Effects of additional and extended acid etching on bonding to caries-affected dentine

Carbon nanotube-modified adhesive to caries affected dentin conditioned with Nd: YAP laser, Phosphoric acid, and Photoactivated-erythrosine

AIM

DENTIN CONDITIONED: with phosphoric acid (PA) Nd: YAP laser, and photoactivated-Ery(Erythrosine) on microleakage, shear bond strength (SBS) degree of conversion (DC), and rheological assessment of adhesive-infused with carbon nanotubes (CNTs).

MATERIAL AND METHOD

Carious ninety-six human mandibular molars were included. Specimens were disinfected and allocated into three groups based on surface pretreatment (n=32) Group 1 (PA), Group 2 (Nd: YAP) laser, and Group 3 (Photoactivated-Ery). Conditioned groups were further divided into two 2 subgroups based on the application of unmodified ERA and CNTs-modified ERA. Composite restorations were placed on the CAD surface and thermal aging of the samples was performed. The microleakage assessment was conducted using a dye penetration test. Universal testing machine (UTM) assessed SBS bond failure was evaluated using a stereomicroscope. Scanning electron microscopy (SEM), energy-dispersive X-ray (EDX) analyses of CNT, and Fourier Transform Infrared FTIR of adhesives were performed. One-way ANOVA and Tukey post hoc analyzed the outcomes.

RESULTS

Group 1B samples (PA+ CNTs modified adhesive) presented the minimum marginal leakage and highest bond integrity. Group 2A (Nd:YAP laser+Unmodified adhesive) displayed the maximum scores of microleakage and lowest bond strength.

CONCLUSION

Photoactivated Ery-PS can serve as an alternative to phosphoric acid for conditioning CAD. Incorporating CNT in adhesive significantly enhanced bond integrity and marginal seal with no significant difference in DC.

Photoactivated rose bengal-doped TiO2 nanoparticles modified fifth-generation adhesive on the survival rate of Streptococcus mutants and mechanical properties of tooth-colored restorative material to carious dentin

Assessment of the antimicrobial, micro tensile bond strength (μTBS), and degree of conversion (DC) of fifth-generation adhesive modified using photoactivated 0.5% rose bengal (RB) and photoactivated RB-doped titanium dioxide nanoparticles (TiO2NPs) in different concentrations (2% and 5%) as compared with the unmodified adhesive bonded to the carious affected dentin (CAD). Forty mandibular molars with caries progression up to the middle third of the dentin, as per the International Caries Detection and Assessment System (ICDAS) score of 4 and 5 were included. Specimens were divided into four groups based on etch and rinse adhesive (ERA) modification group 1: unmodified ERA, group 2: photoactivated 0.5% RB photosensitizer (PS) modified ERA, group 3: photoactivated RB-doped 2 wt% TiO2NPs adhesive, group 4: photoactivated RB-doped 5 wt% TiO2NPs adhesive. Followed by adhesive and composite restoration on the CAD surface. All the specimens were thermocycled and an assessment of μTBS and failure pattern analysis was performed. The antibacterial potency of RB and RB-doped TiO2NPs (2% and 5%) followed by their activation using visible light against Streptococcus mutans (S.mutans) were tested. The survival rate of S.mutans was assessed using the Kruskal-Wallis test. The analysis of μTBS involved the use of ANOVA, followed by a post-hoc Tukey honestly significant difference (HSD) multiple comparisons test. Group 1 (Unmodified ERA) (0.52 ± 0.31 CFU/mL) treated samples unveiled the highest means of bacterial survival and lowest μTBS (11.32 ± 0.63 MPa). Nevertheless, group 4: photoactivated RB-doped 5 wt% TiO2NPs adhesive displayed the lowest outcomes of S.mutans survival (0.11 ± 0.02 CFU/mL) and highest bond strength (18.76 ± 1.45 MPa). The photoactivated RB-doped 2 wt% TiO2NPs in adhesive demonstrated promising enhancements in both μTBS and antibacterial efficacy against S.mutans. However, it is noteworthy that this modification led to a decrease in the DC of the adhesive. RESEARCH HIGHLIGHTS: Unmodified ERA-treated samples unveiled the highest bacterial survival and the lowest μTBS. Photoactivated RB-doped 5 wt% TiO2NPs adhesive displayed the lowest S.mutans survival rate and highest bond strength. DC decreased with an increase in concentration of TiO2.

Effect of silver diamine fluoride on the longevity of the bonding properties to caries-affected dentine

OBJECTIVES

This study aimed to evaluate the adhesive properties in dentine after the application of silver diamine fluoride (SDF) on carious dentine lesions immediately and after 2 years of water storage.

METHODS

96 human molars used were subjected to artificial dentine caries production, and then randomly divided into 12 experimental groups according to 1. application of an SDF solution (carious dentine lesion without SDF treatment [control], with 12 % silver diamine fluoride [SDF 12 %] or 38 % silver diamine fluoride [SDF 38 %]); 2. Universal adhesives (Clearfil Universal Bond Quick [CUQ] and Single Bond Universal [SBU]); 3. adhesive strategy (etch-and-rinse [ER] and self-etch [SE]). After restoration, the specimens were sectioned and submitted to the microtensile bond strength test (μTBS) and energy-dispersive X-ray spectrometry analysis (SEM/EDX). All tests were performed immediately and after 2 years of water storage. Data from the μTBS were analyzed using four-way ANOVA and Tukey's test (α = 0.05).

