Effects of one versus two applications of an unfilled, all-in-one adhesive on dentine bonding

Filler Mixed Into Adhesives Does Not Necessarily Improve Their Mechanical Properties

OBJECTIVES

To investigate the influence of filler type/loading on the micro-tensile fracture strength (μTFS) of adhesive resins, as measured 'immediately' upon preparation and after 1-week water storage ('water-stored').

METHODS

The morphology and particle-size distribution of three filler particles, referred to as 'Glass-S' (Esschem Europe), 'BioUnion' (GC), and 'CPC_Mont', were correlatively characterized by SEM, TEM, and particle-size analysis. These filler particles were incorporated into an unfilled adhesive resin ('BZF-29unfilled', GC) in different concentrations to measure the 'immediate' μTFS. After 1-week water storage, the 'water-stored' μTFS of the experimental particle-filled adhesive resins with the most optimum filler loading, specific for each filler type, was measured. In addition, the immediate and water-stored μTFS of the adhesive resins of three experimental two-step universal adhesives based on the same resin matrix but varying for filler type/loading, coded as 'BZF-21' (containing silica and bioglass), 'BZF-29' (containing solely silica), and 'BZF-29_hv' (highly viscous with a higher silica loading than BZF-29), and of the adhesive resins of the gold-standard adhesives OptiBond FL ('Opti-FL', Kerr) and Clearfil SE Bond 2 ('C-SE2', Kuraray Noritake) was measured along with that of BZF-29unfilled (GC) serving as control/reference. Statistics involved one-way and two-way ANOVA followed by post-hoc multiple comparisons (α<0.05).

RESULTS

Glass-S, BioUnion, and CPC_Mont represent irregular fillers with an average particle size of 8.5-9.9 μm. Adding filler to BZF-29unfilled decreased μTFS regardless of filler type/loading. One-week water storage reduced μTFS of all adhesive resins except BZF-21, with the largest reduction in μTFS recorded for BZF-29unfilled. Among the three filler types, the μTFS of the 30 wt% Glass-S and 20 wt% BioUnion filled adhesive resin was not significantly different from the μTFS of BZF-29unfilled upon water storage.

CONCLUSIONS

Adding filler particles into adhesive resin did not enhance its micro-tensile fracture strength but appeared to render it less sensitive to water storage as compared to the unfilled adhesive resin investigated.

Does the universal adhesive's film thickness affect dentin-bonding effectiveness?

OBJECTIVES

To investigate the influence of adhesive resin application modalities on the film thickness of the adhesive resin and the effectiveness of a two-step universal adhesive (UA) bonded in self-etch (SE) bonding mode to high C-factor class-I cavity-bottom dentin.

MATERIALS AND METHODS

After application of the primer of G2-Bond Universal (G2B, GC), the adhesive resin was applied into standard class-I cavities (human molars) following four application modalities: (1) one layer, strongly air-blown; (2) one layer, gently air-blown; (3) two layers, each gently air-blown; (4) one layer, not air-blown. After being restored with composite, each tooth was sectioned to obtain one micro-specimen (n = 10), of which the adhesive resin film thickness was measured using optical microscopy. The micro-tensile bond strength (μTBS) was tested immediately or upon 100,000 thermocycles. Statistical analyses involved Kruskal-Wallis and Mann-Whitney U testing (p < 0.05).

RESULTS

G2B's μTBS was significantly affected by the adhesive resin application modality and aging. Gently air-blowing the adhesive resin resulted in significantly higher immediate μTBS than strong air-blowing or no air-blowing. No significant difference in μTBS was found between single or double gently air-blown adhesive resin applications. The adhesive resin film thickness significantly varied with the application modalities.

CONCLUSIONS

A too thin or too thick adhesive resin film thickness adversely affected bond strength of the two-step UA applied in SE mode and high C-factor condition.

CLINICAL RELEVANCE

The adhesive resin layer thickness can affect the bonding performance of two-step UAs in high C-factor cavities. Dental clinicians remain advised to avoid improper air-blowing of UAs and strictly follow the application instructions.

Tooth-composite bond failure with a universal and an etch-and-rinse adhesive depending on mode and frequency of application

OBJECTIVES

To evaluate the effect of an additional layer of universal adhesive on the interfacial enamel/dentin-composite gap formation in relation to application mode and aging, via spectral domain optical coherence tomography (SD-OCT) and scanning electron microscopy (SEM).

METHODS

In vitro class V cavities in 114 caries-free premolars were restored by applying one or two layers of a universal adhesive (Scotchbond Universal, SBU) in self-etch (se) and etch-and-rinse (er) mode or the reference adhesive OptiBond FL (OFL-er). The restorations were imaged by SD-OCT (six groups, n = 8) and SEM (n = 3) directly after filling (t1), water storage (t2, 24 h), embedding (t3), and thermo-mechanical loading (t4, TCML). The interfacial gaps were quantified using 26 parameters and analyzed using principal component analysis and linear mixed effect models.

RESULTS

Gap formation at enamel and dentin was significantly influenced by the adhesive, the application mode and number of layers (p < 0.001). This was due to the influence of the SBU-er mode (p < 1e-05), which showed significantly more gap formation and a greater range of variation with double application when compared to SBU-se and OFL. The fewest interfacial gaps occurred with one or two applications of OFL-er and one layer of SBU-er.

SIGNIFICANCE

Adhesive application mode and the number of adhesive layers are relevant factors in the tooth-composite bond failure. Double application worsened the adaptation of SBU to freshly prepared dentin conditioned with phosphoric acid.

Effect of light curing on the efficacy of silver diamine fluoride: A systematic review

Objective

This study was aimed at comparing the performance of light-cured (LC) silver diamine fluoride (SDF) to non-LC SDF in dental applications, in terms of various properties.

Methods

Articles published until April 2023 were retrieved from electronic databases (PubMed, Scopus and Science Direct) according to Boolean operators, and the reference lists of the included articles were manually searched. The included articles were all full-text, original studies in English that assessed the effects of LC SDF compared with SDF alone. The risk of bias in the in vitro studies on dental materials was evaluated with the modified Consolidated Standards of Reporting Trials (CONSORT) checklist.

Results

Six studies (five in vitro and one ex vivo) were included in qualitative analysis after a comprehensive manual search and electronic database search. Every study compared LC SDF versus non-LC SDF in terms of properties such as penetration depth, silver ion precipitation, dentine hardness, surface morphology and anti-bacterial characteristics. Four studies were categorised as low quality with a high risk of bias, whereas the remaining two studies were considered high quality with a low risk of bias.

Conclusion

In this investigation, LC SDF, compared with non-LC SDF, was found to be an efficacious approach for enhancing SDF properties. Future high-quality studies, particularly randomised clinical trials, remain necessary to verify these findings.

Clinical significance

The use of light curing with SDF can be a beneficial strategy that enhances SDF's clinical use. This review comparing various properties of LC SDF and non-LC SDF may help clinicians enhance clinical use and patient acceptance of LC SDF.

In vitro performance of an autocured universal adhesive system in bonding to dentin

BACKGROUND

The successful integration of resin-based dental adhesives significantly impacts restorative dentistry, providing efficient and aesthetically pleasing caries treatments. Among various adhesives, one-step self-etching adhesives (1-SEAs) have gained popularity due to their simplicity and short application time. However, concerns have been raised regarding their bonding performance and marginal adaptation characteristics, which differ from two-step self-etching adhesives (2-SEAs) and three-step etch-and-rinse adhesives. Additionally, light-cured bonding materials may encounter challenges in deep cavities and inaccessible areas, necessitating extended light irradiation time. Autocured bonding materials are a potential solution, but limited comparative studies have been conducted on their performance.

