In vitro interfacial relationship between human dentin and one-bottle dental adhesives

Shear bond strengths of bur or Er:YAG laser prepared dentine to composite resin with or without low-level laser conditioning: an in vitro study

This study aims to compare the different modes of cavity preparation while evaluating the effect of low-level laser therapy (LLLT) on dentine before bonding in terms of shear bond strength between composite resin and dentine. Fifty human molar teeth were mounted on acrylic blocks and dentine specimen were prepared after which they were randomized into four equal groups. Cavity preparation mode differed in respective groups. After etching, bonding; composite resin was placed and polymerized on the prepared dentine surfaces. The specimens were kept in an environment simulating oral cavity and then shear tested in a universal testing machine. The failure surfaces of the specimen teeth were subjected to SEM micrographic evaluation. The cavity prepared with diamond abrasive points had a higher shearing load at failure that was statistically significantly different from the ones prepared with laser. That with diamond abrasive points followed by LLLT of the cavity surface with Nd:YAG laser had a higher bond strength than the ones prepared with just Er:YAG laser and there was no statistically significant difference between these and the ones prepared with diamond abrasive points alone. SEM analysis of the failure mode in bur-cut dentine showed the presence of a hybrid layer at the interface. Surface conditioning of the same with Nd:YAG laser before etching suggested a recrystallisation of dentine due to the heat produced. Cavity preparation with Er:YAG laser leads to reduced shear bond strength to adhesive restorative materials when compared with that using burs and high-speed handpiece.

Effect of Silica-Modified Aluminum Oxide Abrasion on Adhesion to Dentin, Using Total-Etch and Self-Etch Systems

This study compared the shear bond strength (SBS) and micromorphology of composite resin to human dentin after pre-treatment with silica-modified aluminum oxide air abrasion. Forty-six molar teeth were treated with either Scotchbond Multi-Purpose (SCMP) or Clearfil SE Bond (CLSE) adhesive. Buccal surfaces were pre-treated with the CoJet air abrasion system (SB), and lingual surfaces were controls. The adhesion of light-cured resin composite to the treated dentin surface was evaluated with SBS. After debonding, substrate surfaces were examined with an optical microscope for failure analysis. In addition, 15 molar teeth were sectioned and randomly assigned to one of five groups, according to the dentin surface pre-treatment and adhesive type, and examined with high-vacuum scanning electron microscopy/energy dispersive X-rays (SEM/EDS). The type of adhesive had a significant effect on SBS (p = 0.000); CLSE had the highest values. SB did not affect SBS (p = 0.090). SEM/EDS revealed residual aluminum and/or silicon on all dentin surfaces after SB, except for the control. Treatment with 32% phosphoric acid in the SCMP adhesive decreased the amounts of aluminum and silicon compared to SB dentin only, whereas CLSE resulted in similar quantities of aluminum and silicon as air-abraded dentin. The results of this study indicate that CLSE might have a higher bond strength to dentin than SCMP. Pre-treatment with SB does not appear to affect bonding strength.

Removal of Composite Restoration from the Root Surface in the Cervical Region Using Er: YAG Laser and Drill-In Vitro Study

Background: Recently, the defects of the tooth surface in the cervical region are often restored using composite filling materials. It should meet the needs of the patients regarding esthetics and material stability. The aim of the study was to analyze the tooth root surface at the cervical region after the removal of the composite filling material by means of the Erbium-doped Yttrium Aluminium Garnet (Er: YAG) laser or drill using the scanning electron microscopy (SEM) and fluorescence microscopy. Materials and Methods: For the purposes of this study, 14 premolar teeth (n = 14) were removed due to orthodontic reasons. The rectangular shape cavities with 3 mm in width and 1.5 mm in height were prepared with a 0.8 mm bur on high-speed contra-angle in the tooth surface just below cemento-enamel junction (CEJ) and filled with the composite material. The composite material was removed with the Er: YAG laser at a power of 3.4 W, energy 170 mJ, frequency 20 Hz, pulse duration 300 μs, tip diameter 0.8 mm, air/fluid cooling 3 mL/s, and time of irradiation: 6 sec, at a distance from teeth of 2 mm (G1 group, n = 7) or a high-speed contra-angle bur (G2 group, n = 7). After the removal of composite material, the surfaces of teeth were examined using the scanning electron microscopy (SEM) and fluorescence microscopy. Results: The Er: YAG irradiation allowed to remove completely the composite material from the tooth cavity. The study confirmed, that the ends of collagen fibers were only partially denatured after the Er: YAG laser application. Conclusion: It has been proved that using the Er: YAG laser is an effective and safe method of composite removal for the dentin surface.

