Effect of ethanol application on post-luting to intraradicular dentine

Influence of different intraradicular chemical pretreatments on the bond strength of adhesive interface between dentine and fiber post cements: A systematic review and network meta-analysis

Systematic review and network meta-analyses were performed to answer the question: Do intraradicular chemical pretreatments affect the bond strength of the adhesive interface between dentine and fiber post cements? A literature search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane Library in October 2018 (updated September 2021). In vitro studies that compared the bond strength assessed by push-out tests following at least two dentine chemical treatments prior to fiber post cementation were included. Risk of bias was evaluated. A random-effects Bayesian-mixed treatment comparison model was used to compare push-out bond strength of different chemical pretreatments. SUCRA (surface area under the cumulative ranking) analysis was performed to rank the pretreatments. After removing duplicates and screening titles and abstracts, 61 studies remained. SUCRA analysis showed that the best bond strength values for self-etch, etch-and-rinse, and self-adhesive cements were ethyl acetate (SUCRA: 99.8%), low concentration NaOCl (SUCRA: 83.4%), and grape seed extract (SUCRA: 97.6%), respectively. According to the SUCRA rankings, ethanol was in a good position for all adhesive strategies (SUCRA: 78.6%). The use of chemical pretreatments in intraradicular dentine of endodontically treated teeth depends on the adhesive and cementation strategy. The pretreatment generally associated with the highest bond strength was ethanol.

Post-Space Treatment Influences the Bond Strength In Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

OBJECTIVES

This systematic review of in vitro studies investigated the influence of the post-space treatment used to remove the smear layer on the bond strength of the post to root canal dentin.

METHODS AND MATERIALS

In vitro studies included in this study were identified from PubMed/MEDLINE, Lilacs, and Scopus databases up until March 2019, without limits on publication year or language. Two reviewers independently selected the studies based on the inclusion and exclusion criteria, extracted the data, and evaluated the risk of bias of all studies. A random effects model was used for pairwise meta-analyses (control vs. post-space preparation groups) at a significance level of p<0.05.

RESULTS

Of the 2,832 potentially eligible studies, 453 studies were selected for full-text analysis, and 75 were included in this systematic review. Only one study was considered to have a low risk of bias. Overall, post-space treatment significantly improves the bond strength to root canal dentin (p<0.00001).

CONCLUSION

Post-space treatment has a positive influence on the bond strength of the post to root canal dentin. In this review, the post-space treatments that improve the adhesive resistance of the post were ethanol, sodium hypochlorite, and ethylene diamine tetra-acetic acid (NaOCl + EDTA), NaOCl + EDTA + ultrasound, erbium-doped yttrium aluminium garnet laser (Er:YAG laser), neodymium-doped yttrium aluminium garnet laser (Nd:YAG laser), and diode laser.

Root canal pre-treatment and adhesive system affect bond strength durability of fiber posts ex vivo

OBJECTIVES

To investigate the effect of different pre-treatments on the long-term bond strength of fiberglass posts luted either with dual-curing self-etch adhesives and core build-up composites or with a self-adhesive resin (SAR) cement.

MATERIALS AND METHODS

In total, 180 human root-filled teeth received post-space preparations and three different dentin pre-treatments (PTs): PT1, ethanol (99%); PT2, ethanol-tertiary-butanol-water-solution (AH Plus Cleaner, Dentsply Sirona; York, USA); and PT3, distilled water (control). Five luting systems were used: FU, Futurabond U (Voco; Cuxhaven, Germany); CL, Clearfil DC Bond (Kuraray Noritake; Okayama, Japan); GR, Gradia Core SE Bond (GC Europe NV; Leuven, Belgium); LU, LuxaBond Universal (DMG; Hamburg, Germany); and RX, RelyX Unicem 2 (3M; Minnesota, USA). Roots were cut into six slices (1 mm thick). From each root canal region, three slices were submitted to immediate and three to post-storage push-out testing. The latter were subjected to thermocycling (5-55°C, 6.000 cycles) and stored for six months in saline solution (0.9%, 37°C). Data were analysed using repeated measures ANOVA and chi-square tests (MV±SD).

RESULTS

Bond strength was significantly affected by material (p<0.0005), pre-treatment (p=0.016), and storage (p<0.0005; repeated-measures ANOVA). LU (18.8±8.1MPa) revealed significantly higher bond strength than RX (16.08±6.4MPa), GR (15.1±4.6MPa), CL (13.95±5.2MPa), and FU (13.7±6.3MPa). PT1 (16.5±6.9MPa) revealed significantly higher bond strength than PT3 (14.5±5.7MPa).

CONCLUSIONS

A universal adhesive in self-etch mode combined with a core build-up material revealed higher bond strength than a SAR cement, both interacted positively with Ethanol pre-treatment.