RESULTS

Only the interaction of factors 'SDF' vs 'time' was significant (p = 0.03). After 2 years of storage, the groups where SDF was applied showed higher μTBS values compared to the control group. No significant decrease in μTBS values was observed for SBU when comparing immediate and 2-year results, but a significant reduction in μTBS values was observed after 2 years for CUQ.

CONCLUSION

Independent of the adhesive strategy, the use of SDF may be a promising alternative to maintain the bonding of universal adhesives to carious dentinal lesions.

CLINICAL SIGNIFICANCE

This study may clarify and support clinicians regarding the longevity of resin-based restoration in caries-affected dentine treated with silver diamine fluoride.

Caries affected disinfection using Phycocyanin activated by PDT, Holy Basil, and Ti-sapphire laser on adhesive bond strength, microleakage, and bond failure

AIM

To investigate the effect of different cavity disinfectants, Phycocyanin (PC), Ocimum Sanctum (OS), and Ti Sapphire Laser, on the bond integrity and microleakage of resin restorations.

MATERIAL AND METHOD

60 human mandibular molars were extracted and prepared based on ICDAS scores of 4 and 5. To obtain the CAD surface, a visual examination was supported by tactile sensation and a dye for caries detection. Samples were randomly allocated into 4 groups based on cavity disinfectants applied (n = 15). Group 1: Specimens disinfected with CHX, Group 2: Specimens disinfected with Ti sapphire laser, Group 3: Specimens disinfected with Phycocyanin activated by Photodynamic therapy, and Group 4: Specimens disinfected with OS. Following the disinfection of the CAD surfaces, composite bulk-fill restorative material was bonded to each specimen and all samples were subjected to thermocycling. Ten samples from each group underwent SBS testing performed on a universal testing machine. Five samples were subjected to a microleakage analysis.

RESULT

The maximum microleakage scores were displayed by Group 3: PC (0.521 nm) treated specimens. Whereas, and minimum microleakage was exhibited by Group 4: OS (0.471 nm). Group 4: OS (23.06±0.21 MPa) treated group displayed the maximum bond scores of resin adhesive to the CAD surface. However, Group 3: PC (21.67±0.24 MPa) treated specimens exhibited the lowest bond scores. Failure mode analysis revealed that among all the investigated groups the predominant type of failure was cohesive failure i.e., Group 1 (80%), Group 2 (80%), Group 3 (70%), and Group 4 (90%).

CONCLUSION

Ocimum Sanctum, Phycocyanin activated by Photodynamic therapy, and Ti-sapphire laser for disinfection of caries-affected dentin have shown promise in terms of improved bond strength and reduced microleakage.

Dentin disinfection and adhesive bond strength using modified photoactivated carbon nanoparticles

AIMS

The present study aimed to investigate the bond integrity and disinfection efficacy of Methylene blue(MB) alone, MB-PDT (Photodynamic therapy), MB@ carbon nanoparticles (CP)-PDT, and Cr, Cr: YSGG (ECL) against lactobacilli in Caries-affected dentin (CAD) MATERIAL AND METHODS: Methods consisted of Shear bond strength (SBS), Scanning electron microscopy (SEM), energy dispersive X-ray (EDX), methods of disinfection, and failure analysis. CAD samples were prepared and biofilm formed on the specimens randomly allocated into five groups based on disinfection. Group 1: CHX; Group 2: MB; Group 3: MB-PDT: group 4: MB@CP-PDT and group 5: ECL. After disinfection Colony forming units were measured and specimens were restored and positioned under a universal testing machine (UTM). Failure analysis was performed using a stereomicroscope. The difference in survival rate was assessed using the Kruskal-Walis test. Mean and standard deviation for bond values after different methods of disinfection was evaluated using analysis of variance (ANOVA) and Post Hoc Tukey. The significance level was p<0.05 RESULTS: Morphological analysis revealed that CPs under SEM are flat discs with edged irregular shapes. EDX analyses show a spike indicating carbon particles by more than 95%. MB@CP-PDT displayed the highest reduction in lactobacillus levels in comparison to the other disinfection methods. The highest SBS was exhibited by the CAD sample disinfected with ECL. The lowest SBS values in CAD specimens after cavity cleansing with MB alone. The predominant failure type in CAD disinfected with MB alone, ECL CHX, MB-PDT, and MB@CP-PDT was adhesive.

CONCLUSION

The use of MB@CP-PDT showed high antibacterial potency against lactobacillus but demonstrated bond values similar to CHX. Use of Er, Cr: YSGG showed considerable effectiveness against lactobacillus along with the highest bond values.

Minimally invasive selective caries removal: a clinical guide

An evolving understanding of the carious process, along with new research in adhesive restorative materials, has led to a more conservative, minimally invasive and biologically-based approach to managing dental carious lesions. The growing volume of literature has also demonstrated prognostic success in the selective caries excavation technique, subsequently preventing excessive tooth structure removal and injury to the dentine-pulp complex, which maintains pulp vitality and improves the long-term prognosis of the tooth. However, at present, there remains a limited volume of high-quality evidence to support selective caries removal, which subsequently could partly explain some resistance to its use in clinical practice. This clinical technique guide aims to demonstrate the management of carious lesions of moderate-to-deep depth in permanent teeth based on current minimally invasive dental literature.

