Ethanol-wet bonding may improve root dentine bonding performance of hydrophobic adhesive

Effect of chlorhexidine and benzalkonium chloride on the long-term push-out bond strength of fiber posts

Background and Aim

Fiber posts are widely used in endodontically treated teeth with extensive loss of coronal structure. The purpose of this study was to investigate immediate and the long-term effects of chlorhexidine (CHX) and benzalkonium chloride (BAC) application, on the push-out bond strength of fiber posts.

Material and Methods

Sixty mandibular premolars were decoronated, and root canal treatment was performed. After post space preparation, the specimens were divided into three groups according to the post space-surface pretreatment (n = 20); no surface treatment (control group-Group 1), 2% CHX application (Group 2), and 1% BAC application (Group 3). A self-curing adhesive cement and an etch and rinse adhesive were used for the cementation of posts. Three sections (one cervical, one middle, and one apical) of 1 mm thickness were prepared from each specimen. A push-out test was performed immediately on the half of the specimen sections (n = 10). The other half of the specimen sections were subjected to 20.000 thermal cycles before applying the push-out test (n = 10). The failure mode of each specimen was observed under a stereomicroscope at ×40 magnification.

Results

The data were analyzed by one-way analysis of variance (ANOVA), Tukey Honestly significant difference (HSD), and Tamhane tests (P = 0.05). The cervical thirds displayed the highest, and the apical thirds showed the lowest values in all groups (P < 0.05), except the control-aged group (P = 0.554). The aged control groups' values were found to be significantly lower than the aged CHX and BAC groups (P < 0.001). Aging significantly reduced the bond strength values of specimens in control groups (P < 0.001). However, aging did not significantly affect the push-out bond strength values of CHX and BAC groups (P > 0.050). The failure types were adhesive between the post and cement (type 1) in all groups, except control-aged group (type 2).

Conclusion

The application of 2% chlorhexidine or 1% BAC may be an essential step that can be taken to preserve the bond strength of fiber posts.

Root canal pre-treatment and adhesive system affect bond strength durability of fiber posts ex vivo

OBJECTIVES

To investigate the effect of different pre-treatments on the long-term bond strength of fiberglass posts luted either with dual-curing self-etch adhesives and core build-up composites or with a self-adhesive resin (SAR) cement.

MATERIALS AND METHODS

In total, 180 human root-filled teeth received post-space preparations and three different dentin pre-treatments (PTs): PT1, ethanol (99%); PT2, ethanol-tertiary-butanol-water-solution (AH Plus Cleaner, Dentsply Sirona; York, USA); and PT3, distilled water (control). Five luting systems were used: FU, Futurabond U (Voco; Cuxhaven, Germany); CL, Clearfil DC Bond (Kuraray Noritake; Okayama, Japan); GR, Gradia Core SE Bond (GC Europe NV; Leuven, Belgium); LU, LuxaBond Universal (DMG; Hamburg, Germany); and RX, RelyX Unicem 2 (3M; Minnesota, USA). Roots were cut into six slices (1 mm thick). From each root canal region, three slices were submitted to immediate and three to post-storage push-out testing. The latter were subjected to thermocycling (5-55°C, 6.000 cycles) and stored for six months in saline solution (0.9%, 37°C). Data were analysed using repeated measures ANOVA and chi-square tests (MV±SD).

RESULTS

Bond strength was significantly affected by material (p<0.0005), pre-treatment (p=0.016), and storage (p<0.0005; repeated-measures ANOVA). LU (18.8±8.1MPa) revealed significantly higher bond strength than RX (16.08±6.4MPa), GR (15.1±4.6MPa), CL (13.95±5.2MPa), and FU (13.7±6.3MPa). PT1 (16.5±6.9MPa) revealed significantly higher bond strength than PT3 (14.5±5.7MPa).

CONCLUSIONS

A universal adhesive in self-etch mode combined with a core build-up material revealed higher bond strength than a SAR cement, both interacted positively with Ethanol pre-treatment.

CLINICAL RELEVANCE STATEMENT

Ethanol (99%) rinsing can be recommended as part of post and core pre-treatment for the investigated luting systems.

