Shear Bond Strength Evaluation of Composite Resin on Enamel and Dentin after Nonvital Bleaching

The effect of propolis on the bond strength of composite resin to enamel after intracoronal bleaching with different bleaching agents

This study evaluated the effect of propolis as an antioxidant agent on bond strength to enamel after intracoronal bleaching. A total of 160 incisors were endodontically treated. Sixteen teeth were served as control, and the remaining teeth were randomly divided into three main groups according to the bleaching agent used; group 1: Sodium perborate (SP); group 2: Carbamide peroxide (CP); group 3: Hydrogen peroxide (HP). After bleaching, the samples were divided into three subgroups; subgroup A: no antioxidant agent application, subgroup B: sodium ascorbate (SA), subgroup C: propolis (PP). After the antioxidant agents application, the sample's surfaces were washed and dried. After adhesive application, composite resin cylinders were applied to enamel surfaces using tygon tubes and a shear bond strength test was performed. The use of PP significantly decreased the bond strength of composite resin to the enamel (p < 0.05). Using propolis as an antioxidant agent adversely affects the bond strength to enamel after intracoronal bleaching.

Intracoronal tooth bleaching - A review and treatment guidelines

Intracoronal bleaching is a minimally invasive procedure that was introduced into dentistry in the 19th century. The role of that procedure in enhancing the colour of teeth subjected to internal discolouration while being conservative made it extremely popular amongst dental professionals. Different materials and techniques have been utilized over the years attempting to obtain predictable long-term results while minimizing any associated risks. Contemporarily, bleaching agents are mainly based on peroxide-releasing compounds in different formulations and delivery systems. Different theories have been formulated on the bleaching mechanism of such agents, but the exact mechanism is yet to be proven. The effect of hydrogen peroxide-based bleaching agents on the organic structure of enamel and dentine has been extensively investigated to address the effects of bonding of resin-based restorative materials to hard tooth structure. Multiple case reports raised a concern about the contribution of intracoronal bleaching in developing invasive root resorption. Modification of intracoronal bleaching techniques was thus necessary to address such concerns. This review will provide a summary of the important aspects of intracoronal bleaching, focusing on how it applies to the contemporary clinical setting. © 2023 Australian Dental Association.

Evaluation of the Effect of Different Antioxidants on Resin Bond Strength to Enamel after Bleaching: An In Vitro Study

AIM

To compare and evaluate the efficacy of 10% sodium ascorbate (SA) solution, 10% alpha-lipoic acid (ALA) solution, 10% propolis solutions (PLS), and 10% pomegranate peel extract (PPE) solution on the shear bond strength (SBS) between composite resin and bleached enamel after 60 minutes.

MATERIALS AND METHODS

Ninety extracted teeth were divided into 6 subgroups (n = 15) based on the antioxidant applied: Group I: Bleaching + application of 10% SA solution for 60 minutes. Group II: Bleaching + application of 10% ALA solution for 60 minutes. Group II: Bleaching + application of 10% PLS for 60 minutes. Group IV: Bleaching + application of 10% PPE solution for 60 min. Group V: Positive control (PC) bleaching without antioxidant application. Group VI: Negative control (NC) specimen neither subjected to bleaching nor application of an antioxidant solution. About 35% hydrogen peroxide (HP) was used for bleaching the labial surfaces in the groups considered. Labial surfaces were then bonded with composite using a customized cylindrical mold followed by storage in distilled water for 24 hours and shear bond strength was tested using universal testing machine.

RESULTS

The mean shear bond strength values for groups I, II, III, IV, V, and VI are 5.04, 2.29, 5.02, 4.07, 1.42, and 9.08 respectively. The peak shear bond strength value is obtained for the negative control group; whereas the lowest mean SBS value is obtained for the positive control group.

CONCLUSION

All herbal extracts used in the present study have demonstrated a reversal of reduced SBS between resin composite and bleached enamel surface.

CLINICAL SIGNIFICANCE

The reduction in bond strength of adhesive restorations was conventionally overcome by delaying the bonding procedure for a specified period resulting in prolonged treatment duration and multiple appointments. Sodium ascorbate is most commonly used but it is postulated to form a porous scaffold capable of harboring bacteria. Herbal antioxidants are gaining popularity in this regard as they are naturally derived, effective and affordable phytochemicals in addition to being viable alternatives against drug-resistant strains of microorganisms.

