Tensile properties of resin-infiltrated demineralized human dentin

Riboflavin-ultraviolet-A collagen crosslinking treatments in improving dentin bonding and resistance to enzymatic digestion

Background/purpose

The efficacy of riboflavin-ultraviolet-A (RF-UVA) treatment in crosslinking collagen and improving dentin bonding has been proven. However, biodegradation of the hybrid layer may compromise the bonding. The purpose of this study was to evaluate different RF-UVA treatments regarding their ability to preserve dentin bonding from enzymatic digestion.

Materials and methods

Collagen subjected to different RF (0.1 %, 1 %)-UVA (1, 2, 5 min) treatments and 5 % glutaraldehyde (GA), without or with enzymatic digestion, were examined by gel electrophoresis (SDS-PAGE). Twenty-five teeth with exposed dentin were primed with one of three RF-UVA treatments (0.1 %RF/1-minUVA, 0.1 %RF/2-minUVA, and 1 %RF/1-minUVA), GA, or distilled water after acid-etching, then restored with an adhesive and a resin composite. After 24-h storage, these teeth were sectioned into microbeams. Half of them received an early microtensile bond strength (μTBS) test, while the other half was stored in enzyme solution for 7 days before testing. Nanoleakage and hybrid layer degradation were examined by TEM.

Results

According to SDS-PAGE results, all groups showed the dissipation of intense γ bands of collagen after digestion. For the early bonded specimens and after enzymatic digestions, 0.1 %RF/2-minUVA treated group presented the highest μTBS and none of premature failure. Its TEM images showed less nanoleakage after digestion, which is contributed to the well suspended collagen fibrils and resin infiltration in the hybrid layer.

Conclusion

RF-UVA treatment attained collagen crosslinking effects to improve resin-dentin bonding. 0.1 %RF/2-minUVA effectively enhanced dentin bond strength and resistance to enzymatic digestion by optimally expanding dentinal collagen matrix to facilitate hybrid layer formation.

Dual Nanofillers Reinforced Polymer-Inorganic Nanocomposite Film with Enhanced Mechanical Properties

Simultaneously improving the strength and toughness of polymer-inorganic nanocomposites is highly desirable but remains technically challenging. Herein, a simple yet effective pathway to prepare polymer-inorganic nanocomposite films that exhibit excellent mechanical properties due to their unique composition and structure is demonstrated. Specifically, a series of poly(methacrylic acid)x-block-poly(benzyl methacrylate)y diblock copolymer nano-objects with differing dimensions and morphologies is prepared by polymerization-induced self-assembly (PISA) mediated by reversible addition-fragmentation chain transfer polymerization (RAFT). Such copolymer nano-objects and ultrasmall calcium phosphate oligomers (CPOs) are used as dual fillers for the preparation of polymer-inorganic composite films using sodium carboxymethyl cellulose (CMC) as a matrix. Impressively, the strength and toughness of such composite films are substantially reinforced as high as up to 202.5 ± 14.8 MPa and 62.3 ± 7.9 MJ m-3, respectively. Owing to the intimate interaction between the polymer-inorganic interphases at multiple scales, their mechanical performances are superior to most conventional polymer films and other nanocomposite films. This study demonstrates the combination of polymeric fillers and inorganic fillers to reinforce the mechanical properties of the resultant composite films, providing new insights into the design rules for the construction of novel hybrid films with excellent mechanical performances.

Progress in Dentin-Derived Bone Graft Materials: A New Xenogeneic Dentin-Derived Material with Retained Organic Component Allows for Broader and Easier Application

The optimal repair of rigid mineralized tissues, such as bone, in cases of fracture, surgical resection, or prosthetic placement, is a complex process often necessitating the use of bone graft materials. Autogenous bone from the patient is generally the gold standard in terms of outcomes but also has disadvantages, which have resulted in extensive research in the field of tissue engineering to develop better and more convenient alternatives. In the dental field, several initiatives have demonstrated that the dentin material derived from extracted teeth produces excellent results in terms of repairing bone defects and supporting dental implants. Dentin is acellular and thus, in contrast to autogenous bone, cannot provide osteoblasts or other cellular elements to the grafted region, but it does contain growth and differentiation factors, and has other properties that make it an impressive material for bone repair. In this review, the beneficial properties of dentin and the ways it interacts with the host bone are described in the context of bone graft materials. Autogenous tooth material has limitations, particularly in terms of the need for tooth extraction and the limited amount available, which currently restrict its use to particular dental procedures. The development of a xenograft dentin-derived material, which retains the properties of autogenous dentin, is described. Such a material could potentially enable the use of dentin-derived material more widely, particularly in orthopedic indications where its properties may be advantageous.

Bioinspired Stabilization of Amorphous Calcium Carbonate by Carboxylated Nanocellulose Enables Mechanically Robust, Healable, and Sensing Biocomposites

Nature builds numerous structurally complex composites with fascinating mechanical robustness and functionalities by harnessing biopolymers and amorphous calcium carbonate (ACC). The key to successfully mimicking these natural designs is efficiently stabilizing ACC, but developing highly efficient, biodegradable, biocompatible, and sustainable stabilizing agents remains a grand challenge since anhydrous ACC is inherently unstable toward crystallization in the wet state. Inspired by the stabilized ACC in crustacean cuticles, we report the efficient stabilization ability of the most abundant biopolymer-cellulose nanofibrils (CNFs) for ACC. Through the cooperative stabilizing effect of surface carboxyl groups and a rigid segregated network, the CNFs exhibit long-term stability (more than one month) and achieved a stabilization efficiency of 3.6 and 4.4 times that of carboxymethyl cellulose (CMC) and alginate, respectively, even higher than poly(acrylic acid). The resulting CNF/ACC dispersions can be constructed into transparent composite films with the high strength of 286 MPa and toughness up to 28.5 MJ/m³, which surpass those of the so far reported synthetic biopolymer-calcium carbonate/phosphate composites. The dynamic interfacial interaction between nanocomponents also provides the composite films with good self-healing properties. Owing to their good wet stability, the composite films present high humidity sensitivity for monitoring respiration and finger contact.

