In vitro mechanical stimulation promoted remineralization at the resin/dentin interface

Tunable polymer-peptide hybrids for dentin tissue repair

OBJECTIVES

This study targets to assess the remineralization capability of conditioned dentin infiltrated with polymeric nanoparticles (NPs) doped with tideglusib (TDg) (TDg-NPs).

METHODS

Dentin conditioned surfaces were infiltrated with NPs and TDg-NPs. Bonded interfaces were created, stored for 24 h and submitted to mechanical and thermal challenging. Resin-dentin interfaces were evaluated through nanohardness, Masson's trichrome staining microscopy, and Raman analysis.

RESULTS

Dentin surfaces treated with TDg-NPs and load cycled produced higher nanohardness than the rest of the groups at the hybrid layer. At the bottom of the hybrid layer, all samples treated with TDg-NPs showed higher nanohardness than the rest of the groups. Active remineralization underneath the hybrid layer was detected in all groups after TDg application and load cycling, inducting new dentinal tubuli formation. After thermocycling, remineralization at the hybrid layer was not evidenced in the absence of NPs. Raman analysis showed increase mineralization, enriched carbonate apatite formation, and improved crosslinking and scaffolding of the collagen.

CONCLUSIONS

Mechanical loading on the specimens obtained after TDg-NPs dentin infiltration inducts an increase of mineralization at the resin/dentin interface, indicating remineralization of peritubular and intertubular dentin with augmented crystallographic maturity in crystals. Enriched collagen quality was produced, generating an adequate matrix organization to promote apatite nucleation, after tideglusib infiltration.

CLINICAL SIGNIFICANCE

At the present research, it has been proved the creation of reparative dentin, at the resin-dentin interface, after tideglusib dentin infiltration. Chemical stability, to favor integrity of the resin-dentin interface, is warranted in the presence of the TDg-NPs in the demineralized dentin collagen.

Dentin remineralization using a stimuli-responsive engineered small molecule GSK3 antagonists-functionalized adhesive

OBJECTIVES

Tideglusib has shown great performance in terms of dentin regenerative properties. This study aims to evaluate bonding ability, of demineralized dentin infiltrated with polymeric nanoparticles (NPs) doped with tideglusib (TG) (TG-NPs).

METHODS

Dentin conditioned surfaces were infiltrated with NPs and TG-NPs. Bonded interfaces were created and stored for 24 h and then submitted to mechanical, chemical and thermal challenging. The resin-dentin interface was evaluated through a doubled dye fluorescent technique and a calcium chelator fluorophore under a confocal laser scanning microscopy, and by field emission scanning electron microscopy.

RESULTS

Dentin surfaces treated with TG-NPs and load cycled produced higher bond strength than the rest of the groups. Immersion of dentin specimens treated with undoped-NPs in collagenase solution attained the lowest microtensile bond strength (MTBS) values. Both porosity and nanoleakage decreased when dentin was infiltrated with TG-NPs, that revealed strong signals of xylenol orange stain at both hybrid layer and dentinal tubules. The presence of NPs, in general, inducted the presence of mineralized interfaces after mechanical loading and thermocycling.

CONCLUSIONS

Nanoparticles doped with tideglusib promoted the highest dentin bonding efficacy among groups, as they facilitated the maximum bond strength values with creation of mineral deposits at the hybrid layer and dentinal walls. Tideglusib enabled scarce porosity, nanoleakage and advanced sealing among dentin groups.

SIGNIFICANCE

Doping hydrophilic polymeric NPs with tideglusib, infiltrated in etched dentin represents a reproducible technique to create reparative dentin at the resin-dentin interface, by inducing therapeutic bioactivity.