Bonding strategies to deal with caries-affected dentin using cross-linking agents: Grape seed extract, green tea extract, and glutaraldehyde - An in vitro study

Aim

This study evaluated the effect of three collagen cross-linking agents - proanthocyanidins (grape seed extract [GSE] and green tea extract [GTE]) and glutaraldehyde [GA] on microshear bond strength (μSBS) of caries-affected dentin (CAD)-resin complex.

Materials and Methods

Freshly extracted 96 teeth with caries up to the middle third of dentin were sectioned through the deepest part of the occlusal fissure, perpendicular to the long axis of the crown. Caries was excavated with large round bur until firm dentin was obtained, confirmed by visual inspection and tactile examination. Flat occlusal dentin surfaces were treated as follows: Group-1 - 6.5% GSE (n = 30), Group-2 - 2% GTE (n = 30), Group-3 - 5% Glutaraldehyde (n = 30), Group-4 - control group (no agents) (n = 6). Each group was further divided into Subgroup A - Etch-N-Rinse 15s, Subgroup B - Etch-N-Rinse 45s, and Subgroup C - Self-etch. Two increments of 1.5-mm thick composite (Tetric-N-Ceram - Ivoclar Vivadent) with a 1-mm diameter were built-up. Each sample was subjected to μSBS test in Universal Testing Machine. Student's t-test was done for intragroup comparison and one-way ANOVA for intergroup comparison.

Results

Statistically significant difference was present in mean μSBS, with Group 1B showing the best results and Group 4C, the least.

Conclusions

Thus, the application of these collagen cross-linkers, to CAD, increases μSBS and promises a new approach to improve dentin bond strength.

Assessment of Caries-Affected Dentin Adhesive Interface Treated with Contemporary Conditioning Techniques

Objective: The aim of this study was to assess shear bond strength (SBS) and failure analysis of adhesion of composite resin (CR) to caries-affected dentin (CAD) pretreated with the Er,Cr:YSGG (ECY) laser, photodynamic therapy (PDT), and etch and rinse (ER) used for cavity disinfection. Materials and methods: Methods used in this study included scanning electron microscopy (SEM), SBS analysis, failure analysis, and digital microscopy. The methods were adopted to assess bond integrity, CAD interface, smear layer, and hybridization. Thirty human third molars assessed clinically and having scores of 4 and 5 based on International Caries Detection and Assessment System (ICDAS) criteria were inspected. Infected dentin was removed. Dentin that was hard and stained pink was categorized as CAD. Ten samples were used in each group for pretreatment of CAD. Ten samples of healthy dentin [sound dentin (SD)] were collected separately and taken as controls. Samples were divided into the following groups: group 1: SD+ER; group 2: CAD+ER; group 3: CAD+ECY; and group 4: CAD+PDT after the pretreatment bonding agent was applied and the restorative procedure was performed using CR. Results: CAD conditioned with PDT before bonding to CR demonstrated the lowest SBS values (11.22 ± 0.77 MPa), whereas the highest SBS values were observed in the SD surface treated with ER (18.25 ± 1.22 MPa). In CAD and SD pretreated with ER, majority of failure modes were cohesive failure and admixed failure, whereas in CAD pretreated with PDT and the ECY laser, the adhesive failure mode was pertinent. Conclusions: The use of the ECY laser and PDT on CAD for cavity disinfection does not have potential for application in clinical settings as it decreases bond integrity of CR. Moreover, the ER pretreatment method for CAD and SD remains the gold standard.

Biodentine or Mineral Trioxide Aggregate as Direct Pulp Capping Material in Mature Permanent Teeth with Carious Exposure? A Systematic Review and Meta-analysis

OBJECTIVE

To evaluate the success rate of direct pulp capping (DPC) with Biodentine in mature permanent teeth with carious vital pulp exposure compared to that of DPC with mineral trioxide aggregate (MTA) by means of a systematic review and meta-analysis.

DATA SOURCES

The two authors searched independently the literature published through July 31, 2020, in five electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science Core Collection, the Wiley Online Library, and the SCOPUS database).

STUDY SELECTION

The research protocol was previously registered in the PROSPERO database (CRD42020192511). Clinical studies that met the inclusion criteria were chosen and independently screened by the authors.

DATA EXTRACTION

A custom-designed spreadsheet was used to extract the data. The quality of each study was evaluated by means of the revised Cochrane risk of bias (ROB) tool or the ROB of nonrandomized studies of interventions tool.

DATA SYNTHESIS

Three randomized controlled trials and one retrospective study met the inclusion criteria. Only one study had a high risk of bias. The included studies reported data on a total of 95 participants with an age range of 8-51 years. No significant difference was observed in the overall treatment outcome when comparing Biodentine with MTA (Risk ratio=1.00, 95% confidence interval [0.93-1.07], p=1.00).

CONCLUSIONS

Biodentine had comparable clinical and radiographic success to that of MTA when used as a DPC agent in mature permanent teeth with carious vital pulp exposure. Additional high-quality studies are needed.