Clinical Performance of Filled/Nanofilled Versus Nonfilled Adhesive Systems in Noncarious Cervical Lesions: A Systematic Review and Meta-analysis

CLINICAL RELEVANCE

The use of filled adhesive systems does not influence the clinical performance of the adhesive restoration in noncarious cervical lesions.

SUMMARY

Bioinspired multifunctional adhesive system for next generation bio-additively designed dental restorations

Resin-based composite has overtaken dental amalgam as the most popular material for the repair of lost or damaged tooth structure. In spite of the popularity, the average composite lifetime is about half that of amalgam restorations. The leading cause of composite-restoration failure is decay at the margin where the adhesive is applied. The adhesive is intended to seal the composite/tooth interface, but the adhesive seal to dentin is fragile and readily degraded by acids, enzymes and other oral fluids. The inherent weakness of this material system is attributable to several factors including the lack of antimicrobial properties, remineralization capabilities and durable mechanical performance - elements that are central to the integrity of the adhesive/dentin (a/d) interfacial seal. Our approach to this problem offers a transition from a hybrid to a biohybrid structure. Discrete peptides are tethered to polymers to provide multi-bio-functional adhesive formulations that simultaneously achieve antimicrobial and remineralization properties. The bio-additive materials design combines several functional properties with the goal of providing an adhesive that will serve as a durable barrier to recurrent decay at the composite/tooth interface. This article provides an overview of our multi-faceted approach which uses peptides tethered to polymers and new polymer chemistries to achieve the next generation adhesive system - an adhesive that provides antimicrobial properties, repair of defective dentin and enhanced mechanical performance.

Could applying gels containing chlorhexidine, epigallocatechin-3-gallate, or proanthocyanidin to control tooth wear progression improve bond strength to eroded dentin?

STATEMENT OF PROBLEM

A consensus on whether or how to treat eroded dentin to bond to composite resins is lacking. The role of gels containing chlorhexidine (CHX), epigallocatechin-3-gallate (EGCG), and proanthocyanidin (PAC) in controlling erosive wear progression needs to be evaluated for bonding.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of gels containing antiproteolytic agents (CHX or EGCG) or an antiproteolytic and also collagen crosslinking agent (PAC) to control tooth wear progression on the microtensile bond strength (μTBS) of an adhesive system plus a composite resin to simulated eroded dentin.

MATERIAL AND METHODS

Superficial occlusal dentin surfaces obtained from sectioned third molars were ground with SiC paper (600-grit; 1 minute; N-normal dentin) or subsequently submitted to an initial erosive challenge (Coca-Cola; 5 minutes). They then received one of the following treatments: application of a placebo (P), a 0.12% CHX digluconate, an EGCG at 400 μM, or a 10% PAC gel (vehicle: hydroxyethylcellulose, propylene glycol, methylparaben, imidazolidinyl urea, and deionized water; active principle: as per the experimental groups when applicable) or no treatment (C: control). Initially demineralized dentin was also submitted to pH cycling (Coca-Cola; 5 minutes, 3×/day, 5 days) to simulate eroded dentin (E). After acid etching all the specimens, adhesive Adper Single Bond 2 was applied, and composite resin (Filtek Z350 XT) was placed. After 24 hours storage in distilled water at 37 °C, the specimens were sectioned into beams, and the μTBS was tested at 0.5 mm/minute. The μTBS values obtained were evaluated considering each tooth as an experimental unit, and 2-way ANOVA and the Tukey post hoc test for multiple comparisons were applied (α=.05).

RESULTS

Immediate μTBS values for the eroded dentin were always lower than those for the normal dentin, irrespective of whether any of the gels were applied for wear control.

CONCLUSIONS

CHX, EGCG, PAC, and placebo gels, applied after the initial demineralization and before the pH cycling to simulate the eroded dentin, had a similar effect on the μTBS of the adhesive system plus the composite resin to simulated eroded dentin when compared with nonapplication (control).

Biostable, antidegradative and antimicrobial restorative systems based on host-biomaterials and microbial interactions

OBJECTIVES

Despite decades of development and their status as the restorative material of choice for dentists, resin composite restoratives and adhesives exhibit a number of shortcomings that limit their long-term survival in the oral cavity. Herein we review past and current work to understand these challenges and approaches to improve dental materials and extend restoration service life.

METHODS

Peer-reviewed work from a number of researchers as well as our own are summarized and analyzed. We also include yet-unpublished work of our own. Challenges to dental materials, methods to assess new materials, and recent material improvements and research directions are presented.

RESULTS

Mechanical stress, host- and bacterial-biodegradation, and secondary caries formation all contribute to restoration failure. In particular, several host- and bacterial-derived enzymes degrade the resin and collagen components of the hybrid layer, expanding the marginal gap and increasing access to bacteria and saliva. Furthermore, the virulence of cariogenic bacteria is up-regulated by resin biodegradation by-products, creating a positive feedback loop that increases biodegradation. These factors work synergistically to degrade the restoration margin, leading to secondary caries and restoration failure. Significant progress has been made to produce hydrolytically stable resins to resist biodegradation, as well as antimicrobial materials to reduce bacterial load around the restoration. Ideally, these two approaches should be combined in a holistic approach to restoration preservation.

SIGNIFICANCE

The oral cavity is a complex environment that poses an array of challenges to long-term material success; materials testing conditions should be comprehensive and closely mimic pathogenic oral conditions.

Longevity of Bonding of Self-adhesive Resin Cement to Dentin

Objective: To evaluate the effect of root dentin treatment on the bonding of self-adhesive resin cement after 24 hours and after 6 months.

