Effect of self-etching adhesives on dentin permeability in a fluid flow model

The effect of fluoride iontophoresis on seal ability of self-etch adhesive in human dentin in vitro

Background

Fluoride iontophoresis (FI) is a non-invasive method for the transfer of fluoride ions under electrical pressure into dental hard tissue. This study aimed to determine the effect of FI on the seal ability of self-etch adhesive in human dentin using dentin permeability test and scanning electron microscopy (SEM).

Methods

The experiments were divided into 2 series: series 1 was performed on 28 extracted intact third molars and series 2 was performed on 28 extracted carious third molars (ICDAS 4 and 5). In each series, 20 teeth were used for dentin permeability test and 8 teeth were used for SEM study. For dentin permeability test, the specimens were divided into dentin without FI (control) and dentin with FI (experimental) subgroups. Hydraulic conductance (HD) of dentin was measured before and after adhesive treatment, and calculated for the percentage decrease of HD in each subgroup. Two-way ANOVA and Tukey test were used for statistical analysis. SEM study was used to assess the seal ability of self-etch adhesive and penetration of fluoride ions into dentinal tubules.

Results

HD after self-etch adhesive treatment reduced by 57.75 ± 17.99% in intact dentin with FI, 46.60 ± 17.03% in intact dentin without FI, 45.00 ± 15.30% in caries affected dentin without FI, and 37.28 ± 14.72% in caries affected dentin with FI. There was no significant difference in percentage decrease of HD between dentin without FI and dentin with FI (P = 0.742); meanwhile, intact dentin with FI had significant greater percentage decrease than caries affected dentin with FI (P < 0.05). SEM findings showed FI produced more particle formation and deeper precipitation in intact dentin than those in caries affected dentin.

Conclusions

FI did not affect the seal ability of self-etch adhesive in human dentin when compared to without FI. However, FI could augment the seal ability of the self-etch adhesive in intact dentin better than that in caries affected dentin.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02146-w.

CPNE7 Induces Biological Dentin Sealing in a Dentin Hypersensitivity Model

Dentin hypersensitivity commonly occurs due to opened dentinal tubules for many reasons. In our previous study, copine 7 (CPNE7) could induce dentin formation for an indirect pulp-capping model in vivo. This study aims to investigate the formation of tertiary dentin when CPNE7 is applied to intentionally exposed dentin with nothing over it in vivo, whether it affects microleakage of the teeth, and the penetration ability of CPNE7 molecules through dentinal tubules in vitro. Cervical dentin areas of 6 maxillary incisors of 5 beagles were exposed to a class V–like lesion, and 1 side of 3 maxillary incisors was adapted with recombinant CPNE7 protein for 5 min as the experimental group. The other side was the control group, and there was no treatment of ethylenediaminetetraacetic acid (EDTA) and CPNE7 after preparation. The defects were exposed without any restorations, and all beagles were sacrificed after 4 wk. The fluid penetration of exposed dentin areas was investigated by a microleakage-testing device and confocal laser scanning microscope. Tertiary dentin formation was confirmed with histological scanning electronic microscopic analysis. Tertiary dentin formation reduces dentinal fluid flow due to occluded tubules or discontinuity with primary or secondary dentin. The in vivo hypersensitivity model with the anterior teeth of beagle dogs showed newly formed tertiary dentin at the dentin-pulp boundary in recombinant CPNE7–treated teeth when compared with the untreated control group in histologic analysis. Scanning electronic microscopic analysis revealed occluded sites with mineral deposition of intratubular dentin. In the permeability test, the mean microleakage value of the CPNE7-treated group was significantly lower than that of the control group ( P < 0.05). The tubular penetration of rhodamine B–combined CPNE7 was confirmed under confocal laser scanning microscope. CPNE7 induces formation of tertiary dentin through shallowly exposed dentinal tubules, which decreases dentin permeability.

Evaluation of dentin permeability of fluorotic permanent teeth

OBJECTIVE

The in vitro permeability characteristics of dentin have been studied extensively and used to evaluate the efficacy of various preventative and restorative procedures. The aim of this in vitro study was to precisely determine the dentin permeability of fluorotic premolar teeth using an electronic hydraulic conductance measurement system with photosensors and to compare the data with healthy premolars.

