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Gulderen O, Saricam E, Gökhan Açikgöz S, Tezcan Y. Effects of radiotherapy dose and application time on the load-to-failure values of teeth filled with different sealers. BMC Oral Health 2024; 24:1260. [PMID: 39434091 PMCID: PMC11495028 DOI: 10.1186/s12903-024-05029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 10/07/2024] [Indexed: 10/23/2024] Open
Abstract
BACKGROUND The materials used in root canal filling and radiotherapy (RT) application can affect the load-to-failure of the teeth. This study aimed to compare the load-to-failure of the teeth filled with AH Plus (AHP) or AH Plus bioceramic (AHPB) before or after 60 Gy- and 70 Gy-dose radiotherapy. MATERIALS AND METHODS One hundred and ten maxillary incisors were endodontically prepared up to ProTaper Next X4 instruments. The teeth were randomly divided into 5 main groups as: non-irradiated, root canal treatment (RCT) before 60 Gy radiotherapy, RCT before 70 Gy radiotherapy, RCT after 60 Gy radiotherapy, RCT after 70 Gy radiotherapy. These groups were divided into 2 subgroups for filling material: AHP ve AHPB. After filling and radiotherapy procedures, the teeth were fixed on the thermoplastic mask plane. The plane were placed in the middle of a rectangular prism shaped glass phantom, and irradiated via a linear accelerator device. The teeth were then embedded in cylindrical acrylic blocks and the force (N) that caused the fracture was recorded under the Universal testing device. Student t-test was used for statistical comparisons. Statistical significance level was determined as p < 0.05. RESULTS After 70 Gy dose radiotherapy, the group filled with AHPB showed statistically significantly lower fracture strength than the group filled with AHP (p < 0.05). In the control group, before 60 Gy RT group, after 60 Gy RT group, and before 70 Gy RT group, the sealers had statistically significantly similar load-to-failure. (p > 0.05). CONCLUSION The group filled with AHPB caused a lower fracture strength than the group filled with AHP following a 70 Gy dose of RT. The sealers in the control group, before 60 Gy RT group, after 60 Gy RT group, and before 70 Gy RT group exhibited comparable load-to-failure values.
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Affiliation(s)
- Ozgun Gulderen
- Department of Endodontics, Faculty of Dentistry, Ankara Yildirim Beyazit University, Ayvali Mah. 150. Sk. Etlik, Ankara, Turkey
| | - Esma Saricam
- Department of Endodontics, Faculty of Dentistry, Ankara Yildirim Beyazit University, Ayvali Mah. 150. Sk. Etlik, Ankara, Turkey.
| | | | - Yılmaz Tezcan
- Department of Radiation Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
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Pauletto G, Machry RV, Baumhardt T, de Freitas Daudt N, Pereira GKR, Bier CAS. Effect of radiotherapy, immediate dentin sealing and irrigation simulating single- or two-visits endodontic treatment on the bond strength to pulp chamber dentin: an in vitro study. Odontology 2024:10.1007/s10266-024-00971-9. [PMID: 38951300 DOI: 10.1007/s10266-024-00971-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
This study aimed to evaluate the influence of radiotherapy and different endodontic treatment protocols on the bond strength to pulp chamber dentin. Eighty mandibular molars were randomly divided into two groups (n = 40): non-irradiated and irradiated (60 Gy). The pulp chambers were sectioned, and each group was subdivided (n = 8), according to the endodontic treatment protocol: no treatment (Control); Single-visit; Two-visits; Immediate dentin sealing (IDS) + single-visit; and IDS + two-visits. Each endodontic treatment visit was simulated through irrigation with 2.5% NaOCl, 17% EDTA and distilled water. IDS was performed by actively applying two coats of a universal adhesive to the lateral walls of the pulp chamber. After, the pulp chambers were restored with resin composite and four sticks were obtained for microtensile test. In addition, the dentin of the pulp chamber roof was assessed for surface roughness, chemical composition, and topography after each treatment protocol. Two-way ANOVA, Tukey's post hoc, Mann-Whitney, Kruskal-Wallis and Dunn's post hoc were performed (α = 5%). The treatment protocol affected bond strength (p < 0.05), while the irradiation did not (p > 0.05). The control group presented the highest values (p < 0.05). The single-visit group demonstrated better performance compared to the other groups (p < 0.05), which did not differ from each other (p > 0.05) The use of IDS changed the surface roughness (p < 0.05), chemical composition (p < 0.05) and topography of the dentin. In conclusion, the treatment protocol influenced dentin adhesion, while irradiation did not.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Tadeu Baumhardt
