Microtensile bond strength of resin cements to caries-affected dentin

Medium-term evaluation of the bond strength and dentin penetration of self-adhesive resin cements to root dentin

BACKGROUND

Medium-term evaluate the bond strength and tag formation in root dentin using self-adhesive cements Maxcem Elite (MCE), Relyx U200 (RU2), SeT PP (SPP) and Megalink (MGL) compared to conventional cement Relyx ARC (ARC) for glass fibre post cementation.

MATERIALS AND METHODS

One hundred bovine incisors roots were endodontically treated and divided into 5 groups (n = 20) according to the cementation system: MCE, RU2, SPP, MGL and ARC. All cementation systems were evaluated at 24 h (1) and 12 months (2) after post cementation. Specimens from the cervical, middle and apical thirds of the root were submitted to push-out bond strength test and confocal laser microscopy to verify the dentin penetration. The adhesive failure mode was classified as adhesive, cohesive and mixed. Data were analysed by one-way ANOVA and Tukey tests (α = 5%).

RESULTS

ARC-1 and ARC-12 showed the highest bond strength (P < 0.05). ARC showed the greatest tag extension, regardless of the third (P < 0.05). The most frequent failure mode in the 24-h analysis was cohesive, regardless of the cement used. For the 12-month analysis, mixed failure was the most frequent.

CONCLUSION

Conventional cement (ARC) showed the highest bond strength and tag extension, regardless of the evaluation period. In all cementation systems, the bond strength decreased after 12 months. © 2023 Australian Dental Association.

Evaluating the shear bond strength and remineralization effect of calcium silicate-based and conventional self-adhesive resin cements to caries-affected dentin

OBJECTIVE

Given the importance of preserving caries-affected dentin (CAD) in conservative dentistry, the shear bond strength (SBS) of different resin cements to CAD has been investigated. Here, we aimed to compare the SBS and remineralizing effect of a calcium silicate (TheraCem) and conventional self-adhesive cement (Panavia SA) on the SBS of CAD.

MATERIALS AND METHODS

Forty-eight extracted third molars (24 sound and 24 CAD) were used. In each group, 12 teeth were prepared for bonding to TheraCem or Panavia SA. After removal of the enamel and caries, resin composite cylinders were luted on the prepared dentin. After 28 days of storage in the artificial saliva, SBS was measured and the failure mode analysis was investigated. The images of fractured sections were analyzed using scanning electron microscopy and energy-dispersive X-ray to evaluate the Ca/P weight ratio.

RESULTS

SBS of CAD and sound dentin was not different when cemented with TheraCem (9.56 ± 4.51 vs. 9.17 ± 2.76, p = .806), but the CAD showed significantly lower SBS to Panavia SA (9.4 ± 2.36 vs. 7.39 ± 2.18, p = .015). The Ca/P ratio in CAD was significantly higher when bonded to both TheraCem and Panavia-SA than that of the controls (p = .001); however, this ratio was not different for those bonded to TheraCem compared to Panavia SA.

CONCLUSIONS

Based on our results, TheraCem as a calcium silicate cement shows better SBS to attach the restoration to CAD as compared to Panavia SA. Obliteration and mineralization of the dentinal tubules in TheraCem were also higher than in Panavia SA. However, their ability to improve the amount of the Ca/P ratio in CAD was similar.

Influence of two photodynamic therapy sessions and different photosensitizers on the bond strength of glass-fiber posts in different regions of intraradicular dentin

BACKGROUND

Although photodynamic therapy associated with photosensitizers can promote microbial reduction, studies evaluating the consequences of two photodynamic therapy sessions associated with different photosensitizers on the bond strength of glass-fiber posts to endodontically treated intraradicular dentin are scarce. This in vitro study aimed to investigate the influence of two photodynamic therapy sessions using methylene blue or curcumin photosensitizers on the bond strength of glass-fiber posts to intraradicular dentin in different root thirds.