METHODS

In total, 40 fluorotic and healthy premolar teeth with complete root formation that were extracted for orthodontic purposes and had no caries, restoration, fractures, or cracks were selected for this study. Teeth were classified according to a modified form of the dental fluorosis index of Thylstrup and Fejerskov. The dentin discs were placed in an electronic hydraulic conductance measurement system equipped with photosensors, which was designed for measurements of dentin permeability. The amount of distilled water passed through each dentin disc (μL/min) under a constant pressure was determined. Dentin permeability data of the fluorotic and healthy teeth were recorded and analyzed statistically.

RESULTS

The present study showed that fluorosis influenced the volume of fluid that passed through the dentin and the dentin permeability was decreased, whereas dental fluorosis severity was increased in permanent teeth.

CONCLUSION

The number of teeth with fluorosis is increasing, depending on fluorine sources, so more appropriate treatments will need to be evaluated by standardizing the methods employed in related studies.

Bond strength of adhesive systems to sound and demineralized dentin treated with bioactive glass ceramic suspension

OBJECTIVE

The objective of this study was to evaluate the effect of a Biosilicate®, associated with dentin adhesive system, on microtensile bond strength (μTBS) to sound and demineralized dentin.

MATERIALS AND METHODS

Eighty sound-extracted molars had their middle occlusal dentin exposed. In forty teeth, dentin was artificially demineralized (pH cycling). Sound and demineralized dentin teeth were separated into four groups (n = 10), according to the substrate treatment before restoration: Group 1-total-etching adhesive Adper TM Single bond 2 (ASB) + Biosilicate®, Group 2-ASB (without Biosilicate®), Group 3-AdheSE self-etching adhesive system (AdSE) + Biosilicate®, and Group 4-AdSE (without Biosilicate®). Each tooth was restored with a hybrid composite and stored in water at 37 °C for 6 months. After water aging, teeth were cut in sticks (≈ 1 mm² cross-sectional area) and all samples were submitted to μTBS test. The fracture modes of the samples were analyzed by stereomicroscopy. The representatively fractured samples were observed by scanning electron microscopy. Representative samples of each group were analyzed on energy dispersive X-ray spectrometry (EDX). The μTBS and Ca-P ratio values were analyzed by 2-way ANOVA, Bonferroni, and Tukey test, respectively, p < .05.

RESULTS

ASB + Biosilicate® presented the highest μTBS values (p < .05), and lowest μTBS values (p < .05) were found in AdSE Group. There was no statistical difference (p < .05) on μTBS when substrates were compared, except for Group 2. The fracture pattern analysis showed prevalence of adhesive fractures in all groups.

CONCLUSION

Biosilicate® enhanced bond strength of self-etching and etch-and-rinse adhesives to sound and demineralized dentin.

CLINICAL RELEVANCE

Bioactive glass ceramic suspension could be recommended to be used to improve the dentin bond strengths of the total-etching and self-etching adhesives after acid-etching and priming.

MATHEMATICAL MODELING FOR THE PREDICTION AND IMPROVEMENT OF TOOTH THERMAL PAIN: A REVIEW

Tooth pain, especially tooth thermal pain, is one of the most important symptoms and signs in dental clinic and daily life. As a special sensation, pain has been studied extensively in both clinic and experimental research aimed at reducing or eliminating the possible negative effects of pain. Unfortunately, the full underlying mechanism of pain is still unclear, because the pain could be influenced by many factors, including physiological, psychological, physical, chemical, and biological factors and so on. Besides, most studies on pain mechanisms in the literature are based on skin pain sensation and only few are based on tooth pain. In this paper, we present a comprehensive review on both neurophysiology of tooth pain mechanism, and corresponding thermal, mechanical, and thermomechanical behaviors of teeth. We also describe a multiscale modeling approach for quantifying tooth thermal pain by integrating the mathematic methods of engineering into the neuroscience. The mathematical model of tooth thermal pain will enable better understanding of thermal pain mechanism and optimization of existing diagnosis and treatment in dental clinic.