Effect of Antioxidant and Buffering Agent Mixture on Dentin Shear Bond Strengths of Laminate Veneer and pH Change of External Medium After Intracoronal Bleaching

Aim:

To investigate the effect of sodium ascorbate (SA), an antioxidant and calcium hydroxide (Ca(OH)2), a buffering agent mixture, on the shear bond strength of a luting resin to dentin, and pH changes of the extraradicular medium solution after intracoronal bleaching with hydrogen peroxide.

Materials and Methods:

In this in vitro study, 60 human maxillary central incisors were randomly assigned into six groups ( n: 10): Group 1: restored, no bleach; group 2: bleached, bonded immediately; group 3: bleached, treated with 10% SA applications before bonding; group 4: bleached, treated with calcium hydroxide applications before bonding; group 5: bleached, treated with CaOH2 and SA mixture applications before bonding; group 6: delay bonding by seven days. For bleach treatment in groups 2 to 6, intracoronal bleaching was performed with 35% hydrogen peroxide for four days. SA or CaOH2 or mixture of SA and CaOH2 were left in the access cavity for four days. Hybrid blocks, 4 mm × 4 mm wide × 2–mm thick, were luted with resin cements on dentin surface and then the specimens were subjected to shear bond strength testing. Analysis of variance and Tukey post hoc multiple comparison tests were applied ( P < .05).

Results:

G2 and G4 showed significantly low bond strength values and they were lower than the other groups ( P < .05). There were no significant differences between G1, G3, and G6 ( P > .05). The pH values had risen markedly in the groups containing calcium hydroxide (G4 and G5) after four days ( P < .05).

Conclusion:

The application of 10% SA or 10% SA and CaOH2 mixture were effective at reversing bleaching effects on bond strength. CaOH2 or CaOH2 and 10% SA mixture increased the external medium pH and were effective for alkalinization after intracoronal bleaching.

Effect of Er: YAG Laser on Microtensile Bond Strength of Bleached Dentin to Composite

Introduction: In non-vital tooth bleaching, dentin is in direct contact with the bleaching agent, 1 to 3-week delay is needed to eliminate free radicals from tooth structure. The present study aimed to evaluate the effect of irradiation of Er: YAG laser on immediate microtensile bond strength of bleached dentin to composite. Methods: Sixty sounds human teeth were collected and randomly divided into 4 groups (n=15): no bleaching (NB), opalescence endo hydrogen peroxide (HP) gel bleaching, sodium perborate (SP) bleaching and laser bleaching with heydent gel (LB). The groups were divided into 3 subgroups (n=5): no surface treatment, Er: YAG laser irradiation and 10% sodium ascorbate (SA). All samples were restored and underwent microtensile bond strength testing. Statistical analysis was carried out using one-way and two-way ANOVA. Results: Bond strength in NB-SA group had a significant difference with the NB group (P<0.05) while no significant difference was noted between NB and NB-Er groups (P=0.55). Application of SA and Er: YAG laser after bleaching with SP did not enhance the bond strength (P=0.07). Conclusion: Application of SA and Er: YAG laser after HP gel bleaching significantly enhanced the bond strength. Application of Er: YAG laser after internal bleaching with HP gel could enhance the bond strength.

The Evolution of Dental Materials over the Past Century: Silver and Gold to Tooth Color and Beyond

The field of dental materials has undergone more of a revolution than an evolution over the past 100 y. The development of new products, especially in the past half century, has occurred at a staggering pace, and their introduction to the market has been equally impressive. The movement has mostly come in the area of improved esthetics, marked by the gradual replacement of dental amalgam with dental composite and all-metal and porcelain-fused-to-metal indirect restorations with reinforced dental ceramics, all made possible by the rapid improvements in dental adhesive materials. This article covers the time course of dental materials development over the past century in which the Journal of Dental Research has been published. While there have been advances in nearly all materials used in the field, this article focuses on several areas, including dental amalgam, dental composites and light curing, dental adhesives and dental cements, ceramics, and new functional repair materials. A few short statements on future advances will be included at the end.

