Shear bond strength of one etch-and-rinse and five self-etching dental adhesives when used by six operators

Effect of sodium hypochlorite, ethylenediaminetetraacetic acid, and dual-rinse irrigation on dentin adhesion using an etch-and-rinse or self-etch approach

The aim was to investigate the influence of endodontic irrigation solutions and protocols on the micro-tensile bond strength (μTBS) to dentin using an etch-and-rinse (ER) or self-etch (SE) adhesive approach. Eighty extracted human molars were ground to dentin. After pretreating for 27 min (21 min-3 min-3 min) with five different endodontic irrigation protocols (Group 1: NaOCl-EDTA-NaOCl; Group 2: NaOCl-NaOCl-EDTA; Group 3: NaOCl-NaCl-NaOCl; Group 4: Dual Rinse-Dual Rinse-Dual Rinse; Group 5: NaCl-NaCl-NaCl), an ER (Optibond FL, Kerr) or a SE (Clearfil SE Bond, Kuraray) adhesive system was applied. After light-curing, composite build-ups were made and cut into dentin-composite sticks. μTBS and failure modes were analyzed. Nonparametric statistical analyses (α = 0.05) were performed for comparison of the five groups within each type of adhesive as well as between the two adhesive systems used. The use of an ER instead of a SE adhesive system resulted in significantly higher μTBS for all irrigation protocols except for group 1 (NaOCl-EDTA-NaOCl) and 2 (NaOCl-NaOCl-EDTA). A statistical difference between the five different endodontic irrigation protocols was only found within the SE adhesive group, where group 1 (NaOCl-EDTA-NaOCl) achieved highest values. The use of an ER adhesive system cancels out the effect of the endodontic irrigation solution. The highest μTBS was achieved when using a NaOCl-EDTA-NaOCl-irrigation protocol in combination with Clearfil SE Bond, which shows that the selection of the endodontic irrigation should match the corresponding SE adhesive system.

In-Vitro Evaluation of Dental Adhesive Bond Strength With Diode Laser Irradiation Before Photopolymerization

AIM

In-vitro evaluation of shear bond strength, mode of failure, and adaptation of fifth-generation (etch-and-rinse), seventh-generation,and eighth-generation self-etch dental adhesives to human dentin with or without diode-laser irradiation before photopolymerization.

MATERIALS AND METHODS

Seventy-two extracted human maxillary premolar teeth were collected. The buccal and lingual surfaces of teeth were grounded until dentin was exposed. Test areas of 4 mm diameter were created on both surfaces of teeth to standardize the area of treatment. The samples were then randomly allocated into three groups (n = 24): Group 1 Adper Single Bond 2 Etch-and-Rinse; Group 2 Tetric-N-Bond Universal Self-Etch; Group 3 Prime and Bond Universal Self-Etch dental adhesives were used. Buccal surfaces (sub-groups 'a') of all specimens were irradiated with diode laser before photopolymerization of the adhesive material, and palatal surfaces (sub-groups 'b') were directly photopolymerized without prior diode laser irradiation and restored with composite resin. All specimens were thermocycled. Four specimens from each group were then subjected to scanning electron microscopy (SEM) analysis to examine the adaptation of adhesive to dentin, and the remaining 60 specimens were evaluated for shear bond strength tests, modes of failure at the adhesive-dentin interface, and values were recorded, tabulated, and used for data analysis. A one-way ANOVA test and the Student's t-test were used for statistical analysis. A P value ≤ 0.05 was considered statistically significant.

RESULTS

The mean shear bond strength for the groups was: Group 1a (13.96 MPa), 1b (14.95 MPa); Group 2a (10.06 MPa), 2b (10.30 MPa); Group 3a (12.03 MPa), and 3b (10.44 MPa). No statistically significant difference was seen among sub-groups 1a and 3a, 2a and 3a, 2b and 3b as P > 0.05. A significant difference was seen among sub-groups 1b and 3b (P<0.05), 1a and 2a, and 1b and 2b (P<0.01).

CONCLUSION

Adper Single Bond 2 without diode-laser irradiation before photopolymerization showed the highest shear bond strength, followed by Adper Single Bond 2 irradiated with diode laser before photopolymerization, with the maximum adaptation of dental adhesive to dentin compared to other adhesives used either with or without diode-laser irradiation.