METHODS

In this in vitro study, we evaluated a new autocured universal bonding material (Bondmer Lightless 2) and compared the results with recent light-cured bonding materials. Microshear bond strength (μSBS) tests were performed on 25 human molars using five different combinations of adhesives and composite resins: Bondmer Lightless 2 with Estelite Bulk Fill Flow (BE group), Bondmer Lightless 2 with a prototype composite resin (BO group), Prime&Bond Universal with SDR flow + (PS group), Scotchbond Universal with Filtek Bulk Fill (SF group), and G-Premio Bond with Gracefil BulkFlo (GG group). The bond strengths and failure modes were assessed using a universal testing machine and scanning electron microscope (SEM), respectively. Marginal adaptation was evaluated using swept-source optical coherence tomography (SS-OCT) and confocal laser scanning microscopy (CLSM) on 40 sound bovine maxillary incisors.

RESULTS

The μSBS test showed no significant differences in bond strength among the tested groups. Most failure modes were observed at the bond interface between the adhesive and the dentin. The autocured bonding material demonstrated significantly higher marginal adaptation (SI%) than PS, SF, and GG. The CLSM images corresponded with gaps observed in the SS-OCT images, indicating improved marginal sealing in the autocured group.

CONCLUSIONS

The new autocured universal bonding material exhibited comparable bond strength to a conventional light-cured material while demonstrating a superior marginal adaptation level. This finding suggested that the autocured material could be a valuable alternative, especially when extended light irradiation would pose a challenge. Further clinical studies would be warranted to evaluate the performance of the autocured bonding material in actual restorative dental practice.

A randomized clinical study of the performance of self-etching adhesives containing HEMA and 10-MDP on non-carious cervical lesions: A 2-year follow-up study

OBJECTIVE

To evaluate the association of HEMA and 10-MDP in the clinical performance of self-etching adhesives in the restoration of NCCLs during 2-years.

MATERIALS AND METHODS

60 restorations were performed in 17 volunteers and randomized into three groups: G1 (n = 20) - Prime and Bond Universal (10-MDP); G2 (n = 20) - Optibond All-in-One (HEMA); and G3 (n = 20) - Clearfil SE (10-MDP and HEMA). No cavity preparation was performed. After 2 years, the restorations were evaluated using the modified USPHS criteria for retention, marginal adaptation/ staining, postoperative sensitivity and secondary caries. The results were analyzed using Fisher's exact test and Kruskal-Wallis test.

RESULTS

All groups showed 100% retention rate, except G1, who lost two restorations (p > 0.05). Regarding marginal adaptation, G1 showed greater deficiency, as only eight restorations (40%) remained intact (p < 0.05). Regarding marginal staining, G1 and G2 showed higher rate, as only 12 restorations (65%) in each one were free of staining (p < 0.05). All groups showed similar results for postoperative sensitivity and secondary caries (p > 0.05).

CONCLUSION

The association of HEMA and 10-MDP monomers in the self-etching adhesives did not influence the clinical performance of the NCCL restorations with respect to retention, postoperative sensitivity, and incidence of secondary caries. However, positively influenced the marginal adaptation and marginal staining at the 2-year follow-up.

CLINICAL SIGNIFICANCE

The association of HEMA and 10-MDP monomers in the self-etching adhesives positively influence the clinical performance of the NCCL restorations with respect to marginal adaptation and marginal staining.

Effect of Different Application Modalities on the Bonding Performance of Adhesive Systems to Dentin: A Systematic Review and Meta-Analysis

Diverse types of dental adhesives exhibit different cytotoxic outcomes on cells in vitro. Currently, no standard adhesive application technique has so far been decisive for clinicians for better durability of resin-dentin bonds of adhesive systems. The purpose of this study was to systematically review the literature to evaluate the bonding performance of adhesive systems to dentin by using different application modalities. The systematic research strategy was conducted by two reviewers among multiple databases: PubMed, Scopus, Web of Science, Embase, and Scielo. In vitro studies reporting the effects of additional steps for the application of adhesive systems on the bond strength to dentin were selected. Meta-analysis was performed using Review Manager Software version 5.3.5 using the random effects model. The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic review. The electronic research through different databases generated a total of 8318 references. After the examination of titles and abstracts, a total of 106 potentially relevant studies accessed the full-text evaluation phase. After full-text examination, 78 publications were included for the qualitative analysis, and 68 studies were included in the meta-analysis. Regarding the etch-and-rinse adhesive systems, the application modalities that improved the overall bond strength were the application of a hydrophobic resin layer (p = 0.005), an extended application time (p < 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p = 0.05), the agitation technique (p = 0.02), and the active application of the adhesive (p < 0.001). For self-etch adhesive systems, the techniques that improved the overall bond strength were the application of a hydrophobic resin layer (p < 0.001), an extended application time (p = 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p < 0.001), the agitation technique (p = 0.01), and the active application of the adhesive (p < 0.001). The in vitro evidence suggests that the application of adhesive systems using alternative techniques or additional strategies may be beneficial for improving their bond strength to dentin. The application modalities that favored the overall bond strength to dentin were an extended application time, a double-layer application, an application assisted by an electric current, the active application of the adhesive, and the application of a hydrophobic resin layer. Worth mentioning is that some techniques are intended to increase the degree of the conversion of the materials, and therefore, improvements in the biocompatibility of the materials can be expected.

Evaluation of the Bond Strength of Self-Etching Adhesive Systems Containing HEMA and 10-MDP Monomers: Bond Strength of Adhesives Containing HEMA and 10-MDP

The aim of this in vitro study was to assess the bond strength of self-etching adhesives containing HEMA and 10-MDP monomers. Twenty-four bovine teeth were divided into three groups. Two cylinders of composite resin were made in each tooth (n = 16): G1-Prime and Bond Universal (control); G2-OptiBond All-in-One (HEMA); and G3-Clearfil SE (10-MDP and HEMA). After 24-hour storage in distilled water, the specimens were fixed to a universal testing machine (Kratos Equipamentos Ltda.) for the microshear test at a speed of 0.5 mm/min. A qualitative analysis of the fracture pattern was also performed using scanning electron microscopy (500× magnification). The normality of sample data distribution was determined using the Shapiro–Wilk test. The results were assessed using the Kruskal–Wallis test, and α level of 5% was used for the analysis. The results indicated a statistical difference (p > 0.05) between G3 (15.6080 MPa) and G2 (11.2180 MPa). No statistical difference was observed when G1 (14,6325 MPa) was compared with the other two groups. It was also observed that a mixed fracture pattern was predominant in all groups. The self-etching adhesive containing HEMA and 10-MDP monomers showed to be promising in increasing the bond strength between the dental substrate and the composite resin, whereas the adhesive containing only HEMA exhibited lower bond strength to dentin.

Do universal adhesives provide the benefits from double-application or an extra bonding layer in composite repair?

This study aimed to determine whether the application of extra hydrophobic resin (EHR) or double layer (DL) improves microtensile bond strength (μTBS) of two universal adhesives to composite resin. Composite blocks were fabricated and exposed to thermal cycles. The specimens were horizontally sectioned into two halves. Scotch Bond Universal (SBU) and Clearfil S3 Bond Universal (CSBU) were applied to the ground composite surface according to the manufacturers' instructions, or with DL application or EHR application. The repair composite was incrementally placed to bonded planes. Composite sticks were achieved and tensed with a universal testing machine, followed by examining the fracture surfaces by a scanning electron microscope. Data were evaluated by Weibull analysis (shape and scale [σ_θ and σ_0.10 ] parameters) using the maximum likelihood method. The σ_θ and σ_0.10 , respectively, estimate strength at 63.2 and 10% probability of failure. Shape parameter values showed significant differences among treatments. DL application of CSBU did not affect μTBS values at σ_θ of failure but caused to decrease μTBS values at σ_0.10 of failure. DL application of SBU reduced μTBS values at σ_θ of failure. DL or EHR coating did not improve μTBS of SBU. EHR application increased μTBS of CSBU, whereas DL application did not benefit.