The inhibitory effects of various ions released from S-PRG fillers on dentin protease activity

This study investigates the effect of ions released from S-PRG fillers on host-derived enzymatic degradation of dentin collagen matrices. Dentin beams (n=80) were demineralized and distributed to eight groups following baseline dry mass and total MMP activity assessments. Each group treated with boron, fluoride, sodium, silicone, strontium, aluminium, or S-PRG eluate solutions for 5 min. Untreated beams served as control. After pre-treatment, MMP activity was reassessed, beams were incubated in complete medium for 1 week, dry mass was reassessed. Incubation media were analyzed for MMP and cathepsin-K-mediated degradation fragments. Data were analyzed with ANOVA and Tukey's test. All pretreatment groups showed significant reduction in total MMP activity (p<0.05) that was sustainable after incubation in all groups except for boron and silicone groups (p<0.05). Cathepsin-K activity did not differ between control or treatment groups. The results indicated that ions released from S-PRG fillers have the potential to partly inhibit MMP-mediated endogenous enzymatic activity.

Effect of thermo-mechanical cycling and chlorhexidine on the bond strength of universal adhesive system to dentin

OBJECTIVES

This study evaluated the influence of thermo-mechanical cycling (TMC) on the bond strength (BS) of a universal adhesive system (UAS - Adper Single Bond Universal, 3M ESPE) to dentin treated or not with 0.2% chlorhexidine (CHX).

METHODS

Eighty human molars were flattened until reach the dentin and separated into 4 groups according to the bonding protocol: ENR Group: 37% phosphoric acid + 3-step etch-and-rinse adhesive system (ENR); UAS Group: UAS in self-etch mode; ENR + CHX Group: 37% phosphoric acid + CHX + ENR; UAS + CHX Group: CHX + UAS in self-etch mode. After treatments, teeth were restored (Filtek Z350, 3M ESPE). Samples (n = 10) were submitted to aging process: stored in distilled water at 37°C/30 days or TMC (ERIOS - 98N/1.6Hz + thermal cycling 5/37/55 °C - 1,200,000 cycles). Specimens were sectioned into sticks (1.0 mm2) and submitted to the microtensile test (Mechanical Test Machine - 0.5 mm/min). Fracture patterns and hybrid layer integrity were analyzed under Stereomicroscope and Scanning Electron Microscopy (SEM).

RESULTS

The BS results (3-way ANOVA, Bonferroni's test, α = 5%) showed that groups treated with CHX presented higher BS values than control groups; significant in all cases (p < .05), except for ENR submitted to TMC (p > .05). When CHX was applied and samples were cycled, UAS revealed higher BS (p < .05) than ENR. After TMC, cohesive fractures increased for UAS, regardless of CHX application. SEM analysis demonstrated different hybridization patterns for the adhesive systems tested.

CONCLUSION

The performance of the universal adhesive system used in self-etch mode was better than that of the 3-step etch-and-rinse adhesive system.

CLINICAL SIGNIFICANCE

Universal adhesive systems have been developed in order to simplify the dentin hybridization protocol. It is important to determine the longevity of the adhesive interface using these bonding materials after chewing.

In vitro mechanical stimulation facilitates stress dissipation and sealing ability at the conventional glass ionomer cement-dentin interface

OBJECTIVE

The aim of this study was to evaluate the induced changes in the chemical and mechanical performance at the glass-ionomer cement-dentin interface after mechanical load application.

METHODS

A conventional glass-ionomer cement (GIC) (Ketac Bond), and a resin-modified glass-ionomer cement (RMGIC) (Vitrebond Plus) were used. Bonded interfaces were stored in simulated body fluid, and then tested or submitted to the mechanical loading challenge. Different loading waveforms were applied: No cycling, 24 h cycled in sine or loaded in sustained hold waveforms. The cement-dentin interface was evaluated using a nano-dynamic mechanical analysis, estimating the complex modulus and tan δ. Atomic Force Microscopy (AFM) imaging, Raman analysis and dye assisted confocal microscopy evaluation (CLSM) were also performed.

RESULTS

The complex modulus was lower and tan delta was higher at interfaces promoted with the GIC if compared to the RMGIC unloaded. The conventional GIC attained evident reduction of nanoleakage. Mechanical loading favored remineralization and promoted higher complex modulus and lower tan delta values at interfaces with RMGIC, where porosity, micropermeability and nanoleakage were more abundant.

CONCLUSIONS

Mechanical stimuli diminished the resistance to deformation and increased the stored energy at the GIC-dentin interface. The conventional GIC induced less porosity and nanoleakage than RMGIC. The RMGIC increased nanoleakage at the porous interface, and dye sorption appeared within the cement. Both cements created amorphous and crystalline apatites at the interface depending on the type of mechanical loading.

