Additive effects of touch-activated polymerization and extended irradiation time on bonding of light-activated adhesives to root canal dentin

The effect of touch-cure polymerization on the push-out bond strength of fiber posts

Objective

To assess the impact of a novel touch-cure polymerization of dual-curing resin cement on the push-out bonding strength (PBS) of the conventional prefabricated glass fiber-reinforced composite (GFRC) and custom-made glass fiber (GF) posts at different root sections.

Methods

Forty single-root mandibular first premolars were treated endodontically and prepared for receiving the posts, the prepared roots were randomly divided into 4 groups. Group I: A prefabricated (GFRC) post was cemented by G-CEM ONE resin cement with adhesive-enhancing primer (AEP). Group II: A prefabricated (GFRC) post was cemented by G-CEM ONE without AEP. Group III: A customized (GF) post was cemented by G-CEM ONE with AEP. Group IV: A customized (GF) post was cemented by G-CEM ONE without AEP. (n = 10 for each group). The PBS was tested with a universal testing machine, and the values were analyzed with (ANOVA) and Tukey's post hoc test at a P ≤ 0.05 significance level.

Results

Group III revealed the greatest PBS values, followed by Group IV, Group I, and finally, Group II showed the lowest PBS values. The coronal root slices showed the highest PBS in comparison with the middle and apical third.

Conclusion

The touch-cure polymerization improved the PBS of the prefabricated and customized fiber posts. Therefore, ‟touch and cure" cement may be considered a clinical alternative to conventional types of resin cement. The customized (GF) posts exhibited a higher PBS than the prefabricated (GFRC). The combination of customized posts and G-CEM ONE with AEP is recommended as a new strategic approach to improve interfacial adhesion.

Reliability of an Innovative Slab Shear versus Microtensile Bond Strength Test: Mechanical and Finite Element Analysis

OBJECTIVE

 The aim of this study was to evaluate the efficiency of slab shear bond strength test (Slab_SBS) versus the microtensile in evaluation of the bond strength of different substrates.

MATERIALS AND METHODS

 Forty-eight extracted caries-free human third molars were utilized for teeth specimens' preparation. After flattening of all molars' occlusal table, the specimens were divided into two groups based on the type of utilized restorative material: nanohybrid resin composite and resin-modified glass ionomer (RMGI). Each group was further subdivided into three subgroups according to the subsequently applied bond strength test and specimen width; microtensile bond strength test (μTBS), Slab_SBS [2 mm] and Slab_SBS [3 mm]. Both testing methods were additionally applied on CAD/CAM specimens, nanohybrid resin composite blocks (composite-to-composite), and ceramic blocks (ceramic-to-ceramic). CAD/CAM specimens were prepared and cemented and then sectioned and subdivided as followed for teeth specimens' preparation. Pretest failures (PTF), bond strength, and failure mode of each specimen were recorded. Representative three-dimensional (3D) finite element analysis (FEA) models were developed to simulate μTBS and Slab_SBS specimens. Data were statistically analyzed using Shapiro-Wilk test and Weibull analysis.

RESULTS

 Pretest failures were only noted in the μTBS subgroups. Slab_SBS provided comparable bond strength to the μTBS of all substrates with adhesive mode of failure.

CONCLUSION

 Slab_SBS is easier to prepare with consistent and predictable outcome with no pretest failures during specimen preparation and better stress distribution.

Effect of Method of Removing Caries-Affected Dentin on the Bond Strength of Composite Resin to Root Canal Dentin

The adhesion of composite resin to caries-affected dentin differs from the adhesion of resin to sound dentin. We evaluated the bond strengths of dual-cure resin composites applied to caries-affected root canal dentin under various clinical conditions and using several caries removal indicators. In the dye stain 1 group, caries were removed to a pale pink stain level using a caries detector. In the dye stain 2 group, caries were removed to a stain-free level using a caries detector. In the probing group, caries were removed to the level of hardness based on probing with a sharp explorer. Additionally, a sound dentin group was used as a control. We compared the resin composite microtensile bond strengths and failure mode distribution among the groups. The bond strengths (MPa) of the probing (64.6 ± 11.9) and the sound dentin (68.7 ± 11.1) groups were significantly higher than those of the dye stain 1 (46.9 ± 7.9) and 2 (47.5 ± 8.4) groups (p < 0.05). The removal of caries-affected dentin using a dentin-hardness-based technique showed higher tensile strength than that using a dye stain technique involving removal to any color level. Thus, the caries removal technique used on root canal dentin affects the bond strength of the resin composite.

Effect of adhesive strategy on resin cement bonding to dentin

OBJECTIVE

The cement bonding strategy and the polymerization mode can influence the prognosis of indirect restorations. The microtensile bond strength (μTBS) and dentin endogenous enzymatic activity of a dual-cure resin cement (PV5) used in combination with two dentin surface conditioners (accelerator-enhancer primer, TP or universal adhesive, UA) were evaluated.

MATERIALS AND METHODS

PV5 was used to lute composite overlays after dentin treatment with TP or UA. The resin cement was self-cured, SC (1 h at 37 °C) or dual-cured, DC (20 s light-cure followed by 15 min self-cure at 37°C). The μTBS test, fractographic analysis, and the in situ zymography evaluations were performed after 24 h (T₀ ) or 1 yr (T₁₂ ) of artificial storage. Data were statistically analyzed (α = 0.05).

RESULTS

TP/DC obtained the highest adhesive strengths (45 ± 9 and 36.6 ± 8), while UA/SC (17 ± 8 and 11 ± 4) the lowest, both at T₀ and T₁₂ , respectively. DC resulted in superior bonding values than the SC, independent of the dentin surface treatment (p < 0.05). The type of adhesive, curing mode and aging influenced the gelatinolytic activity (p < 0.05).

CONCLUSIONS

The dual-cure resin cement used in combination with its accelerator-enhancer primer showed superior bonding performances with respect to universal adhesive. Dual-curing the resin cement was determinant to enhance bonding capability over time, independent of the adhesive strategy.

CLINICAL RELEVANCE

Clinicians must be aware to faithfully follow manufacturer's recommendation regarding the adhesive strategy suggested with the resin cement used.

The Effect of Touch-Cure Polymerization on the Conversion and Hardness of Core Build-Up Resin Composites: A Laboratory Study

To improve the self-curing capacity and interfacial strength with dentine of dual-cured composite materials, touch-cure activators have been introduced. The aim of the study was to evaluate the effect of these activators on the hardness and conversion of dual-cured resin composite core build-up restoratives. The materials tested were Clearfil DC Core Plus (CF) and Gradia Core (GC) with the corresponding adhesives Clearfil S³ Bond Plus (for CF) and G-Premio Bond/G-Premio DCA activator (for GC). Disk-shaped specimens (n = 6/group) were prepared for the following groups: dual-cured, self-cured and self-cured in contact with the adhesive activators at the bottom surface. After a 3-week storage period (dark/dry/37 °C) the Martens hardness (HM) and degree of conversion (DC%) were determined for the previously mentioned groups and the top surfaces of groups in contact with the adhesives. A statistical analysis was performed by a one-way ANOVA and Holm–Sidak test per material and a Pearson’s correlation analysis (HM vs. DC%) at an α = 0.05. The self-cured specimens resulted in significantly lower HM and DC% values from the dual-cured group, as expected. However, in the presence of the adhesives with touch-cure activators, the conversion of the self-cured groups showed insignificant differences in HM and DC% from the dual-cured in both composite materials. The improvements on the bottom composite surfaces in contact with the adhesives did not extend to the entire specimen length. Nevertheless, improved interfacial curing may improve interfacial durability.