Influência de tratamento dentinário com EDTA sobre a resistência de união de sistemas adesivos autocondicionantes

Resumo Introdução Os adesivos autocondicionantes apresentam técnica adesiva simplificada e diminuição na sensibilidade pós-operatória. Quando aplicados sobre a dentina, atuam sobre a smear layer, cuja efetiva remoção ainda constitui um desafio. Uma substância utilizada como pré-tratamento dentinário na ajuda da remoção da smear layer é o etilenodiamino tetracético dissódico (EDTA). Objetivo Avaliar os efeitos do EDTA em associação com sistemas adesivos autocondicionantes na resistência de união ao microcisalhamento. Material e método Foram seccionadas as superfícies oclusais de 72 terceiros molares humanos extraídos, para expor superfície dentinária plana. Os dentes preparados foram divididos em: dentina sem pré-tratamento; dentina tratada com EDTA 0,1M; dentina tratada com EDTA 0,5M. Cada grupo recebeu tratamento de três sistemas adesivos autocondicionantes: Single Bond Universal (SBU), AdheSE (AdheSE) e Clearfil SE Bond (CSEB). Foi delimitada a área adesiva e assim posicionada uma matriz transparente, para inserção com resina composta Z250XT seguida de polimerização por 40 segundos. Após 24 horas de armazenamento, os dentes foram submetidos ao ensaio de microcisalhamento. Os dados obtidos foram analisados estatisticamente, utilizando-se os testes Two-Way ANOVA e Bonferroni, e sendo considerado nível de significância de 5%. Resultado Não houve diferença estatística significante na resistência de união entre os pré-tratamentos dentinários (p=0,8353), porém houve diferença significativa entre os adesivos (p<0,05) CSEB e AdheSE, mostrando semelhança entre CSEB e SBU, e entre SBU e AdheSE. Conclusão O pré-tratamento dentinário com solução de EDTA não afetou a resistência de união com nenhum dos sistemas adesivos autocondicionantes utilizados.

TiO2 -coated fluoride nanoparticles for dental multimodal optical imaging

Core-shell nanostructures associated with photonics techniques have found innumerous applications in diagnostics and therapy. In this work, we introduce a novel core-shell nanostructure design that serves as a multimodal optical imaging contrast agent for dental adhesion evaluation. This nanostructure consists of a rare-earth-doped (NaYF₄ :Yb 60%, Tm 0.5%)/NaYF₄ particle as the core (hexagonal prism, ~51 nm base side length) and the highly refractive TiO₂ material as the shell (~thickness of 15 nm). We show that the TiO₂ shell provides enhanced contrast for optical coherence tomography (OCT), while the rare-earth-doped core upconverts excitation light from 975 nm to an emission peaked at 800 nm for photoluminescence imaging. The OCT and the photoluminescence wide-field images of human tooth were demonstrated with this nanoparticle core-shell contrast agent. In addition, the described core-shell nanoparticles (CSNps) were dispersed in the primer of a commercially available dental bonding system, allowing clear identification of dental adhesive layers with OCT. We evaluated that the presence of the CSNp in the adhesive induced an enhancement of 67% scattering coefficient to significantly increase the OCT contrast. Moreover, our results highlight that the upconversion photoluminescence in the near-infrared spectrum region is suitable for image of deep dental tissue.

Morphology of the Dentin-resin Interface yielded by Two-step Etch-and-rinse Adhesives with Different Solvents

AIM

The study aimed to analyze the morphology of the dentin-resin interface yielded by two-step etch-and-rinse adhesive systems with different solvents and compositions.

MATERIALS AND METHODS

A total of 32 dentine disks were prepared and randomly assigned to four groups of one-bottle etch-and-rinse adhesive systems containing different solvents: group I, Adper Scotchbond-IXT™ (ethanol/water); group II, XP-Bond™ (tertiary butanol); group III, Prime and Bond NT^® (acetone); and group IV, One Coat bond® (5% water). Adhesive systems were applied onto dentin disks, which were then thermal cycled, divided into two hemi-disks (n = 16), and prepared for field-emission scanning electron microscopy to examine the dentin-resin interdiffusion zone. Microphotographs were scanned and data were processed. Data were compared with analysis of variance multivariant test after Kolmogorov-Smirnov and Shapiro-Wilk tests using Statistic Package for the Social Sciences.

RESULTS

The adhesive layer thickness average found was group I: 45.9 ± 13.41 urn, group II: 20.6 ± 16.32 urn, group III: 17.7 ± 11.75 urn, and group IV: 50.7 ± 27.81 urn. Significant differences were found between groups I and IV and groups II and III (p < 0.000). Groups I (3.23 ± 0.53 μm) and II (3.13 ± 0.73 μm) yielded significantly thicker hybrid layers than groups III (2.53 ± 0.50 μm) and IV (1.84 ± 0.27 μm) (p < 0.003). Group III presented a less homogeneous hybrid layer, with some gaps. Tag length average was greater in groups II (111.0 ± 36.92 μm) and IV (128.9 ± 78.38 μm) than in groups I (61.5 ± 18.10 μm) and III (68.6 ± 15.84 μm) (p < 0.008).

CONCLUSION

Adhesives systems with different solvents led to significant differences in the dentin-resin interface morphology. Solvents role in adhesives bond strength should be considered together with the other adhesive system components.

CLINICAL SIGNIFICANCE

The adhesive containing tertiary butanol, in addition, seems to originate a good-quality hybrid layer and long, entangled tags and also appears to have greater ability to originate microtags, which may indicate higher bond strength.

A study on the compatibility between one-bottle dentin adhesives and composite resins using micro-shear bond strength

Objectives

This study was performed to determine whether the combined use of one-bottle self-etch adhesives and composite resins from same manufacturers have better bond strengths than combinations of adhesive and resins from different manufacturers.

Materials and Methods

25 experimental micro-shear bond test groups were made from combinations of five dentin adhesives and five composite resins with extracted human molars stored in saline for 24 hr. Testing was performed using the wire-loop method and a universal testing machine. Bond strength data was statistically analyzed using two way analysis of variance (ANOVA) and Tukey's post hoc test.