METHODS

Seventy-two teeth were divided into 9 experimental groups according to photosensitizer type, concentration and light-activation: Control - deionized water; Methylene blue 50 mg/L; Methylene blue 50 mg/L + laser; Methylene blue 100 mg/L; Methylene blue 100 mg/L + laser; Curcumin 500 mg/L; Curcumin 500 mg/L + LED; Curcumin 1000 mg/L; and Curcumin 1000 mg/L + LED. Push-out bond strength of the fiber posts to endodontically treated dentin was evaluated using a universal test machine (n = 8). Bond strength data underwent Kruskal-Wallis test, followed by Dunn test for comparison between treatments, and Friedman test for comparison between thirds (α = 0.05). Illustrative scanning electron microscopy images were obtained to qualify the failure mode.

RESULTS

Curcumin at higher concentration, activated or not by blue LED, decreased the bond strength values in the apical region when compared with the control group (P < 0.05). There was no difference between two photodynamic therapy sessions using methylene blue photosensitizer (activated or not) and the control group regardless of concentrations and root canal depth evaluated (P > 0.05). Regarding intraradicular depth, the different thirds showed no statistical difference on bond strength values (P > 0.05). All experimental groups presented predominance of mixed-type failure, excepting the methylene blue group at higher concentration activated by red laser, and the curcumin photosensitizer at both concentrations activated by blue LED.

CONCLUSIONS

Methylene blue at a 50 mg/L concentration can be applied in two PDT sessions, after biomechanical preparation and before glass-fiber post luting, as it presents no influence on root dentin bond strength in in vitro conditions.

Is Conventional Resin Cement Adhesive Performance to Dentin Better Than Self-adhesive? A Systematic Review and Meta-Analysis of Laboratory Studies

CLINICAL RELEVANCE

Conventional multistep resin cements presented higher adhesive performance to dentin than simplified self-adhesive cements, which is an important criterion for indirect restoration prognosis.

SUMMARY

This study aimed to conduct a systematic review of the literature on laboratory studies assessing bonding performance to dentin of conventional and self-adhesive resin cements, in cementing indirect restorations. This review was reported according to the PRISMA Statement. Of a total of 518 studies, 36 were screened full text and reviewed according to exclusion criteria. Nineteen papers were included in the systematic review and meta-analyses, according to the following inclusion criteria: studies that evaluated the bond strength to dentin of indirect restorations cemented with dual conventional or self-adhesive resin cements and those that presented bond strength data in MPa as an outcome. Statistical analyses were conducted using Rev-Man 5.1. Comparisons were performed with random effects models at 5% significance level. A global analysis comparing conventional and self-adhesive cements and three subgroup analyses comparing immediate and long-term results were performed. Global analysis showed a difference between groups, with conventional resin cements presenting higher bond strength results than self-adhesive resin cements, in immediate and long-term time periods (both p=0.03). Immediate and longterm bond strength results were different for self-adhesive cements, favoring immediate bond strength (p=0.03), but immediate and long-term bond strength results for conventional resin cements were not different (p=0.06). Medium or high risk of bias was found in all studies. Conventional multistep resin cements showed superior overall adhesive performance compared with simplified self-adhesive resin cements when used to cement indirect restorations to dentin.

Color Stability of Ceramic Veneers Cemented with Self-Adhesive Cements after Accelerated Aging

OBJECTIVES

Color change of cements over time can be detected through translucent ceramic veneers, compromising the aesthetic appearance of restorations in the long-term. This study aimed to assess the color stability of ceramic laminate veneers cemented with self-adhesive resin cements after accelerated aging.

MATERIALS AND METHODS

In this study, 21 IPS e.max ceramic discs, measuring 8mm in diameter and 0.7 mm in thickness, were fabricated and divided into three groups (n=7) for the application of Choice 2 total-etch light-cure resin cement, RelyX U200 dual-cure self-adhesive resin cement, and SpeedCEM self-cure self-adhesive resin cement. The ceramic discs in each group were cemented on the prepared facial surface of bovine teeth. The color parameters were assessed using a spectrophotometer. Subsequently, the samples were subjected to accelerated aging for 100 hours, and the color parameters were measured again. The data were analyzed using two-way repeated-measures analysis of variance (ANOVA) and Tamhane's post-hoc test (P<0.05).

