Micropermeability of current self-etching and etch-and-rinse adhesives bonded to deep dentine: a comparison study using a double-staining/confocal microscopy technique

Simulated Hydrostatic Pulpal Pressure Effect on Microleakage-An Initial Study

PURPOSE

This study's purpose was to evaluate the effect of simulated in vitro hydrostatic pulpal pressure (HPP) on microleakage.

METHODS AND MATERIALS

Extracted third molars (n=12) were sectioned 5 mm below the cementoenamel junction, pulp tissue removed, and the sectioned crowns mounted on a Plexiglas plate penetrated by an 18-gauge stainless steel tube. The mounted specimen mesial surface received a 2×4×6 mm Class V preparation followed by restoration with a strongly acidic, one-step dental adhesive and a flowable microfilled resin, following all manufacturers' instructions. Restorations were finished to contour, and tubing was attached to a 20-cm elevated, 0.2% rhodamine G reservoir to the specimen steel tube for 48 hours. Specimens then received a nail polish coating to within 1 mm of the restoration margins and were placed in 2% methylene blue (MB) dye for 24 hours, followed by rinsing, embedding in epoxy resin, and sectioning into 1 mm slices using a diamond saw. Controls were intact molars (n=12) processed as above but without HPP. Specimen slices were evaluated using laser confocal microscopy with images exported to ImageJ software with microleakage assessed as the MB linear penetration as a percentage of the total interfacial wall length. Mean values were evaluated with the Kruskal Wallis/Dunn test at a 95% confidence level.

RESULTS

The control specimens demonstrated significantly greater (p<0.0001) MB penetration than experimental specimens with simulated HPP. Under this study's conditions, simulated HPP significantly decreased MB dye penetration.

CONCLUSION

Studies accomplished without simulated HPP may overestimate microleakage results.

Promoting bond durability by a novel fabricated bioactive dentin adhesive

OBJECTIVE

To prepare a bioactive dentin adhesive and investigate its effect on promoting bonding durability of dentin.

METHODS

The mineralization of the bioactive glass with high phosphorus (10.8 mol% P2O5-54.2 mol% SiO2-35 mol% CaO, named PSC) and its ability to induce type I collagen mineralization were observed by SEM and TEM. The Control-Bond and the bioactive dentin adhesive containing 20 wt% PSC particles (PSC-Bond) were prepared, and their degree of conversion (DC), microtensile bond strength (μTBS), film thickness and mineralization performance were evaluated. To evaluate the bonding durability, dentin bonding samples were prepared by Control-Bond and PSC-Bond, and mineralizated in simulated body fluid for 24 h, 3 months, and 6 months. Then, the long-term bond strength and microleakage at the adhesive interface of dentin bonding samples were evaluated by microtensile testing and semiquantitative ELIASA respectively.

RESULTS

The PSC showed superior mineralization at 24 h and induced type I collagen mineralization to some extent under weakly alkaline conditions. For PSC-Bond, DC was 62.65 ± 1.20%, μTBS was 39.25 ± 4.24 MPa and film thickness was 17.00 ± 2.61 μm. PSC-Bond also formed hydroxyapatite and maintained good mineralization at the bonding interface. At 24 h, no significant differences in μTBS and interface microleakage were observed between the Control-Bond and PSC-Bond groups. After 6 months of aging, the μTBS was significantly higher and the interface microleakage was significantly lower of PSC-Bond group than those of Control-Bond group.

SIGNIFICANCE

PSC-Bond maintained bond strength stability and reduced interface microleakage to some extent, possibly reducing the occurrence of secondary caries, while maintaining long-term effectiveness of adhesive restorations.

EDTA-functionalized silica nanoparticles as a conditioning agent for dentin bonding using etch-and-rinse technique

OBJECTIVE

This study investigated the possibility of using ethylenediaminetetraacetic acid functionalized silica nanoparticles (EDTA-SiO₂) as a dentin-conditioning agent using etch-and-rinse technique to promote the durability of dentin bonding.

METHODS

The SiO₂-EDTA were synthesized by N- [(3- trimethoxysilyl) propyl] ethylenediamine triacetic acid (EDTA-TMS) and SiO₂ (50 nm), then characterized by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM). The capacity of SiO₂-EDTA to chelate calcium ions from dentin was examined by inductively coupled plasma-optic emission spectrometry (ICP-OES). The dentin surfaces conditioned with SiO₂-EDTA were detected by field emission scanning electron microscopy (SEM), TEM and microhardness testing. For dentin bonding, dentin surfaces were adopted wet- or dry-bonding technique and bonded with adhesive (Adper^TM Single Bond2) and applied composite resin (Filtek Z350) on them. The durability of dentin bonding was evaluated by mircotensile bond strength test, in-situ zymography and nanoleakage testing.

RESULTS

FTIR, TGA and XPS results showed that SiO₂-EDTA contained N element and carboxyl groups. SEM, TEM and microhardness results indicated that SiO₂-EDTA group created extrafibrillar demineralization and retained more intrafibrillar minerals within dentin surface. In the dentin bonding experiment, SiO₂-EDTA group achieved acceptable bond strength, and reduced the activity of matrix metalloproteinase and nanoleakage along bonding interface.

CONCLUSION

It was possible to generate a feasible dentin conditioning agent (SiO₂-EDTA), which could create dentin extrafibrillar demineralization and improve dentin bond durability.

CLINICAL SIGNIFICANCE

This study introduces a new dentin conditioning scheme based on SiO₂-EDTA to create extrafibrillar demineralization for dentin bonding. This strategy has the potential to be used in clinic to promote the life of restoration bonding.