Results

Two way ANOVA revealed significant differences for the factors of dentin adhesives and composite resins, and significant interaction effect (p < 0.001). All combinations with Xeno V (Dentsply De Trey) and Clearfil S³ Bond (Kuraray Dental) adhesives showed no significant differences in micro-shear bond strength, but other adhesives showed significant differences depending on the composite resin (p < 0.05). Contrary to the other adhesives, Xeno V and BondForce (Tokuyama Dental) had higher bond strengths with the same manufacturer's composite resin than other manufacturer's composite resin.

Conclusions

Not all combinations of adhesive and composite resin by same manufacturers failed to show significantly higher bond strengths than mixed manufacturer combinations.

Comparative scanning electron microscopic study of the effect of different dental conditioners on dentin micromorphology

This study evaluated comparatively by scanning electron microscopy (SEM) the effect of different dental conditioners on dentin micromorphology, when used according to the same protocol. Forty dentin sticks were obtained from 20 caries-free third human molars and were assigned to 4 groups corresponding to 3 conditioners (phosphoric acid 37%, Clearfil SE Bond and iBond) and an untreated control group. After application of the conditioners, the specimens were immersed in 50% ethanol solution during 10 s, chemically fixed and dehydrated to prepare them to SEM analysis. In the control group, dentin surface was completely covered by smear layer and all dentinal tubules were occluded. In the phosphoric acid-etched group, dentin surface was completely clean and presented exposed dentinal tubule openings; this was the only group in which the tubules exhibited the funnel-shaped aspect. In the groups conditioned with Clearfil SE Bond primer and iBond, which are less acidic than phosphoric acid, tubule openings were occluded or partially occluded, though smear layer removal was observed. SE Bond was more efficient in removing the smear layer than iBond. In the Clearfil SE Bond group, the cuff-like aspect of peritubular dentin was more evident. It may be concluded all tested conditioners were able to change dentin morphology. However, it cannot be stated that the agent aggressiveness was the only cause of the micromorphological alterations because a single morphological pattern was not established for each group, but rather an association of different aspects, according to the aggressiveness of the tested conditioner.

Effects of the Solvent Evaporation Technique on the Degree of Conversion of One-Bottle Adhesive Systems

Since methods of solvent evaporation can change the degree of conversion for some adhesives, practitioners should be aware of the type and composition of bonding agents used.

Effect of Surface Treatments and Different Adhesives on the Hybrid Layer Thickness of Non-carious Cervical Lesions

The quality of the hybrid layer created in non-carious cervical sclerotic lesions may determine the longevity of cervical composite restorations.

Influence of solvent type in experimental dentin primer on the marginal adaptation of Class V restorations

OBJECTIVES

The purpose of this in vitro investigation was to evaluate the influence of the solvent type in two experimental dentin primers (ExP) on the handling sensitivity by determining the marginal adaptation of mixed Class V restorations.

METHODS

Standardized cavities were prepared in 32 extracted human molars and randomly assigned to four test groups (n=8). After etching, a three-step adhesive was applied using two ExP which only differed in the type of solvent (acetone/water=ExP-A versus ethanol/water=ExP-E). For ExP-A, the drying procedure (blot-drying versus 2s air drying) prior to primer application was varied, whereas evaporation time (2-3s versus 10s) after primer application was varied for ExP-E. An adhesive was added prior to application of the filling material. Specimens were thermocycled (TC: 2500 cycles; 5-55 degrees C). The length of gap-free margin (LoGfM) was assessed by SEM using replica technique. Data were subjected to non-parametric statistics (p=0.05) as well as the Levene test (p=0.05).

RESULTS

Blot-drying significantly increased the LoGfM after TC for ExP-A in dentin (p<0.05) but decreased LoGfM in enamel (p<0.05). Short evaporation (2-3s) of solvent reduced LoGfM when using ExP-E and led to a significant increase in variances (p<0.05).

CONCLUSIONS

The use of three-step adhesives with ethanol/water-based solvent is recommended due to a lower technique sensitivity versus acetone/water-based systems. Also when using modern ethanol/water-based three-step adhesives, evaporation of primer solvent remains a critical step regarding the marginal quality of the restorations and consequently has to be carried out thoroughly.

Contraction stress and bond strength to dentinfor compatible and incompatible combinations of bonding systems and chemical and light-cured core build-up resin composites

OBJECTIVE

Recent studies have shown that adhesives containing acidic monomers combined with composites can adversely effect the polymerization reaction producing low bond strengths. This phenomenon may also occur in making composite build-ups, jeopardizing one of the key factors for a successful core build-up restoration. The aim of this study was to investigate the contraction stress development and bond strength to dentin of core build-up resin composites combined with adhesives of various acidities. In addition the hypothesis tested was that light irradiation through chemical-cured composites during curing does not influence contraction stress or bond strength to dentin.

METHODS

The chemical-cured (Clearfil Core) and light-cured (Clearfil Photo Core) core build-up resin composites were combined with two light-cured adhesives, Clearfil SE Bond (pH=1.8) and One-Step Bond (pH=4.3) and two dual-cured adhesives, Clearfil Photo Bond (pH=2.5) and All-Bond 2 (pH=6.1). Contraction stress development (at C=3) was determined for a period of 30 min in a universal testing machine where the opposing bonding surfaces were glass and dentin. After the 30 min period, the specimens were loaded in tension to determine the bond strength to dentin. To test the hypothesis, the combinations of the chemical-cured composites with the four bonding systems were also light irradiated for 40s right at the start of curing.

