Optical Evaluation of Enamel Microleakage with One-Step Self-Etch Adhesives

Effect of the prism-interprisms three-dimension spatial microstructure on the enamel bond strength

The prism-interprisms level of the enamel hierarchical microstructure is the largest degree of structural variation and most sophisticated structural adaptation. We studied the effect of the prism-interprisms three-dimension spatial microstructure on the enamel bond strength. We prepared 11 groups of enamel segments: longitudinally sectioned segments with or without a 45-degree bevel (group = 2), horizontally sectioned segments with or without a 45-degree bevel of three regions (the incisal, middle, and cervical) (group = 6), and tangential (labial) sectioned segments of three regions (the incisal, middle, and cervical) (group = 3). The finished surface of each segment was observed by scanning electric microscopy (SEM) before treatment with four self-etch adhesive systems and applied with four corresponding composite resins. Resin-bonded enamel samples were prepared in beams for microtensile bond strength (MTBS) tests. The results were analyzed with a three-way ANOVA followed by Tukey's post-hoc HSD multiple comparisons procedure. SEM observations revealed complex arrangements of prisms and interprisms. MTBS measurement showed that the longitudinally sectioned group had the lowest value, without significant differences between the groups with or without 45-degree bevel. Combining SEM observations and MTBS measurements, the prism-interprisms microstructure varied with the incisor regions, and different prism-interprisms microstructures allowed diverse sectioned surfaces, which could affect the enamel bonding.

Comparative Evaluation of Microleakage With Total-Etch, Universal (Self-Etch Mode), and Nano Adhesive Systems in Class V Composite Restorations: An In-Vitro Study

OBJECTIVES

The adhesion of bonding agents and their longevity are of interest to dentistry. Microleakage remains the major cause of composite restoration failures, which in turn depends on bonding between the restorative material and tooth substrate. The objective of this study is to evaluate and compare the microleakage with total-etch, universal, and nano adhesive systems in Class V composite restorations, utilizing a dye penetration method.

METHODS

Forty-five extracted premolars were included in the present study, and a Class V cavity on the facial surface of each tooth was prepared. The samples were divided into three groups of 15 teeth each depending on the bonding agents used, following which composite restoration was done. Specimens were thermocycled, and nail varnish was applied except around the restorations. Specimens were then immersed in 2% methylene blue for 24 hours and rinsed; sectioning was done and viewed under a stereomicroscope with 10X magnification.

RESULTS

The mean microleakage score was reported to be significantly higher in the universal adhesive system in the self-etch mode (3.60 ± 0.55) when compared with the total-etch adhesive system (2.40 ± 0.55) and least in the nano adhesive system (1.20+.45) (p value <.05).

CONCLUSION

The study findings revealed that nano adhesives showed lesser microleakage as compared to total-etch and universal adhesive systems.

CLINICAL SIGNIFICANCE

The study strengthens the findings that the nano adhesives have reduced microleakage, resulting in better marginal integrity and increased longevity of restoration. This study signifies that an eighth-generation bonding agent is reported to be better than the other bonding agents used in this study.

Noninvasive Adaptation Appraisal of Antimicrobial Nano-Filled Composite

OBJECTIVE

The aim of this research was to assess the effect of incorporating zein-coated magnesium oxide (zMgO) nanofillers to resin-based composite on the internal adaptation of the restorations using cross-polarisation optical coherence tomography (CP-OCT).

METHODS

Thirty noncarious human molar teeth were used. Class V cavities (3 × 5 mm) were prepared on the buccal and lingual surfaces of each tooth. Clearfil SE Bond 2 was applied to all the cavities and then the teeth were divided into 3 groups (n = 10) as follows: group 1-restored with N-Flow composite; group 2 and group 3-restored with N-Flow composite mixed with different zMgO nanoparticle concentrations (0.3% and 0.5% by weight, respectively) and then light cured using an LED curing device. Specimens were examined for interfacial adaptation examination under CP-OCT. Characterisation of the dental composite incorporating zMgO was done by Fourier-transform infrared spectroscopy (FTIR), x-ray diffraction (XRD), and field emission scanning electron microscopy (FESEM). Results were analysed with Kruskall-Wallis test followed by Mann-Whitney U test, at a significance level of P < .05.

RESULTS

XRD spectra exhibited the sharp peaks of zMgO in the composite enhanced with zMgO nanoparticles. FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. The gap percentage along the cavity floor was significantly lower in groups 2 and 3 in comparison to group 1 (P < .05). Also there was a significant difference in gap percentages between groups 2 and 3 (P < .05), with group 3 showing the lowest gap percentage.