Bond strength of demineralized dentin after synthesized collagen/hydroxyapatite nanocomposite application

Treatment the deeper and remineralizable carious zone (DRCZ) in dentin with various remineralizing methods, either with classic top-down or biomimetic bottom-up remineralization approaches, has remained a constant main issue to enhance dentin substrate bonding quality. The concern of remineralizing the remaining, partially demineralized and physiologically re-mineralizable collagen fibrils was the optimum target. However, applying already mineralized type I collage fibrils which have the ability to chemically cross-link with remaining collagen and minerals did not gain much interest. Synthesis of collagen/hydroxyapatite (Col/Hap) nanocomposite was done with self-assembling Hap in situ onto Col fibrils with different % (70/30, 50/50, 30/70% of Col/Hap, respectively). Micro-tensile bond strength (μTBS) was evaluated after pre-treatment of artificially demineralized dentin with these suggested protocols [nanocomposite together with grape seed extract (GSE; 6.5%) cross-linker for two periods, 10min and 1 h] then applying self-adhesive bonding system. Applied Col/Hap (30/70%) together with GSE (6.5%) gave the significantly highest μTBS (25.04 ± 5.47 and 25.53 ± 7.64 MPa, for 10min and 1 h application times, respectively). After thermocycling for 10,000 cycles at 5 and 55 °C, μTBS for all protocols and both application times substantially decreased especially for the two control groups. Using the suggested dentin pre-treatment protocols, in chair-side, may possibly enhance the bond strength to DRCZ and its durability.

Effects of Various Antioxidant Pretreatment Modalities on Adhesion to Sound and Caries-Affected Dentin: An In Vitro Study

Aim:

Natural antioxidants were offered as the answer of dentin adhesion issue. The aim of this study is to investigate the effects of proanthocyanidin and lycopene as pretreatment agents on the sound and caries-affected dentin surface on microtensile bond strength and microleakage.

Materials and Methods:

This study was designed as in vitro because of that 84 mandibular molar teeth were collected. Forty-two of the included teeth were carious teeth, while the other 42 were without caries. Sixty of them were used for microleakage and 24 for microtensile bond strength testing and scanning electron microscopy analysis. The samples were divided into six subgroups randomly according to dentin pretreatments: 5% proanthocyanidin, 5% lycopene, and no antioxidant application. After the restorative procedures, samples were attached to the microtensile tester. Samples were subjected to tensile stress in the load cell until they broke at a speed of 0.5 mm per min. Microtensile bond strength (µTBS) and microleakage test data were analyzed with two-way analysis of variance, Bonferroni correction, and Tamhane’s T2 tests.

Results:

Two-way variance analysis showed that dentin pretreatment applications, dentin substrate, and the interaction between these two parameters had statistically significant effects on µTBS values ( P < .001). There was no difference between dentin pretreatment applications in terms of microleakage scores ( P > .05).

Conclusion:

The application of dentin pretreatment with proanthocyanidin is a successful procedure that increases the bond strength in both dentin substrate, while pretreatment with lycopene in caries-affected dentin reduces it.

Caries removal with Er:YAG laser followed by dentin biomodification with carbodiimide and chitosan: Wettability and surface morphology analysis

This study aimed to investigate dentin wettability and surface morphology after selective removal of carious lesion by erbium-doped yttrium aluminum garnet (Er:YAG) laser, followed by dentin biomodification with carbodiimide (EDC) and chitosan (CHI). Seventy-eight bovine dentin specimens were submitted to caries induction. Specimens were distributed according to methods of carious removal (n = 39): bur at low-speed (40,000 rpm) or Er:YAG laser (noncontact mode, 250 mJ/pulse and 4Hz). All specimens were etched with 35% phosphoric acid, and subdivided according to dentin biomodification (n = 13): Control (no biomodification), EDC or CHI. The contact angle (n = 10) between adhesive system (3M ESPE) and dentin surface was measured by a goniometer. Eighteen specimens (n = 3) were analyzed by scanning electron microscopy. Data were analyzed by two-way ANOVA and Tukey's test (α = .05). The method used to remove carious lesion did not influence the wettability of dentinal surface (p = .748). The angles produced on the remaining dentin after biomodification were influenced (p = .007). CHI promoted higher contact angles (p = .007) and EDC did not differ from the control group (p = .586). In the bur-treated group, most tubules were open, regardless of which biomodifier was used. Laser modified the organic matrix layer. CHI promoted partially closed tubules in some areas while EDC exposed dentinal tubules. Regardless of which method was used for selective removal of carious lesion, biomodification with EDC did not affect the dentin wettability, whereas CHI changed the wettability of remaining dentin. Both biomodifiers promoted a slight change on dentin morphology.

Bonding Performance of Universal Adhesive Systems Applied in Etch-and-Rinse and Self-Etch Strategies on Natural Dentin Caries

Objective:

This study investigated the bonding performance of three universal adhesive systems applied using etch-and-rinse (ER) or self-etch (SE) strategies on natural dentin caries.