Effect of Dentin-Disinfection Chemicals on Shear Bond Strength and Microhardness of Resin-Infiltrated Human Dentin in Different Adhesive Protocols

Background and Objectives: Bacteria and its remnants beneath the restorations predispose the tooth to secondary caries and pulpal pathology. Hence, various chemical antibacterial agents are suggested to disinfect the prepared tooth structure before the definitive restorative procedure. This study aimed to investigate the effects of chemical disinfectant solutions on the micro-shear bond strength (µSBS) and microhardness of total-etch and self-etch resin-infiltrated human dentin. Materials and Methods: 100 caries-free intact permanent third molar teeth were vertically sectioned into the buccal and lingual half. All these specimens were mounted on acrylic resin and underlying dentin surfaces were exposed by grinding. Samples were randomly divided into five groups [n = 20] following total-etch and self-etch adhesive protocol. Teeth samples were divided according to surface treatment, as Group I (Control-CNT), Group II (2% chlorhexidine-CHX), Group III (5.25% sodium hypochlorite-NaOCl), Group IV (17% ethylenediaminetetraacetate acid—EDTA) and Group V (10% povidone iodine-PVI). A randomly selected 10 samples from each subgroup were used for µSBS and microhardness tests. After surface treatment and bonding procedure, nono-hybrid composite cylinders with a 3-mm diameter and 2-mm height were directly cured over the dentin substrate. The samples for µSBS were subjected to 5000 thermocycles and tested using a universal testing machine. Microhardness was assessed using a micro-indenter instrument, data were statistically analyzed using a one-way analysis of variance and Tukey HSD tests at p < 0.05. Results: Amongst the chemical disinfectant assessed, 2% CHX did not affect µSBS and produced a marginal reduction in dentin microhardness compared to the control group. The 5.25% NaOCl and 17% EDTA significantly compromised the microhardness of the dentin substrate. Meanwhile, 10% PVI surface treatment resulted in a substantial reduction in µSBS between composite and dentin. Conclusions: CHX with preservation of bonding to dentin and insignificant negative effect on dentin microhardness is a safe option for tooth disinfection.

Is the presence of 10-MDP associated to higher bonding performance for self-etching adhesive systems? A meta-analysis of in vitro studies

OBJECTIVE

The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other acidic functional monomers, comparing the bonding performance of both compositions.

METHODS

This study is registered in PROSPERO (CRD42020175715) and it followed the PRISMA Statement. The literature search was performed in PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO from the starting coverage date through 30 June 2021. Study eligibility criteria consisted of in vitro studies that evaluated the bond strength (microtensile, microshear, tensile or shear testing) to sound dentin/enamel of a minimum of two distinct SE systems, with at least one material containing 10-MDP and one other being comprised of a distinct acidic composition. Statistical analyses were carried out with RevMan 5.3.5 and using random-effects models with the significance level at p < 0.05. Also, Bayesian network meta-analysis (NMA) was conducted using MetaInsight V3 tool.

RESULTS

From 740 relevant studies evaluated in full-text analysis, 210 were incorporated to the systematic review and 206 in meta-analysis. The majority of studies was classified as having medium risk of bias (56.7%), followed by low (35.2%) and high (8.1%) risk of bias. Data from a total of 64 adhesive systems were collected, which favored the 10-MDP-based group at both dentin (overall effect: 6.98; 95% CI: 5.61, 8.36; p < 0.00001) and enamel (overall effect: 2.79; 95% CI: 1.62, 3.96; p < 0.00001) substrates. Microtensile testing was more frequently used (73.4%) in the included studies. Adhesives based on 10-MDP showed greater bonding performance than adhesives comprised of monomers such as PENTA, 6-MHP, 4-META, 4-MET, pyrophosphate esters, mixed composition or monomers derived from sulfonic acid (p ≤ 0.01); whereas similar bond strength values were verified between 10-MDP-based materials and those containing PEM-F, acrylamide phosphates, 4-AET, MAC-10, or monomers derived from polyacrylic and phosphonic acids (p ≥ 0.05). Adhesives based on GPDM were the only ones that resulted in greater bonding potential than the 10-MDP-based group (p = 0.03). Dental bonds in dentin were favored with the application of 2-step 10-MDP-based adhesives; whereas in enamel the dental bonds were favored for both 2-steps versions of adhesives, regardless of the presence of 10-MDP. Indirect evidence from NMA revealed that 1-step 10-MDP-free and universal 10-MDP-free adhesives seemed to perform worst in dentin and enamel, respectively.

SIGNIFICANCE

Adhesives containing 10-MDP showed higher bonding performance than materials formulated with other acidic ingredients, although this result relied on the type of mechanical testing, type of the substrate, acidic composition of the adhesive, and the application category of the SE system. This review summarized the effects of the foregoing factors on the adhesion to dental substrates.