Effect of a new desensitizing material on human dentin permeability

OBJECTIVES

Resin-modified glass ionomers (RMGI) have demonstrated clinical success providing immediate and long-term relief from root sensitivity. RMGIs have been recently introduced as paste-liquid systems for convenience of clinical usage. The objective of this study was to measure the ability of a new paste-liquid RMGI to reduce fluid flow through human dentin, compared to an established single-bottle nanofilled total etch resin adhesive indicated for root desensitization.

METHODS

Dentin permeability was measured on human crown sections on etched dentin, presenting a model for the exposed tubules typical of root sensitivity, and permitting measurement of the maximum permeability. In the first two groups, the etched dentin was coated with either the RMGI or adhesive, and permeability measured on the coated dentin. In a third group, a smear layer was created on the dentin with sandpaper, then the specimens were coated with the RMGI; permeability was measured on the smeared and coated dentin. Specimens from each group were sectioned and examined via scanning electron microscopy (SEM).

RESULTS

Both the resin adhesive and the new paste-liquid RMGI protective material significantly reduced fluid flow through dentin, and exhibited excellent seal on dentin with either open tubules or smear-layer occluded tubules. The RMGI infiltrated the smear layer with resin during placement, penetrated dentin tubules, and formed resin tags.

SIGNIFICANCE

The RMGI was equivalent to the adhesive in its ability to reduce fluid flow and seal dentin. It is therefore concluded that the new RMGI and the adhesive show the potential to offer excellent sensitivity relief on exposed root dentin.

Real-time measurement of dentinal fluid flow during amalgam and composite restoration

OBJECTIVES

This study examined changes in the dentinal fluid flow (DFF) during restorative procedures and compared permeability after restoration among restorative materials and adhesives.

METHODS

A class 1 cavity was prepared and restored with either amalgam (Bestaloy), or composite (Z-250) with one of two etch-and-rinse adhesives (Scotchbond MultiPurpose: MP and Single Bond 2: SB) or one of two self-etch adhesives (Clearfil SE Bond: CE and Easy Bond: EB) on an extracted human third molar which was connected to a sub-nanoliter fluid flow measuring device (NFMD) under 20 cm water pressure. DFF was measured from the intact tooth state through the restoration procedures to 30 min after restoration, and re-measured at 3 and 7 days post-restoration.

RESULTS

Inward flow during cavity preparation was followed by outward flow after preparation. In amalgam restoration, the outward flow changed into an inward flow during amalgam filling, which was followed by a slight outward flow after finishing. In composite restoration, MP and SB showed an inward flow and outward flow for the rinsing and drying steps, respectively. Application of a hydrophobic bonding resin in the MP and CE systems caused a decrease in the flow rate. Air-drying of solvent for the CE and EB systems caused a sudden outward flow, whereas light-curing of the adhesive and composite caused an abrupt inward flow.

CONCLUSIONS

Each restorative step clearly changed the direction and the rate of the DFF during restoration, which could be well identified with NFMD.

Effect of a new liner/base on human dentin permeability

OBJECTIVES

Resin-modified glass ionomers (RMGI) have demonstrated clinical success in their ability to minimize post-operative sensitivity of restorations. RMGIs have been recently introduced as paste-liquid systems for convenience of clinical usage. The objective of this study was to measure the ability of a new paste-liquid RMGI liner/base to reduce fluid flow through human dentin.

METHODS

Dentin permeability was measured on human crown sections on etched dentin, using etched dentin as a model for the exposed tubules typical of root sensitivity, and permitting measurement of the maximum permeability. In the one group, the etched dentin was coated with the RMGI, and pre- and post-treatment permeability was measured on the coated dentin. In the second group, a smear layer was created on the dentin with sandpaper, then the samples were coated with the RMGI; permeability was measured on the smeared and coated dentin. Samples from each group were sectioned and examined via scanning electron microscopy (SEM).

RESULTS

The new paste-liquid RMGI liner/base significantly reduced fluid flow through dentin, and exhibited excellent seal on dentin with either a smear layer or open tubules. SEM images show evidence that the RMGI infiltrated the smear layer with resin during placement, penetrated dentin tubules, and formed resin tags in acid-etched dentin.