RESULTS

For all composite-adhesive combinations tested, the adhesion to dentin resisted the developing polymerization contraction stresses. Both, dentin as a substrate to bond at and the use of adhesives, were showed to play an important role in keeping the contraction stresses low. The chemical-cured composite (Clearfil Core) combined with the light-cured adhesive SE Bond (pH=1.8) showed for both contraction stress and bond strength significant lower values than the other combinations. The hypothesis was accepted for combinations of the chemical-cured composite with All-Bond 2 and One-Step Bond, but was not supported by combinations with Clearfil SE Bond or Clearfil Photo Bond, as a significant increase in contraction stress was found. The higher values found for bond strength were not significant.

SIGNIFICANCE

Besides combinations of chemical-cured core build-up composites with light or dual-cured adhesives as recommended by the manufacturer, also combinations with adhesives of other manufacturers are compatible, provided that the pH is higher than approximately 4.3. Chemical-cured core build-up composites combined with light-cured adhesives with a pH as low as 1.8 lead to a significantly lower stress and bond strength compared to other combinations. Light irradiation during curing through a combination of a chemical-cured composite and a low pH adhesive reactivates polymerization.

Microhardness evaluation around composite restorations using fluoride-containing adhesive systems

The purpose of this study was to evaluate the microhardness of dental enamel around composite restorations bonded with fluoride-containing adhesive systems (FCAS), after thermo- and pH-cycling protocols. Standardized cylindrical cavities were prepared on enamel surfaces of 175 dental fragments, which were randomly assigned into seven experimental groups (n=25). Four groups used FCAS: Optibond Solo (OS); Prime&Bond 2.1 (PB); Syntac Sprint (SS) and Tenure Quick (TC). Other groups consisted of "Sandwich" technique restoration (STR) (glass ionomer liner + hydrophobic adhesive resin /restorative composite) or used Single Bond with (SB) or without (SBWC) cycling protocols. Adhesive systems were applied according to manufacturers' instructions and cavities were restored with a microfilled composite (Durafill VS). After finishing and polishing, all groups were submitted to 1,000 thermal cycles (5 ºC and 55 ºC) and to demineralization (pH 4.3) and remineralization (pH 7.0) cycling protocols, except for SBWC group. The Knoop microhardness of enamel surfaces were measured around restorations. Indentations were recorded at 150, 300 and 450-mm from the cavity wall. Data were analyzed by two-way ANOVA and Duncan's Test (a=0.05%). Means ± SD of enamel microhardness for the groups were (Kg/mm²): SBWC: 314.50 ± 55.93ª ; SB: 256.78 ± 62.66b; STR: 253.90 ± 83.6b; TQ: 243.93 ± 68.3b; OS: 227.97 ± 67.1c; PB: 213.30 ± 91.3d; SS: 208.73 ± 86.6d. Means ± SD of microhardness for the distances 150, 300, 450mm from the cavity wall were, respectively: 234.46 ± 77.81ª; 240.24 ± 85.12ª; 262.06 ± 79.46b. SBWC group, which was not submitted to thermo- and pH-cycling protocols, showed the highest enamel microhardness mean value and the FCAS resulted in lower microhardness values. At 450 mm from the cavity wall, the enamel microhardness increased significantly.

ADHESIVE-COMPOSITE INCOMPATIBILITY, PART II

Apart from some questions related to the repairability of resin composite restorations, dentists have always assumed that methacrylate-based resins are compatible with each other. For example, there is no clinically relevant problem in using a microfilled composite to laminate a Class IV restoration made with a hybrid composite, even if they are not of the same brand or manufacturer. In the context of adhesive systems, we have always believed that resin composites, regardless of their type or composition, bond well to all types of bonding agents. However, unexpected debonding of self-cured, core buildup composites that had been bonded with single-bottle adhesive systems was reported about 5 years ago. Subsequent studies demonstrated that there were, indeed, compatibility problems between simplified adhesive systems and self- or dual-cured resin composites. Apparently, when such combinations are used, reduced bond strengths and subsequent failures at the resin-adhesive interface can occur because of adverse reactions between the acidic resin monomers, an integral part of the simplified adhesive systems, and the chemicals involved in the polymerization mechanism of the self- or dual-cured composites, particularly the basic tertiary amines.

Scanning Electron Microscope Analysis of Internal Adaptation of Materials Used for Pulp Protection under Composite Resin Restorations

PURPOSE

The aim of this study was to evaluate the interfacial microgap with different materials used for pulp protection. The null hypothesis tested was that the combination of calcium hydroxide, resin-modified glass ionomer, and dentin adhesive used as pulp protection in composite restorations would not result in a greater axial gap than that obtained with hybridization only.

MATERIALS AND METHODS

Standardized Class V preparations were performed in buccal and lingual surfaces of 60 caries-free, extracted human third molars. The prepared teeth were randomly assessed in six groups: (1) Single Bond (SB) (3M ESPE, St. Paul, MN, USA); (2) Life (LF) (Kerr Co., Romulus, MI, USA) + SB; (3) LF + Vitrebond (VT) (3M ESPE) + SB; (4) VT + SB; (5) SB + VT; (6) SB + VT + SB. They were restored with microhybrid composite resin Filtek Z250 (3M ESPE), according to the manufacturer's instructions. However, to groups 5 and 6, the dentin bonding adhesive was applied prior to the resin-modified glass ionomer. The specimens were then thermocycled, cross-sectioned through the center of the restoration, fixed, and processed for scanning electron microscopy. The specimens were mounted on stubs and sputter coated. The internal adaptation of the materials to the axial wall was analyzed under SEM with x1,000 magnification.