RESULTS

Aging significantly affected the ceramic laminate color parameters in all three groups (P<0.05). SpeedCEM cement showed the lowest color stability (ΔE=4.2) after aging, and its color change was clinically unacceptable (ΔE>3.5). The color change of the other two groups was clinically acceptable (1<ΔE<3.5).

CONCLUSION

The self-adhesive dual-cure cement showed color stability comparable to that of the total-etch light-cure cement for cementation of IPS e.max ceramic laminates. The color stability of both cements was superior to that of the self-adhesive self-cure cement.

Analysis of the bond interface between self-adhesive resin cement to eroded dentin in vitro

The purpose of this study was to evaluate the bonding interface between a self-adhesive resin cement to in vitro eroded dentin. Seventy-two third molars were used and divided into two groups: sound dentin and in vitro eroded dentin. The in vitro erosion was performed following a demineralization protocol, in which the specimens were immersed in a demineralizing solution for 2 minutes per cycle and remineralizing solution for 10 minutes per cycle for 9 days. Both groups were submitted to four dentin surface treatments: control group (without any treatment), 2% chlorhexidine, 20% polyacrylic acid, and 0.1 M EDTA (n = 9). Blocks of resin-based composite were bonded with RelyX U200 self-adhesive resin cement applied on the pretreated dentin surfaces. The teeth were sectioned into beams (1mm²) and submitted to microtensile bond strength testing to evaluate the bond strength of self-adhesive resin cement to dentin after 24 hours and 8 months of immersion in artificial saliva. Three specimens of each group were longitudinally cut and evaluated using confocal laser scanning microscopy to analyze the dentin/cement interface. Eroded dentin showed higher bond strength values when compared to sound dentin for the 2% chlorhexidine group (p = 0.03), 24 hours after adhesion. When considering eroded dentin, the 0.1M EDTA group showed higher bond strength values with a statistically significant difference only for the control group (p = 0.002). After 8 months of storage, the present results showed that there was no statistically significant difference between the two substrates for all experimental groups (p>0.05). Analysis of the microscopy confocal showed different types of treatments performed on dentin generally increased tags formation when compared to the control group. The eroded dentin showed a significant increase in density and depth of resinous tags when compared to sound dentin. The storage of samples for 8 months seems to have not caused significant degradation of the adhesive interface.

The effect of repeated bonding on the shear bond strength of different resin cements to enamel and dentin

PURPOSE

Cementation failures of restorations are frequently observed in clinical practice. The purpose of this study is to compare the effect of initial and repeated bonding on the bond strengths of different resin cements to enamel and dentin.

MATERIALS AND METHODS

Ninety human maxillary central incisors were bisected longitudinally. The 180 tooth halves were divided into 2 groups (n = 90) for enamel and dentin bonding. The enamel and dentin groups were further divided into 3 groups (n = 30) for different resin cement types. Composite resin (Filtek Ultimate) cylinders (3 × 3 mm) were prepared and luted to enamel and dentin using Variolink II (Group V), RelyX ARC (Group R), or Panavia F 2.0 (Group P) resin cement. After 24 hours, initial shear bond strengths of the resin cements to enamel and dentin were measured. Using new cylinders, the specimens were de-bonded and re-bonded twice to measure the first and the second bond strengths to enamel and dentin. Failure modes and bonding interfaces were examined. Data were statistically analyzed.

RESULTS

Initial and repeated bond strengths to enamel were similar for all the groups. The first (15.3 ± 2.2 MPa) and second (10.4 ± 2.2 MPa) bond strengths to dentin were significantly higher in Group V (P<.0001). Second bond strengths of dentin groups were significantly lower than initial and first bond strengths to dentin (P<.0001).