CONCLUSIONS

Based on these results, combined with previous research on adhesion and microleakage, it is concluded that the new RMGI liner/base should minimize post-operative sensitivity in restorations.

Evaluation of the effect of four self-etching adhesives on dentin permeability

OBJECTIVE

The aim of this study was to evaluate the effect of two two-step and two single-step self-etching adhesives on dentin permeability using a computerized fluid filtration (CFF) test method.

METHODOLOGY

Forty recently extracted sound human molar teeth were sectioned at the mid level of the crown to obtain dentin discs of 1 +/- 0.2 mm. A total of 40 discs were obtained and randomly divided into four groups (n = 10). The permeability of the discs was measured using the CFF test method before and after application of the following self-etching adhesives: Hybrid Bond, G-Bond, AdheSE, and Protect Bond. Fluid movement measurements were made at 2-min intervals for 8 min, and a mean of the values obtained was calculated for each specimen.

RESULTS

The in vitro fluid conductance of dentin discs treated with Hybrid Bond and AdheSE were lower than the dentin discs treated with G-Bond and Protect Bond (p < 0.05).

CONCLUSION

1-Treating dentin discs with self-etching adhesives caused significant reduction of dentin permeability. 2-All self-etching adhesives allowed diffusion of distilled water. However, AdheSE and Hybrid Bond showed the lowest permeability.

Effect of adhesive hydrophilicity and curing time on the permeability of resins bonded to water vs. ethanol-saturated acid-etched dentin

OBJECTIVE

This study examined the ability of five comonomer blends (R1-R5) of methacrylate-based experimental dental adhesives solvated with 10 mass% ethanol, at reducing the permeability of acid-etched dentin. The resins were light-cured for 20, 40 or 60s. The acid-etched dentin was saturated with water or 100% ethanol.

METHOD

Human unerupted third molars were converted into crown segments by removing the occlusal enamel and roots. The resulting crown segments were attached to plastic plates connected to a fluid-filled system for quantifying fluid flow across smear layer-covered dentin, acid-etched dentin and resin-bonded dentin. The degree of conversion of the resins was measured using Fourier transform infrared spectroscopy.

RESULT

Application of the most hydrophobic comonomer blend (R1) to water-saturated dentin produced the smallest reductions in dentin permeability (31.9, 44.1 and 61.1% after light-curing for 20, 40 or 60s, respectively). Application of the same blend to ethanol-saturated dentin reduced permeability of 74.1, 78.4 and 81.2%, respectively (p<0.05). Although more hydrophilic resins produced larger reductions in permeability, the same trend of significantly greater reductions in ethanol-saturated dentin over that of water-saturated dentin remained. This result can be explained by the higher solubility of resins in ethanol vs. water.

SIGNIFICANCE

The largest reductions in permeability produced by resins were equivalent but not superior, to those produced by smear layers. Resin sealing of dentin remains a technique-sensitive step in bonding etch-and-rinse adhesives to dentin.

Use of electrochemical impedance spectroscopy to evaluate resin-dentin bonds

Electrochemical impedance spectroscopy (EIS) offers a potentially nondestructive quantitative method for measuring the stability of resin films and or resin-bonded dentin over time. The purpose of this study was to measure the electrical impedance of five experimental dental adhesives of increasing hydrophicities as 30-microm films and as resin-bonded coatings on acid-etched dentin. Resin films or resin-coated dentin disks were placed in U-shaped chambers containing pairs of Ag-AgCl electrodes in 0.1M KCl. Electrical impedance spectra were run at day 0, 1, 7, 14, and 21 days. All resin films and resin-bonded dentin showed increases in capacitance during the first day of storage in electrolyte. This was usually associated with an increase in the pore resistance of the resins. Generally, resin-bonded dentin gave lower impedance values than their respective resins (resins 1-4) but solvated resin 5 bonded to water-saturated dentin gave higher capacitance and impedance values than resin 5 films. However, solvated resin 5 films gave higher impedance values than resin 5-bonded dentin. This behavior was confirmed by TEM examinations of silver uptake into films of neat resin 5 vs. ethanol-solvated resin 5, where water tree-like structures seen in the former were not seen in the latter. EIS is useful in examining changes in the capacitance and electrical impedance of very hydrophilic, ionic methacrylate resins. Its utility in detecting degradation in resin-bonded dentin interfaces remains to be determined in longer term studies.