CLINICAL SIGNIFICANCE

Remineralization, lower stress concentration and resistance to deformation after mechanical loading improved the sealing of the GIC-dentin interface. In vitro oral function will favor high levels of accumulated energy and permits micropermeability at the RMGIC-dentin interface which will become remineralized.

Fatigue resistance of dentin bonds prepared with two- vs. three-step adhesives: Effect of carbodiimide

The application of a cross-linker to demineralized dentin is reportedly effective at extending the durability of dentin bonds.

OBJECTIVE

To compare the effect of a cross-linker pretreatment on the fatigue crack growth resistance of resin-dentin bonds prepared with a two- vs. three-step adhesive system.

METHODS

Bonded interface Compact Tension (CT) specimens were prepared using commercial two- and three-step etch-and-rinse adhesives and compatible hybrid resin-composite. For the treated groups, adhesive bonding was preceded by a 1min application of an experimental carbodiimide (EDC) conditioner to the acid-etched dentin. The control groups received no such treatment. The fatigue crack growth resistance was examined after storage in artificial saliva at 37°C for 0, 3 and 6 months.

RESULTS

There was no significant difference in the immediate fatigue crack growth resistance the control and EDC-treated groups at 0 months for either adhesive system. After 3 and 6 months of storage, the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the controls. Although the EDC treatment was equally effective in deterring degradation for both adhesives, bonds prepared with the three-step system exhibited the lowest resistance to fatigue crack growth overall.

SIGNIFICANCE

An EDC treatment applied during dentin bonding could help maintain the durability of bonds prepared with two or three-step adhesive bonding systems.

A zinc chloride-doped adhesive facilitates sealing at the dentin interface: A confocal laser microscopy study

The aim of this study was to ascertain the effect of Zn-doping of dental adhesives and mechanical load cycling on the micromorphology of the resin-dentin interdiffusion zone (of sound and caries affected dentin). The investigation considered two different Zn-doped adhesive approaches and evaluated the interface using a doubled dye fluorescent technique and a calcium chelator fluorophore under a confocal laser scanning microscopy. Sound and carious dentin-resin interfaces of unloaded specimens were deficiently resin-hybridized, in general. These samples showed a rhodamine B-labeled hybrid layer and adhesive layer completely affected by fluorescein penetration (nanoleakage) through the porous resin-dentin interface. It was thicker after phosphoric acid-etching and more extended in carious dentin. Zn-doping promoted an improved sealing of the resin-dentin interface, a decrease of the hybrid layer porosity, and an increment of dentin mineralization. Load cycling augmented the sealing of the Zn-doped resin-dentin interfaces, as porosity and nanoleakage diminished, and even disappeared in caries-affected dentin substrata conditioned with EDTA. Sound and carious dentin specimens analyzed with the xylenol orange technique produced a clearly outlined fluorescence when resins were Zn-doped, due to a consistent Ca-mineral deposition within the bonding interface and inside the dentinal tubules. It was more evident when load cycling was applied on specimens treated with self-etching adhesives that were Zn-doped. Micropermeability at the resin-dentin interface diminished after combining EDTA pretreatment, ZnCl₂-doping and mechanical loading stimuli on restorations. It is clearly preferable to include the zinc compounds into the bonding constituents of the self-etching adhesives, instead of into the primer ingredients. The promoted new mineral segments contributed to reduce or avoid both porosity and nanoleakage from the load cycled Zn-doped resin dentin interfaces. EDTA+SB-ZnCl₂ or SEB·Bd-Zn doping are preferred to treat caries-affected dentin surfaces. ZnO-doping encouraged for etch-and-rinse adhesives.