CONCLUSIONS

The incorporation of 0.3% and 0.5% zMgO nanoparticles in flowable composite assists in improving the internal adaptation of the composite to the tooth surface.

Effect of Preheating and Vibration on Microhardness and Microleakage of Microhybrid Resin Composite (In Vitro Study)

BACKGROUND: Preheating and sonic vibration are two methods for the treatment of microhybrid resin composites that may effect on their mechanical and physical properties. AIM: This study was conducted to assess the effect of using preheating and sonic vibration on microhardness and microleakage of microhybrid resin composite METHODS AND MATERIALS: For microhardness test, a total of 30 samples of resin composite discs were prepared. Samples were divided into three groups according to the method of treatment of resin composite, controlled group (T0), preheated group (T1), and sonic vibration group (T2). Surface microhardness values were evaluated at baseline and after thermocycling. For microleakage test, a total of 30 Class-V cavities were prepared on the labial surfaces of extracted human anterior teeth. The cavities were then divided into three groups according to the method of resin composite treatment as mentioned before in the microhardness test. All samples were sectioned; then two-dimensional cross-sectional images from each sample. Each cross-sectional image was analyzed using Image J software to quantify interfacial microleakage at the cavity floor. STATISTICAL ANALYSIS USED: Two-way ANOVA analysis was used to test the effects of thermocycling on three groups of each test. One-way ANOVA was used to compare between three different methods of resin composite treatment. RESULTS: For microhardness at baseline revealed that the highest mean value was recorded for the control group, followed by the sonic vibration group meanwhile, the lowest mean value was recorded for the sonic vibration group, followed by preheated group at microleakage test. CONCLUSION: Preheating and sonic vibration of microhybrid resin composite does not improve its microhardness; however, sonic vibration provides better marginal adaptation than the preheating and the conventional methods.

An Eggshell-Based Toothpaste as a Cost-Effective Treatment of Dentin Hypersensitivity

Objectives This study aimed to test the efficacy of two experimentally produced eggshell-based toothpastes on dentinal tubules occlusion.

Materials and Methods Two experimental eggshell toothpastes, based on natural ingredients, with or without titanium dioxide nanoparticles (TNPs) were produced and coded “TNPs eggshell toothpaste [TNPsESTP]” or “eggshell toothpaste [ESTP],” respectively. Mid-coronal dentin discs, from 28 human extracted molar teeth, etched with 37% phosphoric acid for 60 seconds to simulate the hypersensitive dentin, were randomly divided into four groups—G1: no treatment (negative control), G2: ESTP treated, G3: TNPsESTP treated, and G4: Biorepair treated (positive control). All treated discs were brushed for 2 weeks and 1 month using a toothbrush simulator at 40 mm/s. Dentinal tubules occlusion was studied using a cross-polarization optical coherence tomography (CP-OCT) and scanning electron microscopy (SEM).

Statistical Analysis Unpaired t -test was conducted using GraphPad software (San Diego, California, United States). Continuous variables were expressed as means ± standard deviation and p < 0.05 was considered statistically significant.

Results From CP-OCT, a marked increase in surface reflectivity of dentin was observed after brushing with tested toothpastes. ESTP and NPsESTP showed higher or comparable grayscale values than Biorepair indicating increase in surface density of dentin. From SEM, at 2 weeks, ESTP showed comparable number of completely occluded dentinal tubules to Biorepair. TNPsESTP showed significantly lower numbers of CODT than Biorepair. At 1 month, the number of CODT was difficult to count for all treated groups. Both ESTP and TNPsESTP showed significantly higher numbers of partially occluded dentinal tubules than Biorepair.

Conclusion ESTP or TNPsESTP could offer a cost-effective substitute for the treatment of dentin hypersensitivity.

Evaluation of microleakage in class-II bulk-fill composite restorations

Background/purpose

Despite the clinical appeal of restoring deep class II cavities in single increment using bulk-fill resin composite, sealing of bulk-filled composite restorations is a concern. This study evaluated interfacial adaptation of bulk-fill composite restoration to axial wall and gingival floor of class II cavities using cross-polarization optical coherence tomography (CP-OCT).

Materials and methods

Box-shaped class II cavities were prepared in extracted molars and divided into three groups (n = 7) according to adhesive used; Clearfil SE Bond 2 (SE2), Tetric-N Bond Self-Etch (TSE) or Tetric-N Bond Universal (TNU). All adhesives were applied in self-etch mode and according to manufacturers' recommendation. Then, preparations were bulk-filled with Filtek Bulk Fill Posterior Restorative resin composite and immersed in a contrast agent. Tomographic images of axial wall and gingival floor of each restoration were obtained by CP-OCT (IVS-300, Santec) with a central wavelength of 1330 nm and were imported to an image analysis software to quantify microleakage.