Assessment of Wettability and Contact Angle of Bonding Agent with Enamel Surface Etched by Five Commercially Available Etchants: An In Vitro Study

Background

The quantity and quality of the etching pattern produced by acids play a significant role in the wettability and contact angle of the adhesive with the enamel surface in orthodontics. The better the etch pattern, the more the surface energy of the enamel, better the penetration of the adhesive, which ultimately results in better bond strength. The present study aimed to evaluate the contact angle of the bonding agent with the enamel surface etched by five commercially available etchants and check if any difference existed between the five.

Materials and Methods

Twenty-five human maxillary and mandibular central incisors and premolars extracted for orthodontic or dental purposes were used in this study as samples. The teeth were allocated into five groups based upon the etchant used to etch the enamel surface. After the samples were etched, a hard tissue microtome was used to create thin slices of the enamel surface. The samples were then exposed to bonding agent Ormco Enlight. The bonding agent was released in the form of droplets onto the enamel slices mounted on a contact angle goniometer. The contact angle values were tabulated, and statistical analysis using the one-way ANOVA test was carried out.

Results

The contact angle measurements of the etchant group, DPI, were the lowest, while D-tech has the highest contact angle values. However, statistical analysis revealed no statistically significant difference between the contact angle measurements of the five groups included in the study.

Conclusion

No statistically significant difference existed between the five etchant groups included in the study. However, commercially available etchant DPI showed lesser contact angle and thus better wettability in comparison to other groups. Further elemental analysis and surface analysis are required to validate these results.

Influence of reduced application time on bonding durability of universal adhesives to demineralized enamel

OBJECTIVES

This study aimed to assess the effect of application time on the microshear bond strength (μSBS) of three universal adhesives in demineralized and sound enamel before and after aging.

MATERIALS AND METHODS

Bovine teeth (192) were prepared where buccal surfaces were ground and divided into two groups (sound enamel and demineralized enamel). The specimens in each group were divided into 12 subgroups by combining 3 adhesive agents (All-Bond Universal, Scotchbond Universal, and Tokuyama Universal Bond) × 4 adhesion strategy. Each adhesive was applied with either prolonged (PA) or reduced (RA) application time in etch-and-rinse or self-etch mode. Bonded composites were subjected to μSBS testing after 24-h or 2-year water storage. The results were evaluated using four-way ANOVA and Tukey's post-hoc test (α = 0.05).

RESULTS

The μSBS of adhesives to sound enamel in both etching modes was mostly similar to demineralized enamel, regardless of application time and aging time. At 24-h, all adhesives with PA in self-etch mode showed higher μSBS when compared with RA, except Tokuyama Universal Bond, but after 2-year aging, no significant difference was found in μSBS between RA and PA. The μSBS of adhesives with PA in etch-and-rinse mode depended on used adhesive and enamel condition compared to RA, regardless of μSBS testing time.

CONCLUSIONS

PA of adhesives did not reveal a significant difference in μSBS to enamel, regardless of substrate type and etching mode.

CLINICAL RELEVANCE

After 2-year aging, the bond strength of universal adhesives presented no significant difference between PA and RA treatments.

On the properties of nanosilicate-based filled dental adhesives: Synthesis, characterization, and optimized formulation

OBJECTIVE

In this study, we incorporated hybrid nanoparticles (poly (acrylic acid)-grafted nanoclay/nanosilica, respectively, with platelet and spherical morphologies, abbreviated as PAA-g-NC-Sil) in different concentrations (0, 0.2, 0.5, 1, 2 and 5 wt%) to an experimental dentin bonding system and investigated the physical properties of the filled adhesive and its shear bond strength (μ-SBS) to dentin. We subsequently compared the properties of the adhesives containing PAA-g-NC-Sil with previously studied adhesives containing poly (methacrylic acid)-g-nanoclay (PMA-g-NC) (Solhi et al., 2012a), poly (acrylic acid)-g-nanoclay (PAA-g-NC) (Solhi et al., 2012b), and the hybrid poly (methacrylic acid)-grafted-nanoclay-nanosilica (PMA-g-NC-Sil) (Solhi et al., 2020).

MATERIALS AND METHODS

In a set of previous publications and the present paper, we grafted poly (acrylic acid) (PAA) or poly (methacrylic acid) (PMA) onto the surface of pristine Na-MMT nanoclay (Cloisite® Na⁺) through free radical polymerization of monomer in an aqueous media in the presence or absence of nanosilica particles. We characterized the resulting modified nanoparticles (PMA-g-NC, PAA-g-NC, PMA-g-NC-Sil and PAA-g-NC-Sil) using GPC, FTIR, TGA, and XRD. We then incorporated the modified particles as functionalized fillers to experimental dentin adhesives in different concentrations and studied the stability of modified fillers dispersion by separation analysis. We also studied the properties of the photo-cured adhesive matrices using FTIR, TEM, SEM, EDXA, and XRD. We examined the shear bond strength of the adhesives (containing different contents of each modified filler, separately) to human premolar teeth. The results were analysed and compared statistically.

RESULTS

The results confirmed that the polymers have been grafted onto the surface of nanoclay. An exfoliated structure for the nanoclay platelets in the photo-cured adhesive containing PAA-g-NC-Sil was observed. Addition of 0.5 wt% of PAA-g-NC-Sil to the experimental adhesive increased the shear bond strength and the dispersion stability in comparison to unfilled adhesive. The same trend was also observed for adhesives containing PMA-g-NC, PAA-g-NC, and PMA-g-NC-Sil. The adhesive containing PAA-g-NC-Sil showed the best dispersion stability and subsequently the highest shear bond strength in the optimal concentration among adhesives containing the four available fillers (PMA-g-NC, PAA-g-NC, PMA-g-NC-Sil and PAA-g-NC-Sil).

SIGNIFICANCE

Addition of poly (acrylic acid) modified nanoparticles to the experimental dentin adhesives resulted in higher shear bond strength due to the potential interactions between the carboxylic acid functional groups on the surface of the modified particles and the dentin structure. Between the poly (acrylic acid) and poly (methacrylic acid), the former acid with higher PK_a performed better. Addition of the spherical nanosilica particles to the adhesives containing platelet nanoclay helped to better exfoliate the platelets resulting in improved μ-SBS and dispersion stability.

Effect of double-layer application on the early enamel bond strength of universal adhesives

OBJECTIVES

The present study aimed to investigate the changes in the enamel bond strengths of universal adhesives in the early phase of specimen creation and evaluate the effect of double-layer application on enamel bond effectiveness using different etching modes.

METHOD

Four universal adhesives, namely Clearfil Universal Bond Quick, G-Premio Bond, Scotchbond Universal, and Tokuyama Universal Bond, were used. Clearfil SE Bond two-step self-etch adhesive system was used as a comparison. Fifteen specimens per group were used for determining the shear bond strength (SBS) to bovine enamel in the etch-and-rinse or self-etch mode. The adhesive was applied to specimens in accordance with the manufacturers' instructions (single-layer application), or the adhesive was applied twice (double-layer application). The bonded specimens were stored in distilled water at 37 °C for 5 min or 1, 6, 12, or 24 h before SBS testing. The flexural properties of the resin composite Clearfil AP-X were measured for the same storage periods.

RESULTS

All universal adhesives exhibited increased SBS values with prolonged storage periods regardless of the application technique or etching mode used. Double-layer application was associated with higher SBS values than single-layer application for most universal adhesives over the same storage period.

CONCLUSION

Phosphoric acid pre-etching and double-layer application of universal adhesives resulted in increased enamel bond strength in the early phase of specimen bonding.

CLINICAL RELEVANCE

Care should be taken when using universal adhesives in the self-etch mode for enamel bonding because the enamel adhesion is sensitive to the duration after filling.