Comparative Evaluation of Retention of Fiber Posts in Different Dentin Regions Using Various Bonding Techniques: An In Vitro Study

Aim This study aims to evaluate the retention of fiber posts in the coronal, middle, and apical dentin regions with various bonding techniques by using fifth, sixth, and eighth-generation bonding agents and self-etch adhesive cement. Materials and methods For this study, 96 freshly extracted human incisors with straight roots were selected. Endodontic treatment of the specimens was performed. The post spaces were created immediately after obturation and the posts were luted with three different bonding agents and self-adhesive resin cement and the specimens were divided into four groups. Approximately 3 mm thick sections were made from different dentin regions of the post space and were tested for three subgroups: Subgroup I: Coronal, Subgroup II: Middle, Subgroup III: Apical. The specimens were tested on a universal testing machine. Results Statistical analysis was done using one-way analysis of variance (ANOVA) and Tukey's post hoc test using SPSS software version 17.0 (SPSS Inc., Chicago ). The intra-group comparison showed that the bond strength was more in the fifth-generation bonding agent (Cervical- 8.2574± 1.49034, Middle- 11.4800± 2.59938, Apical- 14.7108±1.82931), followed by the sixth (Cervical- 9.102± 2.76119, Middle-9.3152±2.11585, Apical- 12.9478±4.69404) and eighth-generation bonding systems (Cervical- 9.0938±2.77537, Middle- 7.1585±1.97601, Apical- 9.3726±0.73720) and the self-etch adhesive dental resin cement (Cervical- 5.1004±2.17389, Middle- 4.1574±1.28664, Apical-7.8884±1.90078). The inter-group comparison showed that the bond strength was higher in the fifth-generation bonding agent followed by sixth-generation, eighth-generation, and self-adhesive resin cement. Conclusion The present study reveals that the highest push-out bond strengths were obtained in apical sections followed by the middle and cervical areas. The bond strength was higher when using the fifth-generation bonding agent followed by the sixth, eighth, and self-adhesive resin cement. Despite many advancements, the fifth-generation bonding agent still showed superior retention in different dentin regions among various other bonding techniques.

Bonding performance and ultramorphology of the resin-dentine interface of contemporary universal adhesives

OBJECTIVES

This study aimed at evaluating the microtensile bond strength (μTBS) and the resin-dentine ultramorphology (24 h and 10 months ageing) of contemporary universal adhesives applied in self-etch (SE) or etch-and-rinse (ER) mode.

MATERIALS AND METHODS

Sixty-four sound human molars were collected and randomly allocated in 4 main experimental groups (n = 16) according to the adhesive system employed and subsequently divided into two subgroups depending on their application mode SE or ER (n = 8): ZipBond X (ZBX-SE; ZBX-ER), Prime and Bond Active (PBA-SE; PBA-ER), Clearfil Universal Bond Quick (CBQ-SE; CBQ-ER) or Scotchbond Universal (SCH-SE; SCH-ER). The specimens were cut into sticks with a cross-sectional area of approximately 0.9 mm² and subjected to μTBS testing at 24 h or after 10 months of ageing in artificial saliva (AS). Five representative fractured specimens from each group were analysed using field-emission scanning electron microscopy (FE-SEM). Resin-dentine slabs (Ø 0.9mm²) from each experimental group were immersed in Rhodamine B and subsequently analysed using confocal microscopy analysis (CLSM). The μTBS results were analysed using a two-way ANOVA and Newman-Keuls multiple-comparison test (α = 0.05).

RESULTS

ZBX, PBA and SCH exhibited greater μTBS values than CQB at 24 h in both SE and ER modes (p < 0.05). CQB showed a significant decrease in μTBS values after ageing both when used in SE and ER mode (p < 0.05). ZBX-ER exhibited no significant differences in the μTBS test after ageing (p > 0.05), while a significant drop in μTBS was seen in SCH-ER and APB-ER after 10-month ageing (p < 0.05). Clear signs of degradation were evident in the resin-dentine interface created with CQB regardless of the application mode or the ageing time. In APB-ER and SCH-ER groups, such signs of degradation were evident after ageing in AS. ZBX showed slight dye infiltration both when used in ER and SE mode.

CONCLUSIONS

The long-term bonding performance of modern universal adhesives is usually influenced by the adhesive strategy employed; self-etching application should be prioritised during dentine bonding. Moreover, the use of shortened bonding protocols may compromise the quality of the resin-dentine interface and the bonding performance of most modern universal adhesives.

CLINICAL RELEVANCE

The use of etch-and-rinse bonding procedures, as well as "shortened" application protocols should be eluded when using modern universal adhesives in dentine. However, new generation universal adhesives based on innovative chemical formulations may probably allow clinicians to achieve long-term bonding performance with such simplified system also when employed in ER mode.

Siloranes-Suitability of a Novel Adhesive for Orthodontic Bracket Bonding

Recently, an epoxy-based resin-Filtek Silorane-has been proposed for restorative fillings. It was the aim of the investigation to evaluate the suitability of this novel resin for orthodontic bracket bonding on unground enamel. Shear bond strength was measured for two adhesives-Filtek Silorane, Transbond XT-in combination with steel, ceramic and polymer brackets. For Filtek Silorane etching was performed with the Silorane self-etching primer, as well as phosphoric acid. The Transbond XT samples were etched with phosphoric acid only and served as the control group. All samples were thermo-cycled (1000×, 5-55 °C). Shear testing was carried out with an Instron 3344. In addition, ARI scores were evaluated. The Shear bond strength showed a weak adhesion of Filtek Silorane to unprepared enamel, either with the self-etching primer or the conventional etching (0.87-4.28 MPa). The Shear bond strength of the control group was significantly higher (7.6-16.5 MPa). The ARI scores showed a clear failure at the enamel-adhesive interface for all Filtek Silorane samples. For the combination of Transbond XT and different brackets the failure was found at the adhesive-bracket interface. The novel epoxy-based resin Filtek Silorane is not appropriate for bracket bonding to unprepared enamel.

Traditional Microscopic Techniques Employed in Dental Adhesion Research-Applications and Protocols of Specimen Preparation

Microscopy is a traditional method to perform ex vivo/in vitro dental research. Contemporary microscopic techniques offer the opportunity to observe dental tissues and materials up to nanoscale level. The aim of this paper was to perform a literature review on four microscopic methods, which are widely employed in dental studies concerning the evaluation of resin-dental adhesive interfaces-confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and atomic force microscopy (AFM). The literature search was performed using digital databases: PubMed, Web of Science and Scopus. On the basis of key words relevant to the topic and established eligibility criteria, finally 84 papers were included in the review. Presented microscopic techniques differ in their principle of operation and require specific protocols for specimen preparation. With regard to adhesion studies, microscopy assists in the description of several elements involved in adhesive bonding, as well as in the assessment of the condition of enamel surface and the most appropriate etching procedures. There are several factors determining the quality of the interaction between the substrates which could be recognized and a potential for further implementation of microscopic techniques in dental research could be recognized, especially when these techniques are used simultaneously or combined with spectroscopic methods. Through such microscopy techniques it is possible to provide clinically relevant conclusions and recommendations, which can be easily introduced for enamel-safe bonding and bonding protocols, as well as optimal pretreatments in dentine preparation.