Effects of Erbium Family Laser on Shear Bond Strength of Composite to Dentin After Internal Bleaching

Introduction: The aim of this study was to assess the effect of surface treatment with erbium: yttrium-aluminum-garnet (Er:YAG) and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers on shear bond strength of composite resin to recently bleached dentin. Methods: In this study, 40 extracted human premolars were selected. The teeth were cut 4 mm apical to the cusp tip and were randomly divided into four groups (n=10 in each group) for shear bond strength testing. For bleaching, 35% hydrogen peroxide (H2 o2 ) gel (Opalescence Endo, Ultradent, South Jordan, UT, USA) was applied to dentin surfaces of all specimens for 10 days. Before etching and bonding, in Er,Cr:YSGG and Er:YAG laser groups, dentin surfaces were irradiated with Er,Cr:YSGG and Er:YAG lasers, respectively. In Er,Cr:YSGG group, Er:YAG group and control group, composite restoration was performed immediately after bleaching while in common procedure group, composite restoration was performed after seven days. The teeth were then subjected to shear bond strength testing machine. The data were statistically analyzed using analysis of variance (ANOVA) and Tukey test. Results: The mean and standard deviation (SD) of shear bond strength was 4.3 ± 1.4 MPa for control group, 6.7 ± 2.0 Mpa for Er,Cr:YSGG group, 14.4 ± 3.7 Mpa for Er:YAG group and 19.4 ± 2.6 Mpa for common procedure group. Conclusion: The shear strength of composite to Er:YAG laser-treated bleached dentin was significantly higher than control group while significantly lower than common procedure.

Efficacy of quercetin flavonoid in recovering the postbleaching bond strength of orthodontic brackets: A preliminary study

Objectives:

To evaluate comparatively the effect of quercetin on postbleaching shear bond strength (SBS) and adhesive remnant index (ARI).

Materials and Methods:

Intact maxillary premolars were divided randomly into 12 groups of 10 each: (1) bonding the bracket immediately after bleaching, (2) bonding 1 week after bleaching, (3–8) application of three experimental concentrations of quercetin (0.1%, 0.5%, and 1%) at two time durations (5 and 10 min), (9–10) application of the solvent of quercetin at two time periods (5 and 10 min), (11) application of 10% sodium ascorbate for 10 min, and (12) bonding the brackets on nonbleached teeth. Bleaching was performed using 15% carbamide peroxide gel for 5 days (6 h daily). After incubation and thermocycling, the SBS of brackets was measured. The ARI too was recorded at ×20. The data were analyzed statistically (α =0.05).

Results:

Bleaching reduced the SBS below 10 Megapascal (MPa) level (P < 0.05) while all the postbleaching treatments (except the application of the solvent of quercetin) recovered the SBS back to values greater than 10 MPa (P < 0.05) and also back to nonbleached SBS levels (P > 0.01). All eight postbleaching treatments had rather similar efficacies (P = 0.1396). The concentration of quercetin (beta = 0.259, P = 0.042) but not its duration (beta = 0.213, P = 0.093) significantly improved its efficacy.

Conclusion:

Bleaching can weaken the bond strength of orthodontic brackets below acceptable levels. The application of quercetin or Vitamin C or delaying the bracket bonding improved the postbleaching SBS.

Bonding Effectiveness of Universal Adhesive to Intracoronal Bleached Dentin Treated with Sodium Ascorbate

Abstract This study evaluated the effect of restorative protocol with sodium ascorbate on the shear bond strength (SBS) of a universal adhesive to intracoronal bleached dentin. One hundred-and-twenty bovine dentin fragments were randomly divided into 12 groups (n=10), according to the bleaching procedure (unbleached and bleached) and restorative protocol (no treatment, 10% sodium ascorbate -10SA, 35% sodium ascorbate -35SA and two-step etch-and-rinse -ER or one-step self-etch -SE Scotchbond universal adhesive approaches). Four whitening sessions were performed using 35% hydrogen peroxide. The samples from control groups were kept in relative humidity at 37 °C. Immediately after bleaching procedures, the assigned antioxidant solution was applied on dentin and restorative procedures were performed following either the ER or the SE approach. After 24 h, the specimens were subjected to SBS test. Data (MPa) were analyzed by ANOVA and Tukey's test (?=0.05). Lower SBS values were found for bleached specimens (8.54 MPa) compared with those unbleached (12.13 MPa) (p<0.05). The bond strength of the sodium ascorbate-treated groups was higher than those untreated, regardless of the strategy employed (p<0.05). Groups restored without sodium ascorbate showed lower bond strength values for both ER (8.32 MPa) and SE (8.28 MPa) adhesive strategies. The group treated with 10SA submitted to ER approach (10.14 MPa) was similar to untreated groups (p>0.05). It may be concluded that bond strength of composite resin to intracoronal dentin was affected by restorative protocol and reduced by bleaching.