Materials and Methods:

Sixty human third molars were selected for this study: 30 naturally carious (CAD) and 30 sound (SD) teeth. The dentin surfaces were exposed, and teeth were randomly assigned to each evaluated adhesive system: Scotchbond Universal (SBU), Futurabond U (FBU), and Prime&Bond Elect (PBE) and an adhesive strategy: ER or SE. The adhesive systems were applied following the manufacturer's instructions, and the teeth were restored using a resin composite (Filtek Supreme Ultra, 3M). After 24 hours (distilled water at 37°C), samples were sectioned and evaluated using microtensile bond strength analysis (μTBS), micro-Raman spectroscopy to evaluate the degree of conversion within the hybrid layer (DC), and scanning electronic microscopy (SEM) to describe the morphology of the hybrid layer. The μTBS and DC data were analyzed using three-way analysis of variance and Tukey's test for means comparison (α=0.05). The SEM images were analyzed qualitatively.

Results:

Reduced μTBS values were observed when comparing CAD with SD, regardless of adhesive system or strategy (p&lt;0.0001). SBU showed statistically higher μTBS for both dentin substrates and strategies (p&lt;0.0001). Furthermore, SBU showed greater integrity of the hybrid layer and resin tag formation compared with FBU and PBE. Mean μTBS values for FBU were higher for SD in the SE mode, whereas higher mean μTBS values were observed for CAD in the ER mode, both compared with PBE (p&lt;0.001).

Conclusion:

Bonding performance is reduced on a caries-affected substrate. The ER strategy was not able to improve the bonding performance on natural CAD for universal adhesive systems. Improved bonding performance was obtained when using the Scotchbond Universal system.

Comparison of the micro-tensile bond strengths of four different universal adhesives to caries-affected dentin after ER:YAG laser irradiation

The micro-tensile bond strengths (micro-TBSs) of four universal adhesive systems, applied in two different bonding techniques, to carries-affected dentin after Er:YAG laser irradiation were investigated. Twenty-four extracted human molars were divided into four groups, according to the adhesive systems used. Each group was subdivided into two subgroups, depending on the bonding method used: the etch-and-rinse procedure or self-etch procedure. The carious lesions were irradiated using an Er:YAG laser. Resin composites were used to restore the adhesive-treated dentin surfaces. After 2,500 thermal cycles, the vertical composite resin-dentin sticks obtained were subjected to micro-TBS tests. One tooth in each group was examined using scanning electron microscopy (SEM). There were statistically significant differences (p<0.001) in micro-TBS values between universal adhesives. The results of this study suggested that universal adhesives applied both with self and total etch technique can be used for adhesive restorations to caries-affected dentin after Er:YAG laser irradiation. If lasers are preferred as a caries removal method, choosing a dentin bonding agent containing MDP may be recommended in clinical practice due to the property of increasing the bonding strength.

Effect of caries-affected dentin on one-step universal and multi-step etch-and-rinse adhesives’ bond strength

Abstract Objective To evaluate the influence of caries-affected dentin on bond strength of a universal one-step and a multi-step etch-and-rinse adhesive system. Material and method Enamel of 60 third human molars with and without caries was removed to expose dentin. The teeth were randomly assigned to six groups: Single Bond Universal (3M ESPE, St. Paul, MN, USA) in etch-and-rinse and in self-etch mode and Prime & Bond NT (Dentsply Co, Konstanz, Germany), all on sound and caries-affected dentin. Smear layer of the 30 sound dentin specimens was standardized by polishing with 600-grit SiC paper under water cooling. Residual infected dentin of the 30 caries-affected specimens was removed with a number 4 CA carbide bur until no caries smooth tissue was detectable by tactile-visual inspection. Cylinders of a light cured composite resin (Filtek Z350 XT, 3M ESPE) were built up using starch tubes and microshear test was performed until failure. The data was analyzed by one-way ANOVA and Tukey’s post hoc test. Result Significant differences in microshear bond strength (μSBS) were observed for the caries-affected groups, but not for sound dentin. The μSBS of Single Bond Universal were not influenced by the application protocol on sound dentin, however they were lower in the caries-affected group with both application protocols. The μSBS for Prime & Bond NT was not influenced by the dentin conditions. Conclusion Caries-affected dentin decrease in bond strength of Single Bond Universal in comparison to sound dentin. The bond strength of Prime & Bond NT was not altered by substrate conditions.

Current trends and future perspectives of dental pulp capping materials: A systematic review

To systematically review the literature to analyze the current trends and future perspectives of dental pulp capping materials through an analysis of scientific and technological data. This study is reported in accordance with the PRISMA Statement. Nine databases were screened: PubMed (MedLine), Lilacs, IBECS, BBO, Web of Science, Scopus, SciELO, Google Scholar, and The Cochrane Library. Additionally, the following patent applications were searched online in Questel Orbit (Paris, France), USPTO, EPO, JPO, INPI, and Patentscope databases. A total of 716 papers and 83 patents were included. Calcium hydroxide was the main type of material studied, especially for direct pulp capping, followed by MTA. Patents related to adhesives or resins increased from 1998 e 2008, while in the last years, a major increase was observed in bioactive materials (containing bioactive proteins), materials derived from MTA (calcium silicate, calcium phosphate and calcium aluminate-based cements) and MTA. It was possible to obtain a scientific and technological overview of pulp capping materials. MTA has shown favorable results in vital pulp therapy that seem to surpass the disadvantages of calcium hydroxide. Recent advances in bioactive materials and those derived from MTA have shown promising results that could improve biomaterials used in vital pulp treatments. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1358-1368, 2018.