Influence of the adhesive strategy in the sealing ability of resin composite inlays after deep margin elevation

Background

The aim of this study was to determine the influence of the gingival margin position and the adhesive strategy selected to perform deep margin elevation (DME) in marginal sealing of resin composite inlays by a nanoleakage test.

Material and Methods

12 sound third molars were selected and expulsive MOD cavities for inlays were prepared. Experimental groups were established according to gingival margin location (enamel: 1 mm above cemento-enamel junction (CEJ), dentin: 1 mm below CEJ, or DME, and the adhesive strategy used to lute inlays and elevate the gingival margin. Therefore, the six experimental groups were: 1) Enamel + etch-and-rinse adhesive (ERA) Adper Scotchbond 1XT (SB1XT); 2) Dentin + SB1XT; 3) DME + SB1XT; 4) Enamel + self-etching adhesive (SEA) with enamel selective etching Clearfil SE Bond (CSE); 5) Dentin + CSE; 6) DME + CSE. Resin composite inlays were constructed (Gradia Indirect) and all luted with the same resin cement (RelyX ARC). Specimens were submitted to nanoleakage test. Results were analyzed by Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction (p<0.05).

Results

A perfect sealing ability was evidenced for experimental groups with gingival margins on enamel. Similar nanoleakage values were determined when CSE adhesive was applied regardless the gingival margin position. The highest silver nitrate infiltration was detected for elevated margins with the ERA SB1XT.

Conclusions

The SEA Clearfil SE Bond showed higher sealing ability than the ERA Adper Scotchbond 1XT when margins were located on dentin, regardless margin elevation. Gingival margins on enamel together with enamel acid etching provided an excellent sealing with both adhesive systems. Key words:Adhesion, composite inlays, gingival margin, deep margin elevation, marginal seal, nanoleakage test.

An in-vitro study investigating the effect of air-abrasion bioactive glasses on dental adhesion, cytotoxicity and odontogenic gene expression

OBJECTIVE

To assess the microtensile bond strength (MTBS) and interfacial characteristics of universal adhesives applied on dentine air-abraded using different powders. The analysis includes the cytotoxicity of the powders and their effect on odontogenic gene expression.

METHODS

Sound human dentine specimens were air-abraded using bioglass 45S5 (BAG), polycarboxylated zinc-doped bioglass (SEL), alumina (AL) and submitted to SEM analysis. Resin composite was bonded to air-abraded or smear layer-covered dentine (SML) using an experimental (EXP) or a commercial adhesive (ABU) in etch&rinse (ER) or self-etch (SE) modes. Specimens were stored in artificial saliva (AS) and subjected to MTBS testing after 24 h and 10 months. Interfacial nanoleakage assessment was accomplished using confocal microscopy. The cytotoxicity of the powders was assessed, also the total RNA was extracted and the expression of odontogenic genes was evaluated through RT-PCR.

RESULTS

After prolonged AS storage, specimens in the control (SML) and AL groups showed a significant drop in MTBS (p > 0.05), with degradation evident within the bonding interface. Specimens in BAG or SEL air-abraded dentine groups showed no significant difference, with resin-dentine interfaces devoid of important degradation. The metabolic activity of pulp stem cells was not affected by the tested powders. SEL and BAG had no effect on the expression of odontoblast differentiation markers. However, AL particles interfered with the expression of the odontogenic markers.

SIGNIFICANCE

The use of bioactive glass air-abrasion may prevent severe degradation at the resin-dentine interface. Unlike alumina, bioactive glasses do not interfere with the normal metabolic activity of pulp stem cells and their differentiation to odontoblasts.

Does Adhesive Layer Thickness and Tag Length Influence Short/Long-Term Bond Strength of Universal Adhesive Systems? An In-Vitro Study

(1) Background: This study investigated the effect of the adhesive layer thickness and the length of resin tags on dentin bond strength of five universal adhesives applied in self-etch mode. (2) Methods: One hundred and fifty extracted human third molars were used. Five different universal adhesives were applied in self-etch mode on the dentin surface. Half of the specimens were subjected to an aging procedure for six months. A shear bond strength (SBS) test was performed and the results were statistically analyzed with a t-test and one-way ANOVA test. Scanning electron microscopy (SEM) was executed to measure the adhesive layer thickness and tag depth. (3) Results: No statistical differences were found between the five adhesive systems after a 24 h storage period, regardless of layer thickness and tag depth (p < 0.05). After 6 months of aging in water at 37 °C, Iperbond Max and Scotchbond Universal preserved the bond strength over time (p < 0.05), whilst the SBS of Iperbond Ultra, FuturaBond M+, and Ibond Universal decreased significantly after the aging period. No relation was observed between the adhesive thickness or tags’ length on SBS. (4) Conclusions: Within the limitation of this study, the stability over time of the bond strength of universal adhesives depends on their compositions regardless of the adhesive layer thickness and/or tags’ length.

The effect of phytic acid on enzymatic degradation of dentin

We evaluated the effect of phytic acid on matrix metalloproteinase (MMP)- or cysteine cathepsin (CC)-mediated dentin degradation. Demineralized dentin beams were divided into five groups (n = 12) and treated with 1%, 2%, or 3% phytic acid or with 37% phosphoric acid. Untreated demineralized beams served as controls. After incubation for 1 or 3 wk, dry mass loss was determined and aliquots of incubation media were analysed for cross-linked telopeptide of type I collagen (ICTP) fragments for MMP-mediated and c-terminal telopeptide of type I collagen (CTX) for cathepsin-k-mediated degradation. The direct effect of phytic acid was evaluated using MMP activity assay. Data were analysed using repeated-measures anova. ICTP releases with 1% and 2% phytic acid treatment were statistically significantly lower than those following phosphoric acid treatment at 3 wk. The CTX release for phytic acid-treated beams at 3 wk was not significantly different from that of untreated control beams, but it was significantly lower than that of phosphoric acid-treated beams. Their MMP activities at 3 wk were not significantly different from those of the controls but they were significantly lower than those seen for phosphoric acid-treated beams. Compared to phosphoric acid, phytic acid treatment resulted in a reduced dentinal host-derived endogenous enzymatic activity and collagen degradation.