- Radiotherapy Sector, University Hospital of Santa Maria, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Natália de Freitas Daudt
- Post-Graduate Program in Mechanical Engineering, Faculty of Mechanical Engineering, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Roraima Avenue #1000, T Street, Building 26F, Room 2383, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
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Pelloso AM, Rossi ME, Miranda RRD, Soares CJ, Novais VR. Radiotherapy in the head and neck region influences the chemical and mechanical properties of intraradicular dentin. Arch Oral Biol 2024; 158:105868. [PMID: 38070323 DOI: 10.1016/j.archoralbio.2023.105868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES To investigate the chemical and mechanical properties of intraradicular dentin submitted to radiotherapy. MATERIALS AND METHODS Sixteen mandibular incisors were divided into two groups (n = 8): non-irradiated and irradiated. The irradiated teeth were obtained from head and neck radiotherapy patients, with a total dose ranging from 70.2 to 72 Gy divided into 1.8 Gy daily. After sample preparation, intraradicular dentin slices of each root third were evaluated by Raman spectroscopy, energy dispersive spectroscopy and Knoop microhardness test. Data were analyzed by Two-way ANOVA and Tukey's test (α = 0.05). RESULTS In Raman spectroscopy, carbonate and amide III showed a significant difference for irradiation and third (carbonate p = 0.021 and p < 0.001; amide III p < 0.001 and p = 0.001, respectively). For amide I, there was a significant difference for third (p < 0.001). For carbonate/mineral ratio, there was a significant difference for irradiation (p = 0.0016) and third (p < 0.001), with the irradiated middle third showing the lowest values. For amide I/amide III ratio, there was a significant difference for irradiation (p = 0.005) in the cervical third. In energy dispersive spectroscopy, carbon (p = 0.004; p = 0.020), phosphorus (p < 0.001; p = 0.009) and calcium (p = 0.008; p = 0.007) showed differences for irradiation and third, with the irradiated groups presenting lower values in cervical and middle thirds. For calcium/phosphorus ratio, there was a significant difference for irradiation (p < 0.001) in cervical and middle thirds. Regarding microhardness, there was a significant difference for irradiation (p < 0.001), with all irradiated groups showing lower microhardness values. CONCLUSIONS The radiotherapy altered the chemical and mechanical properties of intraradicular dentin, mainly in the cervical and middle root thirds.
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Affiliation(s)
- Alessandro Marcelo Pelloso
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Av Pará 1720, Block 4L, Campus Umuarama, Uberlândia, MG 38405-320, Brazil
| | - Matheus Elias Rossi
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Av Pará 1720, Block 4L, Campus Umuarama, Uberlândia, MG 38405-320, Brazil
| | - Rafael Resende de Miranda
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Av Pará 1720, Block 4L, Campus Umuarama, Uberlândia, MG 38405-320, Brazil
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Av Pará 1720, Block 4L, Campus Umuarama, Uberlândia, MG 38405-320, Brazil
| | - Veridiana Resende Novais
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Av Pará 1720, Block 4L, Campus Umuarama, Uberlândia, MG 38405-320, Brazil.
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Arandi NZ. The Classification and Selection of Adhesive Agents; an Overview for the General Dentist. Clin Cosmet Investig Dent 2023; 15:165-180. [PMID: 37692095 PMCID: PMC10488680 DOI: 10.2147/ccide.s425024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords "adhesive agents", "classification", "dentin", "enamel", "universal", "self-etch", "etch-and-rinse", and "bonding". The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or "multi-mode" according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.