Methods: A total of 48 single-rooted premolars were endodontically treated and divided into four groups (n=12): Adper Scotchbond Multi-Purpose + RelyX ARC (ARC); RelyX U200 (U200); EDTA + RelyX U200 (EU200); and phosphoric acid (H3PO4) + RelyX U200 (HU200). After filling the roots, an Exacto No. 2 fiber post was cleaned, treated with silane (60 seconds), positioned, and light cured (LED; 60 seconds at 1200 mW/cm2). After storage (37°C/24 h), the roots were cut to obtain two discs (1 mm) of each third. They were stored in distilled water (24 hours at 37°C); one disc of each root-third was subjected to the push-out test (0.5 mm/min) at 24 hours and the other disc after six months of water storage (37°C). The data on the root-thirds were averaged for statistical purposes. The average values of bond strength (MPa) were analyzed by two-way analysis of variance and post hoc Student-Newman-Keuls (5%).

Results: There were statistical differences for the treatment of dentin (p<0.001), for time (p=0.003), and the interaction of treatment and time (p=0.017). After 24 hours, we observed lower bond strength in the HU200 group when compared with other groups (ARC, U200, and EU200). After six months, HU200 showed the lowest bond strength. Higher strengths were observed for EU200 and U200 similarly, which were higher than ARC.

Conclusion: The bonding of the self-adhesive resin cement varied over time in the tested groups.

Assessment of Self-Adhesive Resin Composites: Nondestructive Imaging of Resin-Dentin Interfacial Adaptation and Shear Bond Strength

Shear bond strength (SBS) and the interfacial adaptation (IA) of self-adhesive resin (SAR) composites to dentin were evaluated. Two SARs [Vertise Flow (VTF) and Fusio Liquid Dentin (FLD)] were evaluated and compared with a conventional restorative system [adhesive: OptiBond FL and composite: Herculite Précis (OBF/HP)]. Human third molars were used for SBS testing and IA imaging (n=7) using optical coherence tomography (OCT). Flattened dentin disks were prepared and the composites were applied into molds (2.4 mm diameter) that were positioned on dentin. Samples were subjected to SBS testing and OCT analysis, which considered an increase in signal intensity at the bonded interface as evidence of internal gaps. SBS data were analyzed by one-way analysis of variance and Tukey's test and IA data (% distribution of high brightness values) by Kruskal-Wallis and Dunn's test (p≤0.05). No statistically significant difference in SBS was observed between VTF (13.9±3.6 MPa) and FLD (11.3±3.2 MPa), whereas OBF/HP showed higher average strength (27.3±6.1 MPa). However, there was a statistically significant difference in IA when VTF (33.3%) was compared with FLD (1.2%) and OBF/HP (1.5%). The conventional restorative system exhibited superior SBS performance compared with SARs. However, the IA of FLD to dentin had values that were not significantly different from OBF/HP.

In vitro analysis of riboflavin-modified, experimental, two-step etch-and-rinse dentin adhesive: Fourier transform infrared spectroscopy and micro-Raman studies

To modify two-step experimental etch-and-rinse dentin adhesive with different concentrations of riboflavin and to study its effect on the bond strength, degree of conversion, along with resin infiltration within the demineralized dentin substrate, an experimental adhesive-system was modified with different concentrations of riboflavin (m/m, 0, 1%, 3%, 5% and 10%). Dentin surfaces were etched with 37% phosphoric acid, bonded with respective adhesives, restored with restorative composite–resin, and sectioned into resin–dentin slabs and beams to be stored for 24 h or 9 months in artificial saliva. Micro-tensile bond testing was performed with scanning electron microscopy to analyse the failure of debonded beams. The degree of conversion was evaluated with Fourier transform infrared spectroscopy (FTIR) at different time points along with micro-Raman spectroscopy analysis. Data was analyzed with one-way and two-way analysis of variance followed by Tukey's for pair-wise comparison. Modification with 1% and 3% riboflavin increased the micro-tensile bond strength compared to the control at 24 h and 9-month storage with no significant differences in degree of conversion (P<0.05). The most predominant failure mode was the mixed fracture among all specimens except 10% riboflavin-modified adhesive specimens where cohesive failure was predominant. Raman analysis revealed that 1% and 3% riboflavin adhesives specimens showed relatively higher resin infiltration. The incorporation of riboflavin in the experimental two-step etch-and-rinse adhesive at 3% (m/m) improved the immediate bond strengths and bond durability after 9-month storage in artificial saliva without adversely affecting the degree of conversion of the adhesive monomers and resin infiltration.

Dentin biomodification: strategies, renewable resources and clinical applications

OBJECTIVES

The biomodification of dentin is a biomimetic approach, mediated by bioactive agents, to enhance and reinforce the dentin by locally altering the biochemistry and biomechanical properties. This review provides an overview of key dentin matrix components, targeting effects of biomodification strategies, the chemistry of renewable natural sources, and current research on their potential clinical applications.

METHODS

The PubMed database and collected literature were used as a resource for peer-reviewed articles to highlight the topics of dentin hierarchical structure, biomodification agents, and laboratorial investigations of their clinical applications. In addition, new data is presented on laboratorial methods for the standardization of proanthocyanidin-rich preparations as a renewable source of plant-derived biomodification agents.

RESULTS

Biomodification agents can be categorized as physical methods and chemical agents. Synthetic and naturally occurring chemical strategies present distinctive mechanism of interaction with the tissue. Initially thought to be driven only by inter- or intra-molecular collagen induced non-enzymatic cross-linking, multiple interactions with other dentin components are fundamental for the long-term biomechanics and biostability of the tissue. Oligomeric proanthocyanidins show promising bioactivity, and their chemical complexity requires systematic evaluation of the active compounds to produce a fully standardized intervention material from renewable resource, prior to their detailed clinical evaluation.

SIGNIFICANCE

Understanding the hierarchical structure of dentin and the targeting effect of the bioactive compounds will establish their use in both dentin-biomaterials interface and caries management.