Effects of Ions-Releasing Restorative Materials on the Dentine Bonding Longevity of Modern Universal Adhesives after Load-Cycle and Prolonged Artificial Saliva Aging

This study aimed at evaluating the microtensile bond strength (MTBS) and fractographic features of dentine-bonded specimens created using universal adhesives applied in etch-and-rinse (ER) or self-etching (SE) mode in combination with modern ion-releasing resin-modified glass-ionomer cement (RMGIC)-based materials after load cycling and artificial saliva aging. Two universal adhesives (FTB: Futurabond M+, VOCO, Germany; SCU: Scotchbond Universal, 3M Oral Care, USA) were used. Composite build-ups were made with conventional nano-filled composite (AURA, SDI, Australia), conventional resin-modified glass ionomer cement (Ionolux VOCO, Germany), or a (RMGIC)-based composite (ACTIVA, Pulpdent, USA). The specimens were divided in three groups and immersed in deionized water for 24 h, load-cycled (350,000 cycles; 3 Hz; 70 N), or load-cycled and cut into matchsticks and finally immersed for 8 months in artificial saliva (AS). The specimens were cut into matchsticks and tested for microtensile bond strength. The results were analyzed statistically using three-way ANOVA and Fisher's LSD post hoc test (p < 0.05). Fractographic analysis was performed through stereomicroscope and FE-SEM. FTB showed no significant drop in bond strength after aging. Unlike the conventional composite, the two RMGIC-based materials caused no bond strength reduction in SCU after load-cycle aging and after prolonged aging (8 months). The SEM fractographic analysis showed severe degradation, especially with composite applied on dentine bonded with SCU in ER mode; such degradation was less evident with the two GIC-based materials. The dentine-bond longevity may be influenced by the composition rather than the mode of application (ER vs. SE) of the universal adhesives. Moreover, the choice of the restorative material may play an important role on the longevity of the finalrestoration. Indeed, bioactive GIC-based materials may contribute to maintain the bonding performance of simplified universal adhesives over time, especially when these bonding systems are applied in ER mode.

Determining Optimal Fluorescent Agent Concentrations in Dental Adhesive Resins for Imaging the Tooth/Restoration Interface

Fluorescent dyes like Rhodamine B (RB) have been used to identify the spatial distribution of adhesive restorative materials in the tooth/restoration interface. Potential effects of the addition of RB to dental adhesives were addressed in the past, but no further information is available on how to determine suitable concentrations of RB in these bonding agents for imaging in the confocal laser scanning microscope. This study provides systematical strategies for adding RB to viscous dental adhesive resins, focusing on the determination of the lowest range of dye concentrations necessary to achieve an acceptable image of the dentin/adhesive interface. It was demonstrated that optimized images of the resin distribution in dentin can be produced with 0.1-0.02 mg/mL of RB in the (tested) adhesives. Our approaches took into account aspects related to the dye concentration, photophysical parameters in different host media, specimen composition and morphology to develop a rational use of the fluorescent agent with the resin-based materials. Information gained from this work can help optimize labeling methods using dispersions of low-molecular-weight dyes in different monomer blend systems.

Water interaction and bond strength to dentin of dye-labelled adhesive as a function of the addition of rhodamine B

Objective

This study investigated the effect of the fluorescent dye rhodamine B (RB) for interfacial micromorphology analysis of dental composite restorations on water sorption/solubility (WS/WSL) and microtensile bond strength to dentin (µTBS) of a 3-step total etch and a 2-step self-etch adhesive system.

Material and Methods

The adhesives Adper Scotchbond Multi-Purpose (MP) and Clearfil SE Bond (SE) were mixed with 0.1 mg/mL of RB. For the WS/WSL tests, cured resin disks (5.0 mm in diameter x 0.8 mm thick) were prepared and assigned into four groups (n=10): MP, MP-RB, SE, and SE-RB. For µTBS assessment, extracted human third molars (n=40) had the flat occlusal dentin prepared and assigned into the same experimental groups (n=10). After the bonding and restoration procedures, specimens were sectioned in rectangular beams, stored in water and tested after seven days or after 12 months. The failure mode of fractured specimens was qualitatively evaluated under optical microscope (x40). Data from WS/WSL and µTBS were assessed by one-way and three-way ANOVA, respectively, and Tukey’s test (α=5%).

Results

RB increased the WSL of MP and SE. On the other hand, WS of both MP and SE was not affected by the addition of RB. No significance in µTBS between MP and MP-RB for seven days or one year was observed, whereas for SE a decrease in the µTBS means occurred in both storage times.

Conclusions

RB should be incorporated into non-simplified DBSs with caution, as it can interfere with their physical-mechanical properties, leading to a possible misinterpretation of bonded interface.

Nanoleakage Evaluation of Posterior Teeth Restored with Low Shrinkable Resin Composite- An invitro Study

INTRODUCTION

The effect of nanoleakage on the integrity of resin-dentin bond has been in interest for long-term adhesion.

AIM

This study evaluated the nanoleakage in premolar teeth restored with low shrinkable resin composite.

MATERIALS AND METHODS

A total of 40 human premolars were used for nanoleakage evaluation in this study. Each group was divided into four equal groups; Group A: using silorane with its adhesive system. Group B: using silorane with G-bond. Group C: using Filtek supreme composite with G-bond. Group D: using Filtek supreme composite with AdheSE adhesive. Nanoleakage analysed using Scaning Electron Microscope (SEM) and Energy Dispersive X-Ray Spectrometery (EDX).

RESULTS

The amount of silver present in hybrid layer depend on the adhesive used; this indicated different nanoleakage expressions in different adhesive systems. Filtek Z350 composite with G-bond showed clear silver uptake in both the adhesive and hybrid layer. Low shrinkable resin composite (silorane) with its adhesive system showed less silver penetration and slight silver peak on the elemental energy spectroscopy of energy dispersive X-Ray spectrometry (EDS) as compared to other samples.

CONCLUSION

Adhesives used between different groups, influence the location and degree of nanoleakage. There is difference in nanoleakage patterns between two-step and one-step adhesives and also among the one-step adhesives themselves.

Evaluation of cuspal deflection in premolar teeth restored with low shrinkable resin composite (in vitro study)

Objectives:

This study evaluated cuspal deflection in premolar teeth restored with low shrinkable resin composite.

