Blood contamination and dentin bonding--effect of anticoagulant in laboratory studies

Universal adhesive application to contaminated/non-contaminated dentin with three different protocols: An in vitro shear bond strength and SEM analysis

This study aimed to comparatively evaluate the shear bond strength (SBS) of a universal adhesive to contaminated/non-contaminated dentin when applied with three different protocols. One-hundred-eighty dentin samples were divided randomly into 12 groups (n=15). The groups were created by combining four dentin contamination conditions (non-contaminated or contaminated with blood, hemostatic, or blood+hemostatic) with three application protocols for Single Bond Universal (no-preconditioning or preconditioning with the 35% phosphoric or 1% gallic acid). Following thermal cycling, the SBS test was performed. Data were analyzed using two-way-ANOVA and Tukey's HSD (p<0.05). Dentin surfaces subjected to phosphoric acid, gallic acid, or hemostatic were examined using scanning electron microscope (SEM) analysis. SBS results were influenced by both the dentin contamination (p<0.001) and application protocol (p<0.001). A significant interaction was found between the two factors (p=0.005). The highest bonding performance to contaminated dentin -at all contamination conditions- was achieved with the gallic acid preconditioning.

Evaluation of Cleaning Methods on Lithium Disilicate Glass Ceramic Surfaces After Organic Contamination

The purposes of this study were to 1) evaluate the effectiveness of different cleaning methods from a previously etched and silanized lithium disilicate glass ceramic (EMX) surface after contact with organic fluids (saliva or human blood) and 2) assess the effect of applying a new silane layer after the cleaning methods on the microshear bond strength (mSBS) of resin cement to EMX. EMX discs were etched with 5% hydrofluoric acid (HF) and properly silanized. Three control groups were created (n=10): control (without contamination), saliva positive, and human blood positive. Later, after new contaminations, the samples were distributed into four groups according to the cleaning method (n=20): air–water spray (AWS), 35% phosphoric acid, 70% alcohol, or Ivoclean cleaning paste. After the cleaning methods, subgroups were submitted to a new silane layer application, or not (n=10). All samples received a thin layer of a bonding agent and, subsequently, three light-cured resin cement cylinders were prepared on each EMX surface for the mSBS test. This test was performed on a universal testing machine at a vertical speed of 1 mm/minute until rupture. Contaminated and cleaned silanized EMX surfaces were assessed by scanning electron microscopy (SEM) (n=1). The noncontaminated control group showed an average mSBS of 18.7 MPa, and the positive saliva and human blood control groups yielded a 34% and 42% reduction in bond strength, respectively, compared to the uncontaminated control (p&lt;0.05). For saliva-contaminated surfaces, all cleaning methods were effective and not different from one another or the control group (p&gt;0.05). However, for human blood contamination, only Ivoclean cleaning paste was effective in restoring μSBS to uncontaminated control group levels (p&gt;0.05). SEM images showed a clean surface (ie, with no contaminant residues) after the cleaning methods, regardless of the organic contaminant type. All the assessed cleaning methods were effective in removing saliva from the silanized EMX surface; however, only Ivoclean was able to restore the adhesion quality when the silanized EMX surface was contaminated with human blood.

Status of decontamination methods after using dentin adhesion inhibitors on indirect restorations: An integrative review of 19 publications

The purpose of this review was to assess the literature regarding the decontamination of resin cement before the luting procedure in order to provide clinicians with a comparative overview of decontamination effects. A total of 19 articles were selected for inclusion in this review. The results indicated that bonding effectiveness is reduced due to residual adhesion inhibitors such as saliva, blood, hemostatic agents, and temporary/provisional cement. Self-etching and self-adhesive systems tend to be more negatively affected by adhesion inhibitors than do etch and rinse systems. Cleaning with an ultrasonic scaler or rotating brush have demonstrated conflicting effects in several studies. Some studies have reported that phosphoric acid has negative effects and recommend mild acid for decontamination. The application of phosphoric acid followed by sodium hypochlorite has been shown to help avoid negative effects. Alumina blasting has been investigated as a mechanical cleaning method in a relatively large number of experiments, most of which have confirmed its effectiveness. An intraoral cleaner containing functional monomers that has become commercially available in recent years is a promising method in clinical practice because it can easily and effectively remove temporary adhesive material. In addition, adhesion inhibitors can be easily removed from resin-coated dentin surfaces.

Effect of Decontamination Treatments on Micro-Shear Bond Strength between Blood-Saliva-Contaminated Post-Etched Dentin Substrate and Composite Resin

Blood–saliva contamination negatively affects the bonding potential of adhesive agents. The study aimed to assess the effect of various cleaning protocols on micro-shear bond strength (μSBS) between blood–saliva-contaminated post-etched dentin and composite resin in total-etch and self-etch adhesives. The cleaning methods tested were water rinsing, 37.5% phosphoric acid (H3PO4) re-etching, 6% sodium hypochlorite (NaoCl), 2% chlorhexidine gluconate (CXG), isopropyl alcohol (IPA), and pumice. Nono-hybrid composite cylinders with a 3-mm diameter and 2-mm height were directly cured over the dentin substrate, stored for 24 h, and subjected to 12,000 thermocycles. The shear force was exerted with a 200-μm knife-edged chisel-shaped head from a universal testing machine. The type of failure was assessed with stereomicroscope magnified images. The obtained data were evaluated by Kruskal–Wallis and Mann–Whitney U post-hoc tests. Water-rinsed contaminated dentin surfaces showed substantially reduced μSBS in the total etch from 25.93 to 20.29 Mpa and the corresponding values for the one-step self-etch adhesive were 10.10 to 8.8. Re-etching with 37.5% H3Po4 resulted in a recovery of bonding potential in both total-etch (24.58 Mpa) and self-etch adhesive (9.23 Mpa). Alternately, NaoCl and pumice cleaning showed promising results for the total-etch (23.51 Mpa) and self-etch (7.79 Mpa).