Limitations in bonding to dentin and experimental strategies to prevent bond degradation

The limited durability of resin-dentin bonds severely compromises the lifetime of tooth-colored restorations. Bond degradation occurs via hydrolysis of suboptimally polymerized hydrophilic resin components and degradation of water-rich, resin-sparse collagen matrices by matrix metalloproteinases (MMPs) and cysteine cathepsins. This review examined data generated over the past three years on five experimental strategies developed by different research groups for extending the longevity of resin-dentin bonds. They include: (1) increasing the degree of conversion and esterase resistance of hydrophilic adhesives; (2) the use of broad-spectrum inhibitors of collagenolytic enzymes, including novel inhibitor functional groups grafted to methacrylate resins monomers to produce anti-MMP adhesives; (3) the use of cross-linking agents for silencing the activities of MMP and cathepsins that irreversibly alter the 3-D structures of their catalytic/allosteric domains; (4) ethanol wet-bonding with hydrophobic resins to completely replace water from the extrafibrillar and intrafibrillar collagen compartments and immobilize the collagenolytic enzymes; and (5) biomimetic remineralization of the water-filled collagen matrix using analogs of matrix proteins to progressively replace water with intrafibrillar and extrafibrillar apatites to exclude exogenous collagenolytic enzymes and fossilize endogenous collagenolytic enzymes. A combination of several of these strategies should result in overcoming the critical barriers to progress currently encountered in dentin bonding.

EDTA or H3PO4/NaOCl dentine treatments may increase hybrid layers' resistance to degradation: a microtensile bond strength and confocal-micropermeability study

OBJECTIVES

The aim of this study was to reduce hybrid layer degradation created with simplified dentine adhesives by using two different methods to condition the dentine surface.

METHODS

A smear-layer was created on flat dentine surfaces from extracted human third molars with a 180-grit/SiC-paper. Dentine specimens were conditioned before bonding with the following procedures: 37% H(3)PO(4); H(3)PO(4)/0.5% NaOCl; 0.1M EDTA; 0.1M EDTA/0.5% NaOCl. Two etch-and-rinse adhesives: (Scotchbond 1XT or Optibond Solo Plus) were applied and light-cured. Composite build-ups were constructed. The bonded teeth were sectioned into beams, stored in distilled water (24h) or 12% NaOCl solution (90 min) and finally tested for microtensile bond strengths (microTBS). Additional dentine surfaces were conditioned and bonded as previously described. They were prepared for a pulpal-micropermeability confocal microscopy study and finally observed using confocal microscopy.

RESULTS

microTBS results revealed that both adhesives gave high bond strengths to acid-etched dentine before, but not after a 12% NaOCl challenge. Bonds made to acid-etched or EDTA-treated dentine plus dilute NaOCl, gave high microTBS that resisted 12% NaOCl treatment, as did EDTA-treated dentine alone. A confocal micropermeability investigation showed very high micropermeability within interfaces of the H(3)PO(4), etched specimens. The lowest micropermeability was observed in H(3)PO(4)+0.5% NaOCl and 0.1M EDTA groups.

CONCLUSIONS

The use of dilute NaOCl (0.5%) after acid-etching, or the conditioning of dentine smear layers with 0.1M EDTA (pH 7.4) produced less porous resin-dentine interfaces. These dentine-conditioning procedures improve the resistance of the resin-dentine bond sites to chemical degradation (12% NaOCl) and may result in more durable resin-dentine bonds.

Influence of Different Primer Application Times On Bond Strength of Self-etching Adhesive Systems to Unground Enamel

An increase in application time of acid primer does not improve the bonding of self-etching adhesive systems to unground enamel.

PMMA-grafted nanoclay as novel filler for dental adhesives

OBJECTIVE

The aim of this study was to investigate the benefits of incorporation of poly(methyl methacrylate)-grafted-nanoclay on the bond strength of an experimental one-bottle dentin bonding system. The effect of the modification on the stability of the nanoparticle dispersion in the dilute adhesive was also studied.

MATERIALS AND METHODS

Poly(methyl methacrylate) was grafted onto the pristine Na-MMT nanoclay (Cloisite Na(+)) through the free radical polymerization of methyl methacrylate in an aqueous media in the presence of ammonium persulfate as initiator. A reactive surfactant (AMPS) was also used in the reaction recipe to provide active sites on the surface of the nanoclay. The grafting polymerization reaction was carried out at 70 degrees C. The PMMA-g-nanoclay was then coagulated in methanol and filtered. The resulting PMMA-g-nanoclay was characterized using FTIR, TGA, X-ray diffraction (XRD) and particle size distribution analysis. The modified nanoclay was added to an experimental dentin bonding system as filler and the morphology of the nanoclay layers in the adhesive matrix was studied using TEM and XRD. Shear bond strength of the adhesives containing different filler contents was tested on the caries-free extracted human premolar teeth. The mode of failure was studied by scanning electron microscopy. The stability of the nanoclay dispersion in the dilute adhesive was also studied using a separation analyzer. The results were then statistically analyzed and compared.

RESULTS

The grafting of poly(methylmethacrylate) onto the nanoclay was confirmed and the results revealed a partially exfoliated structure for the PMMA-g-nanoclay. Incorporation of the modified nanoclay provided a dentin bonding system with higher shear bond strength. The dispersion stability of the modified nanoparticles in the dilute adhesive was also increased more than 40 times in comparison with the pristine nanoclay.

SIGNIFICANCE

The grafting modification provided nanoclay particles with higher dispersion stability than pristine Na-MMT nanoclay in a dilute dentin bonding system. Incorporation of the modified nanoclay into the bonding system provided higher shear bond strength. The finding would be beneficial in producing nano-filler containing adhesive systems.