Materials and Methods:

A total of 40 human premolars were used for cuspal deflection evaluation in this study. Each group was divided into four equal groups according to the type of resin composite and the adhesive used as follows: group A: Using low shrinkable resin composite (silorane) with its adhesive system; group B: Using low shrinkable composite (silorane) with G-bond; group C: Using Filtek Z350 composite with G-bond; and group D: Using Filtek Z350 composite with AdheSE. Cusp deflection was detected using Universal measuring microscope and laser horizontal metroscope.

Results:

This study was done to investigate the effect of polymerization shrinkage stresses of two resin composite materials (Filtek Z350 and Filtek P90) on cuspal deflection of mesio-occluso-distal restoration. For this study, the extracted non-carious maxillary second premolars were selected. Forty teeth that showed no more than 5% variation in their dimensions were used. A significant increase in cuspal deflection of cavities restored with the methacrylate-based (Filtek Z350) compared with the silorane (P90) resin-based composites was obtained.

Conclusion:

The change in the organic matrix or materials formulation of the resin composite using silorane has a positive effect on controlling the cusp deflection.

Effect of silorane-based adhesive system on bond strength between composite and dentin substrate

CONTEXT

The complexities of the oral environment, the dentin substrate, and the different bond and composite resin systems represent a challenge to the maintenance of reasonable bond between the composite resin and the tooth structure.

AIMS

To evaluate the effect of the adhesive system on bond strength between silorane-based composite resin and dentin.

MATERIALS AND METHODS

Fourteen human molars extracted were selected and vertically cut into 3 dentin fragments, randomly divided among the experimental groups and restored with Z250 and P90 composite resin using different adhesive protocols (Adper Single Bond 2, Silorano primer, Adper SE Plus, and Scotchbond Multiuse). Two composite resin cylinders were built up on each dentin surface (n = 10) and subjected to a micro-shear bond strength test.

STATISTICAL ANALYSIS USED

Kruskal-Wallis one-way analysis of variance and Tukey test (P = 0.05).

RESULTS

According to the results, Kruskal-Wallis test evidenced at least one statistical significant difference (P = 0.001). The Tukey test showed statistically significant differences among the group (P < 0.05). Group PSM8 (P90 + SM) showed statically significant higher results when compared with groups PSP4 (P90 + SP), PSB2 (P90 + SB), and ZSE5 (Z250 + SE).

CONCLUSION

The results evidenced that the monomer of the adhesive system has an effect on bond strength between the composite resin and dentin.

Effect of EDTA Conditioning and Carbodiimide Pretreatment on the Bonding Performance of All-in-One Self-Etch Adhesives

Objective. This study evaluated the effect of ethylenediaminetetraacetic acid (EDTA) conditioning and carbodiimide (EDC) pretreatment on the shear bond strength of two all-in-one self-etch adhesives to dentin. Methods. Flat coronal dentin surfaces were prepared on one hundred and sixty extracted human molars. Teeth were randomly divided into eight groups according to two different self-etch adhesives used [G-Bond and OptiBond-All-In-One] and four different surface pretreatments: (a) adhesive applied following manufacturer's instructions; (b) dentin conditioning with 24% EDTA gel prior to application of adhesive; (c) EDC pretreatment followed by application of adhesive; (d) application of EDC on EDTA conditioned dentin surface followed by application of adhesive. Composite restorations were placed in all the samples. Ten samples from each group were subjected to immediate and delayed (6-month storage in artificial saliva) shear bond strength evaluation. Data collected was subjected to statistical analysis using three-way ANOVA and post hoc Tukey's test at a significance level of p < 0.05.  Results and Conclusion. EDTA preconditioning as well as EDC pretreatment alone had no significant effect on the immediate and delayed bond strengths of either of the adhesives. However, EDC pretreatment on EDTA conditioned dentin surface resulted in preservation of resin-dentin bond strength of both adhesives with no significant fall over six months.

Immediate human pulp response to ethanol-wet bonding technique

OBJECTIVES

To evaluate the short-term response of human pulps to ethanol-wet bonding technique.

METHODS

Deep class V cavities were prepared on 17 sound premolars and divided into three groups. After acid-etching, the cavities from groups 1 (G1) and 2 (G2) were filled with 100% ethanol or distilled water, respectively, for 60 s before the application of Single Bond 2. In group 3 (G3, control), the cavity floor was lined with calcium hydroxide before etching and bonding. All cavities were restored with resin composite. Two teeth were used as intact control. The teeth were extracted 48h after the clinical procedures. From each tooth serial sections were obtained and stained with haematoxylin and eosin (H/E) and Masson's trichrome. Bacteria microleakage was assessed using Brown & Brenn. All sections were blindly evaluated for five histological features.

RESULTS

Mean remaining dentine thickness was 463±65μm (G1); 425±184μm (G2); and 348±194μm (G3). Similar pulp reactions followed ethanol- or water-wet bonding techniques. Slight inflammatory responses and disruption of the odontoblast layer related to the cavity floor were seen in all groups. Stained bacteria were not detected in any cavities. Normal pulp tissue was observed in G3 except for one case.

CONCLUSIONS

After 48h, ethanol-wet bonding does not increase pulpal damage compared to water-wet bonding technique.

CLINICAL SIGNIFICANCE

Ethanol-wet bonding may increase resin-dentine bond durability. This study reported the in vivo response of human pulp tissue when 100% ethanol was applied previously to an etch-and-rinse simplified adhesive system.

Morphological and chemical comparative analysis of the human and bovine dentin-adhesive layer

Micro energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF) and scanning electron microscopy (SEM) were used to evaluate dentin treated with an etch and rinse adhesive (ER) and a self-etch adhesive (SE). Ten human molars (H) and ten bovine anterior teeth (B) were prepared (exposure of dentin and divided in the middle) and allocated into two different adhesion strategy groups per substrate (n=40). µ-EDXRF data and SEM images were obtained before and after treatment. Untreated dentin of both substrates did not differ in terms of Ca (p<0.1503), P (p<0.2986) or Ca/P ratio (p<0.1400). H-SE and B-SE specimens showed reduced P content (p<0.0001; p<0.0002), while H-ER and B-ER specimens showed reduced Ca and P content (p<0.0001; p<0.0001) when compared with untreated specimens. The Ca/P ratio was significantly higher in H-ER and B-ER specimens than in H-SE and B-SE specimens (p<0.0001; p<0.0080). Untreated dentin showed a homogeneous elemental distribution. However, after adhesive treatments, the surface of the dentin showed an irregular demineralization pattern. The resin tags and adhesive layer were shorter in bovine specimens than in human specimens due to morphological differences.