CLINICAL RELEVANCE STATEMENT

Ethanol (99%) rinsing can be recommended as part of post and core pre-treatment for the investigated luting systems.

Effect of ethanol-wet bonding on porosity and retention of fiberglass post to root dentin

This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength.

Effects of Epigallocatechin-3-gallate (EGCG) on the bond strength of fiber posts to Sodium hypochlorite (NaOCl) treated intraradicular dentin

This study was to evaluate the effect of Epigallocatechin-3-gallate (EGCG) on the bond strength of two adhesive systems to the Sodium hypochlorite (NaOCl) treated intraradicular dentin. The roots were accepted regular root canal treatments and post space preparations, and further divided into eight groups according to the four post space pretreatments and two dentin adhesives [Single Bond 2 (SB2) and Clearfil SE Bond (CSB)] used. The push-out strength before and after thermocycling in different root region (coronal and apical), DC of the adhesive and morphologic patterns of treated post space were evaluated. NaOCl + EGCG groups showed the highest push-out strength regardless of the adhesive type, root region and time (P < 0.05). NaOCl pretreatment significantly decreased the push-out strengths and DC of CSB (P < 0.05). EGCG could improve the bonding properties of both SB2 and CSB to NaOCl treated intraradicular dentin. The effect of NaOCl on bonding of a fiber post depended on the type of the adhesive.

Long-term bond strength of a self-adhesive resin cement to intraradicular dentin pretreated with chlorhexidine and ethanol

Abstract Introduction Self-adhesive resin cements do not require prior preparation of the tooth surface, therefore dentin pretreatments may influence long-term bond strength. Objective To evaluate the influence of 100% ethanol (ET) and 2% chlorhexidine (CL) treatment of intraradicular dentin on the long-term bond strength (BS) of a self-adhesive resin cement (SRC). Material and method 80 bovine roots were restored with fiber posts and SRC (U200 3M/ESPE) and distributed into 4 groups according to dentin treatment: Group 1 – without treatment; Group 2 – 2% CL for 1 minute; Group 3 – 100% ET for 1 minute; Group 4 – 2% CL, followed by 100% ET. The samples were cross-sectioned to obtain two sections (0.7 mm) thick for each root third: coronal, middle and apical. The immediate push-out test was carried out after 48 hours, and the long-term push-out test, after 180 days. Result The three-way ANOVA test for randomized blocks showed no difference between the BS values at 48 hours and 80 days, irrespective of the treatment and the third (p>0.05). The interaction of the treatment/third pairing was significant (p = 0.041) since the treatment with CL promoted lower BS in the coronal third, while treatment with ET promoted better BS in the apical third. Conclusion Treatment with CL and ET, separately or combined, promoted no differences between the BS values of the SRC to root dentin over time.

Effect of dimethyl sulfoxide on bond durability of fiber posts cemented with etch-and-rinse adhesives

PURPOSE

This study was undertaken to investigate whether use of an adhesive penetration enhancer, dimethyl sulfoxide (DMSO), improves bond stability of fiber posts to root dentin using two two-step etch-and-rinse resin cements.

MATERIALS AND METHODS

Forty human maxillary central incisor roots were randomly divided into 4 groups after endodontic treatment and post space preparation, based on the fiber post/cement used with and without DMSO pretreatment. Acid-etched root dentin was treated with 5% DMSO aqueous solution for 60 seconds or with distilled water (control) prior to the application of Excite DSC/Variolink II or One-Step Plus/Duo-link for post cementation. After micro-slicing the bonded root dentin, push-out bond strength (P-OBS) test was performed immediately or after 1-year of water storage in each group. Data were analyzed using three-way ANOVA and Student's t-test (α=.05).

RESULTS

A significant effect of time, DMSO treatment, and treatment × time interaction were observed (P<.001). DMSO did not affect immediate bonding of the two cements. Aging significantly reduced P-OBS in control groups (P<.001), while in DMSO-treated groups, no difference in P-OBS was observed after aging (P>.05).

CONCLUSION

DMSO-wet bonding might be a beneficial method in preserving the stability of resin-dentin bond strength over time when fiber post is cemented with the tested etch-and-rinse adhesive cements.

Effect of Chlorhexidine and Ethanol Application on Long-term Push-out Bond Strength of Fiber Posts to Dentin

AIM

The aim of this study was to evaluate the effect of chlorhexidine and ethanol application on the push-out bond strength and bond durability of fiber posts cemented with an etch-and-rinse adhesive system/resin cement to intraradicular dentin.

MATERIALS AND METHODS

Fifty-four bovine roots were shaped for the cementation of a fiberglass post and received the application of 37% phosphoric acid. They were then randomly divided into three groups, according to the type of dentin treatment (n = 18) performed: no treatment (control group), 100% ethanol, or 2% chlorhexidine. Next, the adhesive system (Adper Scotch Bond Multipurpose Plus, 3M ESPE) was applied to the dentin, according to the manufacturer's instructions. Glass fiber posts were cemented with dual resin cement (Rely X ARC, 3M ESPE). After 48 hours, the specimens were serially sectioned for push-out test analysis, providing two slices from each root third (cervical, medium and apical), one of which was tested immediately and the other stored in distilled water for 180 days. The data were analyzed with three-way analysis of variance (ANOVA) for repeated measures and Tukey's test at a 5% significance level.