The Influence of Application Protocol of Simplified and Universal Adhesives on the Dentin Bonding Performance

Contemporary adhesives use etch-and-rinse, self-etch, and multimode adhesive strategies. Simplified and universal adhesives present lower bond strength to dentin than conventional, two-bottle etch-and-rinse adhesives. The purpose of this study was to evaluate bonding performance of simplified and universal adhesives to dentin after modifying their application protocol (multiplying applications and extending application time). Adhesive layer thickness (ALT) and shear bond strength (SBS), as well as the correlation between these parameters was calculated. Two universal (Single Bond Universal and Prime & Bond One Select) and two self-etch adhesives (Adper Easy One and Xeno V) were tested. Significant differences in ALT were detected between the adhesives, as well as within the same adhesive between study groups. Tested adhesives presented the thinnest adhesive layer when applied 2 times in 20 s. Single Bond Universal obtained the highest SBS results of all adhesives. Most adhesives (except for Prime & Bond One Select) obtained the highest SBS, when applied two or three times in 40 or 60 s, respectively. No correlation between the ALT and SBS was found. The study showed that increasing the number of applications and extending the application time of self-etch and universal adhesives can be recommended to improve their performance.

Effect of Immediate Dentin Sealing and Surface Conditioning on the Microtensile Bond Strength of Resin-based Composite to Dentin

This study evaluated the microtensile bond strength (μTBS) of resin-based composite (RBC) to dentin after different immediate dentin sealing (IDS) strategies and surface-conditioning (SC) methods and on two water storage times. Human molars (n=48) were randomly divided into eight experimental groups involving four different IDS strategies-IDS-1L with one layer of adhesive, IDS-2L with two layers of adhesive, IDS-F with one layer of adhesive and one layer of flowable RBC, and DDS (delayed dentin sealing) with no layer of adhesive (control)-and two different SC methods-SC-P with pumice rubbing and SC-PC with pumice rubbing followed by tribochemical silica coating. The μTBS test was performed after one week and after six months of water storage, being recorded as the "immediate" and "aged" μTBS, respectively. Composite-adhesive-dentin microspecimens (0.9×0.9×8-9 mm) were stressed in tension until failure to determine the μTBS. Failure mode and location of failure were categorized. Two-way analysis of variance was applied to analyze the data for statistically significant differences between the experimental groups (p<0.05). Two-way analysis of variance revealed no significant differences between the one-week μTBS specimens for IDS strategy (p=0.087) and SC methods (p=0.806). However, the interaction of IDS strategy and SC methods appeared statistically significant (p=0.016). The six-month specimen evaluation showed no significant difference in μTBS for SC (p=0.297) and SC/IDS interaction (p=0.055), but the μTBS of the IDS strategies differed significantly among them (p=0.003). For tribochemical silica-coated IDS, no significant effect of aging on μTBS was recorded (p=0.465), but there was a highly significant difference in μTBS depending on the IDS strategy (p<0.001). In addition, the interaction of IDS and aging was borderline statistically significant (p=0.045). The specimens failed mainly at the adhesive-dentin interface for all experimental groups. Dentin exposure during clinical procedures for indirect restorations benefits from the application of IDS, which was shown to result in higher bond strength. No significant differences were found between cleaning with solely pumice or pumice followed by tribochemical silica coating.

Multi-Layer Application of Self-Etch and Universal Adhesives and the Effect on Dentin Bond Strength

Contemporary self-etch and multi-mode adhesives were introduced to ensure a fast and reliable bonding procedure. Yet, in terms of bond strength and stability they failed to perform as well as two-bottle, etch-and-rinse adhesives, which remain the gold standard in terms of durability. The purpose of this study was to assess the shear bond strength (SBS) of dental adhesives to dentin with different application protocols. Two self-etch (Adper Easy One and Xeno V) and two multi-mode adhesives (Single Bond Universal and Prime&Bond One Select) were used in the study. The highest SBS was obtained for Single Bond Universal applied in three layers, while the lowest, for Xeno V applied in one layer. Other tested adhesives obtained the highest SBS when applied in three layers. For all tested adhesives, multi-layer application resulted in an increase in adhesive layer thickness, as observed in SEM. The increased thickness of the adhesive layer produced by triple application of unfilled adhesives corresponded with higher SBS values. The present study showed that using triple adhesive layers with simplified adhesive systems can be recommended to improve their performance. Due to differences in the composition of self-etch and universal adhesives, the exact application protocol is product dependent.

Effect of hydrophobic surface treated fumed silica fillers on a one-bottle etch and rinse model dental adhesive

The objective of this study was to investigate the effect of hydrophobic surface treatment to fumed silica fillers on the bonding performance of a one-bottle etch and rinse model dental adhesive. In this study, 0.5-5 wt.% of Filler 1 and Filler 2 were loaded into BisGMA/HEMA model dental adhesive. Filler 1 was not treated, while Filler 2 was surface treated with a dimethyl silicone fluid making the silica extremely hydrophobic. The prepared adhesives were characterized through measurements of viscosity, degree of conversion, and water contact angle. SEM was utilized to observe the microstructures at the bonding interface. Micro-tensile bond strength (µTBS) test coupled with fracture surface analysis was carried out to study the mechanical properties. From the experiment, the loadings of Filler 2 is favorable to the improvement of µTBS. The µTBS of experimental adhesive with 1 wt.% Filler 2 increased 42% compared to the model adhesive without filler, and 24% compared to the experimental adhesive with 1 wt.% Filler 1. The effectively penetration of the hydrophobic compositions of the adhesive is considered as the main reason that leads to the increased bond strength, which was proved by the contact angle measurement and SEM observations.

Classification review of dental adhesive systems: from the IV generation to the universal type

Adhesive dentistry has undergone great progress in the last decades. In light of minimal-invasive dentistry, this new approach promotes a more conservative cavity design, which relies on the effectiveness of current enamel-dentine adhesives. Adhesive dentistry began in 1955 by Buonocore on the benefits of acid etching. With changing technologies, dental adhesives have evolved from no-etch to total-etch (4^th and 5^th generation) to self-etch (6^th, 7^th and 8^th generation) systems. Currently, bonding to dental substrates is based on three different strategies: 1) etch-and-rinse, 2) self-etch and 3) resin-modified glass-ionomer approach as possessing the unique properties of self-adherence to the tooth tissue. More recently, a new family of dentin adhesives has been introduced (universal or multi-mode adhesives), which may be used either as etch-and-rinse or as self-etch adhesives. The purpose of this article is to review the literature on the current knowledge for each adhesive system according to their classification that have been advocated by many authorities in most operative/restorative procedures. As noted by several valuable studies that have contributed to understanding of bonding to various substrates helps clinicians to choose the appropriate dentin bonding agents for optimal clinical outcomes.

The effect of double-coating and times on the immediate and 6-month dentin bonding of universal adhesives

OBJECTIVE

The purpose of this study was to evaluate the effect of double-application coats and times on microtensile bond strength (μTBS) and adhesive-dentin interfaces created by dentin adhesive systems after 6 months of storage in water.

MATERIALS AND METHODS

Two-hundred sixteen extracted non-carious human third molars were selected for the study. Single-Bond Universal (SU) and All-Bond Universal (AU), Adper Easy One (Eo) Self-Etch adhesive and Adper Single-Bond 2 (Sb) etch-and-rinse adhesive were applied to a flat dentin surface using three methods (1): dentin adhesives were applied as recommended by the manufacturers; (2): two consecutive coats of dentin adhesives were applied before photo-polymerization; and (3): a single coat of adhesive was applied but with twice the manufacturers recommended application time. Microtensile bond strength was determined either immediately or after 6 months of water storage. Data were analyzed using one-way analysis of variance and Tukey's post-hoc tests.

RESULTS

At 24 h, groups 1, 2, and 3 exhibited statistically similar results for all dentin adhesive systems. For AU-Er, group 3 showed significantly higher bond strength than all group of AU-Se after 6 months.

CONCLUSION

Universal adhesives seemed more stable against water degradation than traditional two-step etch-and-rinse and all-in-one systems within the 6-month period.