Effect of Short-Duration, Localized Carbamide Peroxide Application to Remove Enamel Staining on Bond Strength of Resin Cement to Enamel

Objective Peripheral enamel staining is often noticed after removal of long-term veneer or crown provisional restorations. Application of carbamide peroxide (CP) easily removes the stain, but the potential for immediate bonding with a resin-based cement is questionable. This project tested the short-term, shear bond strength of a commercial, photo-curable, resin cement to bovine enamel after application of a 10% concentration of CP placed for different exposure times.

MATERIALS AND METHODS

Bovine enamel was flattened and polished. Surfaces had either no CP application (control), or 10% CP applied for 10, 20, or 30 seconds. Teeth were acid-etched, rinsed, dried, and controlled sized stubs of a commercial resin cement were photocured onto the treated surfaces. The shear bond strength of each specimen was determined using a universal testing machine, and results were compared using an analysis of variance at a preset alpha of 0.5 (n = 10/group).

RESULTS

No significant differences (p = 0.819) in shear bond strength were found among any CP cleaning treatments or the experimental (nontreated) control.

CONCLUSIONS

Short-term application of 10% carbamide peroxide prior to acid etching, to remove enamel stains in teeth prepared to receive ceramic veneers or crowns, does not reduce immediate shear bond strength of resin-based cement to enamel.

CLINICAL SIGNIFICANCE

Clinicians can confidently apply 10% CP for short-term, localized stain removal on enamel and not be concerned about affecting subsequent bond strength of a resin-based cement to enamel. (J Esthet Restor Dent, 2016).

Effects of Internal Bleaching on the Adhesion of Glass-Fiber Posts

Objective:

We evaluated the effects of internal bleaching on the adhesion of glass-fiber posts (GFPs) luted with different resin cements.

Methods:

Forty extracted human single-root teeth were endodontically treated and divided into four groups (n=10): G1- conventional resin cement (CRC); G2- self-adhesive resin cement (SARC); G3- bleaching + CRC; and G4- bleaching + SARC. Specimens were sectioned transversally into three slices to perform the push-out test at the coronal, middle and apical regions of the root canals. Data were analyzed using analysis of variance and Tukey's test (p<0.05).

Results:

The push-out bond strength of GFPs luted with SARC after bleaching (G4) was significantly lower than that of the other groups (p<0.001). We found no statistically significant differences in push-out bond strength among the other groups.

Significance:

Internal bleaching reduced the adhesion of GFPs luted with SARC. The adhesion of GFPs luted with CRC was not decreased after bleaching.

Impact of Intracoronal Dentin Treatment Prior to Bleaching on Bond Strength of Restorative Materials

Surface treatment of dentin before the bleaching procedure may affect its permeability and influence the bond strength of restorative materials. This study evaluated the influence of surface treatment before the bleaching on shear bond strength (SBT) of restorative materials to intracoronal dentin. Dentin slabs were subjected to surface treatment: no bleaching (control - CON), no surface treatment + bleaching (HP), 37% phosphoric acid + bleaching (PA) and Er:YAG laser + bleaching (L). After the bleaching procedure, specimens (n=10) were restored with: microhybrid composite resin (MH), flowable composite resin (F), and resin-modified glass-ionomer cement (RMGIC). The shear test was carried out. ANOVA and Tukey's test (α=0.05) showed significant difference for surface treatment and restorative materials (p<0.05). CON presented higher STB and was statistically different from HP (p<0.05). PA and L showed intermediate values and were statistically similar to CON and HP (p>0.05). STB for MH and F were higher than RMGIC (p<0.05), and did not differ from each other (p>0.05). The surface treatments with phosphoric acid and Er:YAG laser before the bleaching procedure provided shear bond strength at the same level of unbleached dentin and the composite resins presented superior bond strength to the intracoronal dentin.