RESULTS

The data obtained were analyzed with nonparametric tests (Kruskal-Wallis, p < or = .05). The null hypothesis was rejected. Calcium hydroxide and resin-modified glass ionomer applied alone or in conjunction with each other (p < .001) resulted in statistically wider microgaps than occurred when the dentin was only hybridized prior to the restoration.

A three-year clinical evaluation of two-bottle versus one-bottle dentin adhesives

BACKGROUND

The authors conducted an in vivo investigation to compare the clinical performance of two commercial one-bottle adhesives and a two-bottle adhesive for restoration of noncarious cervical lesions (NCCLs).

METHOD

The patient pool consisted of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. Each patient received three resin-based composite restorations, each with a different adhesive: one tooth with a two-bottle, water-based adhesive as the control; another tooth with a one-bottle, ethanol-based adhesive; and a third tooth with a one-bottle, solvent-free adhesive. The authors assessed restorations in terms of retention, marginal integrity, margin discoloration and air sensitivity at baseline, six months, one year, two years and three years after initial placement.

RESULTS

The retention rates at 36 months were 88 percent for the first adhesive, 81 percent for the second adhesive and 90 percent for the third adhesive. No statistically significant differences in retention rates could be shown, with 86 percent of restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives (P > .05).

CONCLUSIONS

All three adhesives performed with acceptable outcomes after a 36-month period, with small differences between the one- and two-bottle systems and between the various solvents. Retention rate was moderately high and air sensitivity was markedly reduced; however, superficial marginal discoloration and marginal degradation was notable. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure.

CLINICAL IMPLICATIONS

The type of solvent may not be a major factor in retention of Class V restorations in NCCLs. Both single-bottle adhesives and conventional two-bottle adhesives performed acceptably.

Effect of endodontic irrigation on bonding of resin cement to radicular dentin

The influence of endodontic irrigation on shear bond strengths of resin cement to radicular dentin was investigated. Human radicular dentin blocks were divided into four groups and subjected to one of four endodontic irrigations: ethylenediaminetetraacetic acid (EDTA) group, 17% EDTA for 60 s; EDTA/sodium hypochlorite (NaOCl) group, 17% EDTA for 60 s followed by 10 ml of 5% NaOCl for 15 s; NaOCl group, 10 ml of 5% NaOCl for 15 s; and control group, no treatment. Morphological changes of dentin surface after endodontic irrigation were observed by scanning electron microscopy (SEM). A resin block was bonded to the radicular dentin after irrigation using resin cement with either wet-bonding (Uni-Etch/One-Step; Bisco) or self-etching (Tyrian SPE/One-Step Plus; Bisco) adhesives. Shear bond strengths were measured and the penetration of resin tags into dentinal tubules at resin-dentin interface was observed by SEM. With the wet-bonding system, the shear bond strengths for the EDTA/NaOCl group, in which dentinal tubules openings and uniform resin tag penetration into dentinal tubules were observed, were significantly higher than the EDTA and control groups. With the self-etching system, the shear bond strengths were significantly lower in the EDTA group compared with the NaOCl and control groups. The effects of endodontic irrigation on the bonding of resin cement to radicular dentin depended on the dentin bonding system used.

Water movement in the hybrid layer after different dentin treatments

The aim of this study was to examine the morphology of the hybrid layer (HL) of bonded water-stored specimens after different chemical pre-treatments of dentin.

MATERIALS AND METHODS

Twenty-seven recently extracted human molars were selected. Fifty-four dentin disks in middle/deep dentin were obtained with a slow speed saw with a diamond-impregnated disk under water lubrication. Smear layers were created with 180 grit silicon carbide under running water for 1 min. Different pre-treatments of dentin were: Group (1) no treatment; Group (2) 35% H3PO4 etch for 15 s followed by 10% glutaraldehyde for 120 s; Group (3) 37% H3PO4 etch for 15 s followed by 5% NaOCl for 120 s. Three dentin bonding agents (DBAs), Prime and Bond NT (P and B), AdmiraBond (AB), and Clearfil SE Bond (SEB) were applied in association with a resin composite following the manufacturers' directions. Each specimen was then longitudinally sectioned and polished with wet SiC papers (up to #4000 grit). Impressions of the polished dentin were immediately taken with a silicone impression material. Bonded specimens were then stored for 3 or 12 h in deionized water. Further impressions of stored specimens were taken after air-drying of specimens for 10 s. Positive replicas were obtained using a polyether impression material. All the replicas and the original specimens were inspected by SEM.

RESULTS

A line of droplets (0.5-4 microm in diameter) was observed along the region of the adhesive-HL junction in all replicas of specimens stored in water, except in group 3, when P and B and AB were used. When SEB was used in each group the droplet were found in all groups except the zone of droplets was thinner. No differences in droplets dimensions were seen between 3 or 12 h water storage, or between the different dentin treatments.

CONCLUSIONS

The replica procedure used in this study was able to detect water trapped in the adhesive-HL region that was released during the setting of the impression material. The droplets observed in this region support the hypothesis that there can be bidirectional water movement within the adhesive-HL complex.