Preparation and properties of calcium-silicate filled resins for dental restoration. Part II: Micro-mechanical behaviour to primed mineral-depleted dentine

OBJECTIVE

Evaluating microtensile bond strength (μTBS) and Knoop micro-hardness (KHN) of resin bonded-dentine interfaces created with two methacrylate-based systems either incorporating Bioglass 45S5 (3-E&RA/BG) or MTA (3-E&RA/WMTA).

MATERIALS AND METHODS

Solvated resins (50% ethanol/50% co-monomers) were used as primers while their neat counterparts were filled with the two calcium-silicate compounds. Application of neat resin adhesive with no filler served as control (3-E&RA). μTBS, KHN analysis and confocal tandem scanning microscopy (TSM) micropermeability were carried out after 24 h and 10 months of storage in phosphate buffer solution (DPBS). Scanning electron microscopy (SEM) was also performed after debonding.

RESULTS

High μTBS values were achieved in all groups after 24 h of DPBS storage. On the contrary, solely the specimens created using 3-E&RA/BG and 3-E&RA/WMTA agents showed no significant reduction in terms of μTBS even after 10 months in DPBS; similarly, they did not restore the average superficial micro-hardness to the level of sound dentine, but maintained unchanged KHN values, and no statistical decrease was found following 10 months of DPBS storage. The only statistically significant changes occurred in the resin-dentine interfaces bonded with 3-E&RA that were subjected to a reduction of both μTBS and KHN values with ageing. In terms of micropermeability, adverse results were obtained with 3-E&RA while 3-E&RA/BG and 3-E&RA/WMTA demonstrated a beneficial effect after prolonged DPBS storage.

CONCLUSION

Calcium-silicate filled composite resins performed better than a current etch-and-rinse adhesive and had a therapeutic/protective effect on the micro-mechanical properties of mineral-depleted resin-dentine interfaces.

CLINICAL SIGNIFICANCE

The incorporation of calcium-silicates into dental restorative and bonding agents can create more biomimetic (life-like) restorations. This will not only enable these materials to mimic the physical characteristics of the tooth structure, but will also stabilize and protect the remaining dental hard tissues.

Bond strengths of silorane- and methacrylate-based composites to various underlying materials

OBJECTIVE

To evaluate shear bond strength (SBS) values of a methacrylate (FZ 250) and a silorane-based (FS) resin composite to various underlying materials.

MATERIALS AND METHODS

A total of 80 samples were prepared with four different underlying materials; a flowable (FLC) and a bulk-fill flowable composite (BFC), and a conventional (CGIC) and resin modified glass-ionomer cement (RMGIC). These underlying materials were laminated plus to methacrylate or silorane-based resin composites (n = 10). To evaluate the specimens SBS values were evaluated with a universal testing machine (cross-head speed; 1.0 mm/min). Statistical comparisons were carried out using two-way ANOVA and Tukey's post hoc test with a significance level of P < 0.05.

RESULTS

SBS values for FZ250 were significantly higher than for FS for all of the underlying materials tested (P < 0.05). SBS values of FZ250 to BFC were significantly higher than to all other materials (P < 0.05), whereas SBS values of FS did not vary significantly according to underlying material (P > 0.05).

CONCLUSION

The use of FS in conjunction with any of the tested materials showed lower SBS than the FZ 250. Also, new low elastic modulus liner BFC presented slightly good interfacial adhesion so, the usage of BFC as an underlying material may be preferable for FZ 250.

Evaluation of bond strength of silorane and methacrylate based restorative systems to dentin using different cavity models

OBJECTIVE

The aim of this in vitro study was to evaluate the microtensile bond strength (µTBS) to dentin of two different restorative systems: silorane-based (P90), and methacrylate-based (P60), using two cavity models.

MATERIAL AND METHODS

Occlusal enamel of 40 human third molars was removed to expose flat dentin surface. Class I cavities with 4 mm mesial-distal width, 3 mm buccal-lingual width and 3 mm depth (C-factor=4.5) were prepared in 20 teeth, which were divided into two groups (n=10) restored with P60 and P90, bulk-filled after dentin treatment according to manufacturer's instructions. Flat buccal dentin surfaces were prepared in the 20 remaining teeth (C-factor=0.2) and restored with resin blocks measuring 4x3x3 mm using the two restorative systems (n=10). The teeth were sectioned into samples with area between 0.85 and 1.25 mm2 that were submitted to µTBS testing, using a universal testing machine (EMIC) at speed of 0.5 mm/min. Fractured specimens were analyzed under stereomicroscope and categorized according to fracture pattern. Data were analyzed using ANOVA and Tukey Kramer tests.

RESULTS

For flat surfaces, P60 obtained higher bond strength values compared with P90. However, for Class I cavities, P60 showed significant reduction in bond strength (p<0.05). No statistical difference between restorative systems was shown for Class I cavity model (p>0.05), or between Class I Cavity and Flat Surface group, considering P90 restorative system (p>0.05). Regarding fracture pattern, there was no statistical difference among groups (p=0.0713) and 56.3% of the fractures were adhesive.

CONCLUSION

It was concluded that methacrylate-based composite µTBS was influenced by cavity models, and the use of silorane-based composite led to similar bond strength values compared to the methacrylate-based composite in cavities with high C-factor.

Six-month evaluation of a resin/dentin interface created by methacrylate and silorane-based materials

OBJECTIVES

This study aimed to compare the micro-tensile bond strength of methacrylate resin systems to a silorane-based restorative system on dentin after 24 hours and six months water storage.

MATERIAL AND METHODS

The restorative systems Adper Single Bond 2/Filtek Z350 (ASB), Clearfil SE Bond/Z350 (CF), Adper SE Plus/Z350 (ASEP) and P90 Adhesive System/Filtek P90 (P90) were applied on flat dentin surfaces of 20 third molars (n=5). The restored teeth were sectioned perpendicularly to the bonding interface to obtain sticks (0.8 mm2) to be tested after 24 hours (24 h) and 6 months (6 m) of water storage, in a universal testing machine at 0.5 mm/min. The data was analyzed via two-way Analysis of Variance/Bonferroni post hoc tests at 5% global significance.