CONCLUSION

All resin cements have similar initial and repeated bond strengths to enamel. Variolink II has the highest first and second bond strength to dentin. Bond strength to dentin decreases after the first re-bonding for all resin cements.

Effect of indirect composite treatment microtensile bond strength of self-adhesive resin cements

Background

No specific indications about the pre-treatment of indirect composite restorations is provided by the manufacturers of most self-adhesive resin cements. The potential effect of silane treatment to the bond strength of the complete tooth/indirect restoration complex is not available.The aim of this study was to determine the contribution of different surface treatments on microtensile bond strength of composite overlays to dentin using several self-adhesive resin cements and a total-etch one.

Material and Methods

Composite overlays were fabricated and bonding surfaces were airborne-particle abraded and randomly assigned to two different surface treatments: no treatment or silane application (RelyX Ceramic Primer) followed by an adhesive (Adper Scotchbond 1 XT). Composite overlays were luted to flat dentin surfaces using the following self-adhesive resin cements: RelyX Unicem, G-Cem, Speedcem, Maxcem Elite or Smartcem2, and the total-etch resin cement RelyX ARC. After 24 h, bonded specimens were cut into sticks 1 mm thick and stressed in tension until failure. Two-way ANOVA and SNK tests were applied at α=0.05.

Results

Bond strength values were significantly influenced by the resin cement used (p<0.001). However, composite surface treatment and the interaction between the resin cement applied and surface treatment did not significantly affect dentin bond strength (p>0.05). All self-adhesive resin cements showed lower bond strength values than the total-etch RelyX ARC. Among self-adhesive resin cements, RelyX Unicem and G-Cem attained statistically higher bond strength values. Smartcem2 and Maxcem Elite exhibited 80-90% of pre-test failures.

Conclusions

The silane and adhesive application after indirect resin composite sandblasting did not improve the bond strength of dentin-composite overlay complex. Selection of the resin cement seems to be a more relevant factor when bonding indirect composites to dentin than its surface treatment.

Key words:Bond strength, self-adhesive cement, silane, dentin, indirect composite.

Mechanical properties of components of the bonding interface in different regions of radicular dentin surfaces

STATEMENT OF PROBLEM

The mechanical properties of the adhesive materials used in intraradicular treatments could vary according to the interaction between the restorative material and dentin substrate. An evaluation of these properties is essential to determine the success of the luting procedures performed on glass-fiber posts.

PURPOSE

The purpose of this study was to evaluate the mechanical properties of dentin adhesives, resin cements, and the dentin that underlies the bonding interface in different thirds of intraradicular dentin.

MATERIAL AND METHODS

Forty extracted, single-rooted human teeth were used in this study. After the endodontic treatment of the post spaces, the teeth were divided into 5 groups (n=8): Adper Single Bond 2 + RelyX ARC, Excite DSC + RelyX ARC, Adper SE Plus + RelyX ARC, RelyX Unicem, and Set. The hardness and elastic modulus values were measured at the adhesive interface in different thirds of the radicular dentin by using an ultramicrohardness tester. The data were subjected to 2-way ANOVA and the Fisher protected least significant difference test (α=.05).

RESULTS

In the underlying dentin, the highest Martens hardness values were found in the apical region for all groups; the exceptions were the groups with the self-etching adhesive. In the adhesive layer, the highest Martens hardness values were obtained for the Adper SE Plus + RelyX ARC group; further, no statistical differences were found among the different regions for this group. RelyX ARC had the lowest Martens hardness and elastic modulus values in the apical regions when used with Adper Single Bond 2 and Adper SE Plus. No differences were found in the Martens hardness and elastic modulus values for the self-adhesive resin cement in the regions investigated.

CONCLUSION

The mechanical properties of adhesive materials and the underlying dentin are influenced by the interaction between the two as well as by the depth of the analyzed intraradicular area.