Tensile Bond Strength of a One-Bottle Adhesive System to Indirect Composites Treated with Er:YAG Laser, Air Abrasion, or Fluoridric Acid

OBJECTIVE

This in vitro study evaluated the tensile bond strength of Single Bond adhesive system to indirect composite surfaces treated with Er:YAG laser, fluoridric acid, or air abrasion.

BACKGROUND DATA

Application of adhesive techniques is well established in restorative dentistry, yet the influence of surface treatments on the bond strength of adhesive systems to indirect composite restorations prior to luting or repair procedures remains unclear.

METHODS

Two hundred and ten samples made of three indirect composites (BelleGlass, Sculpture, and Targis) were divided into 21 groups (n = 10) and treated with (1) control (no treatment); (2) silane (RelyX 3M ceramic primer); (3) 10% fluoridric acid; (4) Er:YAG laser; (5) Er:YAG laser + 10% fluoridric acid; (6) air abrasion; and (7) air abrasion + 10% fluoridric acid. Afterwards, silane and Single Bond adhesive system were applied on each treated surface, and a direct composite resin (Z250) cone was built. The prepared specimens were submitted to tensile bond strength test and stereoscopy evaluation to determine the type of failure after rupture.

RESULTS

Bond strength mean values were statistically different in function of indirect composite and surface treatment. BelleGlass treated with Er:YAG laser had the highest mean value (22.92 MPa), and Sculpture conditioned with fluoridric acid had the lowest mean (11.88 MPa). Stereoscopy showed a predominant cohesive failure in Targis resin and mixed type for Sculpture and BelleGlass.

CONCLUSIONS

These results suggest that Single Bond tensile bond strength improves with Er:YAG laser as a surface treatment compared to fluoridric acid or air abrasion.

Scanning electron microscopic evaluation of resin-dentin interface after Er:YAG laser preparation

BACKGROUND AND OBJECTIVES

The aim of this study was to observe the morphological characteristics of dentin-resin interfaces when a composite resin was bonded to Er:YAG laser irradiated dentin.

STUDY DESIGN/MATERIALS AND METHODS

Human dentin surfaces were divided into three equal areas. One third was prepared using a carbide bur and etched with phosphoric acid, the second third was conditioned using an Er:YAG laser, the third one was irradiated and etched. A hybrid composite resin was bonded on dentin surfaces using a single-component adhesive system. Longitudinal sections were exposed to 5 N HCl then to 1% NaOCl. The thickness of the hybrid layer and the dimensions of the resin tags were measured using scanning electron microscopy (SEM) pictures and an image analysis software.

RESULTS

When acid etching was performed, a hybrid layer as well as the characteristic funnel-shaped resin tags were observed. When Er:YAG laser was used alone, no hybrid layer could be detected. The resin tags appeared thinner and exhibited a cylindrical shape.

CONCLUSIONS

The acid pre-treatment of the irradiated surface allowed both the seal of the dentinal surface and the increase of the diameter of the resin tags.

Dentin permeability: self-etching and one-bottle dentin bonding systems

STATEMENT OF PROBLEM

There are many bonding systems available, with or without a prior acid etch. The mechanisms differ from system to system. Therefore it is important that the clinician know which are the most effective and which provide the best seal.

PURPOSE

This study measured the infiltration of physiological saline solution across dentin after application of self-etching or 1-bottle dentin bonding systems.

MATERIALS AND METHODS

Thirty-six extracted noncarious human third molars from patients 18 to 25 years old were used for this study. Dentin disks were cut from crown segments parallel to the occlusal surface at the incisal portion of the pulp cavity. The 36 disks, each 1 mm thick, were divided into 6 groups (n=6 per group), each of which received one of the following dentin bonding systems: Optibond Solo Plus and Excite, which have ethanol as the solvent; Prime & Bond NT, which has acetone as the solvent; Single Bond, which has a mixed solvent; and Clearfil SE Bond or Prompt L-Pop, both self-etching systems The hydraulic conductance, the volume of fluid transported across a known area of surface (0.28 cm(2)) per unit time under a unit pressure gradient (200 cm H(2)O), was analyzed for the self-etching and 1-bottle dentin bonding systems with the Flodec apparatus. Both sides of each specimen were etched with 36% phosphoric acid for 30 seconds. Measurements were made every 30 seconds for 15 minutes. The initial measurement served as the reference value for each specimen. The measurements were repeated when a smear layer had been formed and, finally, after one of the 6 bonding systems had been applied. The data were analyzed by use of analysis of variance and a posteriori tests (Fischer's PLSD, Duncan's new multiple range) with alpha=.05.

RESULTS

The greatest mean reduction (40%, P<.05) in penetration was observed with the 4 products with conventional etching: Optibond Solo Plus, Single Bond, Excite, and Prime & Bond NT. The self-etching products were associated with reductions of 36% (Clearfil SE Bond) and 16% (Prompt L Pop). Standard deviations were high, 50% of the mean value, except for the Single Bond group (-42 +/- 13) and Prime & Bond NT (-41 +/- 14).

CONCLUSION

Within the limitations of this study, the 4 bonding systems tested with a phosphoric acid before etching provided a greater decrease in dentin permeability than the 2 self-etching systems. The difference in permeability decrease was significant for Prompt L-Pop but not for Clearfil SE Bond.