Effect of adhesive layers on microshear bond strength of nanocomposite resin to dentin

Background

Bond strength of adhesive layer can absorb unwanted stresses of polymerization shrinkage in composite resin restorations; increased microshear bond strength can prevent failure of restoration materials, the purpose of this study was to evaluate the effect of adhesive layers on microshear bond strength of nanocomposite resin to dentin.

Material and Methods

Two different types of adhesive systems: universal adhesive (ExciTE) and newly developed adhesive (Nano-Bond), and one type of light-cured resin restorative material (Nanocomposite resin) were used in this study. The occlusal surfaces of extracted human molar teeth were ground perpendicular to the long axis of each tooth to expose a flat dentin surface. The adhesives were applied on dentin surfaces (single application or double application). Nanocomposite resin was then placed and light cured for 40 seconds. After 24 hours of immersion in water at 37°C, then subjected to thermocycling before testing, a microshear bond test was carried out. The data were analyzed by a two-way ANOVA. For comparison between groups, Tukey’s post-hoc test was used.

Results

The mean bond strengths of ExciTE and Nano-Bond adhesives with a single application were 8.8 and 16.6 MPa, respectively. The mean bond strengths of ExciTE and Nano-Bond adhesives with double application were 13.2 and 21.8MPa, respectively. There were no statistically significant differences in microshear bond strengths between the single application of Nano-Bond and the double application of ExciTE adhesives.

Conclusions

Microshear bond strength increased significantly as the applied adhesive layer was doubled.

Key words:Adhesive, microshear, bond, strength, nanocomposite.

Electric-current-assisted Application of Self-etch Adhesives to Dentin

The use of electric current during the application of etch-and-rinse adhesive systems has been recently claimed to increase bonding of etch-and-rinse adhesives by enhancing substrate impregnation. The null hypothesis tested in this study was that electrically assisted application has no effect on bond strength of self-etching bonding systems. Three self-etch adhesives (Protect-Bond, Xeno III, and Prompt L-Pop) were applied with the aid of an electric signal-generating device (ElectroBond) and tested vs. controls prepared with the same disposable sponges but without electric current. Specimens bonded under the influence of electric current exhibited increased microtensile bond strength compared with the controls (p < 0.05). High-resolution SEM analysis showed that bonding under the influence of electricity reduced interfacial nanoleakage. It is speculated that resin infiltration may be improved by the attraction of polar monomers by an electric current or by modification of the dentin surface charges, resulting in better water substitution or evaporation.

Effect of dentin dehydration and composite resin polymerization mode on bond strength of two self-etch adhesives

Background:

Dual-cured composite resins are similar to self-cured composite resins in some of their clinical applications due to inadequate irradiation, lack of irradiation, or delayed irradiation. Therefore, incompatibility with self-etch adhesives (SEAs) should be taken into account with their use. On the other, the extent of dentin dehydration has a great role in the quality of adhesion of these resin materials to dentin. The aim of this study was to investigate the effect of dentin dehydration and composite resin polymerization mode on bond strength of two SEAs.

Materials and Methods:

A total of 120 dentinal specimens were prepared from extracted intact third molars. Half of the samples were dehydrated in ethanol with increasing concentrations. Then Clearfil SE Bond (CSEB) and Prompt L-Pop (PLP) adhesives were applied in the two groups. Cylindrical composite resin specimens were cured using three polymerization modes: (1) Immediate light-curing, (2) delayed light-curing after 20 min, and (3) self-curing. Bond strength was measured using universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed with two-way ANOVA and Duncan post hoc tests. Statistical significance was defined at P < 0.05.

Results:

There were no significant differences for CSEB subgroups with hydrated and dehydrated dentin samples between the three different curing modes (P > 0.05). PLP showed significant differences between subgroups with the lowest bond strength in hydrated dentin with delayed light-curing and self-cured mode of polymerization.

Conclusion:

Within the limitations of this study, a delay in composite resin light-curing or using chemically cured composite resin had a deleterious effect on dentin bond strength of single-step SEAs used in the study.

The effect of bonding and surface sealant application on postoperative sensitivity from posterior composites

PURPOSE

The purpose of the study was to evaluate the postoperative sensitivity of posterior Class I composite restoration at short-term, restorated with two different all-in-one self-etch adhesives with or without surface sealant application.

MATERIALS AND METHODS

44 restorations were inserted in 11 patients who required Class I restorations in their molars. Each patient received 4 restorations, thus four groups were formed; (1) G-Aenial Bond (GC, Japan); (2) Clearfil S3 Bond (Kuraray, Japan); (3) G-Aenial Bond+Fortify Plus (Bisco, USA), (4) Clearfil S3 Bond+Fortify Plus. Sensitivity was evaluated at 24h, 7, 15, and 30 days using cold air, ice, and pressure stimuli using a visual analog scale. Comparisons of continuous variables between the sensitivity evaluations were performed using the Friedman's One-Way Analysis of Variance with repeated measures test (p<0.05).

RESULTS

The type of adhesive used and the application of a surface sealant had no significant effects in postoperative sensitivity (p>0.05). The use of Clearfil S3 Bond resulted in almost the same level of postoperative sensitivity as did the use of G-Aenial Bond. The highest sensitivity scores were observed for the surface sealant applied teeth without any statistical significance (p>0.05).

CONCLUSION

Self etch adhesives displayed postoperative sensitivity. The sensitivity scores slightly decreased at the end of 30 days (p>0.05). Surface sealant application did not result in a decrease in sensitivity scores for either dentin adhesives.

Effect of Thermocycling, Degree of Conversion, and Cavity Configuration on the Bonding Effectiveness of All-in-One Adhesives

The aim of this study was to compare five all-in-one bonding agents with respect to microleakage, microtensile bond strength (μTBS), degree of conversion (DC) and the impact of cavity configuration. The materials tested were Adper Easy Bond, Clearfil S3 Bond, iBond, Optibond All-in-One, Xeno IV, and Adper Single Bond Plus as a control. The DC of each adhesive was measured on the surfaces of dentin discs (n=5) by attenuated total reflectance Fourier transform infrared spectroscopy. One hundred and forty-four extracted human molars were randomly divided and assigned to one of the five tested adhesives and the control group. The μTBS to dentin was measured on flat occlusal dentin with and without thermocycling and to the gingival floor dentin of class II cavities (n=8). All specimens were restored with Filtek Z250 resin composite. Class II samples were immersed in a 5% methylene blue dye solution for 24 hours, and microleakage was examined under a stereomicroscope. Micromorphological analysis of demineralized/deproteinized specimens was done using scanning electron microscopy. The DC and microleakage data were statistically analyzed by one-way analysis of variance (ANOVA) and μTBS data by two-way ANOVA followed by a Bonferroni multiple comparison post hoc test (α=0.05) and Weibull-distribution survival analysis. The relation between different variables and μTBS and microleakage was tested by the Pearson correlation coefficient and regression statistics. A moderate direct relation between DC and μTBS durability was found for all the adhesives tested. Significant wide variations exist among the results obtained for single-bottle adhesives tested regarding their μTBS and microleakage. Some of the all-in-one materials tested have shown significantly inferior results under a high C-factor or after aging. The use of these materials should be carefully considered.