Mechanical loading influences the viscoelastic performance of the resin-carious dentin complex

The aim of this study was to evaluate the changes in the mechanical behavior and bonding capability of Zn-doped resin-infiltrated caries-affected dentin interfaces. Dentin surfaces were treated with 37% phosphoric acid (PA) followed by application of a dentin adhesive, single bond (SB) (PA+SB) or by 0.5 M ethylenediaminetetraacetic acid (EDTA) followed by SB (EDTA+SB). ZnO microparticles of 10 wt. % or 2 wt. % ZnCl₂ was added into SB, resulting in the following groups: PA+SB, PA+SB-ZnO, PA+SB-ZnCl₂, EDTA+SB, EDTA+SB-ZnO, EDTA+SB-ZnCl₂. Bonded interfaces were stored for 24 h, and tested or submitted to mechanical loading. Microtensile bond strength was assessed. Debonded surfaces were evaluated by scanning electron microscopy and elemental analysis. The hybrid layer, bottom of the hybrid layer, and peritubular and intertubular dentin were evaluated using a nanoindenter. The load/displacement responses were used for the nanodynamic mechanical analysis III to estimate complex modulus, tan delta, loss modulus, and storage modulus. The modulus mapping was obtained by imposing a quasistatic force setpoint to which a sinusoidal force was superimposed. Atomic force microscopy imaging was performed. Load cycling decreased the tan delta at the PA+SB-ZnCl₂ and EDTA+SB-ZnO interfaces. Tan delta was also diminished at peritubular dentin when PA+SB-ZnO was used, hindering the dissipation of energy throughout these structures. Tan delta increased at the interface after using EDTA+SB-ZnCl₂, lowering the energy for recoil or failure. After load cycling, loss moduli at the interface decreased when using ZnCl₂ as doping agent, increasing the risk of fracture; but when using ZnO, loss moduli was dissimilarly affected if dentin was EDTA-treated. The border between intertubular and peritubular dentin attained the highest discrepancy in values of viscoelastic properties, meaning a risk for cracking and breakdown of the resin-dentin interface. PA used on dentin provoked differences in complex and storage modulus values at the intertubular and peritubular structures, and these differences were higher than when EDTA was employed. In these cases, the long-term performance of the restorative interface will be impaired.

Oral Function Improves Interfacial Integrity and Sealing Ability Between Conventional Glass Ionomer Cements and Dentin

The aim of this study was to investigate if load cycling affects interfacial integrity of glass ionomer cements bonded to sound- or caries-affected dentin. A conventional glass ionomer, Ketac Bond, and a resin-modified glass ionomer (Vitrebond Plus), were applied to dentin. Half of the specimens were load cycled. The interfaces were submitted to dye-assisted confocal microscopy evaluation. The unloaded specimens of sound and carious dentin were deficiently hybridized when Ketac Bond was used. Ketac Bond samples showed an absorption layer and an adhesive layer that were scarcely affected by fluorescein penetration (nanoleakage), in sound dentin. Nevertheless, a higher degree of micropermeability was found in carious dentin. In Ketac Bond specimens, load cycling improves the sealing capability and remineralization at the cement-dentin interface as porosity and nanoleakage was reduced. In contrast, samples treated with Vitrebond Plus exhibited a Rhodamine B-labeled absorption layer with scarce nanoleakage in both sound and carious unloaded dentin. The adhesive layer was affected by dye sorption throughout the porous cement-dentin interface. Samples treated with Vitrebond Plus had significant increases in nanoleakage and cement-dye sorption after load cycling. Within the limitations of an in vitro study, it is expected that conventional glass ionomers will provide major clinical efficacy when applied to carious-affected or sound dentin.

Determining Optimal Fluorescent Agent Concentrations in Dental Adhesive Resins for Imaging the Tooth/Restoration Interface

Fluorescent dyes like Rhodamine B (RB) have been used to identify the spatial distribution of adhesive restorative materials in the tooth/restoration interface. Potential effects of the addition of RB to dental adhesives were addressed in the past, but no further information is available on how to determine suitable concentrations of RB in these bonding agents for imaging in the confocal laser scanning microscope. This study provides systematical strategies for adding RB to viscous dental adhesive resins, focusing on the determination of the lowest range of dye concentrations necessary to achieve an acceptable image of the dentin/adhesive interface. It was demonstrated that optimized images of the resin distribution in dentin can be produced with 0.1-0.02 mg/mL of RB in the (tested) adhesives. Our approaches took into account aspects related to the dye concentration, photophysical parameters in different host media, specimen composition and morphology to develop a rational use of the fluorescent agent with the resin-based materials. Information gained from this work can help optimize labeling methods using dispersions of low-molecular-weight dyes in different monomer blend systems.