Morphological study of fiber-reinforced post-bonding system-root dentin interface by evaluation of two bonding systems

Morphological study of fiber post/bonding system/root dentin interface by evaluation of two bonding systems.

OBJECTIVES

The aim of the study was to analyze the interfaces, and thus the seal, between root dentin and bonded fiber-reinforced posts. The interfaces were obtained by applying two enamel-dentin adhesive systems, a one-bottle system used after application of phosphoric acid and a self-etch system, both used with an adhesive cement. The interface was evaluated by SEM observation of the continuity of the hybrid layer and the morphology of the resin tags, in terms of length, density and presence of side branches, at the interface between the fiber-reinforced post, the bonding system and the root dentin.

METHODS

Twenty-six anterior single-rooted teeth extracted for periodontal reasons were treated endodontically and then randomly separated into two groups of 13 teeth each: group 1: Excite DSC (Ivoclar Vivadent, Liechtenstein); group 2: AdheSE DC (Ivoclar Vivadent, Schaan, Liechtenstein). After preparation of the root canal and application of the adhesive, each specimen received a Postec translucent FRC post (Ivoclar Vivadent, Schaan, Liechtenstein) that was cemented in with Variolink II dual-curing luting composite (Ivoclar Vivadent, Schaan, Liechtenstein). The specimens were then prepared for SEM observation of the continuity of the hybrid layer and scoring of the morphology of the resin tags in each third of the root (at 1, 4.5 and 8mm from the coronal surface).

RESULTS

There was no significant difference (at p<0.05) between the two groups in terms of continuity of the hybrid layer or morphology of the resin tags. The hybrid layer was present, unbroken and uniform in both the group where adhesive was used with a phosphoric acid total etch and the self-etch system group. Whatever the bonding system, the resin tags had side branches, and greater length and density in the cervical third than in the middle or apical thirds. Bubbles were found in the cement layer in most of the specimens.

CONCLUSIONS

The one-bottle and self-etch bonding systems gave similar results in terms of interface morphology when a translucent fiber-reinforced post was cemented into the endodontically prepared roots.

Dentine sealing provided by smear layer/smear plugs vs. adhesive resins/resin tags

The aim of this study was to evaluate the ability of five experimental resins, which ranged from hydrophobic to hydrophilic blends, to seal acid-etched dentine saturated with water or ethanol. The experimental resins (R1, R2, R3, R4, and R5) were evaluated as neat bonding agents (100% resin) or as solutions solvated with absolute ethanol (70% resin/30% ethanol). Fluid conductance was measured at 20 cm H(2)O hydrostatic pressure after sound dentine surfaces were: (i) covered with a smear layer; (ii) acid-etched; or (iii) bonded with neat or solvated resins, which were applied to acid-etched dentine saturated with water or ethanol. In general, the fluid conductance of resin-bonded dentine was significantly higher than that of smear layer-covered dentine. However, when the most hydrophobic neat resins (R1 and R2) were applied to acid-etched dentine saturated with ethanol, the fluid conductance was as low as that produced by smear layers. The fluid conductance of resin-bonded dentine saturated with ethanol was significantly lower than for resin bonded to water-saturated dentine, except for resin R4. Application of more hydrophobic resins may provide better sealing of acid-etched dentine if the substrate is saturated with ethanol instead of with water.

Effect of Pulp Pressure on the Micropermeability and Sealing Ability of Etch & Rinse and Self-etching Adhesives

Etch & rinse adhesives are much more micropermeable and affected by pulp fluid compared with self-etching adhesives. Pulp pressure reduces dentin sealing with etch & rinse adhesives but not with self-etching adhesives. Pulp pressure has no effect on enamel sealing, which is lower when self-etching adhesive is used.