Changes in resin-infiltrated dentin stiffness after water storage

Plasticization of polymers by water sorption lowers their mechanical properties in a manner that is predictable by the polarity of their component resins. This study tested the hypothesis that when adhesive resins were used to create resin-infiltrated dentin, the reductions in their flexural moduli after water storage would be lowered proportional to their hydrophilic characteristics. Three increasingly hydrophilic resin blends were used to fabricate polymer beams and macro-hybrid layer models of resin-infiltrated dentin for testing with a miniature three-point flexure device, before and after 1-4 weeks of water storage. Flexural modulus reductions in macro-hybrid layers were related to, and more extensive than, reductions in the corresponding polymer beams. Macro-hybrid layers that were more hydrophilic exhibited higher percent reductions in flexural modulus, with the rate of reduction proportional to the Hoy's solubility parameters for total intermolecular attraction forces (delta(t)) and polar forces (delta(p)) of the macro-hybrid layers.

Compressive Fracture Resistance of Porcelain Laminates Bonded to Enamel or Dentin with Four Adhesive Systems

PURPOSE

To measure the compressive strength of porcelain laminates of 0.5 or 1.0 mm thickness when bonded to enamel or dentin using these resin cements: All-Bond 2 + Choice, Panavia 21, Scotchbond + Opal, and Super-Bond C&B.

MATERIALS AND METHODS

The buccal and lingual aspects of human molars were sectioned to prepare specimens at least 3 x 3 x 3 mm in size. Thirty horizontally flat enamel surfaces were prepared with a diamond disc for each group using a milling machine. Ten enamel specimens were randomly selected to test the fracture strength of 0.5-mm thick porcelain laminates without resin cement, and the data were recorded for a control group. The enamel specimens of each group were divided into two subgroups of 15 specimens to bond with either 0.5- or 1.0-mm thick porcelain laminates. Four resin cements were used for bonding of individual groups. All bonded specimens were stored in 37 degrees C for 24 hours before fracture testing. The horizontally flat dentin surfaces were prepared on the fractured bonded specimens using a diamond disc for each group. Ten 0.5 mm porcelain laminates were randomly selected to test the fracture strength on dentin (control group). The bonded laminates to dentin were prepared using the same procedure as for enamel. The fracture strengths were statistically analyzed at alpha= 0.05.

RESULTS

Statistically significant differences in mean fracture strengths between groups were revealed. No significant difference in fracture strengths of control specimens between enamel and dentin was found. Super-Bond C&B provided a higher fracture resistance of porcelain than the other resin cements. Increasing the thickness of porcelain laminate increased the fracture strength. The 0.5-mm thick porcelain bonded to enamel had higher fracture strength than that of 1.0-mm thick porcelain bonded to dentin when using Super-Bond C&B and Scotchbond + Opal cements.

CONCLUSIONS

Bonding techniques and curing systems of resin cements influenced the fracture resistance of porcelain laminates. Dry bonding with auto-polymerization of Super-Bond C&B resin provided the highest fracture resistance of porcelain. Porcelain bonded to enamel with this resin had a much higher fracture strength than when bonded to dentin.

The effect of thermal stress on bonding durability of resin composite adaptation to the cavity wall

This study evaluated the effect of thermal stress on marginal sealing and cavity wall adaptation using two adhesive systems. Cylindrical cavities were prepared in superficial dentin of bovine incisors and bonded with Clearfil SE Bond or Single Bond adhesive. Cavities were bulk-filled with Photo Clearfil Bright or Filtek Flow resin composite and light-cured for 40 seconds. Specimens were thermocycled for 0, 500, or 5000 times. A dye penetration test was carried out to determine adaptation to the cavity wall. Dye penetration length was calculated as a percentage of the total cavity wall length. Clearfil SE Bond showed excellent marginal sealing and cavity wall adaptation regardless of composite type up to 500 cycles of thermal stress. As for the Single Bond groups, significantly greater marginal leakage occurred after 500 cycles. At 5000 cycles of thermal stress, both adhesive systems showed significantly decreased marginal integrity compared with the 0 cycle group.

Adhesion between dental ceramic and bonding resin: quantitative evaluation by Vickers indenter methodology

OBJECTIVES

The purpose of this study was to evaluate the adhesion to dental ceramic by Vickers indenter methodology. This technique allows the creation of adhesive fractures and determines the influence of the surface treatment on adhesive capacities.

METHODS

A single bond adhesive system (One Step Bisco) was applied to ceramic Vitapan 3D Master CE 0124 samples. Ceramic samples were polished with 500 or 4000-grit paper, sandblasted or not (Sa/NSa), treated with fluorhydric acid or not (A/NA) and silane or not (Si/NSi). The experimental groups (Gr) were: (Gr 1) 4000; (Gr 2) 4000+Si; (Gr 3) 4000+Sa+A; (Gr 4) 4000+Sa+A+Si; (Gr 5) 500+Sa+A+Si. Each sample was indented with the diamond Vickers indenter Leitz Durimet 2 (Wetzlar, Germany) using a load of 20N for 30s. The surfaces of the debonded areas were observed in an optical microscope providing a digital image of the debonded surface. The adhesion bond strength was calculated according to the formula of Engel and Roshon [Engel PA, Roshon DD. Indentation-debonding of an adhered surface layer. J Adhesion 1979;10(33): 237-53]. The statistical analysis was conducted using Student's t test (p<0.05).

RESULTS

The values obtained for each group were: (Gr 1) 32MPa; (Gr 2) 52MPa; (Gr 3) 112MPa; (Gr 4) 131MPa; (Gr 5) 265MPa. There is a significant improvement in bond strength with the silane application on the 4000 polished surface (Gr 2). However, there is no significant difference when silane is applied or not on a sanded and etched ceramic (Gr 4). Bond strengths were higher with 500 grit polished, sanded, etched with silane application on the surface (Gr 5).

SIGNIFICANCE

The Vickers indenter methodology is able to discriminate between the influences of different surface treatments on the adhesion of an adhesive layer on a feldspathic ceramic.