Effect of Different Intermediary Bases on Microleakage of a Restorative Material in Class II Box Cavities of Primary Teeth

Introduction

The aim of this in vitro study was to assess and compare the effect of different intermediary bases on microleakage between tooth and a nanocomposite interface in Class II box cavities in primary teeth.

Methods

Standard Class II box cavities were prepared in 52 primary molars and randomly divided into 9 groups according to the intermediary base used (Multicore Flow, Fuji II LC, SDR, Smart Dentin Replacement, and Biodentine). All specimens were subjected to thermocycling and prepared for microleakage testing and evaluation.

Results

There was significant difference in the mean ranks of microleakage between the 9 groups, which was observed in the gingival side (p<0.0001) and the occlusal side (p<0.0001). The mean ranks microleakage was significantly higher with experimental SDR, experimental Multicore Flow, and positive control materials when compared with the other 6 groups. The microleakage mean ranks were statistically significantly lower in experimental Fuji II LC, experimental Biodentine, and all negative control groups when compared with the other 3 groups.

Conclusions

Microleakage is affected by the application of intermediate material. Experimental Biodentine and Fuji II LC showed the lowest microleakage while experimental SDR and experimental Multicore Flow showed the highest microleakage.

The Simultaneous Effect of Extended Etching Time and Casein Phosphopeptide-Amorphous Calcium Phosphate containing Paste Application on Shear Bond Strength of Etch-and-rinse Adhesive to Caries-affected Dentin

AIM

This study evaluated the simultaneous effect of extended etching time and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing paste application on shear bond strength (SBS) of etch-and-rinse adhesive to caries-affected-dentin (CAD).

MATERIALS AND METHODS

Fifty human third molars were used; 10 normal in group 1 and 40 caries-affected teeth in groups 2 to 5. In the CAD groups, teeth were randomly assigned into four groups (n = 10). In groups 2 and 4, phosphoric acid etching for 15 and 45 seconds was used and in groups 3 and 5, after 15 or 45 seconds etching respectively, CPP-ACP containing paste (MI paste) was applied for 3 minutes. After rinsing, single bond adhesive system and Z250 composite were used for resin composite build-up in all groups. After storage, SBS test was measured at cross head speed of 0.5 mm/min. Data were analyzed using one/two-way ANOVA and Tukey HSD test (α = 0.05).

RESULTS

Normal dentin groups showed the highest SBS among different groups. There was a statistically significant difference between different etching times in CAD groups (p < 0.05), but there were no significant differences between SBS of SB adhesive to CAD with or without CPP-ACP pretreated in both etching times. Most of the failure modes were adhesive except in groups 1 and 5 which cohesive failure in composite was also observed.

CONCLUSION

The results of our study indicated that extended etching time up to 45 seconds could enhance the SBS of CAD and approach nearly to SBS of normal dentin. Moreover, MI paste pretreatment had not significant effect on SBS of etch-and-rinse adhesive in CAD.

CLINICAL SIGNIFICANCE

Simultaneous application of extended etching time and CPP-ACP containing paste may be a suggested method in increasing the SBS of adhesive to CAD.

Influence of metalloproteinases on dentin hybridization of one-bottle or self-etch dental bonding systems

AIM

To assess the influence of dentin substrate and chlorhexidine on the marginal seal of composite resin restorations.

MATERIALS AND METHODS

The sample comprised 20 third molars. Four cavities were drilled in the dentin sur face, followed by sealing and restoration of sound dentin (n = 10) or carious dentin (n = 10). In the control group, cavities were immediately restored as follows: G1: one-bottle bonding agent (OB) + composite resin (CR); G2: chlorhexidine 2.0% (CLX) + OB + CR; G3: self-etch bonding agent (SE) + CR; G4: CLX + SE + CR. In the experimental group (carious dentin), carious lesions were induced with S. mutans and cavities were restored as in the control group. Five specimens from each group (sound and carious) were stored in brain-heart infusion (BHI) medium for 6 months. All specimens were submerged in methylene blue 0.5% to test for microleakage. The Kruskal-Wallis and Student-Newman-Keuls tests were used to assess results.

RESULTS

On immediate assessment, there were no significant between-group differences in the sound dentin group, whereas in carious dentin, there was less leakage when OB and CLX were used. At 6 months, there was less leakage in the sound dentin group when OB and CLX were used; there were no between-group differences in carious dentin. Comparison of immediate and 6-month assessments showed a significant increase in leakage at 6 months when sound dentin was treated with SE and CLX and when carious dentin was treated with OB and CLX.

CONCLUSION

To ensure better dentin hybridization and preservation of the organic constituents of the dentin matrix, the properties of chlorhexidine digluconate and the components of the resin matrix must be taken into account.

CLINICAL SIGNIFICANCE

Metalloproteinases influence degradation of the hybrid layer in composite resin restorations, regardless of whether the bonding system used is one-bottle or self-etching.

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.