Morphology and thickness of the diffusion of resin through demineralized or unconditioned dentinal matrix

The formation of a hybrid layer is the main bonding mechanism of current dentin-bonding systems. This study evaluated the morphology and thickness of the resin-infiltrated dentinal layer after the application of adhesive systems. The dentin-bonding agents were evaluated on flat dentinal preparations confected on the occlusal surfaces of human teeth. The test specimens were prepared and inspected under scanning electron microscopy at a magnification of X 2,000. The adhesive systems were responsible for different hybrid layer thicknesses (p < 0.05), and the mean values were: for Scotchbond MP Plus (SM), 7.41 +/- 1.24 micrometer for Single Bond (SB), 5.55 +/- 0.82 micrometer for Etch & Prime 3.0 (EP), 3.86 +/- 1.17 micrometer and for Clearfil SE Bond (CB), 1.22 +/- 0.45 micrometer. The results suggest that the conventional three-step adhesive system (SM) was responsible for the thickest hybrid layer, followed by the one-bottle adhesive (SB). The self-etching adhesives, EP and CB, produced the formation of the thinnest hybrid layers.

Adverse surface interactions between one-bottle light-cured adhesives and chemical-cured composites

OBJECTIVES

This study examined the effect of one-bottle adhesives with different acidities on bonding to chemical-cured and light-cured resin composites.

METHODS

Twenty-four non-carious human third molars were divided into eight groups. A flat dentin surface was created for each tooth. Acid-conditioned dentin surfaces were bonded with Prime&Bond NT (Dentsply), OptiBond SOLO (Kerr), Single Bond (3M) or One-Step (Bisco). Each adhesive group was covered with composite buildups, using either a light-cured (Z100, 3M) or a chemical-cured composite (BisFil 2, Bisco). Specimens were vertically sectioned into 0.9x0.9 mm beams. Microtensile bond strengths were recorded and failure modes were classified using a stereoscopical microscope. Four representative beams from each group were further prepared for SEM examination.

RESULTS

Two-way ANOVA showed that the effect of adhesive types, composite curing modes and their interaction were statistically significant (P<0.001). Multiple comparison tests revealed no statistically significant difference in the bond strength of the four adhesives with the light-cured composite (P>0.05). However, they were significantly lower when used with the chemical-cured composite (P<0.01). A positive correlation was observed between the acidity of adhesives and the bond strengths of the chemical-cured composite. Failure occurred predominantly along the composite-adhesive interface, with microporosities on the adhesive surface and voids within the chemical-cured composite.

SIGNIFICANCE

Air incorporated during mixing of chemical-cured composites only contributed partially to the decreased bond strength observed in simplified-step adhesives. Ultrastructural observations suggested the presence of a surface interaction between the uncured, acidic resin monomers from the oxygen inhibition layer of the adhesive and the initiator components in the chemical-cured composite.

The influence of water storage and C-factor on the dentin-resin composite microtensile bond strength and debond pathway utilizing a filled and unfilled adhesive resin

OBJECTIVE

To test the elastic wall concept utilizing adhesive resins of varying stiffness in a low- and high-C-factor cavity design after short- and long-term water storage.

METHODS

A flat and box-shaped cavity was restored on occlusal dentin with a resin composite using a filled and unfilled adhesive resin from which microtensile specimens with a 0.5mm(2) cross-sectional area were formed. After storage for 30- and 150-days the microtensile bond strength (muTBS) was determined in a Zwick materials testing machine and the subsequent debond pathway was examined under scanning electron microscopy. Fisher's exact test was used to determine differences in joint and substrate failure modes and a Weibull regression model with gamma frailties was used to test for differences between failure distributions. Tests for three-way and two-way interactions were also completed for storage time, C-factor and adhesive. All tests were at 95% confidence levels.

RESULTS

The characteristic strength (TBS degrees ) for the Optibond FL adhesive applied on a flat cavity was 47.57 and 20.90MPa and a box-shaped cavity was 49.26 and 17.49MPa for short- and long-term storage, respectively, while the corresponding TBS degrees for the unfilled Optibond adhesive on the flat cavity design was 36.93 and 32.68MPa and in a box-shaped cavity was 32.84 and 15.46MPa. Combining all groups according to storage time revealed a three-fold increase in the debond pathway including the bottom of the hybrid layer.

SIGNIFICANCE

Evidence suggests that the durability of the bonded joint is threatened by hydrolysis and the most susceptible region is the bottom half of the hybrid layer and in low C-factor cavity designs a more flexible adhesive resin liner was more durable.

Effect of a sodium hypochlorite gel on dentin bonding

It has been suggested that the hybrid layer (HL) does not play any important role in the mechanism of adhesion to dentin. To substantiate this hypothetical insignificance of the HL, sodium hypochlorite (NaOCl) has been used to remove collagen from etched dentin prior to bonding.

OBJECTIVES

The present study was conducted to determine the effect of a commercial 10% NaOCl gel on the dentin shear bond strengths and HL ultra-morphology of two simplified dentin adhesives. The null hypothesis tested was that treatment of etched dentin collagen with NaOCl would not compromise dentin bonding.