Multiscale mechanics of hierarchical structure/property relationships in calcified tissues and tissue/material interfaces

This paper presents a review plus new data that describes the role hierarchical nanostructural properties play in developing an understanding of the effect of scale on the material properties (chemical, elastic and electrical) of calcified tissues as well as the interfaces that form between such tissues and biomaterials. Both nanostructural and microstructural properties will be considered starting with the size and shape of the apatitic mineralites in both young and mature bovine bone. Microstructural properties for human dentin and cortical and trabecular bone will be considered. These separate sets of data will be combined mathematically to advance the effects of scale on the modeling of these tissues and the tissue/biomaterial interfaces as hierarchical material/structural composites. Interfacial structure and properties to be considered in greatest detail will be that of the dentin/adhesive (d/a) interface, which presents a clear example of examining all three material properties, (chemical, elastic and electrical). In this case, finite element modeling (FEA) was based on the actual measured values of the structure and elastic properties of the materials comprising the d/a interface; this combination provides insight into factors and mechanisms that contribute to premature failure of dental composite fillings. At present, there are more elastic property data obtained by microstructural measurements, especially high frequency ultrasonic wave propagation (UWP) and scanning acoustic microscopy (SAM) techniques. However, atomic force microscopy (AFM) and nanoindentation (NI) of cortical and trabecular bone and the dentin-enamel junction (DEJ) among others have become available allowing correlation of the nanostructural level measurements with those made on the microstructural level.

EDTA treatment improves resin-dentin bonds' resistance to degradation

The existence of unprotected collagen fibrils within the hybrid layer compromises the longevity of restorations. This phenomenon may be avoided if solutions other than strong acids are used for dentin demineralization. The hypothesis to be tested is that bond durability may be improved by EDTA demineralization. Dentin surfaces (human and bovine) were bonded: (1) after phosphoric-acid-etching, and after EDTA demineralization with (2) a total-etch adhesive and (3) a self-etching adhesive. After the teeth were sectioned into beams, half of the specimens were immersed in NaOCl, while the other half was immersed in water. Beams were tested to failure in tension. ANOVA and multiple-comparisons tests were used (P < 0.05). No differences in bond strength were found among the 3 bonding procedures, although bonds made to human molars were 43-61% higher than those to bovine incisors. After NaOCl immersion, only specimens subjected to EDTA demineralization maintained the initial bond strength. We conclude that the collagen network is better-preserved after EDTA demineralization.

Bonding Efficacy of Single-step Self-etch Systems to Sound Primary and Permanent Tooth Dentin

Single-step self-etch systems are capable of producing a predictable bond to primary dentin, although the bond strength was found to be lower than permanent dentin.

Effect of light-cure time of adhesive resin on the thickness of the oxygen-inhibited layer and the microtensile bond strength to dentin

A thick oxygen-inhibited layer (OIL) on a cured adhesive layer (AL) is believed to result in both good adaptation of composite resin (CR) and high bond strength. A high degree of conversion (DC) of the AL is also needed for durable bonding. This study evaluated the hypothesis that increasing the DC by prolonging the light-curing time of adhesive bonding resin might decrease the bond strength of the adhesive to dentin because of the subsequent thinning of the OIL thickness. The OIL thickness and the DC of solvent-removed One Step and D/E bonding resin of All Bond 2 (Bisco, USA) were measured simultaneously with FT-NIR spectroscopy according to increasing light-cure times (10, 20, 30, and 60 s) so as to evaluate their effect on the microtensile bond strength. The bonded interfaces were evaluated using scanning electron microscopy. Excessive irradiation of light-curing adhesives increased the DC, but decreased the OIL thickness. When the OIL was significantly thin by curing the adhesives for 30 or 60 s, defects were observed at the interface between the AL and the CR, as well as at the interface between the AL and the hybrid layer. When the OIL was thick, free radicals from the overlying CR may have diffused into the unreacted monomer mixtures of the OIL, chemically connecting the cured AL and the newly curing composite. It was found that to obtain maximum dentin bond strength, light-curing adhesives should be cured for the irradiation time recommended by the manufacturer.

Tensile strength of mineralized/demineralized human normal and carious dentin

The bond strengths of resins to caries-affected dentin are low. This could be due to weakened organic matrix. The purpose of this work was to determine if the ultimate tensile strength (UTS) of excavated carious dentin is weaker than that of normal dentin. Soft caries was excavated from extracted human molars, and the tooth was vertically sectioned into slabs. Each slab was trimmed to an hourglass shape, parallel or perpendicular to the tubule direction. Half of the specimens were mineralized, while the other half were completely demineralized in EDTA. ANOVA on ranks showed that the three-factor interactions (mineralization, caries, tubule direction) were all significant (p < 0.0001), indicating that mineralization and tubule direction gave different UTS results in normal and caries-affected dentin. No significant differences were seen between the UTS of normal and and that of caries-affected demineralized dentin in the parallel or perpendicular group. The matrix of demineralized caries-affected dentin was as strong as that of normal demineralized dentin when tested in the same direction.

Effect of fracture strength of primer–adhesive mixture on bonding effectiveness

OBJECTIVE

The purpose of this study was to measure the micro-tensile bond strength (microTBS) of two adhesives to dentin and to correlate this microTBS with the micro-tensile fracture strength (microTFS) of primer-adhesive mixtures of the two adhesives.

METHODS

The three-step etch&rinse adhesive OptiBond FL (Kerr) and the two-step self-etch adhesive Clearfil SE Bond (Kuraray) were used to bond Filtek Z100 (3M ESPE) to twenty mid-coronal dentin surfaces. The microTBS was determined at 1 and 24 h after light-curing. In addition, the microTFS of primer-adhesive mixtures (primer:adhesive=1:3 by weight) and of the pure adhesives (controls) were measured after the same time intervals.