Effect of Sodium Ascorbate on Resin Bonding to Sodium Perborate–bleached Dentin

This was an in vitro study to evaluate the effect of sodium ascorbate on the microshear bond strength (MSBS) of resin composite to sodium perborate–bleached dentin. Molar dentin sections were divided into six groups: 1) control, 2) sodium perborate (SP) bleach and immediate bonding, 3) SP and 30 second sodium ascorbate (SA); 4) SP and 1 minute SA; 5) SP and 2 minute SA; and 6) SP and 7 day delay before bonding. They were further divided into two-step self-etching (Clearfil SE Bond) or all-in-one self-etching (Xeno IV) adhesive systems. Resin composite microtubes were bonded according to dentin location—center, pulp horn, and peripheral positions—and an MSBS test was carried out. Failure mode was determined using light microscopy and scanning electron microscopy. There were no significant differences between the treatment types/groups. MSBSs were significantly higher for two-step self-etching adhesive compared with all-in-one self-etching adhesive (p=0.028). For the all-in-one adhesive, MSBSs at the center and pulp horn positions were significantly lower than the peripheral positions (p&lt;0.001). All-in-one groups had significantly more adhesive failures than two-step adhesive groups (p=0.015). The odds of adhesive failure were higher at the pulp horn position than the peripheral position (p=0.004). Sodium perborate bleaching of dentin had no effect on MSBS or mode of failure for either two-step or all-in-one self-etching adhesives; therefore, the effect of sodium ascorbate was negligible. The two-step adhesive groups demonstrated the highest MSBS, and the all-in-one groups, when bonded to center and pulp horn dentin, exhibited the lowest MSBS.

Effect of Ascorbic Acid on Shear Bond Strength of Orthodontic Brackets Bonded with Resin-modified Glass-ionomer Cement to Bleached Teeth

BACKGROUND AND AIMS

Bleaching can considerably reduce shear bond strength (SBS) of orthodontic brackets bonded with composite adhesives. Application of antioxidants is a method to reverse the negative effect of bleaching on composite-to-enamel bond. However, the efficacy of antioxidants in increasing the SBS of brackets bonded using resin-modified glass-ionomer cement (RMGIC) has not been studied, which was the aim of this study.

MATERIALS AND METHODS

Fifty freshly extracted human maxillary first premolars were bleached with 35% hydrogen peroxide (Pola Office Bleaching, SDI). Sodium ascorbate 10% was applied to the experimental specimens (n=25). All the specimens were etched with 37% phosphoric acid (Ivoclar/Vivadent) and bonded using RMGIC (Fuji Ortho LC, GC). The specimens were subjected to incubation (37°C, 24h) and thermocycling (1000 cycles, 5-55°C, dwell time = 1 min). The SBS was measured at 0.5 mm/min debonding crosshead speed. The adhesive remnant index (ARI) was scored under ×10 magni-fication. Data were analyzed using Mann-Whitney U test, one- and independent-samples t-test, and Fisher'sexact test (α=0.05).

RESULTS

The mean SBS of experimental and control groups were 11.97 ± 4.49 and 7.7 ± 3.19 MPa, respectively. The dif-ference was statistically significant (P=0.000 by t-test). SBS of both control (P=0.014) and experimental (P=0.000) groups were significantly higher than the minimum acceptable SBS of 6 MPa, according to one-sample t-test.

CONCLUSION

Application of ascorbic acid can guarantee a strong bond when RMGIC is to be used. However, RMGIC might tolerate the negative effect of bleaching with minimum SA treatments (or perhaps without treatments), which de-serves further studies.

Effects of different intracoronal bleaching methods on shear bond strengths of orthodontic brackets

OBJECTIVE

To evaluate the effects of different intracoronal bleaching methods on the shear bond strengths (SBS) of orthodontic brackets.