Effect of Phosphoric Acid Pre-etching on Fatigue Limits of Self-etching Adhesives

The purpose of this study was to use shear bond strength (SBS) and shear fatigue limit (SFL) testing to determine the effect of phosphoric acid pre-etching of enamel and dentin prior to application of self-etch adhesives for bonding resin composite to these substrates. Three self-etch adhesives—1) G- ænial Bond (GC Corporation, Tokyo, Japan); 2) OptiBond XTR (Kerr Corp, Orange, CA, USA); and 3) Scotchbond Universal (3M ESPE Dental Products, St Paul, MN, USA)—were used to bond Z100 Restorative resin composite to enamel and dentin surfaces. A stainless-steel metal ring with an inner diameter of 2.4 mm was used to bond the resin composite to flat-ground (4000 grit) tooth surfaces for determination of both SBS and SFL. Fifteen specimens each were used to determine initial SBS to human enamel/dentin, with and without pre-etching with a 35% phosphoric acid (Ultra-Etch, Ultradent Products Inc, South Jordan, UT, USA) for 15 seconds prior to the application of the adhesives. A staircase method of fatigue testing (25 specimens for each test) was then used to determine the SFL of resin composite bonded to enamel/dentin using a frequency of 10 Hz for 50,000 cycles or until failure occurred. A two-way analysis of variance and Tukey post hoc test were used for analysis of SBS data, and a modified t-test with Bonferroni correction was used for the SFL data. Scanning electron microscopy was used to examine the area of the bonded restorative/tooth interface. For all three adhesive systems, phosphoric acid pre-etching of enamel demonstrated significantly higher (p&lt;0.05) SBS and SFL with pre-etching than it did without pre-etching. The SBS and SFL of dentin bonds decreased with phosphoric acid pre-etching. The SBS and SFL of bonds using phosphoric acid prior to application of self-etching adhesives clearly demonstrated different tendencies between enamel and dentin. The effect of using phosphoric acid, prior to the application of the self-etching adhesives, on SBS and SFL was dependent on the adhesive material and tooth substrate and should be carefully considered in clinical situations.

Influence of double application technique on the bonding effectiveness of self-etch adhesive systems

AIM

To evaluate and compare the effect of double-application of single-step self-etch adhesives using microleakage study and to analyze the dentin-adhesive interfacial micromorphology.

METHODS

In total, 72 extracted human premolars were divided into three groups for different self-etch adhesives (G Bond, GC [GB], Optibond, Kerr [OB], and Xeno V Plus, Dentsply [XV]). Class V cavities were prepared. Each group was further divided into two subgroups (n = 10) according to the placement technique of the adhesive, using the single-application [subgroup (a)] or double-application method [subgroup (b)]. Resin composite (Z 250, 3M ESPE, St. Paul, MN) was used to restore the cavities and light cured for 40 s. Twenty samples from each group were subjected to microleakage study. Two samples from both the subgroups of the three adhesives were used for scanning electron microscopic examination of the resin-dentin interfacial ultrastructure. Dye leakage scores were subjected to statistical analysis using Kruskal-Wallis and Mann-Whitney U-tests at significance level of P < 0.05.

RESULTS

GB depicted significantly more microleakage which was significantly greater than OB and XV. The double application led to significant decrease in microleakage of GB with no significant effect on the microleakage scores of other two all-in-one adhesives, that is OB and XV.

CONCLUSION

Double application of all-in-one self-etch adhesives improves the marginal sealing ability in dentin although it appears to be product dependent.

Determination of molecular species of calcium salts of MDP produced through decalcification of enamel and dentin by MDP-based one-step adhesive

Enamel and dentin particles were added to an experimental 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based one-step adhesive to react for 30 s. After enamel and dentin reactants were analyzed using X-ray diffraction (XRD) and phosphorus-31 nuclear magnetic resonance ((31)P NMR) techniques, curve-fitting analysis was performed on the (31)P NMR spectra of enamel and dentin reactants. By varying the molar ratio of calcium chloride to MDP, a series of three types of MDP-Ca salts were synthesized. The molecular species of calcium salts of MDP (MDP-Ca salts) produced by decalcification of enamel or dentin were determined based on the XRD and (31)P NMR analysis results of these three types of synthesized MDP-Ca salts. Curve-fitting analysis showed that enamel and dentin developed several types of MDP-Ca salts and amorphous dicalcium phosphate dihydrate (DCPD) during decalcification. The molecular species of MDP-Ca salts produced by enamel and dentin were mono-calcium salts of MDP monomer and MDP dimer. In addition, dentin produced a di-calcium of MDP dimer.

Ultramorphological assessment of dentin-resin interface after use of simplified adhesives

This study assessed dentin-resin interface integration in Class I cavities restored with simplified adhesives by using a focused ion-beam milling (FIB) and transmission electron microscope (TEM). Class I cavities (1.5-mm depth with dentin thickness of ∼0.5 mm, 4-mm length, and 2-mm width) were prepared on freshly extracted, sound human molars. Two all-in-one adhesive systems (Scotchbond/Single Bond Universal [SUD] and Xeno-V(+) [X5D]) were used and compared with a two-step etch-and-rinse system (Prime&Bond NT [NTD]). The adhesives were applied according to the manufacturers' guidelines. A universal resin composite (Filtek Z350 XT Universal) was used to restore the cavities in one bulk filling and was irradiated at 550 mW/cm(2) for 40 seconds by a quartz-tungsten-halogen light (Optilux 501). After exposure to liquid nitrogen coolant, the specimens were milled to nanoscale thickness by FIB to view and then assess the area of dentin-resin interface by TEM. Unlike the unfilled X5D, a noticeably smooth transition zone at the dentin-resin interface was shown for the SUD and NTD adhesives. The SUD demonstrated an uneven hybrid layer with clearly demineralized collagen bundles. Ultramorphologically, dispersed needlelike apatite crystals were detected within the partially demineralized dentin or the hybrid layer of both compositionally different all-in-one simplified adhesives. Conversely, these crystals were entirely absent from the hybrid layer of the etch-and-rinse NTD adhesive. In the X5D group, a bright band was noted beneath the hybrid layer. The methacryloxydecyl dihydrogen phosphate monomer containing ultramild self-etch adhesive (SUD) was still validated in terms of its capability in dentin adhesion.

Effect of Double-layer Application on Dentin Bond Durability of One-step Self-etch Adhesives

Purpose

The aim of this in vitro study was 1) to analyze the influence of a double-layer application technique of four one-step self-etch adhesive systems on dentin and 2) to determine its effect on the stability of the adhesive interfaces stored under different conditions.

Materials and Methods

Four different one-step self-etch adhesives were selected for the study (iBondSE, Clearfil S3 Bond, XenoV+, and Scotchbond Universal). Adhesives were applied according to manufacturers' instructions or with a double-layer application technique (without light curing of the first layer). After bonding, resin-dentin specimens were sectioned for microtensile bond strength testing in accordance with the nontrimming technique and divided into 3 subgroups of storage: a) 24 hours (immediate bond strength, T0), b) six months (T6) in artificial saliva at 37°C, or c) five hours in 10 % NaOCl at room temperature. After storage, specimens were stressed to failure. Fracture mode was assessed under a light microscope.

Results

At T0, iBond SE showed a significant increase in microtensile bond strength when the double-application technique was applied. All adhesive systems showed reduced bond strengths after six months of storage in artificial saliva and after storage in 10% NaOCl for five hours; however at T6, iBond SE, Clearfil S3 Bond, and XenoV+ showed significantly higher microtensile bond strength results for the double-application technique compared with the single-application technique. Scotchbond Universal showed no difference between single- or double-application, irrespective of the storage conditions.

Conclusion

The results of this study show that improvements in bond strength of one-step self-etch adhesives by using the double-application technique are adhesive dependent.

The influence of air temperature for solvent evaporation on bonding of self-etch adhesives to dentin

Objective:

This study evaluated the effect of air temperature (warm or cold) for solvent evaporation on bonding and nanoleakage of self-etching adhesives to dentin.

Materials and Methods:

The adhesives Clearfil 3S Bond [S3], OptiBond All-In-One [OB], Adper SE Plus [AD], and Silorane adhesive [SI] were applied on dentin surfaces, and a warm (60 ± 2°C) or cold air (20 ± 1°C) was applied and light-cured. After water storage (24 h), the teeth were sectioned into sticks (0.8 mm²) and tested in tensile. Then, they were immersed in a 50% solution of silver nitrate, photo-developed and the nanoleakage observed in a scanning electron microscope. The bond strength and nanoleakage pattern were analyzed by two-way analysis of variance and post hoc Tukey's test (α =0.05).

Results:

Higher bond strength and lower silver nitrate uptake were observed for the adhesives under warm condition (P < 0.05). AD and SI showed better adhesive results than S3 and OB (P < 0.05).

