) biomodified by collagen cross-linkers at 24h, 3 and 6 months following restorative procedure. Demineralized dentin surfaces were biomodified with 5% glutaraldehyde (GD) or 6.5% grape seed extract (GSE) prior to placement of adhesive systems and composite resin. Nano-measurements of the interface components in a fluid cell showed that both agents increased the Er and H of underlying dentin after 3 and 6 months when compared to a control. The mechanical properties of the adhesive and hybrid layers decreased over time. Biomodification of the dentin-resin interface structures using GD and GSE can increase the mechanical properties of the interface over time and may contribute to the long-term quality of adhesive restorations.

Nanomechanical properties of biochemically modified dentin bonded interfaces

The effect of biomodification of dentin matrices using collagen cross-linkers, glutaraldehyde (GD) and grape seed extract (GSE), on the reduced modulus of elasticity (Er) and nanohardness (H) of the hybrid layer and underlying dentin was investigated at the dentin-resin bonded interface. The coronal dentin of nine molars were exposed and divided into groups: 5% GD, 6·5% GSE and control. Control samples were etched, bonded with Adper Single Bond Plus and Premise composite. GD and GSE were applied for 1 h prior to bonding procedures. After 24 h, samples were sectioned, and resin-dentin beams were either kept in distilled water or exposed to collagenase treatment for 24 h. Nano-indentations were performed at the hybrid layer and underlying dentin. GD and GSE treatment increased the Er and H of resin-dentin interface structures when compared to the control group (P<0·05), particularly the hybrid layer, and may be a promising novel approach to strengthen the dentin-resin bonded interface structures when using these adhesive system and resin-based composite.

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

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