MATERIALS AND METHODS

Sixty freshly extracted mandibular incisors were randomly divided into four groups (n = 15 per group). After filling the root canals, root fillings were removed 2 mm apical to the cementoenamel junction, and a 2-mm-thick layer of zinc-phosphate cement base was applied. Group 1 served as the control. Intracoronal bleaching was performed with hydrogen peroxide (Opalacence Endo, Ultradent products Inc, South Jordan, Utah) in group 2, sodium perborate (Sultan Healthcare, Englewood, NJ) in group 3, and 37% carbamide peroxide (Whiteness Super Endo, Dentscare, ltda, Joinville, Brazil) in group 4. Orthodontic brackets were bonded with a light cure composite resin and cured with an LED light. After bonding, the SBS of the brackets was tested with a Universal testing machine.

RESULTS

Analysis of variance indicated a significant difference between groups (P < .001). The highest values for SBS were measured in group 1 (10.15 ± 1.15 MPa). The SBS was significantly lower in groups 2, 3, and 4 than in group 1 (P < .001). The lowest values for SBS were measured in group 3 (6.17 ± 0.85 MPa). SBS was significantly higher in group 4 than in group 3 (P < .05).

CONCLUSIONS

Intracoronal bleaching significantly affected the SBS of orthodontic brackets on human enamel. Bleaching with sodium perborate affects SBS more adversely than does bleaching with other agents.

Effect of high-concentrated bleaching agents on the bond strength at dentin/resin interface and flexural strength of dentin

This study evaluated the effect of bleaching agents on bond strength at the dentin/resin interface and the flexural strength of dentin. Forty maxillary canines were selected for the study. In the shear strength test, 40 slabs of intracoronary dentin (5 x 5 mm) obtained from buccal surfaces of the crowns were included in acrylic resin. In the flexural strength test, 40 dentin bars (8 x 2 x 2 mm) were obtained from the roots. The 40 hemi-sections of the lingual surface were prepared for scanning electron microscopy (SEM). The specimens were divided into 4 groups according to the bleaching protocol (n=10): Unbleached (control), Sodium perborate + 20% hydrogen peroxide (SP + 20% HP), 37% carbamide peroxide (37% CP) and 38% hydrogen peroxide (38% HP). After 7 days, the bond strength specimens were restored and tested. Dentin bars were bleached and subjected to a three-point bending test. Data (MPa) were analyzed by ANOVA and Tukey's test (α=0.05). In the shear test, the control group was superior (p<0.05) to the bleached groups, which, in turn, were statistically similar (p>0.05). In the flexural strength test, the control group also had the highest values and differed significantly from the other groups (p<0.05). SEM revealed smear layer in all groups, with fissures in the bleached specimens. SP + 20% HP and 38% HP showed discontinuous interfaces with few tags. In conclusion, bond strength of restorative material to dentin and flexural strength of dentin were reduced after the use of high-concentration bleaching agents.

Effect of 10% sodium ascorbate hydrogel and delayed bonding on shear bond strength of composite resin and resin-modified glass ionomer to bleached enamel

OBJECTIVE

The aim of this study was to comparatively investigate the neutralizing effect of antioxidant treatment and delayed bonding after bleaching with hydrogen peroxide on the shear bond strength of a composite resin (CR) and resin-modified glass ionomer (RmGI) to enamel.

MATERIALS AND METHODS

Ninety-six freshly extracted human 3rd molars with flat enamel surfaces were divided into six experimental groups (n=12/group) and two control groups (n=12/group). After initial preparation, specimens in Groups 1 and 5 (control groups) were not bleached and the buccal enamel surface of specimens were bonded immediately with CR and RmGI. The samples of the remaining groups were all bleached six hours a day for seven days consecutively. Immediately after bleaching, groups two and six specimens were bonded with CR and RmGI. Groups 3 and 7 specimens were immersed in distilled water at 37°C for 7 days and the specimens in Groups 4 and 8 were treated with 10% sodium ascorbate as an antioxidant agent after bleaching. Specimens in Groups 3 and 4 were bonded with CR and Groups 7 and 8 specimens were bonded with RmGI immediately. After specimens were bonded, the shear bond strength (SBS) was measured. The SBS data analyses were subjected to one-way analysis of variance (ANOVA) followed by Tukey test for comparison of specific mean values.

RESULTS

The mean SBS value in Group 2 (immediately bonded with CR after bleaching) was significantly lower than other CR groups (P=0.045). RmGI did not bond to buccal enamel surface of specimens in group 6. There was no significant difference between other groups bonded with RmGI (P>0.05).