Conclusion:

The use of a warm air was useful to improve the bonding and diminish the nanoleakage of adhesive systems to dentin.

Effects of Er:YAG laser on bond strength of self-etching adhesives to caries-affected dentin

The erbium:yttrium-aluminum-garnet (Er:YAG) laser may be effective the bond strength of adhesive systems on dentine surfaces, the chemical composition and aggressiveness of adhesive systems in clinical practice. The purpose of this study was to evaluate the effects of the Er:YAG laser system with the bonding ability of two different self-etching adhesives to caries-affected dentine in primary molars. Ninety mid-coronal flat dentine surfaces obtained from sound and caries-affected human primary dentine were treated with an Er:YAG laser or a bur. The prepared surfaces were restored with an adhesive system (Xeno V; Clearfil S³) and a compomer (Dyract Extra). The restored teeth were sectioned with a low-speed saw and 162 samples were obtained. The bond strength of the adhesive systems was tested using the micro-tensile test method. The data were statistically analyzed. A restored tooth in each group was processed for scanning electron microscopy evaluation. The values of the highest bond strength were obtained from the Clearfil S³-Er:YAG laser-sound dentine group in all groups. (24.57 ± 7.27 MPa) (P > 0.05). The values of the lowest bond strength were obtained from the Xeno V-Er:YAG laser-sound dentine group in all groups (11.01 ± 3.89 MPa). It was determined that the Clearfil S³ increased the bond strength on the surface applied with Er:YAG laser according to the Xeno V.

Development of MDP-based one-step self-etch adhesive--effect of additional 4-META on bonding performance

We designed three experimental 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based one-step (EX) adhesives consisting of MDP, urethane dimethacrylate, and triethylene glycol dimethacrylate adhesives with different water contents (98.4, 196.8, and 294.4 mg/g), and 4-methacryloyloxyethyl trimellitic anhydride (4-META) or 2-hydroxyethyl methacrylate (HEMA)-containing onestep adhesive. The effect of the amount of MDP-calcium (MDP-Ca) salt produced through demineralization of enamel and dentin on the bonding performance was examined. The efficacy of 4-META and HEMA was then discussed. When the amount of water in EX adhesive was increased, the production amount of MDP-Ca salt of enamel increased, but not the dentin. The enamel bond strength slightly increased with increasing the production amount of MDP-Ca salt, in contrast to the dentin. However, addition of 4-META in the EX adhesive (water content=98.4 mg/g) increased both bond strengths, although the production amounts of MDP-Ca salt significantly decreased. The 4-META enhances both bond strengths more effectively than the HEMA.

Effect of the application time of phosphoric acid and self-etch adhesive systems to sclerotic dentin

Objectives:

To evaluate the effect of application time on the resin-dentin bond strength (µTBS) and etching pattern of adhesive systems applied on sclerotic dentine.

Material and Methods:

A total of forty-two bovine incisors had their roots removed. The 1-step self-etch GO (SDI), the 2-step self-etch Adper SE Bond (3MESPE) and the 35% phosphoric acid (3MESPE) from the 2-step etch-and-rinse Adper Single Bond 2 (3MESPE) were applied on the bovine incisal surfaces according to the manufacturer's instructions or duplicating the recommended conditioning time. After adhesive application, thirty teeth were restored with composite resin, stored for 24 h in distilled water at 37º C, and sectioned into resin-dentin bonded sticks (0.8 mm²⁾ and tested according to the µTBS at 0.5 mm/min. The etching pattern of the remaining twelve teeth (n=4 for each material) was examined under scanning electron microscopy. Each tooth was divided into a buccal-to-lingual direction into three thirds, and each third randomly assigned to the groups: control (no treatment), according to the manufacturers' instructions and duplicating the recommended application time. The µTBS and the relative percentage of the tubule area opening were evaluated by two-way repeated measures ANOVA and Tukey's tests (α=0.05).

Results:

The duplication of the conditioning time favored only the GO adhesive (p<0.05). Both application methods significantly increased the tubule area opening (p<0.05) compared to the controls.

Conclusions:

The efficacy of duplicating the conditioning time was only effective for the 1-step self-etch adhesive system tested.

Effect of changes to the manufacturer application techniques on the shear bond strength of simplified dental adhesives

PURPOSE

The aim of this work was to assess the shear bond strength (SBS) between a composite resin and dentin, promoted by two dental adhesive systems (one-step self-etching adhesive Easy Bond [3M ESPE], and two-step etch-and-rinse adhesive Scotchbond 1XT [3M ESPE]) with different application protocols (per manufacturer's instruction (control group); with one to four additional adhesive layers; or with an extra hydrophobic adhesive layer).

METHODS

Proximal enamel was removed from ninety caries-free human molars to obtain two dentin discs per tooth, which were randomly assigned to twelve experimental groups (n=15). After adhesion protocol, the composite resin (Filtek Z250 [3M ESPE]) was applied. Specimens were mounted in the Watanabe test device and shear bond test was performed in a universal testing machine with a crosshead speed of 5 mm/min. Data were analyzed with ANOVA followed by Student-Newman-Keuls tests (P<0.05).

RESULTS

The highest SBS mean value was attained with the Easy Bond three layers group (41.23±2.71 MPa) and the lowest with Scotchbond 1XT per manufacturer's instructions (27.15±2.99 MPa). Easy Bond yielded higher SBS values than Scotchbond 1XT. There were no statistically significant differences (P>0.05) between the application protocols tested, except for the three and four layers groups, that presented higher SBS results compared to manufacturer's instruction groups (P<0.05). No statistically significant differences were detected between the three and four layers groups (P≥0.05).

CONCLUSION

It is recommendable to apply three adhesive layers when using Easy Bond and Scotchbond 1XT adhesives, since it improves SBS values without consuming much time.

Effect of sonic application mode on the resin-dentin bond strength and nanoleakage of simplified self-etch adhesive

OBJECTIVES

This study aims to evaluate the effect of different application modes on the immediate and 6-month resin-dentin bond strength (μTBS) and nanoleakage in the hybrid and adhesive layers.

MATERIALS AND METHODS

Three 1-step self-etch adhesives (One Coat 7.0 (OC), Clearfil S(3) Bond (CS), and FuturaBond NR (FB)) were applied on a flat superficial dentin surface of 30 human molars under manual mode or sonic vibration at a frequency of 170 Hz (SV). Composite build-ups were constructed incrementally; specimens were sectioned to obtain resin-dentin sticks with cross-sectional area of 0.8 mm(2) and tested in tension (0.5 mm/min) immediately (IM) or after 6 months (6M) of water storage. Two bonded sticks, from each tooth at each storage time, were immersed in a silver nitrate solution, photo-developed, and analyzed under scanning electron microscopy. The amount of nanoleakage was measured using the ImageTool 3.0 software. Data, from each adhesive, were analyzed by two-way ANOVA and Tukey's test (α = 0.05).

RESULTS

OC and CS showed higher μTBS and lower nanoleakage in the IM period when applied with SV groups. For FB, no significant difference was observed between the two modes of application. All materials showed lower nanoleakage in the SV groups. Higher nanoleakage was observed after 6M for OC and FB.

CONCLUSIONS

The sonic application mode at an oscillating frequency of 170 Hz can improve the resin-dentin μTBS, reduce the nanoleakage, and retard the degradation of the resin-dentin μTBS of Clearfil S(3) Bond and One Coat 7.0 adhesives.

CLINICAL SIGNIFICANCE

Sonic application mode at an oscillating frequency of 170 Hz can be helpful and easy to use in dental practice to guaranty long-lasting restorations.

Influence of adhesive application methods and rebonding agent application on sealing effectiveness of all-in-one self-etching adhesives

STATEMENT OF PROBLEM

The choice of adhesive application methods could affect the microleakage of self-etch adhesives.