RESULTS

The microTBS to dentin of OptiBond FL at 24 h was significantly higher than at 1 h and than the microTBS of Clearfil SE Bond at 24 h. The mean microTFS of the primer-adhesive mixtures was always lower than the microTFS of the respective adhesives. The highest reduction in microTFS due to mixing primer with the adhesive resin was measured for Clearfil SE Bond. Both the microTFS of the primer-adhesive mixtures and the pure adhesives of OptiBond FL and Clearfil SE Bond increased with time.

SIGNIFICANCE

The early 1 h microTBS to dentin was lower than the 24 h microTBS for OptiBond FL, but not for Clearfil SE Bond. Differences in polymerization efficiency as well as in the resulting interfacial strength may explain such varying early bond strengths to dentin.

Mechanical stability of resin-dentin bond components

OBJECTIVES

To evaluate the effects of long-term storage on the mechanical properties of the components of resin-dentin bonds, that is, resin composite, adhesive system, demineralized and mineralized dentin.

METHODS

Specimens of resin composite (Z250) and adhesive systems (Single Bond-SB; One-Step-OS and Clearfil Liner Bond 2V-CL) were cast in molds. Dentin specimens were prepared from dentin discs obtained from the crowns of extracted human molars. Specimens of demineralized dentin were obtained by immersion of dentin discs for 6 days in 0.5 mol/l EDTA (pH 7.0). Both dentin and resin-based substrates were shaped to hourglass or I-beam specimens that were used to determine the true stress (TS) or apparent modulus of elasticity (E), respectively. Control specimens were subjected to tensile testing at 0.6 mm/min after 24 h of immersion in distilled water. Experimental specimens were stored at 37 degrees C in either distilled water or mineral oil and tested after 12 months. The data of each group were individually analyzed by ANOVA and Tukey's test.

RESULTS

Both TS and E of the resin-based materials decreased significantly after 12 months of storage in water (p < 0.05) except the TS of SB (p > 0.05). No changes were observed for specimens of mineralized dentin, regardless of storage condition (p > 0.05). Storage of demineralized dentin in water did not cause any significant effect in either TS or E (p > 0.05), however, significant reductions of TS and E of demineralized dentin occurred after storage in oil for 1 year (p < 0.05).

SIGNIFICANCE

Storage time and medium may be deleterious to the mechanical properties of the resin-dentin bond components, which ultimately could compromise the durability of resin-dentin bonds.

Microhardness of acid-treated and resin infiltrated human dentine

OBJECTIVE

The aim is to determine if superficial or deep dentine microhardness (MH) is affected by different chemical dentine pre-treatments performed for resin bonding.

METHODS

Dentine discs of superficial (SD) and deep dentine (DD) were obtained by transversally sectioning the crowns of human third molars. Knoop MH was measured after different treatments: (1) polished up to 4000 grit, (2) polished and etched (37% ortophosphoric acid for 15 s), (3) resin (Single Bond -SB-) infiltrated dentine after acid etching, (4) polished, etched and treated with 5% NaOCl for 2 min, (5) resin infiltrated (SB) after etching and NaOCl treatment. For resin infiltrated surfaces care was taken in order to remove the excess adhesive layer, and obtain infiltrated dentine, by measuring thickness of the sample before resin infiltration and polishing after resin infiltration until obtaining the initial thickness of the sample. Indentations (n=20) were performed on moist surfaces with a standard Knoop MH tester (20 g, 5 s). Data were expressed in Knoop Hardness Numbers (KHN) and analysed by ANOVA and multiple comparisons (P<0.05).

RESULTS

Dentine KHN decreased on both SD and DD after acid etching. NaOCl treatment after acid etching did not affect MH on SD, but KHN of DD was lowered. Resin infiltration increased KHN but did not recover the initial MH values in both SD and DD.

CONCLUSIONS

Treating dentine with either H3PO4 or NaOCl caused marked reduction of its surface hardness and subsequent resin infiltration was not capable to restore it.

Effect of the hydrophilic nanofiller loading on the mechanical properties and the microtensile bond strength of an ethanol-based one-bottle dentin adhesive

This study evaluated the hypothesis that if hydrophilic nanofillers were dispersed evenly within the adhesive layer under moist conditions, adding them to a one-bottle dentin adhesive might improve the mechanical properties of the adhesive layer, and accordingly increase the bond strength. The flexural strength (FS), the degree of conversion (DC), and the microtensile bond strength (MTBS) to the dentin of four experimental ethanol-based one-bottle dentin adhesives containing 0, 0.5, 1.0, and 3.0 wt % of 12-nm hydrophilic fumed silica were evaluated, and the distribution of the nanofillers were compared using transmission electron microscopy (TEM). Although the nanofiller content did not affect the DC, the FS tended to increase with increasing nanofiller content. The MTBS appeared to increase when up to 1.0 wt % of the nanofillers were added, but they were statistically not significant. However, when 3.0 wt % of the nanofillers were added, the MTBS decreased significantly comparing to the adhesive containing 0.5 wt % nanofillers (p < 0.05). The TEM image suggested that if the nanofillers within the adhesive were 3.0 wt % and applied to a wet dentin surface, they aggregated easily into large clusters and would decrease the MTBS.

Adhesive layer properties as a determinant of dentin bond strength

The goal of this study is to evaluate the hypothesis that the properties of the resin adhesive might affect the microtensile bond strength (MTBS) of multibottle dental adhesive system. In order to alter the properties, the experimental resin adhesives containing 2,2-bis (4-2-hydroxy-3-methacryloyloxypropoxyphenyl)propane (Bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) at various ratios were prepared. Degree of conversion immediately after curing (DC-immed), degree of conversion at 48 h after curing (DC-48h) of a thin coat of the experimental adhesives, the flexural strength (FS) of the bulk specimens made of the experimental adhesives, pH, viscosity at shear rate of 1 S(-1), and the microtensile bond strength (MTBS) values of the adhesives to dentin were investigated. The maximum MTBS and FS values of the resin adhesives were observed when the ratio of Bis-GMA/TEGDMA was 60/40. However, pH and viscosity values increased with increasing Bis-GMA content in the adhesives. When Bis-GMA content was more than 60 wt %, the viscosity increased exponentially and restricted the DC and FS, and accordingly decreased the bond strength. The stronger the resin adhesives were, the higher the bond strength to dentin could be obtained.