CONCLUSIONS

Applying 10% sodium ascorbate hydrogel and one week delay before bonding resulted in reversal of reduced bond strength of CR and RmGI to bleached enamel.

Effect of bleaching protocols with 38% hydrogen peroxide and post-bleaching times on dentin bond strength

This study assessed the effect of bleaching protocols with 38% hydrogen peroxide (HP) and post-bleaching times on shear bond strength of a composite resin to dentin. One-hundred slabs of intracoronary dentin were included and randomly assigned into 2 groups according to the bleaching protocol: HP (2 applications of 10 min each) and HP activated by LED laser (2 applications of 10 min each/45 s of light activation). Groups were subdivided according to the post-bleaching time (n=10): 1 day, 3 days, 7 days, 10 days and 14 days. The control group was unbleached and restored (n=10). The specimens were restored with Single Bond adhesive system/Filtek Z250 resin using a polytetrafluorethylene matrix and were submitted to the shear bond strength testa after 24 h,. Data were analyzed by ANOVA and Tukey's test (α=0.05). Unbleached group (0.283 ± 0.134) had the highest bond strength and was statistically similar (p>0.05) to HP/10 days (0.278 ± 0.064), HP + LED laser/10 days (0.280 ± 0.078), HP/14 days (0.281 ± 0.104), HP + LED laser/14 days (0.277 ± 0.093). Lower bond strength were verified in HP/1 day (0.082 ± 0.012), HP/3 days (0.079 ± 0.013), HP + LED laser/1 day (0.073 ± 0.018) and HP + LED laser/3 days (0.080 ± 0.015), which were statistically similar (p>0.05). HP/7 days (0.184 ± 0.154) and HP + LED laser/7 days (0.169 ± 0.102) had intermediate values (p<0.05). The restorative procedure of intracoronary dentin bleached with 38% HP with or without the use of light source should be performed after at least 10 days after the bleaching treatment.

Fracture resistance and failure pattern of teeth submitted to internal bleaching with 37% carbamide peroxide, with application of different restorative procedures

Objective.

This study investigated the compressive fracture strength and failure pattern in premolars submitted to endodontic treatment and internal bleaching with 37% carbamide peroxide for 21 days, with application of different restorative procedures.

Material and methods.

Six groups were employed (n = 10): 1) non-bleached teeth and pulp chamber sealed with IRM; 2) bleached teeth and pulp chamber sealed with IRM; 3) bleached teeth and pulp chamber filled with light cured composite resin; 4) bleached teeth, root canals prepared at 10mm, filling of the root canal and pulp chamber with IRM; 5) bleached teeth, root canals prepared at 10mm, luting of prefabricated metallic post with zinc phosphate and pulp chamber sealed with composite resin; 6) bleached teeth, root canals prepared at 10mm, luting of glass fiber post with resin cement and pulp chamber sealed with composite resin. After 24-hour storage in distilled water, the specimens were submitted to compressive fracture strength testing in a universal testing machine.

Results.

The following values were found: Group 1 – 56.23kgf; Group 2 – 48.96kgf; Group 3 – 53.99kgf; Group 4 – 45.72kgf; Group 5 – 54.22kgf; Group 6 – 60.12kgf. The analysis of variance did not reveal statistically significant difference between groups (p<0.05), suggesting that internal bleaching with 37% carbamide peroxide did not weaken the dental tissues. The largest number of unfavorable fractures was observed for Groups 2 (50%), 4 (40%), and 5 (30%). Group 6 exhibited the most favorable failure pattern.

Conclusions.

The results suggest that internal bleaching with 37% carbamide peroxide did not significantly weaken the teeth. Among the bleached teeth, those with temporary IRM restorations or metallic posts demonstrated the most unfavorable fracture pattern, whereas the most favorable fracture pattern occurred in teeth restored with composite resin and glass fiber posts.

Merging orthodontics and restorative dentistry: an integral part of esthetic dentistry

This article discusses the different approaches in treatment planning of patients who desire an esthetic and functional improvement of their dentition but are hesitant to sacrifice healthy tooth structure. Preservation of tooth structure, whenever possible, should be paramount to any practicing dentist. The importance of such an approach, as taught for so many years, appears to be fading away lately under the pressure of advertisements full of promises for quick esthetic solutions. Exploration of the link between orthodontic and conservative restoration, along with minor use of periodontal procedures, will give another perspective in solving the esthetic dilemma.