Influence of proanthocyanidins combined with ethanol-wet bonding on the bonding quality of fibre posts to root dentine

This study evaluated the influence of a bonding approach using proanthocyanidins (PAs) combined with ethanol-wet bonding (EWB) and a hydrophobic adhesive on the bonding quality of fibre posts. After endodontic treatment and post-space preparation, 72 single-rooted extracted human teeth were etched, thoroughly rinsed, and then treated using the following procedures (n = 24 teeth per group): group 1, no pretreatment; group 2, pretreatment with absolute ethanol three times, for 30 s each time; or group 3, pretreatment with absolute ethanol solution containing 5% PAs three times, for 30 s each time. Six teeth per group were dried according to a dry and a wet drying protocol and then observed using field emission-scanning electron microscopy. The remaining 18 teeth in each group were cemented with fibre posts: All-Bond 3 and Duo-Link cement were used for group 1; and hydrophobic adhesive and Duo-Link cement were used for groups 2 and 3. Push-out bond strength, failure mode, and nanoleakage were evaluated immediately and after collagenase treatment. Higher push-out bond strength and less nanoleakage were observed in the two ethanol-pretreatment groups, regardless of storage conditions. Teeth pretreated with PAs + ethanol exhibited significantly higher push-out bond strength after collagenase treatment than did teeth pretreated with ethanol alone. Within the limits of this study, the bonding approach of PAs combined with EWB and a hydrophobic adhesive synergistically improved the durability of fibre post bonds.

Effects of three drying methods of post space dentin bonding used in a direct resin composite core build-up method

PURPOSE

The purpose of this study was to evaluate drying methods for post space dentin bonding in a direct resin composite core build-up method.

METHODS

Experiment 1: Four root canal plastic models, having diameters of 1.0 or 1.8mm and parallel or tapered shapes, were prepared. After drying each post space using three drying methods (air drying, paper-point drying, or ethanol drying, which involves filling the space with 99.5 vol% ethanol followed by air drying), the residual liquid in the models was weighed. Experiment 2: Thirty endodontically treated single-root teeth were dried using the above-described drying methods and filled with dual-cure resin composite. The bonded specimens were sectioned into square beams of approximately 1mm² for microtensile bond strength (μTBS) testing. Nine teeth were observed through transmission electron microscopy (TEM) and micro computed tomography (μCT). The weight of residual liquid and μTBS were analyzed using Scheffé multiple comparison.

RESULTS

Experiment 1: The results of air drying were significantly different from those of paper-point drying (p<0.001) and ethanol drying (p<0.001), and no significant difference was observed between paper-point drying and ethanol drying. Experiment 2: The μTBS significantly decreased in the order of ethanol drying, paper-point drying, and air drying (air drying/ethanol drying: p<0.001, air drying/paper-point drying: p=0.048, ethanol drying/paper-point drying: p=0.032). TEM and μCT observation revealed a sufficient dentin/adhesive interface in the ethanol drying group.

CONCLUSIONS

Ethanol drying was found to be more effective for post space dentin bonding, as compared with air drying and paper-point drying.

The effects of chlorhexidine and ethanol on push-out bond strength of fiber posts

CONTEXT

Irrigation of root canals with chlorhexidine (CHX) and ethanol is common practice to prevent root canal infection during postplacement. However, pretreatment with these solvents may interfere with the bond strength of posts.

AIMS

This study aimed to evaluate if root dentin pretreatment using CHX and/or ethanol influences the push-out bond strength of fiber-reinforced composite resin (FRCR) posts.

MATERIALS AND METHODS

Fifty space posts prepared in endodontically treated extracted human canine roots were randomly divided into five groups (n = 10) according to the dentin pretreatment: Distilled water (W); 1% CHX diacetate solution (1C); CHX diacetate + 99% ethanol (1CE); 99% ethanol (E); and 2% CHX digluconate solution (2C). After pretreatment, the adhesive system (Peak Universal Bond; Ultradent, South Jordan, UT, USA) was applied in the root dentin and the FRCR was cemented with resin cement. Then, horizontal slices of 2 mm were obtained from each root third and the push-out bond strength was assessed. Statistical analysis was done using analysis of variance (ANOVA) and Tukey's tests (P = 0.05).

RESULTS

At all thirds, 1CE and E groups presented similar push-out bond strength values (P > 0.05), which were higher than the other groups (P < 0.05). W, 1C, and 2C groups were similar (P > 0.05).

CONCLUSION

The root dentin pretreatment with ethanol, alone or mixed with CHX diacetate increased the bond strength of FRCR luted with resin cement.

Adjunctive application of chlorhexidine and ethanol-wet bonding on durability of bonds to sound and caries-affected dentine

OBJECTIVES

To examine the effect of adjunctive application of chlorhexidine (CHX) and ethanol-wet bonding (EWB) on bond durability and nanoleakage of hydrophobic adhesive to sound (SD) and caries-affected dentine (CAD).