METHODS

The labial surface of eighty bovine incisors was polished to expose middle dentin. The specimens were randomly assigned to two total-etch adhesive systems (N = 40): Prime&Bond NT (Dentsply Caulk); and Single Bond (3M Dental Products Division). After rinsing off the etchant, one drop of 10% NaOCl (AD Gel, Kuraray Ltd.) was applied to the etched dentin surface and left for 0 (control), 15, 30, or 60 s. The gel was rinsed off with water and the dentin surface kept visibly moist prior to the application of the adhesive as per manufacturer's instructions. The respective composite resin was subsequently applied and light-cured. After 24 h in water at 37 degrees C, the specimens were thermocycled for 500 cycles in baths kept at 5 and 55 degrees C and the shear bond strengths measured. The data were analyzed with two-way ANOVA. For TEM, sixteen dentin disks were taken from middle dentin of extracted human third molars, assigned to the eight treatment sequences, and observed.

RESULTS

The increase in the NaOCl application time resulted in a progressive decrease in shear bond strengths for both dentin adhesives. For Single Bond, the application of AD Gel for 60 s resulted in a reduction of bond strengths to 38% of that obtained for the control. For Prime&Bond NT, the mean bond strength obtained when AD Gel was applied for 60 s was 31% of that obtained for the control. The application of AD Gel resulted in distinct morphology for each one of the two adhesives tested. For Single Bond, the general morphology of the collagen network was maintained, regardless of the deproteinization time. The interfibrillar space within the collagen network increased with increasing deproteinization times. For Prime&Bond NT, the general appearance of the HL was maintained for deproteinization times of 15 and 30 s. When the NaOCl gel was applied for 60 s, the morphological appearance of the HL lost its fibrillar arrangement. While remnants of the collagen fibers were observed in one of the dentin disks, the other specimen showed an amorphous structure without any discernible HL morphological features.

SIGNIFICANCE

The integrity of the collagen fibrils left exposed upon acid-etching plays a major role in the mechanism of adhesion of the specific adhesive systems tested in this study. The intermingling of the adhesive monomers with the filigree of collagen fibers or HL should still be considered the paramount dentin bonding mechanism.

Nanoleakage patterns of four dentin bonding systems

OBJECTIVES

The purpose of this study was to evaluate the nanoleakage patterns of four dentin bonding systems.

METHODS

The dentin bonding systems used in this study were: Single Bond, One Coat Bond, Prime & Bond NT/Non Rinse Conditioner (NRC), and PermaQuik. Flat occlusal dentin surfaces from extracted human molars were finished with wet 600-grit silicon carbide paper, and bonded with one of the dentin bonding systems. After 24 h storage at 37 degrees C in water, margins were finished with polishing discs and the surrounding tooth surfaces coated with nail varnish. The samples were immersed in a 50% (w/v) solution of silver nitrate for 24 h, and exposed to photodeveloping solution for 8 h. The samples were cut longitudinally, polished, and mounted on stubs, carbon coated and observed in a Field Emission-SEM using backscattered electron mode.

RESULTS

Different nanoleakage patterns were observed with the different adhesive systems. However, accumulations of silver particles were often noted at the base of the hybrid layer for all materials. Single Bond and One Coat Bond demonstrated uptake of silver particles both within the hybrid layer and the adhesive resin. Prime & Bond NT/NRC showed silver staining throughout almost the entire thickness of the hybrid layer. The leakage pattern of PermaQuik revealed loose silver deposition within the hybrid layer. The composition of each adhesive system may play a role in forming the different leakage patterns.

SIGNIFICANCE

The current dentin bonding systems used in this study do not achieve perfect sealing at the restoration/dentin interface, which may influence the durability of the bond to dentin.

Laboratory evaluation and clinical application of a new one-bottle adhesive

PURPOSE

The purposes of this project were to compare the enamel and dentin bond strengths of a new nanofilled one-coat adhesive system with its predecessor, an unfilled two-coat adhesive system; to analyze the dentin interfacial ultramorphology, using scanning and transmission electron microscopy (SEM and TEM); and to illustrate the clinical technique associated with the use of the new nanofilled one-coat adhesive system.

MATERIAL AND METHODS

Twenty flat dentin surfaces and 20 flat enamel surfaces were polished on the labial surface of bovine incisors mounted in acrylic resin. The specimens were equally and randomly assigned to four bonding groups: (1) dentin with Prime & Bond 2.1; (2) dentin with Prime & Bond NT; (3) enamel with Prime & Bond 2.1; and (4) enamel with Prime & Bond NT. A composite post was then adapted to the treated area and light-cured. After thermocycling, shear bond strengths were determined by testing the shear strength of the specimens. The data were analyzed using one-way analysis of variance (ANOVA) and Student's t-test. For SEM and TEM, six dentin disks were obtained from middle dentin of human third molars and assigned equally to each adhesive. The adhesives were applied to dentin according to manufacturer's directions. The hybrid layer and resin penetration into dentin tubules were analyzed at an ultramorphologic level, and the observations were compared.

RESULTS

Shear bond strengths were as follows: group 1: 17.8 +/- 4.1 MPa; group 2: 20.5 +/- 3.5 MPa; group 3: 24.7 +/- 6.7 MPa; and group 4; 27.0 +/- 5.4 MPa. Electron microscopy showed that both adhesives penetrated the dentin tubules and formed a fully infiltrated hybrid layer. The nanofiller included in the new one-application adhesive penetrated the dentin tubules and infiltrated the microspaces between the collagen fibers within the hybrid layer.

CLINICAL SIGNIFICANCE

The new one-application nanofilled adhesive tested in this study resulted in bond strengths and dentin hybridization comparable to those obtained with the corresponding two-application system. The clinical sequences presented illustrate the ease of use of the newest simplified adhesives.