Effect of carbodiimide on the fatigue crack growth resistance of resin-dentin bonds

Recent studies have shown that ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) inactivates endogenous dentin proteases, thereby preventing collagen degradation and improving the durability of adhesive bonds to dentin. Bond durability is routinely assessed by monotonic microtensile testing, which does not consider the cyclic nature of mastication.

OBJECTIVE

To characterize the effect of an EDC pretreatment on the fatigue crack growth behavior of resin-dentin bonds.

METHODS

Bonded interface Compact Tension (CT) specimens were prepared using a three-step etch-and-rinse adhesive and hybrid resin-composite. Adhesive bonding of the treated groups included a 1 min application of an experimental EDC conditioner to the acid-etched dentin. The control groups did not receive EDC treatment. The fatigue crack growth resistance was examined after storage in artificial saliva for 0, 3 and 6 months.

RESULTS

There was no significant difference in the immediate fatigue crack growth resistance of the EDC-treated and control groups at 0 months. However, after the 3 and 6 months storage periods the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the control specimens.

SIGNIFICANCE

Although the EDC treatment maintained the fatigue crack growth resistance of the dentin bonds through 6 months of storage, additional studies are needed to assess its effectiveness over longer periods and in relation to other cross-linking agents.

Improved Sealing and Remineralization at the Resin-Dentin Interface After Phosphoric Acid Etching and Load Cycling

The purpose of this study was to investigate micro-morphology of the resin-dentin inter-diffusion zone using two different single-bottle self-etching dentin adhesives with and without previous acid-etching, after in vitro mechanical loading stimuli. Extracted human third molars were sectioned to obtain dentin surfaces. Two different single-bottle self-etching dentin adhesives, Futurabond U and Experimental both from VOCO, were applied following the manufacturer's instructions or after 37% phosphoric acid application. Resin-dentin interfaces were analyzed with dye assisted confocal microscopy evaluation (CLSM), including the calcium-chelation technique, xylenol orange (CLSM-XO). CLSM revealed that resin-dentin interfaces of unloaded specimens were deficiently resin-hybridized, in general. These samples showed a Rhodamine B-labeled hybrid complex and adhesive layer completely affected by fluorescein penetration (nanoleakage) through the porous resin-dentin interface, but thicker after PA-etching. Load cycling promoted an improved sealing of the resin-dentin interface at dentin, a decrease of the hybrid complex porosity, and an increment of dentin mineralization. Load cycled specimens treated with the XO technique produced a clearly outlined fluorescence due to consistent Ca-mineral deposits within the bonding interface and inside the dentinal tubules, especially when the experimental adhesive was applied.

On the durability of resin-dentin bonds: Identifying the weakest links

Fatigue of resin-dentin adhesive bonds is critical to the longevity of resin composite restorations.

OBJECTIVES

The objectives were to characterize the fatigue and fatigue crack growth resistance of resin-dentin bonds achieved using two different commercial adhesives and to identify apparent "weak-links".

METHODS

Bonded interface specimens were prepared using Adper Single Bond Plus (SB) or Adper Scotchbond Multi-Purpose (SBMP) adhesives and 3M Z100 resin composite according to the manufacturers' instructions. The stress-life fatigue behavior was evaluated using the twin bonded interface approach and the fatigue crack growth resistance was examined using bonded interface Compact Tension (CT) specimens. Fatigue properties of the interfaces were compared to those of the resin-adhesive, resin composite and coronal dentin.

RESULTS

The fatigue strength of the SBMP interface was significantly greater than that achieved by SB (p≤0.01). Both bonded interfaces exhibited significantly lower fatigue strength than that of the Z100 and dentin. Regarding the fatigue crack growth resistance, the stress intensity threshold (ΔKth) of the SB interface was significantly greater (p≤0.01) than that of the SBMP, whereas the ΔKth of the interfaces was more than twice that of the parent adhesives.

SIGNIFICANCE

Collagen fibril reinforcement of the resin adhesive is essential to the fatigue crack growth resistance of resin-dentin bonds. Resin tags that are not well hybridized into the surrounding intertubular dentin and/or poor collagen integrity are detrimental to the bonded interface durability.