Results

Mann–Whitney U test showed statistically significant difference in microleakage percentage between the groups at both axial wall and gingival floor (p < 0.05). SE2 group had the lowest percentage of microleakage (p < 0.05), as only few cross-sections showed areas of reflections from contrast agent penetrating into axial wall (8.23 ± 6.8) and gingival floor (7.07 ± 4.1), followed by TNU group (18.13 ± 12.9 axially and 30.61 ± 11.9 gingivally). Microleakage was frequently observed at the axial wall and gingival floor of TSE group, showing the highest percentages of 25.50 ± 12.5 and 36.97 ± 10.2, respectively (p < 0.05).

Conclusion

All tested groups exhibited different extent of interfacial microleakage, however, two-step self-etch adhesive yielded superior adaptation in comparison to one-step self-etch adhesive and universal adhesive.

Effect of light irradiation condition on gap formation under polymeric dental restoration; OCT study

OBJECTIVE

To investigate the effect of two light-curing systems; quartz tungsten-halogen (QTH) and light-emitting diode (LED), and irradiation time on interfacial gap formation of dental composite resin restorations bonded with an adhesive resin using optical coherence tomography (OCT).

MATERIALS AND METHODS

Forty cavities were prepared in extracted human molar teeth and divided into four groups (n=10) based on the type of light curing system QTH (LITEX 680A) and LED (Demi Plus) and curing duration (10 s or 40 s). A single-step self-etching dental adhesive (Tetric® N-Bond; Ivoclar Vivadent AG, Schaan, FL, Liechtenstein) was applied and polymerized with QTH for 10 s (QTH-10), or for 40 s (QTH-40). Similarly, the adhesive in LED-10 and LED-40 groups was polymerized with an LED for 10 s or 40 s, respectively. Then, all specimens were restored with Filtek™ Z350 XT flowable composite (3M ESPE AG, St. Paul, MN, USA) and immersed in ammoniacal silver-nitrate contrasting solution. Cross-sectional images were recorded at every 250μm using cross-polarization OCT system (CP-OCT; IVS-300, Santec, Komaki, Aichi, Japan). Image analysis to quantify the percentage of gap at resin-dentin interface was performed using a custom plugin for ImageJ software.

RESULTS

Data analysis using one-way ANOVA showed a significant difference in mean gap percentage between the four test groups (p<0.0001). Mean gap percentage values were 75.8%, 53.2%, 9.9% and 5.6%. The highest for LED-10 followed by LED-40 (p <0.05). QTH-40 revealed a slightly better adaptation compared with QTH-10, but the difference between them was not significant (p <0.05).

CONCLUSION

CP-OCT with a contrast agent is a useful non-invasive imaging tool for dental composite resin materials. QTH showed better results than LED under the experimental conditions. When using an LED light-curing unit, prolonged irradiation improved interfacial adaptation of dental composite bonded with a self-etching adhesive.

Effect of self-etch adhesives on the internal adaptation of composite restoration: a CP-OCT Study

Despite improvements in dental adhesive materials, internal adaptation remains a challenge in bonded restorations. The aim of this study was to compare microgaps and internal floor adaptation between two different self-etch adhesives in class-V cavities using cross-polarization optical coherence tomography (CP-OCT). In this in vitro study, standardized round class-V cavities were prepared in 20 non-carious human upper central incisor teeth. They were randomly divided into two groups, TN and SE, with each group receiving a different dental adhesive. In TN group, the adhesive used was all-in-one Tetric N-Bond Self-Etch (TN; Ivoclar/Vivadent, Liechtenstein), while SE group was bonded with two-step self-etch Clearfil SE Bond 2 adhesive (SE; Kuraray Noritake Dental Inc, Japan). The prepared cavities were restored with flowable composite and then stored in distilled water for 24 h. Next, they were immersed in silver nitrate, followed by immersion in a photo-developing solution. Optical comparison was carried out by CP-OCT to assess microgaps and composite adaptation at the cavity floor. A Mann-Whitney test was applied to the data, which showed a statistically significant difference in composite adaptation among the two groups (p < 0.001) with the SE group showing superior adaptation. CP-OCT is a reliable tool for non-invasive imaging that gives an insight into composite performance. Better adaptation was found with the two-step self-adhesive for the composite used in this study.