Influence of self-etch all-in-one adhesives on fissure sealant shear bond strength under contaminated enamel conditions

AIM

To determine the influence of two all-in-one self-etching adhesive systems on shear bond strength of a fissure sealant applied under different enamel surface conditions.

METHODS

A total of 180 bovine enamel specimens were randomly distributed to nine experimental groups, defined by the combination of the sealant application technique (using phosphoric acid, or a self-etching water-based adhesive or a self-etching ethanol and water-based adhesive) and enamel surface conditions (dry enamel, saliva or water contaminated enamel). The specimens were submitted to thermocycling prior to the shear bond strength test.

RESULTS

High shear bond strength mean values were obtained with the classic technique for dry enamel (31.47 MPa), statistically similar values were obtained when the sealant was combined with a self-etching water-based adhesive, in dry enamel (32.36 MPa), and when the sealant was combined with a self-etching water-based adhesive in water contaminated enamel (32.62 MPa). Under enamel salivary contamination, the best results were achieved using a water-based adhesive (24.78 MPa).

CONCLUSIONS

In saliva contaminated enamel, the combination of a sealant with a water-based self-etching adhesive can maintain high and satisfactory values of bond strength.

Analysis of pre-test failures and bond-strengths of seven adhesive systems to bovine dentine: A nine-year novice/beginner operator study

OBJECTIVE

The aims were to evaluate, via multi-year student cohorts: (i) the incidence of pre-test failures and (ii) shear bond strengths of single- and multi-step adhesives to bovine dentin.

METHODS

The experiments were performed by cohorts of dental students (2008-2016). Each year the bond strengths of three dental adhesives to bovine dentin were tested. Four self-etching adhesives (Optibond-All-in-One, [OBAIO]; Optibond XTR [OBXTR]); Xeno V [XV]; Xeno V+ [XV+]; a three-step etch-and-rinse-system (Optibond FL, [OBFL]), a self-etch universal adhesive (Scotchbond Universal [SBU]) and a self-etch/etch-and-rinse adhesive (Xeno Select, [XS]) were included in the study. Composite-cylinders were bonded perpendicularly to prepared bovine dentin surfaces. Shear-tests were performed with a universal-testing-machine.

RESULTS

Both overall, and within years, XV and XV+ showed significantly (p<0.01) higher percentages of pre-test failures versus other adhesive systems tested in the period 2008-2014 (OAIO, OBFL, OBXTR). Fewest pre-test failures were observed for OBFL, OBXTR and SBU. Trends in mean bond strengths and Weibull distributions were noted, per adhesive, with trends in the incidence of pre-test failures. Pre-test-failures and bond strengths depended on the air-drying technique. The adhesive systems showed variable technique sensitivity. Multistep bonding systems (Optibond FL and Optibond XTR) showed minimal pre-test failures and high bond strength applied by relatively inexperienced operators and irrespective of the applied air-drying technique. However, two single-step adhesives (OAIO and SBU) showed comparable results to the multi-step systems.

SIGNIFICANCE

The clinical need for rapid application dentine adhesives can result in varied outcomes with relatively inexperienced operators. These outcomes include both the incidence of pre-test failures as well as the distributions of shear bond strengths achieved, although these measures appear to be related. However, both outcomes are dependent upon the adhesive products utilised and especially upon the applied air pressure (flow rate). Some rapid application systems appear to perform comparably with well-established multi-step adhesives.

Bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin irradiated with a novel CO2 9.3 μm short-pulsed laser for dental restorative procedures

The objective of this study was to evaluate the influence of CO₂ 9.3 μm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO₂ 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa).

Enamel Wetness Effects on Microshear Bond Strength of Different Bonding Agents (Adhesive Systems): An in vitro Comparative Evaluation Study

AIMS

The purpose of this study was to compare the effect of enamel wetness on microshear bond strength using different adhesive systems.

OBJECTIVES

To evaluate microshear bond strength of three bonding agents on dry enamel; to evaluate microshear bond strength of three bonding agents on wet enamel; and to compare microshear bond strength of three different bonding agents on dry and wet enamel.

MATERIALS AND METHODS

Sixty extracted noncarious human premolars were selected for this study. Flat enamel surfaces of approximately 3 mm were obtained by grinding the buccal surfaces of premolars with water-cooled diamond disks. This study evaluated one etch-and-rinse adhesive system (Single Bond 2) and two self-etching adhesive systems (Clearfil SE Bond and Xeno-V). The specimens were divided into two groups (n = 30). Group I (dry) was air-dried for 30 seconds and in group II (wet) surfaces were blotted with absorbent paper to remove excess water. These groups were further divided into six subgroups (n = 10) according to the adhesives used. The resin composite, Filtek Z 250, was bonded to flat enamel surfaces that had been treated with one of the adhesives, following the manufacturer's instructions. After being stored in water at 37°C for 24 hours, bonded specimens were stressed in universal testing machine (Fig. 3) at a crosshead speed of 1 mm/min. The data were evaluated with one-way and two-way analysis of variance (ANOVA), t-test, and Tukey's Multiple Post hoc tests (a = 0.05).