Synergistic degradation of dentin by cyclic stress and buffer agitation

Secondary caries and non-carious lesions develop in regions of stress concentrations and oral fluid movement. The objective of this study was to evaluate the influence of cyclic stress and fluid movement on material loss and subsurface degradation of dentin within an acidic environment. Rectangular specimens of radicular dentin were prepared from caries-free unrestored 3rd molars. Two groups were subjected to cyclic cantilever loading within a lactic acid solution (pH = 5) to achieve compressive stresses on the inner (pulpal) or outer sides of the specimens. Two additional groups were evaluated in the same solution, one subjected to movement only (no stress) and the second held stagnant (control: no stress or movement). Exterior material loss profiles and subsurface degradation were quantified on the two sides of the specimens. Results showed that under cyclic stress material loss was significantly greater (p ≤ 0.0005) on the pulpal side than on the outer side and significantly greater (p ≤ 0.05) under compression than tension. However, movement only caused significantly greater material loss (p ≤ 0.0005) than cyclic stress. Subsurface degradation was greatest at the location of highest stress, but was not influenced by stress state or movement.

Bond strength and bioactivity of Zn-doped dental adhesives promoted by load cycling

The purpose of this study was to evaluate if mechanical loading influences bioactivity and bond strength at the resin-dentin interface after bonding with Zn-doped etch-and-rinse adhesives. Dentin surfaces were subjected to demineralization by 37% phosphoric acid (PA) or 0.5 M ethylenediaminetetraacetic acid (EDTA). Single bond (SB) adhesive—3M ESPE—SB+ZnO particles 20 wt% and SB+ZnCl2 2 wt% were applied on treated dentin to create the groups PA+SB, SB+ZnO, SB+ZnCl2, EDTA+SB, EDTA+ZnO, and EDTA+ZnCl2. Bonded interfaces were stored in simulated body fluid for 24 h and tested or submitted to mechanical loading. Microtensile bond strength (MTBS) was assessed. Debonded dentin surfaces were studied by high-resolution scanning electron microscopy. Remineralization of the bonded interfaces was assessed by atomic force microscope imaging/nanoindentation, Raman spectroscopy/cluster analysis, and Masson's trichrome staining. Load cycling (LC) produced reduction in MTBS in all PA+SB, and no change was encountered in EDTA+SB specimens, regardless of zinc doping. LC increased the mineralization and crystallographic maturity at the interface; a higher effect was noticed when using ZnO. Trichrome staining reflected a narrow demineralized dentin matrix after loading of dentin surfaces that were treated with SB-doped adhesives. This correlates with an increase in mineral platforms or plate-like multilayered crystals in PA or EDTA-treated dentin surfaces, respectively.

Masticatory function induced changes, at subnanostructural level, in proteins and mineral at the resin-dentine interface

OBJECTIVE

This study evaluated the ability of different in vitro mechanical loading tests to promote new mineral formation at the bonded dentine interfaces created with a two-step self-etching resin adhesive.

METHODOLOGY

Restored teeth were divided in the following groups: (1) unloaded, load cycling with (2) sine waveform, (3) square waveform, and hold waveform for (4) 24h, and (5) 72 h. Raman spectroscopy and cluster analysis were used to assess the resin-dentine interface.

RESULTS

Mechanical loading in CSEB-treated samples promoted a generalized increase of relative presence of minerals and ratio of phosphate peaks, except in square waveform, where the nature of collagen resulted damaged. Crystallinity of carbonate was higher than phosphate. The organic component showed, in general terms, an increase in crosslinking. Molecular orientation (α-helices) peaks augmented in all tests. Pentosidine vibration increases in all tests, except in hold 72 h. Ratios amide I and II/CH2 incremented, in general. Non uniform parameters of Bis-GMA and adhesive penetration were encountered, as both increased at the bottom of the hybrid layer when loading square and hold 72 h were applied.

SIGNIFICANCE

Functional remineralisation at the resin-dentine interface was attained after in vitro mechanical stimuli application. When loading in square waveform, the lowest vibrations to favor remineralisation were attained.