CLINICAL SIGNIFICANCE

Often underutilized, the combination of procedures such as orthodontics and composite bonding gives practicing clinicians conservative, predictable, esthetic, and functional results.

Improvement of bonding to bleached bovine tooth surfaces by ascorbic acid treatment

The purposes of this study were twofold: (1) to examine the effects of bleaching on the bond strength of an adhesive to bovine tooth surfaces; and (2) to explore the effectiveness of an ascorbic acid application in preventing the deterioration of bonding ability due to bleaching. In the experimental groups, ascorbic acid was applied to the bleached bovine tooth surfaces. In the control groups, the tooth specimens were bleached but no ascorbic acid application was carried out. All bonded specimens were subjected to shear bond test, and the data were statistically analyzed with two-way ANOVA and Bonferroni's test (p=0.05). Bond strengths to the bleached specimens were significantly lower than those of non-bleached specimens. No statistical differences were found in bond strength between the bleached and non-bleached groups when the ascorbic acid treatment was carried out. Results of this study suggested that ascorbic acid application was effective in preventing the reduction of bonding ability to bleached teeth.

The effect of tooth bleaching on the bond strength of an experimental primer to enamel

This study evaluated the effect of tooth bleaching on the microtensile bond strength (microTBS) of an experimental primer to enamel. Materials used were an experimental tooth manicure system (Shofu) composed of primer and light-cured flowable resin composite. Flattened enamel surfaces of bovine teeth were bleached with Nite White Excel (Discus Dental) or Hi-Lite (Shofu), with nonbleached teeth used as a control group. Each bleaching group was subdivided into three bonding modes. These were group A, application of primer for 3 s, followed by 5 s of air blowing; group B, application of primer for 10 s, followed by 5 s of air blowing; and group C, application of 20% phosphoric acid for 10 s, spraying with water for 5 s, and then air blowing for 5 s. The flowable resin paste was placed and polymerized after each enamel surface treatment. Using a low-speed diamond saw, the specimens were sectioned into beam-shaped samples with a cross-sectional area of approximately 1 mm(2) at the bonded interface. The samples were subjected to the microTBS test with a 1.0 mm/min crosshead speed. Data were statistically analyzed using two-way analysis of variance (ANOVA) followed by the Bonferroni/Dunn post-hoc test. The two-way ANOVA revealed significant differences in the effects of the bleaching systems and bonding mode, and significant differences were also found for the interaction between them (P < 0.01). There were no statistically significant differences in microTBS values among the specimens in groups A and B regardless of bleaching or nonbleaching (P > 0.05). In contrast, the microTBS value of group C without bleaching was significantly higher than that of all other experimental groups (P < 0.01).

Influence of whitening on the degree of conversion of dental adhesives on dentin

The aim of this study was to analyze the extent of polymerization of different adhesive systems on whitened dentin. One adhesive of each class was investigated: Adper Scotchbond Multi Purpose (3M ESPE); One-Step (Bisco); Clearfil Protect Bond (Kuraray); and Xeno III (Dentsply DeTrey). Dentin disks were treated with Opalescence Xtra Boost (Ultradent) for 30 min and bonded immediately after 24 h or after 14 d of storage in 100% humidity at 37 degrees C. Unbleached dentin disks were prepared as controls. The extent of polymerization of bonded interfaces was obtained with differential scanning calorimetry (DSC) at 20, 40 and 60 s, and the data were statistically analyzed. The extent of polymerization obtained from DSC exotherms of adhesives applied immediately after whitening was significantly lower compared with controls. An increased extent of polymerization after storage was confirmed for all adhesives, and no difference with controls was found after 14 d. A prolonged irradiation time increased the curing rate for all the tested adhesives. This study supports the hypothesis that polymerization of the adhesive is reduced after dentin whitening and that delayed adhesive application reverses the polymerization inhibition. Prolonged polymerization intervals may counteract the inhibition of polymerization caused by the whitening procedure. Nevertheless, further in vivo studies should validate this issue.