The role of acrylophosphonic acid monomers in the formation of hybrid layers based on self-etch adhesives

The role of acrylophosphonic acid monomers in the formation of hybrid layers based on self-etch adhesives.

OBJECTIVES

Our plan was to define the reaction products formed when an acrylophosphonic acid reacts with tooth hard tissue. Our aim was to describe the incorporation of the reaction products in the hybrid layer formed.

METHODS

Potentiometric methods were used to measure acid dissociation constants and investigate calcium complex formation. Infrared spectroscopy and NMR were used to follow water contents and show transformation of phosphorous containing compounds.

RESULTS

The acrylophosphonic acid contained in AdheSE (Ivoclar Vivadent, Schaan, Liechtenstein) is characterized by two acidities with pK(a1)=2.4 and pK(a2)=7.0, and interacts with calcium ions in a purely ionic fashion. When hydroxyapatite crystals are dissociated by the presence of AdheSE, brushite is formed together with a calcium cross-linked network of the phosphonate containing copolymer.

CONCLUSION

The results give a new image of the hybrid layer where the adhesive behaves like an ionomer resin incorporating collagen but also minerals and salt bridges.

Single-bottle adhesives behave as permeable membranes after polymerisation. II. Differential permeability reduction with an oxalate desensitiser

OBJECTIVES

This study examined the changes in hydraulic conductance and ultrastructure of dentine bonded with simplified etch-and-rinse adhesives to oxalate desensitiser pre-treated acid-etched dentine.

METHODS

Human dentine disks were acid-etched, treated with an oxalate desensitiser (BisBlock, Bisco), and bonded with One-Step (OS), Single Bond (SB), OptiBond Solo Plus (OB) or Prime and Bond NT (PB). Similar disks from each group were acid-etched, and bonded without oxalate pre-treatment. Hydraulic conductance of the specimens was measured at 20 cm of water pressure and analysed with nonparametric statistical methods. Epoxy resin replicas of the smear layer-covered dentine and bonded dentine were examined with SEM for the extent of fluid transudation. Specimens bonded under perfusion were examined with TEM after tracer immersion.

RESULTS

OB and PB exhibited a highly significant reversal of the reduced hydraulic conductance obtained with BisBlock on unbonded acid-etched dentine. Profuse water transudation across the bonded dentine was observed from the replicas. Adhesive interfaces were covered with spherical globules that interfered with dentine hybridization. Conversely, no significant difference in hydraulic conductance was observed in SB, between Bisblock pre-treated, unbonded and bonded acid-etched dentine. Significantly lower hydraulic conductance was shown on application of OS to Bisblock-treated acid-etched dentine. Water transudation was sparse, interfering surface globular structures were absent, and only angular subsurface crystals were seen in the dentinal tubules.

CONCLUSIONS

Convective water fluxes through dentine may be reduced by applying Bisblock to acid-etched dentine before bonding with One-Step or Single Bond. However, reducing adhesive permeability with the use of oxalate desensitiser is not applicable to low acidity adhesives such as OptiBond Solo Plus and Prime and Bond NT.

Degree of conversion and permeability of dental adhesives

The aim of this study was to analyse the extent of polymerization of different adhesive films in relation to their permeability. One adhesive of each class was investigated: OptiBond FL; One-Step; Clearfil Protect Bond; and Xeno III. Adhesive films were prepared and cured with XL-2500 (3M ESPE) for 20, 40 or 60 s. Polymerization kinetic curves of the adhesives tested were obtained with differential scanning calorimetry (DSC) and data were correlated with microhardness. The permeability of the adhesives under the same experimental conditions was evaluated on human extracted teeth connected to a permeability device and analysed statistically. The results showed that the extent of polymerization obtained from DSC exotherms was directly correlated with microhardness. An increased level of polymerization after prolonged light-curing was confirmed for all adhesives. Simplified adhesives exhibited a lower extent of polymerization and showed incomplete polymerization, even after 60 s. An inverse correlation was found between the degree of cure and the permeability. This study supports the hypothesis that the permeability of simplified adhesives is correlated with incomplete polymerization of resin monomers and the extent of light exposure. These adhesives may be rendered less permeable by using longer curing times than those recommended by the respective manufacturer.