RESULTS

Overall outcomes did not indicate a statistical difference for the resin systems (p=0.26) nor time (p=0.62). No interaction between material × time was detected (p=0.28). Mean standard-deviation in MPa at 24 h and 6 m were: ASB 31.38 (4.53) and 30.06 (1.95), CF 34.26 (3.47) and 32.75 (4.18), ASEP 29.54 (4.14) and 33.47 (2.47), P90 30.27 (2.03) and 31.34 (2.19).

CONCLUSIONS

The silorane-based system showed a similar performance to methacrylate-based materials on dentin. All systems were stable in terms of bond strength up to 6 month of water storage.

Effect of loading on the microtensile bond strength and microleakage of a self-etching and etch-and-rinse adhesive in direct Class II MOD composite restorations in vitro

The effect of loading on microleakage and microtensile bond strength of MOD composite restorations bonded with either self-etching or etch-and-rinse adhesive was investigated. MOD cavities were prepared in 28 extracted molar teeth. 14 teeth were bonded with a one-step self-etching adhesive (G-Bond) and 14 with an etch-and-rinse adhesive (Optibond Solo Plus) then restored with resin composite. For each adhesive, 7 teeth were loaded and 7 unloaded (controls). Loading was achieved with an axial force of 80 N at 2.5 cycles/s for 250,000 cycles. All the teeth were stored in 0.25% rhodamine solution for 24 h and sectioned in a bucco-lingual direction at the proximal boxes to examine microleakage then further sliced mesiodistally into beams for the μTBS test. Failure modes were determined using confocal and scanning electron microscopy. ANOVA assessed the effect of loading on microleakage and bond strength. After loading, restorations bonded with G-Bond exhibited significantly greater dye penetration compared to Optibond Solo Plus at both the axial walls and cavity floor. On the other hand, loading significantly reduced the μTBS of Optibond Solo Plus, whereas it had no significant effect on the μTBS of G-Bond.

Hydrolytic degradation of the resin-dentine interface induced by the simulated pulpal pressure, direct and indirect water ageing

OBJECTIVES

The aim of this study was to compare the hydrolytic effects induced by simulated pulpal pressure, direct or indirect water exposure within the resin-dentine interfaces created with three "simplified" resin bonding systems (RBSs).

METHODS

A two-step/self-etching (CSE: Clearfil SE Bond), one-step/self-etching (S3: Clearfil S3) and etch-and-rinse/self-priming (SB: Single-bond 2) adhesives were applied onto dentine and submitted to three different prolonged (6 or 12 months) ageing strategies: (i) Simulated Pulpal Pressure (SPP); (ii) Indirect Water Exposure (IWE: intact bonded-teeth); (iii) Direct Water Exposure (DWE: resin-dentine sticks). Control and aged specimens were submitted to microtensile bond strength (μTBS) and nanoleakage evaluation. Water sorption (WS) survey was also performed on resin disks. Results were analysed with two-way ANOVA and Tukey's test (p < 0.05).

RESULTS

The μTBS of CS3 and SB dropped significantly (p < 0.05) after 6 months of SPP and DWE. CSE showed a significant μTBS reduction only after 12 months of DWE (p = 0.038). IWE promoted no statistical change in μTBS (p > 0.05) and no evident change in nanoleakage. Conversely, SPP induced a clear formation of "water-trees" in CS3 and SB. WS outcomes were CS3 > SB = CSE.

CONCLUSION

The hydrolytic degradation of resin-dentine interfaces depend upon the type of the in vitro ageing strategy employed in the experimental design. Direct water exposure remains the quickest method to age the resin-dentine bonds. However, the use of SPP may better simulate the in vivo scenario. However, the application of a separate hydrophobic solvent-free adhesive layer may reduce the hydrolytic degradation and increase the longevity of resin-dentine interfaces created with simplified adhesives.

Degree of conversion of two-step etch-and-rinse adhesives: In situ micro-Raman analysis

OBJECTIVES

DC of three commercial two-step etch-and-rinse adhesives across the dentine-adhesive interface was investigated using micro-Raman spectroscopy. The hypothesis tested was that no difference in DC would exist among the adhesives tested.

METHODS

Adper Scotchbond 1XT (3M ESPE), Prime&Bond NT (Dentsply DeTrey), and Ambar (FGM) were applied on human dentine disks (n=9). Composite increments of 2mm were then applied on the adhesive surface. Raman spectra were collected along the dentine-adhesive interface. The relative intensities of the peaks associated with the mineral (PO(4)(3-) at 960cm(-1)) and the adhesive (CC at 1640cm(-1); phenyl CC at 1610cm(-1)) were used to identify the adhesive within the hybrid layer and calculate its DC.

RESULTS

Adper Scotchbond 1XT and Ambar showed similar DC (79±7% and 77±7%, respectively), while a lower DC was found for Prime&Bond NT (70±7%; p<0.05).

CONCLUSIONS

The hypothesis tested was rejected because differences were found among the adhesives tested. The difference in DC among the three adhesive systems can be attributed to different monomer compositions and solvents. Further studies are needed to correlate DC with other mechanical properties of these adhesives.

CLINICAL SIGNIFICANCE

Insufficient polymerization of an adhesive can result in a weak hybrid layer, and the presence of unreacted monomers may result in degradation of the polymeric network, decreasing the strength and longevity of the bond. In the present study, Adper Scotchbond 1XT and Ambar performed significantly better than Prime&Bond NT.

Effects of MMP inhibitors incorporated within dental adhesives

Matrix metalloproteinase (MMP) inhibition has been shown to reduce adhesive bond degradation when applied as a pre-conditioner, adding to clinical steps in the placement of adhesives, but their incorporation within dental adhesives has not been fully explored. This study examined the effect of including 2 MMP inhibitors (BB94 and GM6001) within the primers of 3 commercially available adhesives. Fluorometric assay and zymography showed that adhesives with MMP inhibitors had high affinity toward both synthetic fluorogenic FRET peptides (95%) and dentin powder substrates, respectively. The immediate microtensile bond strength was enhanced for 2 types of adhesives following the addition of both inhibitors. However, no changes were detected between the control and the inhibitor groups following 3-month storage. The modified two-step etch-and-rinse and single-step systems showed less Rhodamine B penetration to the "hybrid layer" and to the "adhesive", respectively. The incorporation of BB94 and GM6001 within the primers resulted in the inhibition of dentin MMPs with improved initial bond strength and enhanced sealing ability.