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Affiliation(s)
- Naji Ziad Arandi
- Department of Conservative Dentistry, Faculty of Dentistry, Arab American University, Jenin, Palestine
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Buyukcavus E, Ugurlu M, Buyukcavus MH. Shear bond strength of orthodontic molar tubes to composite restoration bonded with particular adhesives after different surface pre-treatments. Orthod Craniofac Res 2022; 25:541-548. [PMID: 35080117 DOI: 10.1111/ocr.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/25/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate in vitro the shear bond strength of orthodontic molar tubes to composite restoration bonded with particular adhesives after different surface pre-treatments. SETTING AND SAMPLE POPULATION The sample population is 60 extracted molars. MATERIALS AND METHODS After the teeth were thermocycled, they were randomly divided into six groups according to the adhesive and various surface pre-treatments that had been applied. The surface pre-treatments included sandblasting with 50-μm aluminium oxide particles and roughening with diamond bur and 37% phosphoric acid. Transbond XT Adhesive Primer (3M Unitek) (TXT) and Assure Plus (Reliance Orthodontic Products) adhesives were used in the study. Following the application of the adhesives, the brackets were bonded to the surfaces of the teeth. Shear bond strength was measured using a universal testing machine. Data were analysed with one-way ANOVA and LSD tests (P = .05). The adhesive remnant index (ARI) was determined using a stereomicroscope. Data from the ARI scores were submitted to Pearson's chi-squared test (P = .05). RESULTS The highest shear bond strengths were obtained in the Assure Plus group 15.05 ± 3.72 MPa after sandblasting (P < .05). The lowest shear bond strengths were found in the TXT group (7.52 ± 2.89 MPa; P < .05). Sandblasting and bur pre-treatment for TXT and Assure Plus adhesives increased shear bond strength in both of them. There were no significant differences in the ARI scores between the groups (P > .05). CONCLUSION Sandblasting and roughening pre-treatment can increase the bond strength of teeth with composite restoration. Assure Plus is also more effective than conventional adhesive systems.
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Affiliation(s)
- Esra Buyukcavus
- Department of Restorative Dentistry, Isparta Dental Health Center, Isparta, Turkey
| | - Muhittin Ugurlu
- Department of Restorative Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Oglakci B, Burduroğlu D, Eriş AH, Mayadağlı A, Arhun N. The Effect of Radiotherapy on the Marginal Adaptation of Class II Direct Resin Composite Restorations: A Micro-computed Tomography Analysis. Oper Dent 2022; 47:43-54. [PMID: 35226728 DOI: 10.2341/20-066-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 12/24/2022]
Abstract
This laboratory study was designed to evaluate the marginal adaptation of Class II mesio-occluso-distal (MOD) restorations at the cervical region with micro-computed tomography (micro-CT). Two groups of restorations were compared: 1) those that had been exposed to radiotherapy before restoration was performed using a universal adhesive in etch-and-rinse and self-etch modes; and 2) those that had previously been restored using a universal adhesive in etch-and-rinse and self-etch modes and had subsequently undergone radiotherapy. Sixty intact human molars were randomly divided into groups according to irradiation status: no radiotherapy (control group); radiotherapy followed by restoration (radiotherapy-first group); and restoration followed by radiotherapy (restoration-first group). These three groups were then subdivided into two groups each on the basis of adhesive application type (etch-and-rinse and self-etch modes), for a total of six groups (n=10/group). Standardized Class II MOD cavities were prepared. A universal adhesive (Clearfil Universal Bond Quick, Kuraray, Okayama, Japan) was applied. The teeth were restored with resin composite (Estelite Posterior Quick, Tokuyama, Tokyo, Japan). The radiotherapy protocol was conducted with 60 gray (Gy) at 2 Gy/day, five days a week for six weeks. Adhesive defects were analyzed in distal and mesial views and evaluated with micro-CT (SkyScan 1174v2, Kontich, Antwerp, Belgium) on the basis of the volume of black spaces between the cavity walls and the restorative materials (mm3). The data were analyzed using the Kruskal-Wallis, Mann Whitney U and Wilcoxon tests (p<0.05). The radiotherapy protocol did not affect the marginal adaptation of the universal adhesive at the cervical regions. Regarding the application modes, for the radiotherapy-first group, the self-etch mode caused significantly higher adhesive defects than the etch-and-rinse mode at the dentin margin. For the no-radiotherapy group, the adhesive defects at the dentin margin were significantly higher than at the enamel margin with the application of the etch-and-rinse mode.