Effect of saliva and blood contamination on the bond strength of self-etching adhesive system- An in vitro study

Aim:

The aims of this study were to determine the effect of saliva and blood contamination on the shear bond strength of self-etching adhesive to enamel and dentin; and, to compare the difference in bond strength due to contamination beforeand after application of the self-etch adhesive.

Materials and Methods:

40 human mandibular molars were wet ground on both buccal and lingual surfaces to prepare flat superficial enamel and dentin surfaces. They were randomly divided into two groups (n = 40) based on the substrate (enamel and dentin). Each group was further divided into five subgroups (n = 8) based on the type of contamination it was subjected to, and the step in the bonding sequence when the contamination occurred (before or after adhesive application). Fresh saliva and fresh human blood were applied either before or after the application of Xeno III^® self-etching adhesive system (SES). Composite resin was applied as inverted, truncated cured cones that were subjected to shear bond strength test.

Statistical Analysis:

One-way analysis of variance (ANOVA) and Tukey's Honestly Significant Difference (HSD) test were used.

Results:

Statistically significant reduction in the bond strength was shown after both saliva and blood contamination before and after Xeno III^® application (P< 0.05). Bond strength is significantly reduced after contamination with blood as compared to saliva.

Conclusions:

When self-etching adhesive systems are used, saliva and blood contamination significantly decrease the bond strength of the adhesive to enamel and dentin of the tooth.

Influence of blood contamination before or after surface treatment on adhesion of 4-META/MMA-TBB resin to root dentin

The purpose of this study was to evaluate the influence of blood contamination before or after surface treatment on adhesion of 4-META/MMA-TBB resin. After bovine root dentin surfaces were contaminated with blood before or after dentin surface treatment with 10-3 solution, the contaminated surface was rinsed with water, air-dried, or re-treated with 10-3 solution. Dye leakage and microtensile bond strength (MTBS) of 4-META/MMA-TBB resin to dentin were measured after storage in water for 24 h. When blood contamination occurred before surface treatment, there was no significant difference in the leakage value and MTBS as compared with that of the uncontaminated group. When blood contamination occurred after surface treatment, the leakage value increased and MTBS significantly decreased (p<0.05) even if the blood was washed away. However, when the surface was re-treated with 10-3 solution after rinsing with water, the leakage value and MTBS were restored to those of the uncontaminated group.

The Effect of Tooth-preparation Cleansing Protocol on the Bond Strength of Self-adhesive Resin Cement to Dentin Contaminated with a Hemostatic Agent

After contamination with hemostatic agents, tooth-preparation cleansing protocols using either particle abrasion with low-pressure aluminum oxide particles or phosphoric acid-etching restored bond strengths to pre-contamination levels for a self-adhesive resin cement.

Effect of blood contamination with 1-step self-etching adhesives on microtensile bond strength to dentin

This study evaluated the effect of blood contamination and decontamination methods on the microtensile bond strength of 1-step self-etching adhesive systems to dentin contaminated after adhesive application and light curing. Three commercially available "all-in-one" adhesives (One Up Bond F, Xeno III and Adper Prompt L-Pop) and 1 resin composite (Clearfil AP-X) were used. Third molars that had been stored in distilled water with 0.5% thymol at 4 degrees C were ground with #600 SiC paper under running water to produce a standardized smear layer. The specimens were randomly divided into groups according to the 3 adhesive systems. The adhesive systems were used under 3 conditions: no contamination, which was the control (C); contamination of the light-cured adhesive surface with blood and reapplication of adhesive (Contamination 1) and contamination of the light-cured adhesive surface with blood, then washing, drying and reapplication of the adhesive (Contamination 2). Following light curing of the adhesive, the resin composite was placed in 3 increments up to a 5-mm-thick layer on the bonded surface. All specimens were stored in distilled water at 37 degrees C for 24 hours. The microtensile bond strength was measured using a universal testing machine (EZ test), and data were analyzed by 1-way ANOVA followed by the Duncan test to make comparisons among the groups (p=0.05). After debonding, 5 specimens were selected from each group and examined in a scanning electron microscope to evaluate the modes of fracture. For all adhesives, contamination groups showed lower bond strength than the control (p<0.05). There was no statistically significant difference among the control groups (p>0.05). For Xeno III and Adper Prompt L-Pop, contamination group #2 showed the lowest bond strength among the groups (p<0.05). For One Up Bond F, contamination group #2 showed higher bond strength than contamination group #1 but showed no statistical significance between them (p>0.05).