METHODS

Dentine surfaces of molars were etched after caries removal and randomly allocated to four groups (n=12). In Groups 1 and 2, dentine surfaces were saturated with either 2 ml of 100% ethanol or 2 ml of ethanol with 2% CHX for 60s. In Groups 3 and 4, dentine surfaces were saturated with either 15 μL of distilled water or 15 μL of distilled water with 2% CHX for 60s. Two coats of primer, followed by neat resin were applied and light-cured for 40s. Resin composite build-ups were placed and bonded specimens were sectioned for bond strength testing after 24 h and 12 months' storage in artificial saliva. Bond strength data were analyzed using 3-way ANOVA and SNK tests. Interfacial nanoleakage was evaluated after 24 h and 12 months using a field-emission scanning electron microscopy and data were analyzed using Kruskal-Wallis test.

RESULTS

Significant differences were observed for the three factors: "substrate" (p<0.001), "rewetting agents" (p<0.001) and "time" (p<0.001) on bond strength. Incorporation of 2% CHX to EWB preserved bond strength to SD and CAD and reduced interfacial nanoleakage after 12 months. Incorporation of 2% CHX to WWB also preserved bond strength to SD after ageing.

CONCLUSIONS

Incorporation of chlorhexidine to ethanol-wet bonding has an interaction effect on preservation of bond durability to sound and caries-affected dentine.

CLINICAL SIGNIFICANCE

Incorporation of chlorhexidine to ethanol-wet bonding with hydrophobic adhesive enhances the success rate of aesthetic bonded restorations.

Bond strength of composite resin to enamel: assessment of two ethanol wet-bonding techniques

OBJECTIVE

Ethanol wet-bonding (EWB) technique has been stated to decrease degradation of resin-dentin bond. This study evaluated the effect of two EWB techniques on composite resin-to-enamel bond strength.

MATERIALS AND METHODS

Silicon carbide papers were used to produce flat enamel surfaces on the buccal faces of forty-five molars. OptiBond FL (OFL) adhesive was applied on enamel surfaces in three groups of 15 namely: Enamel surface and OFL (control);Protocol 1 of the EWB technique: absolute ethanol was applied to water-saturated acid-etched enamel surfaces for 1 minute before the application of ethanol-solvated hydrophobic adhesive resin of OFL 3 times;Protocol 2: progressive ethanol replacement; water was gradually removed from the enamel matrix using ascending ethanol concentrations before OFL application. Composite build-ups were made and the specimens were stored for 24 hours at 37°C and 100% relative humidity. Shear bond strength test was performed using a universal testing machine at 1 mm/min crosshead speed. Fracture patterns were evaluated microscopically. Data were analyzed with one-way ANOVA and Fisher's exact test (α=0.05).

RESULTS

There were no significant differences in bond strength between the groups (P=0.73). However, regarding failure patterns, the highest cohesive enamel fractures were recorded in groups 2 and 3.

CONCLUSION

In this study, although both methods of EWB did not influence immediate bond strength of composite resin to enamel, the majority of failure patterns occurred cohesively in enamel.

Effect of chlorhexidine and ethanol-wet bonding with a hydrophobic adhesive to intraradicular dentine

PURPOSE

To evaluate the effect of adjunctive application of ethanol-wet bonding and chlorhexidine (CHX) with a hydrophobic adhesive on bond durability of fibre posts to intraradicular dentine.

METHODS

Ninety-six extracted human teeth with a single root and root canal were prepared for post placement after endodontic treatment. The teeth were randomly divided into four groups (n=24) after etching and rinsing for rewetting: Group 1: water-wet bonding, Group 2: water-wet bonding with CHX, Group 3: ethanol-wet bonding and Group 4: ethanol-wet bonding with CHX. Teeth in Groups 1 and 2 were treated with either distilled water or distilled water with 2% CHX for 60 s; while teeth in Groups 3 and 4 were treated with either 100% ethanol or 100% ethanol with 2% CHX. Two coats of primer, followed by neat resin were applied and light-cured for 40 s. Fibre posts were luted to bonded root dentine using dual-cure resin cement. Bonded roots were subjected to push-out bond strength testing and interfacial nanoleakage evaluation after 24 h, 6 and 12 months of storage. Data were analyzed using 3-way ANOVA (rewetting solutions, time and post space regions) and SNK tests.

RESULTS

Groups 3 and 4 showed significantly (p<0.05) higher bond strengths and lower nanoleakage than Groups 1 and 2 after 12 months of ageing. Addition of 2% chlorhexidine to ethanol-wet bonding with a hydrophobic adhesive did not further improve the bonding of a fibre post to intraradicular dentine, when compared to ethanol-wet bonding alone after 12 months of ageing.

CLINICAL SIGNIFICANCE

Ethanol-wet bonding with a hydrophobic adhesive alone could improve the bond durability of fibre post to intraradicular dentine and therefore would increase the success rate of post and core restorations of endodontically treated teeth.