RESULTS

Intraradicular treatment with chlorhexidine yielded the highest bond strength means, followed by ethanol treatment. The control group presented the lowest bond strength means. Water storage exerted no effect on bond strength values.

CONCLUSION

Both chlorhexidine and ethanol improved push-out bond strength to intraradicular dentin, with the former providing the best results, regardless of the storage time.

CLINICAL SIGNIFICANCE

The application of 2% chlorhexidine or 100% ethanol may be an important step that can be taken to enhance bond strength of fiber posts to intraradicular dentin, when dual resin cements are used.

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal

Objective

This study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure.

Material and Methods

One luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: Group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blotdried. A trial adhesive (base to catalyst on a 1:1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TeGDMA, 0.5% eDMAB, 0.13% CQ); Group 2: A trial adhesive (base to catalyst on a 1:2 ratio) was luted as in Group 1; Group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in Group 1; Group 4: OSP strictly following the manufacturer's instructions using the luting agent as in Group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy.

Results

Push-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as Group 1 (exp 1 - ethanol-wet bonding technique)=Group 2 (exp 2 - ethanol-wet bonding technique)=Group 3 (OSP - ethanol-wet bonding technique)=Group 4 (control, OSP - water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface.

Conclusions

The results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

Effectiveness of immediate bonding of etch-and-rinse adhesives to simplified ethanol-saturated dentin

This study examined the immediate bond strength of etch-and-rinse adhesives to demineralized dentin saturated with either water or absolute ethanol. The research hypothesis was that there would be no difference in bond strength to dentin between water or ethanol wet-bonding techniques. The medium dentin of 20 third molars was exposed (n = 5). The dentin surface was then acid-etched, left moist and randomly assigned to be saturated via either water wet-bonding (WBT) or absolute ethanol wet-bonding (EBT). The specimens were then treated with one of the following etch-and-rinse adhesive systems: a 3-step, water-based system (Adper Scotchbond Multipurpose, or SBMP) or a 2-step, ethanol/water-based system (Adper Single Bond 2, or SB). Resin composite build-ups were then incrementally constructed. After water storage for 24 h at 37°C, the tensile strength of the specimens was tested in a universal testing machine (0.5 mm/min). Data were analyzed by two-way ANOVA and Tukey's test (a = 5%). The failure modes were verified using a stereomicroscope (40'). For both adhesives, no significant difference in bond strength was observed between WBT and EBT (p > 0.05). The highest bond strength was observed for SB, regardless of the bonding technique (p < 0.05). No significant interaction between adhesives and bonding techniques was noticed (p = 0.597). There was a predominance of adhesive failures for all tested groups. The EBT and WBT displayed similar immediate bond strength means for both adhesives. The SB adhesive exhibited higher means for all conditions tested. Further investigations are needed to evaluate long-term bonding to dentin mediated by commercial etch-and-rinse adhesives using the EBT approach.

Deproteinization technique stabilizes the adhesion of the fiberglass post relined with resin composite to root canal

To evaluate the effects of pretreatment of root dentin by 5.25% sodium hypochlorite (NaOCl) alone, associated with 2% chlorhexidine in gel base (CHX) and/or ethanol (EtOH), and the air-drying technique (Air) on the bond strength and adhesive durability of fiberglass post relined with resin composite to root dentin. A total of 100 bovine incisor roots were divided into 10 groups: G1 (control), irrigation with physiologic solution; G2, Air; G3, NaOCl; G4, NaOCl + Air; G5, NaOCl + EtOH; G6, NaOCl + EtOH + Air; G7, NaOCl + CHX; G8, NaOCl + CHX + Air; G9, NaOCl + CHX + EtOH; G10, NaOCl + CHX + EtOH + Air. Fiberglass post relined with resin composite was cemented and each group was randomly divided into two subgroups: 24 h of water storage and 12 months of water storage. The push-out test was performed and bond strength values were analyzed by ANOVA and Tukey's test. The use of NaOCl alone or associated with CHX had the highest values of bond strength with or without Air in the immediate and stored groups, being statistically similar to the immediate control group (p > 0.05). The groups using EtOH or Air alone had lower bond strength in the immediate and stored groups (p < 0.05). A significant decrease with the time of the bond strength in the control group was observed after 12 months of storage (p > 0.05). The use of NaOCl or NaOCl associated with CHX preserved the bond strength immediate and for 12 months. The air-drying technique and the other associations decreased the immediate bond strength values.