RESULTS

The two-way ANOVA and Tukey's Multiple Post hoc tests showed significant differences among adhesive systems, but wetness did not influence microshear bond strength (p = 0.1762). The one-way ANOVA and t-test showed that the all-in-one adhesive (Xeno-V) was the only material influenced by the presence of water on the enamel surface. Xeno-V showed significantly higher microshear bond strength when the enamel was kept wet. Single Bond 2 adhesive showed significantly higher microshear bond strength as compared with Xeno-V adhesive but no significant difference when compared with Clearfil SE Bond adhesive in dry enamel. Single Bond 2 adhesive showed no significant difference in microshear bond strength as compared with self-etching adhesive systems (Clearfil SE Bond and Xeno-V), when the enamel was kept wet.

CONCLUSION

From the findings of the results, it was concluded that self-etching adhesives were not negatively affected by the presence of water on the enamel surface.

CLINICAL SIGNIFICANCE

The all-in-one adhesive showed different behavior depending on whether the enamel surface was dry or wet. So the enamel surface should not be desiccated, when self-etching adhesives are used.

Bond strength tests of dental adhesive systems and their correlation with clinical results - A meta-analysis

OBJECTIVE

To evaluate the variability of bond strength test results of adhesive systems (AS) and to correlate the results with clinical parameters of clinical studies investigating cervical restorations.

MATERIALS AND METHODS

Regarding the clinical studies, the internal database which had previously been used for a meta-analysis on cervical restorations was updated with clinical studies published between 2008 and 2012 by searching the PubMed and SCOPUS databases. PubMed and the International Association for Dental Research abstracts online were searched for laboratory studies on microtensile, macrotensile and macroshear bond strength tests. The inclusion criteria were (1) dentin, (2) testing of at least four adhesive systems, (3) same diameter of composite and (4) 24h of water storage prior to testing. The clinical outcome variables were retention loss, marginal discoloration, detectable margins, and a clinical index comprising the three parameters by weighing them. Linear mixed models which included a random study effect were calculated for both, the laboratory and the clinical studies. The variability was assessed by calculating a ratio of variances, dividing the variance among the estimated bonding effects obtained in the linear mixed models by the sum of all variance components estimated in these models.

RESULTS

Thirty-two laboratory studies fulfilled the inclusion criteria comprising 183 experiments. Of those, 86 used the microtensile test evaluating 22 adhesive systems (AS). Twenty-seven used the macrotensile test with 17 AS, and 70 used the macroshear test with 24 AS. For 28 AS the results from clinical studies were available. Microtensile and macrotensile (Spearman rho=0.66, p=0.007) were moderately correlated and also microtensile and macroshear (Spearman rho=0.51, p=0.03) but not macroshear and macrotensile (Spearman rho=0.34, p=0.22). The effect of the adhesive system was significant for microtensile and macroshear (p < 0.001) but not for macrotensile. The effect of the adhesive system could explain 36% of the variability of the microtensile test, 27% of the macrotensile and 33% of the macroshear test. For the clinical trials, about 49% of the variability of retained restorations could be explained by the adhesive system. With respect to the correlation between bond strength tests and clinical parameters, only a moderate correlation between micro- and macrotensile test results and marginal discoloration was demonstrated. However, no correlation between these tests and a retention loss or marginal integrity was shown. The correlation improved when more studies were included compared to assessing only one study.

SIGNIFICANCE

The high variability of bond strength test results highlights the need to establish individual acceptance levels for a given test institute. The weak correlation of bond-strength test results with clinical parameters leads to the conclusion that one should not rely solely on bond strength tests to predict the clinical performance of an adhesive system but one should conduct other laboratory tests like tests on the marginal adaptation of fillings in extracted teeth and the retention loss of restorations in non-retentive cavities after artificial aging.

Effect of moisture and drying time on the bond strength of the one-step self-etching adhesive system

Objectives

To investigate the effect of dentin moisture degree and air-drying time on dentin-bond strength of two different one-step self-etching adhesive systems.