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Affiliation(s)
- B Oglakci
- *Burcu Oglakci, DDS, assistant professor, Bezmialem Vakif University Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - D Burduroğlu
- Defne Burduroğlu, DDS, PhD, prosthetic dentistry specialist, Bezmialem Vakif University, Faculty of Dentistry, Department of Prosthetic Dentistry, Istanbul, Turkey
| | - A H Eriş
- Ali Hikmet Eriş, medical radiophysic specialist, Bezmialem Vakif University, Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey
| | - A Mayadağlı
- Alpaslan Mayadağlı, MD, professor, Bezmialem Vakif University, Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey
| | - N Arhun
- Neslihan Arhun, DDS, PhD, professor, Başkent University Faculty of Dentistry, Department of Restorative Dentistry, Ankara, Turkey
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Chemical analysis of irradiated root dentin and its interaction with resin cements. Clin Oral Investig 2022; 26:4315-4325. [PMID: 35149905 DOI: 10.1007/s00784-022-04395-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the chemical changes in root dentin submitted to ionizing radiation and how it affects the interaction with resin cements. MATERIALS AND METHODS Forty human premolars were randomly divided into two groups (n = 20): non-irradiated and irradiated. They were randomly subdivided according to the type of resin cement (n = 10): conventional (RelyX ARC, 3 M ESPE) or self-adhesive (RelyX U200, 3 M ESPE). After cementation of the fiberglass posts, the roots were sectioned to be analyzed by Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, and confocal laser scanning microscopy (CLSM). The data obtained from FTIR and Raman were analyzed using two-way ANOVA followed Tukey's test (α = 0.05). For CLSM, a descriptive analysis was performed. RESULTS In the FTIR, there was a significant difference between the non-irradiated and irradiated groups for phosphate (p = 0.011), carbonate (p < 0.001), amide III (p = 0.038), and carbonate/mineral ratio (p < 0.001). Regarding the root third, there was a difference for amide I (p = 0.002), mineral/matrix ratio (p = 0.001), and amide I/CH2 (p = 0.026) between the cervical and the others. Raman spectroscopy revealed no difference between groups for 961/1458 cm-1 in the diffusion zone. CLSM showed a different interaction pattern for the two cements with the irradiated dentin from the cervical third. CONCLUSIONS Ionizing radiation altered the chemical composition of root dentin, especially in the cervical third. The resin cements showed less interaction with the irradiated root dentin. CLINICAL RELEVANCE As radiotherapy alters the chemical composition of root dentin, the interaction of resin cement with dentin can compromise the success of rehabilitation with fiberglass posts.
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Fehrenbach J, Isolan CP, Münchow EA. Is the presence of 10-MDP associated to higher bonding performance for self-etching adhesive systems? A meta-analysis of in vitro studies. Dent Mater 2021; 37:1463-1485. [PMID: 34456050 DOI: 10.1016/j.dental.2021.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Julia Fehrenbach
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Santa Cecília, Porto Alegre, Brazil.
| | - Cristina Pereira Isolan
- Department of Restorative Dentistry, School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, 187, Centro, Diamantina, Brazil.
| | - Eliseu Aldrighi Münchow
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Santa Cecília, Porto Alegre, Brazil; Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, Brazil.
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