Cross-Compatibility of Methacrylate-Based Resin Composites and Etch-and-Rinse One-Bottle Adhesives

Cross-compatibility between different combinations of methacrylate-based resin composites and etch-and-rinse one-bottle adhesives was evidenced for products from different manufacturers. This represents a desirable property of adhesives as it allows the flexibility to select different composite systems based on the specific restorative needs.

Effect of cavity configuration (C factor) on the marginal adaptation of low-shrinking composite: a comparative ex vivo study

Aim. To investigate the effect of C factor on marginal adaptation of low-shrinking composite (Silorane).The null hypothesis was that the marginal adaptation of “Silorane” is not affected by the cavity configuration. Materials and Methods. A Silorane based and a methacrylate based composites, with their corresponding self-etch adhesive systems “Filtek Silorane/Silorane Adhesive Bond System and Filtek Z250/Prompt L-Pop” respectively were used. Standardized cavities were prepared on the buccal surfaces of 100 maxillary premolars. Teeth were grouped into 5 groups (n = 20), for the 5 C factors. Restored teeth were subjected to thermocycling. Microleakage testing was done and linear dye penetration was assessed using a stereomicroscope. Statistical analysis was done using the Student's t-test. Results. For the methacrylate based systems' overall leakage score was significantly higher than the Silorane-based one (P = 0.034). For the methacrylate-based, leakage was found in all tested teeth groups except group 1 (C factor 1/5). For the Silorane, One-way ANOVA revealed a statistically significant increase in dye penetration in the 5th group (P = 0.010). Conclusions. The null hypothesis was rejected. The Silorane-based resin although it resulted in a statistically significant good marginal adaptation, it showed tendency toward a high leakage score with C-factor of 5.

Resin-dentin bonds to EDTA-treated vs. acid-etched dentin using ethanol wet-bonding. Part II: Effects of mechanical cycling load on microtensile bond strengths

OBJECTIVE

To compare microtensile bond strengths (MTBS) subsequent to load cycling of resin bonded acid-etched or EDTA-treated dentin using a modified ethanol wet-bonding technique.

METHODS

Flat dentin surfaces were obtained from extracted human molars and conditioned using 37% H(3)PO(4) (PA) (15s) or 0.1M EDTA (60s). Five experimental adhesives and one commercial bonding agent were applied to the dentin and light-cured. Solvated experimental resins (50% ethanol/50% comonomers) were used as primers and their respective neat resins were used as the adhesives. The resin-bonded teeth were stored in distilled water (24h) or submitted to 5000 loading cycles of 90N. The bonded teeth were then sectioned in beams for MTBS. Modes of failure were examined by scanning electron microscopy.

RESULTS

The most hydrophobic resin 1 gave the lowest bond strength values to both acid and EDTA-treated dentin. The hydrophobic resin 2 applied to EDTA-treated dentin showed lower bond strengths after cycling load but this did not occur when it was bonded to PA-etched dentin. Resins 3 and 4, which contained hydrophilic monomers, gave higher bond strengths to both EDTA-treated or acid-etched dentin and showed no significant difference after load cycling. The most hydrophilic resin 5 showed no significant difference in bond strengths after cycling loading when bonded to EDTA or phosphoric acid treated dentin but exhibited low bond strengths.

SIGNIFICANCE

The presence of different functional monomers influences the MTBS of the adhesive systems when submitted to cyclic loads. Adhesives containing hydrophilic comonomers are not affected by cycling load challenge especially when applied on EDTA-treated dentin followed by ethanol wet bonding.

Imperfect hybrid layers created by an aggressive one-step self-etch adhesive in primary dentin are amendable to biomimetic remineralization in vitro

Degradation of hybrid layers created in primary dentin occurs as early as 6 months in vivo. Biomimetic remineralization utilizes "bottom-up" nanotechnology principles for interfibrillar and intrafibrillar remineralization of collagen matrices. This study examined whether imperfect hybrid layers created in primary dentin can be remineralized. Coronal dentin surfaces were prepared from extracted primary molars and bonded using Adper Prompt L-Pop and a composite. One-millimeter-thick specimen slabs of the resin-dentin interface were immersed in a Portland cement-based remineralization medium that contained two biomimetic analogs to mimic the sequestration and templating functions of dentin noncollagenous proteins. Specimens were retrieved after 1-6 months. Confocal laser scanning microscopy was used for evaluating the permeability of hybrid layers to Rhodamine B. Transmission electron microscopy was used to examine the status of remineralization within hybrid layers. Remineralization at different locations of the hybrid layers corresponded with quenching of fluorescence within similar locations of those hybrid layers. Remineralization was predominantly intrafibrillar in nature as interfibrillar spaces were filled with adhesive resin. Biomimetic remineralization of imperfect hybrid layers in primary human dentin is a potential means for preserving bond integrity. The success of the current proof-of-concept, laterally diffusing remineralization protocol warrants development of a clinically applicable biomimetic remineralization delivery system.

Biodegradation of resin-dentin interfaces increases bacterial microleakage

Bis-GMA-containing resin composites and adhesives undergo biodegradation by human-saliva-derived esterases, yielding Bis-hydroxy-propoxy-phenyl-propane (Bis-HPPP). The hypothesis of this study is that the exposure of dental restorations to saliva-like esterase activities accelerates marginal bacterial microleakage. Resin composites (Scotchbond, Z250, 3M) bonded to human dentin were incubated in either buffer or dual-esterase media (pseudocholinesterase/cholesterol-esterase; PCE+CE), with activity levels simulating those of human saliva, for up to 90 days. Incubation solutions were analyzed for Bis-HPPP by high-performance liquid chromatography. Post-incubation, specimens were suspended in a chemostat-based biofilm fermentor cultivating Streptococcus mutans NG8, a primary species associated with dental caries, for 7 days. Bacterial microleakage was assessed by confocal laser scanning microscopy. Bis-HPPP production and depth and spatial volume of bacterial cell penetration within the interface increased with incubation time and were higher for 30- and 90-day PCE+CE vs. buffer-incubated groups, suggesting that biodegradation can contribute to the formation of recurrent decay.