PURPOSE

To evaluate the effect of acid-etching, doubling adhesive application time, doubling adhesive coating, and rebonding agent application on microleakage of self-etch adhesives in Class V cavities.

MATERIALS AND METHODS

Seventy human third molars with Class V cavities assigned to five groups according to different adhesive application protocols for the three dentin adhesives (Clearfil S3 Bond, Kuraray Medical, Okayama, Japan; Optibond All-in-One, Kerr Corporation Orange, CA, USA; G-Aenial Bond, GC Corporation, Tokyo, Japan): group 1, manufacturer's recommendations; group 2, prior acid-etching of cavities; group 3, double application time; group 4, two consecutive coats of the adhesives; group 5, rebonding application on restoration margins. After bonding, the cavities were filled with a resin composite (Filtek Supreme XT, 3M ESPE Dental Products, St. Paul, MN, USA). The teeth were thermocycled, and the specimens were examined for microleakage using methylene blue as a marker.

RESULTS

For Clearfil S3 Bond and Optibond All-in-One, microleakage in groups 2 and 5 were significantly lower than other groups' enamel margins. In groups 1, 2, 4, and 5, Clearfil S3 Bond exhibited significantly more leakage than the other dentin bonding agents in dentin margins. Microleakage was significantly higher on dentinal margins compared with the enamel margins for Clearfil S3 Bond in all of the groups. Optibond All-in-One showed significantly lower microleakage in dentin margins in all groups except groups 2 and 5.

CONCLUSION

Acid-etching usually promoted the reduction of microleakage in enamel margins. On the other hand, rebonding application usually contributed to the reduction of microleakage more than other methods in enamel and dentin margins.

CLINICAL RELEVANCE

Acid-etching or rebonding application may contribute to reduction of microleakage of all-in-one self-etching adhesives.

Two-year Clinical Performance of Self-etching Adhesive Systems in Composite Restorations of Anterior Teeth

Objective

The aim of this study was to evaluate the two-year clinical performance of Class III, IV, and V composite restorations using a two-step etch-and-rinse adhesive system (2-ERA) and three one-step self-etching adhesive systems (1-SEAs).

Material and Methods

Two hundred Class III, IV, and V composite restorations were placed into 50 patients. Each patient received four composite restorations (Amaris, Voco), and these restorations were bonded with one of three 1-SEAs (Futurabond M, Voco; Clearfil S3 Bond, Kuraray; and Optibond All-in-One, Kerr) or one 2-ERA (Adper Single Bond 2/3M ESPE). The four adhesive systems were evaluated at baseline and after 24 months using the following criteria: restoration retention, marginal integrity, marginal discoloration, caries occurrence, postoperative sensitivity and preservation of tooth vitality. After two years, 162 restorations were evaluated in 41 patients. Data were analyzed using the χ2 test (p&lt;0.05).

Results

There were no statistically significant differences between the 2-ERA and the 1-SEAs regarding the evaluated parameters (p&gt;0.05).

Conclusion

The 1-SEAs showed good clinical performance at the end of 24 months.

Effect of Artificial Aging and Surface Treatment on Bond Strengths to Dental Zirconia

The objective of this project was to study the influence of artificial aging and surface treatment on the microtensile bond strengths (μTBS) between zirconia and a phosphate monomer–based self-adhesive cement. Thirty zirconia disks (IPS e.max ZirCAD, Ivoclar Vivadent) were randomly assigned to two aging regimens: AR, used as received, which served as a control, and AG, artificial aging to simulate low-temperature degradation. Subsequently, the disks of each aging regimen were assigned to three surface treatments: NT, no surface treatment; CO, surface silicatization with CoJet sand (3M ESPE); and ZP, zirconia surface treated with Z-Prime Plus (Bisco Inc). Thirty discs were made of Filtek Z250 (3M ESPE) composite resin and luted to the zirconia discs using RelyX Unicem (3M ESPE). The specimens were sectioned with a diamond blade in X and Y directions to obtain bonded beams with a cross-section of 1.0 ± 0.2 mm. The beams were tested in tensile mode in a universal testing machine at a speed of 0.5 mm/min to measure μTBS. Selected beams were selected for fractographic analysis under the SEM. Statistical analysis was carried out with two-way analysis of variance and Dunnett T3 post hoc test at a significance level of 95%. The mean μTBS for the three AR subgroups (AR-NT, AR-CO, and AR-ZP) were significantly higher than those of the corresponding AG groups (p&lt;0.0001). Both AR-CO and AR-ZP resulted in statistically significant higher mean bond strengths than the group AR-NT (p&lt;0.006 and p&lt;0.0001, respectively). Both AG-CO and AG-ZP resulted in statistically significant higher mean bond strengths than the group AG-NT (both at p&lt;0.0001). Overall, AG decreased mean μTBS. Under the SEM, mixed failures showed residual cement attached to the zirconia side of the beams. CO resulted in a characteristic roughness of the zirconia surface. AR-ZP was the only group for which the amount of residual cement occupied at least 50% of the interface in mixed failures.

Microleakage of Er:YAG laser and dental bur prepared cavities in primary teeth restored with different adhesive restorative materials

The purpose of this study was to evaluate and compare the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation and conventional dental bur cavity preparation on in vitro microleakage of class V cavities restored with different adhesive restorative materials and two types of self-etching adhesives in primary teeth. Standard class V cavities were prepared on 80 extracted primary, and the teeth were randomly divided into eight subgroups prepared either by dental bur or Er:YAG laser irradiation and then restored with self-cured glass ionomer (GI), resin-modified glass ionomer (RMGI), resin composite and Clearfil SE Bond (two-step self-etching adhesive), and resin composite and Clearfil S3 Bond (one-step self-etching adhesive). Restorations were finished and stored in distilled water at 37 °C for 24 h and then subjected to thermocycling. All the teeth were sealed with nail varnish, placed in a silver nitrate solution, and then vertically cut in a buccolingually direction. Subsequently, the specimens were evaluated for gingival and occlusal microleakage using a stereomicroscope. Data were analyzed using Kruskal-Wallis test followed by Mann-Whitney test. Wilcoxon test was used for comparing occlusal microleakage with gingival microleakage at p < 0.05. A higher degree of occlusal and gingival microleakage values for the teeth restored with GI or RMGI was obtained by both preparation methods compared with that of resin composites and the two self-etching primers. Er:YAG laser irradiation resulted in a significantly higher degree of microleakage only at the gingival margins for teeth restored with GI or RMGI, or composite and Clearfil S3 Bond compared with the bur preparation. The Er:YAG laser-prepared teeth restored with composite and Clearfil SE Bond demonstrated a better marginal seal on occlusal and gingival margins compared with that of bur-prepared cavities. The degree of microleakage in class V cavities was affected by the type of adhesive restorative materials, type of self-etching adhesive, cavity margin location, and tooth preparation method either by Er:YAG laser or dental bur.

In vitro permeability of etch-and-rinse and self-etch adhesives used for immediate dentin sealing

To investigate the permeability of deep dentin following immediate sealing with different etch-and-rinse and self-etch adhesives (Single Bond 2, Adper Prompt L-Pop, Clearfil Protect Bond, Clearfil S3 Bond, G-Bond) and a dentin desensitizer (Gluma). Fluid-transport model was used to measure fluid conductance during and after application of adhesives. Polyvinylsiloxane impressions of bonded dentin were taken to monitor fluid transudation from the surface of the adhesives. The area and number of dentinal fluid droplets and/or blisters were calculated using image analysis. None of the adhesives were able to block fluid conductance completely. The fluid conductance values of the adhesives displayed the following statistical ranking (p<0.05): G-Bond≤Clearfil Protect Bond<Smear-layer-covered dentin<S3 Bond≤Single Bond 2≤Adper Prompt L-Pop<Gluma Desensitizer<Acid-etched dentin. Highly significant correlation was observed between the permeability of the tested adhesives and the area fraction of fluid droplets/blisters on the adhesive surfaces (r=0.99, p<0.01).