Materials and Methods

Twenty-four human third molars were used for microtensile bond strength testing of G-Bond and Clearfil S³ Bond. The dentin surface was either blot-dried or air-dried before applying these adhesive agents. After application of the adhesive agent, three different air drying times were evaluated: 1, 5, and 10 sec. Composite resin was build up to 4 mm thickness and light cured for 40 sec with 2 separate layers. Then the tooth was sectioned and trimmed to measure the microtensile bond strength using a universal testing machine. The measured bond strengths were analyzed with three-way ANOVA and regression analysis was done (p = 0.05).

Results

All three factors, materials, dentin wetness and air drying time, showed significant effect on the microtensile bond strength. Clearfil S³ Bond, dry dentin surface and 10 sec air drying time showed higher bond strength.

Conclusions

Within the limitation of this experiment, air drying time after the application of the one-step self-etching adhesive agent was the most significant factor affecting the bond strength, followed by the material difference and dentin moisture before applying the adhesive agent.

Enamel wetness effects on bond strength using different adhesive systems

OBJECTIVE

To evaluate, through the application of different dentin bonding systems, the influence of wetness on shear bond strength in enamel.

METHODS

This study evaluated three etch-and-rinse adhesive systems (Scotchbond MP [used with and without primer]; Singlebond; and Prime&Bond 2.1) and two self-etching adhesive systems (Clearfil SE Bond; and Xeno IV). Flat bovine enamel surfaces were either air-dried for 30 seconds or blotted with absorbent paper after acid-etching for the conventional bonding agents or before the application of self-etching bonding agents. The resin composite EsthetX was bonded to flat surfaces that had been treated with one of the adhesives, following the manufacturer's instructions. After being stored in water at 37°C for one week, bonded specimens were broken in shear. Data were evaluated with two-way analysis of variance (ANOVA) and Student-Newman-Keuls tests (α=0.05). For comparing each condition individually, regardless of the adhesive or wetness condition, a one-way ANOVA and a Student-Newman-Keuls test (α=0.05) were applied.

RESULTS

The two-way ANOVA showed significant differences among adhesive systems. An interaction effect was also observed (p<0.05), but wetness did not influence shear bond strength (p=0.98). The one-way ANOVA showed that the all-in-one adhesive was the only material influenced by the presence of water at the enamel's surface.

CONCLUSION

The all-in-one adhesive behaved differently depending on whether the enamel surface was dry or wet.

Comparison of shear bonding strength for two different etching systems in canine and human dentin

Canine dentin has increased size and number of dentinal tubules compared to human dentin. With less intertubular surface area for bonding to composite material in dog teeth, bonding shear strength may be affected negatively. This study was designed to compare the shear bonding strength of canine and human dentin. It also compared bond strength of two different acid etch systems when used with the same composite resin. The shear bond strength of composite cylinders to dentin was measured in 30 extracted canine cuspid teeth and a similar number of human molar teeth. Shear bond strength was 40% greater for human compared with canine dentin. This significantly different (P < 0.05) result validates the hypothesis that dentin bond strength is positively correlated with the area of intertubular dentin. Results also indicated that shear bond strength was greater in the self-etching bond system compared with the etch and rinse system, although this difference was not significant.

Effect of dentine smear layer on the performance of self-etching adhesive systems: A micro-tensile bond strength study

This study aimed to evaluate the effect of the smear layer on the micro-tensile bond strength when two self-etching adhesives were used with different techniques. Flat dentine surfaces were prepared using either medium grit diamond burs or tungsten carbide burs. Ten specimens from each prepared surfaces were subjected for smear layer evaluation under SEM. Forty specimens from each of the prepared surfaces were further divided into two groups, bonded with either Clearfil SE Bond (SE) or Clearfil S(3) Bond (S3) using one of four applications (as manufacturer's instructions, agitation, reapplication, and increased application time), restored with composites and subjected to a micro-tensile bond strength test. Smear layers created with diamond burs were thicker than those created with tungsten carbide burs. Surfaces prepared with tungsten carbide burs produced a higher bond strength than those prepared with diamond burs and the same type of adhesive resin. SE demonstrated a higher bond strength than S3 for all surfaces. S3 applied with the agitation technique demonstrated a higher bond strength to dentine prepared with tungsten carbide and diamond burs than that applied with other techniques. SE applied with increased time on dentine treated with carbide burs produced the highest bond strength. In conclusion, a thick smear layer decreased bond strength to dentine, and this might be improved by modification of application technique.

Effect of Saliva Contamination and Decontamination on Bovine Enamel Bond Strength of Four Self-etching Adhesives

Salivary contamination before and after priming could significantly reduce the enamel bond strength of self-etching adhesives. Proper isolation should be performed before and during application of the adhesives and placement of the resin composite. Thorough water-spraying could significantly improve the μTBS of saliva-contaminated enamel.