Influence of dentin and enamel pretreatment with acidic sulfur compounds on adhesive performance

OBJECTIVE

This study tested the potential hampering effects of acidic sulfur compounds (ASC) containing hydroxybenzene sulfonic acid, hydroxymethoxybenzene sulfonic acid, and sulfuric acid, prior to self-etch and etch-and-rinse bonding procedures on enamel and dentin. According to the manufacturer, ASC should be applied after cavity preparation and prior to application of a primer in order to reduce the remaining biofilm in the preparation cavity. Despite promoted marketing, data on the investigated liquid are almost completely lacking.

MATERIAL AND METHODS

One hundred and fifty-two extracted mandibular bovine incisors were embedded and polished to expose either enamel (E) or dentin (D). Then, specimens were randomly divided and conditioned as follows (n = 12/group): ASC and consecutive phosphoric acid application (E1/D1), ASC (E2/D2; E5/D5), phosphoric acid (E3/D3), and no conditioning (E4/D4; E6/D6). Groups were then treated with either Optibond FL(®) (etch-and-rinse; 1-4) or Clearfil SE Bond(®) (self-etch; 5-6). Hollow acrylic cylinders were bonded with a hybrid composite resin (Filtek Supreme XTE®) to the specimens, and the shear bond strength was measured (1 mm/min). In addition, failure types were assessed. Descriptive statistics and statistical analyses were performed with one-way ANOVA followed by the Scheffé post hoc test.

RESULTS

For enamel, the highest shear bond strength values were obtained applying routine bonding procedures (23.5 ± 5.6 MPa for etch-and-rinse and 26.0 ± 6.0 MPa for self-etch, respectively). In contrast, dentin pretreatment with a combination of ASC and phosphoric acid led to the highest shear bond values (22.8 ± 4.1 MPa).

CONCLUSION

This study shows that ASC prior to dental restoration placement cannot be recommended for etch-and-rinse procedures on enamel but is appropriate for dentin without interfering with routine bonding procedures.

CLINICAL RELEVANCE

The application of acidic sulfur compounds prior to adhesive restoration placement should be restricted to dentin only as it may negatively influence shear bond strength on sound enamel.

Bond strength of adhesive systems to Er,Cr:YSGG laser-irradiated dentin

OBJECTIVE

The purpose of this study was to evaluate the effects of Er,Cr:YSGG laser irradiation and different adhesive procedures on bond strength of two bonding agents to dentin.

BACKGROUND DATA

Studies have shown that laser-irradiated dentinal tissue yields lower bond strengths than does nonirradiated dentin. In this study, different treatment methods of laser irradiating dentin were studied to enhance the bond strength of bonding agents to nonirradiated dentin.

METHODS

Third molars were wet ground with SiC until the occlusal flat dentin surface was exposed, and the teeth were randomly assigned to six groups (n=5). A two-step self-etching primer (Clearfil SE Bond, G1) and a two-step etch-and-rinse adhesive (Single Bond Plus, G2) were applied to the nonirradiated dentin surface according to manufacturer's instructions, as control groups. In G3 and G4, the same adhesives were applied after Er,Cr:YSGG laser irradiation, whereas in G5 and G6 adhesives were applied after Er,Cr:YSGG laser irradiation, phosphoric acid etching, and NaOCl deproteinization of etched dentin. The Er,Cr:YSGG laser worked at 2.78??m and the repetition rate was fixed at 20?Hz. Composite blocks were built on bonded surfaces and the teeth were stored for 24?h at 37?C. Restored teeth were vertically and serially sectioned to obtain bonded specimens for the bond strength test. Data were analyzed by two-way ANOVA and Tukey test (?=5%).

RESULTS

Laser irradiation reduced bond strengths for the two adhesives, regardless of acid etching and deproteinization of dentin post-irradiation (p<0.05). The self-etching primer system showed higher bond strengths to laser irradiated dentin than did Single Bond Plus (p<0.05). The adhesive systems applied to normal dentin yielded higher bond strengths than when they were applied to laser irradiated dentin (p<0.05).

CONCLUSIONS

The self-etching primer seemed to be less affected by dentin irradiation with Er,Cr:YSGG laser. The additional etching and NaOCl solution did not overcome the effects of laser irradiation on dentin.

Direct comparison of the bond strength results of the different test methods: a critical literature review

OBJECTIVE

The goal of this paper is to undertake a literature search collecting all dentin bond strength data obtained for six adhesives with four tests (shear, microshear, tensile and microtensile) and to critically analyze the results with respect to average bond strength, coefficient of variation, mode of failure and product ranking.

METHOD

A PubMed search was carried out for the years between 1998 and 2009 identifying publications on bond strength measurements of resin composite to dentin using four tests: shear, tensile, microshear and microtensile. The six adhesive resins were selected covering three step systems (OptiBond FL, Scotch Bond Multi-Purpose Plus), two-step (Prime & Bond NT, Single Bond, Clearfil SE Bond) and one step (Adper Prompt L Pop).

RESULTS

Pooling results from 147 references showed an ongoing high scatter in the bond strength data regardless which adhesive and which bond test was used. Coefficients of variation remained high (20-50%) even with the microbond test. The reported modes of failure for all tests still included high number of cohesive failures. The ranking seemed to be dependant on the test used.

SIGNIFICANCE

The scatter in dentin bond strength data remains regardless which test is used confirming Finite Element Analysis predicting non-uniform stress distributions due to a number of geometrical, loading, material properties and specimens preparation variables. This reopens the question whether, an interfacial fracture mechanics approach to analyze the dentin-adhesive bond is not more appropriate for obtaining better agreement among dentin bond related papers.

Influence of sterilization method on the bond strength of caries-affected dentin

This study evaluated the effect of sterilization method on the bond strength of caries-affected dentin before artificial caries development and after restoration. Twelve bovine incisors were sectioned perpendicularly to their long axes at 7 mm from the amelodentinal junction. They were painted with acid-resistant nail varnish, except on an exposed coronal dentin area. Four groups were formed (n = 3) in accordance with the sterilization method used, before artificial caries development and after complete restoration: NE - no sterilization (control group); G - gamma-rays before and after; A - steam autoclave before and after; AG - steam autoclave before and gamma-rays after. For artificial caries development, dentin sections were immersed in BHI broth with S. mutans. After the soft carious tissue was removed, dentin was restored with Scotchbond Multi-Purpose and Filtek Z250. Next, the samples were sterilized in accordance with the methods described above and microtensile testing was performed. The data were analyzed by the Mann-Whitney test (p < 0.05). The G (22.7 MPa) and AG groups (16.3 MPa) were not statistically different from the NE group (17.5 MPa). Nevertheless, there were statistical differences between groups A (6.3 MPa) and NE, A and G, A and AG, G and AG. The bond strength of caries-affected dentin was not influenced by gamma-ray sterilization irrespective of whether the sterilization was performed before or after restoration.

Microtensile bond strength between crown and root dentin and two adhesive systems

STATEMENT OF PROBLEM

Since bonding agent effectiveness is usually evaluated on coronal substrates, available knowledge for judging the effectiveness of bonds to root dentin is insufficient.

PURPOSE

The objective of this study was to evaluate the bond strength of 2 adhesive systems to crown, cervical finish line, and post space dentin.

MATERIAL AND METHODS

Twenty bovine maxillary incisors were used in this study. Teeth were sectioned along the cemento-enamel junction using a low-speed diamond blade to separate the crowns and roots. Then the crowns and roots were each divided into 2 groups, according to the 2 adhesive systems tested (n=10). The facial enamel surfaces of the crowns were abraded with 600-grit silicon carbide paper to expose flat, midcoronal dentin surfaces. Drills and a diamond rotary cutting instrument were used in a low-speed handpiece to prepare post spaces in the root canals. The same diamond rotary instrument was used to prepare horizontally flat surfaces in the cervical areas, similar to the horizontal aspect of a shoulder finish line. Composite resin was placed incrementally into the post spaces, over the flat cervical shoulder areas, and on the coronal dentin. Bonded beam specimens (0.5 mm(2) of cross-sectional area) derived from crown, cervical finish line, and post space dentin, were prepared for microtensile bond testing and tested in tension. Data were analyzed using 2-way ANOVA and Tukey post hoc test (alpha=.05). Failure patterns of tested specimens were analyzed using scanning electron microscopy.

RESULTS

The mean tensile bond strength values (SD) (MPa) were: Single Bond-crown: 29.8 (4.0); Single Bond-finish line: 18.7 (4.3); Single Bond-post space: 17.0 (4.8); Clearfil SE Bond-crown: 30.1 (6.4); Clearfil SE Bond-finish line: 30.4 (5.3); and Clearfil SE Bond-post space: 17.0 (4.2). Bond strengths to post space dentin were lower than those to coronal dentin for both adhesives (P<.001). However, no significant difference was observed between coronal and finish line dentin for Clearfil SE Bond.

CONCLUSION

Bond strength was reduced when adhesives were used in bonding to post space dentin. Cervical finish line sites bonded using Clearfil SE Bond adhesive yielded bond strength similar to that of coronal dentin sites.

Microtensile Bond Strength of Resin Composite Bonded to Caries-affected Dentin with Three Adhesives

Compared to two other adhesives, a self-etch adhesive resulted in higher microtensile bond strength values when used to bond a resin composite to both sound and caries-affected dentin.

Resin adhesion to caries-affected dentine after different removal methods

BACKGROUND

Caries-affected dentine is the common bonding substrate when treating a patient. At present, there are many methods used for caries removal. The aim of this study was to evaluate the microtensile bond strength of two adhesives (Clearfil Protect Bond and OptiBond Solo Plus Total-Etch) to caries-affected dentine after three different caries removal methods.

METHODS

Extracted carious human third molars were used and caries-affected dentine surfaces were obtained from one of the three removal methods: (i) round steel bur in a slow-speed handpiece; (ii) Er:YAG laser; or (iii) 600-grit silicon carbide abrasive paper. Each of the adhesives was used to bond resin composite to the caries-affected dentine according to the manufacturers' instructions. Hourglass-shaped specimens were prepared and stressed in tension at 1mm/min. Data were analysed using two-way analysis of variance and least significant difference test.

RESULTS

Clearfil Protect Bond showed significantly lower bond strength than OptiBond Solo Plus Total-Etch after caries removal with round steel bur, but the opposite was found for specimens treated with silicon carbide abrasive paper. For laser-treated dentine, no significant differences between the adhesives were revealed.

CONCLUSIONS

Besides the differences in adhesives, different caries removal methods seem to influence resin adhesion to caries-affected dentine.