Tensile strength and microhardness of treated human dentin

OBJECTIVES

To determine the ultimate tensile strength and Knoop hardness of mineralized, EDTA-treated, sodium hypochlorite (NaOCl)-treated, EDTA-treated resin-infiltrated, and NaOCl-treated resin-infiltrated dentin.

METHODS

Dumbell-shaped specimens with a cross-sectional area of 0.5 mm2 were prepared from the crowns of extracted human third molars. Specimens were randomly assigned to the following experimental groups: (1) mineralized dentin; (2) 0.5 M EDTA-demineralized dentin, pH 7/5 days; (3) 5% NaOCl-deproteinized dentin/2 days; (4) EDTA-treated, Single Bond resin-infiltrated dentin; (5) NaOCl-treated, Single Bond resin-infiltrated dentin. All specimens were tested in tension in a Vitrodyne testing machine at 0.6 mm/min. Knoop microhardness was measured on the fractured edges of specimens in groups 1, 3, 4, and 5. Results were analyzed by ANOVA and SNK tests (p < 0.05).

RESULTS

Both EDTA and NaOCl treatments caused significant reductions in the tensile strength and microhardness of mineralized dentin (p < 0.05) with the largest reductions observed after NaOCl treatment (p < 0.05) Resin infiltration of treated dentin resulted in moderate increase of its tensile strength and microhardness, however, the original mineralized values were not recovered (p < 0.05).

SIGNIFICANCE

Whenever dentin surfaces are treated with EDTA or NaOCl prior to a clinical bonding procedure, clinicians must be aware that a weak layer may be present at the interface, which may lead to premature failures of resin/dentin bonds.

Microhardness of superficial and deep sound human dentin

Our purpose in this study was to determine the microhardness of superficial and deep dentin by means of two indentation methods (Knoop and Vickers) under two different applied loads. Twelve dentin discs approximately 2-mm thick were obtained from both superficial and deep dentin by transversally sectioning the crowns of sound, extracted human third molars with a diamond blade under water irrigation. Dentin surfaces were sequentially polished, and indentations (n = 20 per surface) were performed with either Vickers indentor at loads of 300 and 500 g, respectively, or Knoop indentor at loads of 50 and 100 g, respectively. Average Vickers hardness number (VHN) and Knoop hardness number (KHN) were calculated and treated with two-way analysis of variance (ANOVA) and Student's t test. Microhardness of dentin was not influenced by the different loads applied for both indentation methods. Knoop hardness was significantly higher for superficial than for deep dentin (p < 0.05). Conversely, Vickers hardness was not significantly different for both substrates (p > 0.05). Differences in dentin hardness as a function of depth exist, but they might not be relevant, and no alteration of the distribution of stresses along the adhesive interface is expected.

Ultimate tensile strength of dentin: Evidence for a damage mechanics approach to dentin failure

Dentin structure and properties are known to vary with orientation and location. The present study explored the variation in the ultimate tensile strength (UTS) of dentin with location in the tooth. Hourglass specimens were prepared from dentin located in the center, under cusps, and in the cervical regions of human molar teeth. These were tested in tension at various distances from the pulp. Median tensile strengths ranged from 44.4 MPa in the inner dentin near the pulp, to 97.8 MPa near the dentino-enamel junction (DEJ). This increase in the median UTS with distance from the pulp to the DEJ was statistically significant (P <.001). Of particular importance was the observation that the UTS measurements followed a Weibull probability distribution, with a Weibull modulus of about 4.5. The Weibull behavior of the UTS data strongly suggests that the large variances in fracture strength data result from a distribution of preexisting defects in the dentin. These findings justify a damage-mechanics approach to studies of dentin failure.

Effects of water and water-free polar solvents on the tensile properties of demineralized dentin

OBJECTIVES

The aim of this study was to test the null hypothesis that the tensile properties of demineralized dentin are not influenced by the hydrogen bonding ability of anhydrous polar solvents.

METHODS

Dentin disks 0.5mm thick were prepared from mid-coronal dentin of extracted, unerupted, human third molars. 'I' beam and hour-glass shaped specimens were prepared from the disks, the ends protected with nail varnish and the central regions completely demineralized in 0.5M EDTA for 5 days. Ultimate tensile stress (UTS) and low-strain apparent modulus of elasticity (E) were determined with the specimens immersed for 60 min in water, methanol, HEMA, acetone or air prior to testing in those same media. Apparent moduli of elasticity were measured on the same specimens in a repeated measures experimental design. The results were analyzed with a one-way ANOVA on ranks, followed by Dunn's test at alpha=0.05. Regression analysis examined the relationship between UTS or E and Hansen's solubility parameter for hydrogen bonding (delta(h)) of each solvent.

RESULTS

The UTS of demineralized dentin in water, methanol, HEMA, acetone and air was 18(7), 29(7), 31(6), 41(13) and 146(27)MPa, x(SD), n=10. Low-strain E for the same media were 11(7), 43(12), 79(21), 132(31) and 253(115)MPa. Regression analysis of UTS vs delta(h) revealed a significant (p<0.0005, r=-0.69, R(2)=0.48) inverse, exponential relationship. A similar inverse relationship was obtained between low-strain E vs delta(h) (p<0.0001, r=-0.93, R(2)=0.86).

SIGNIFICANCE

The tensile properties of demineralized dentin are dependent on the hydrogen bonding ability of polar solvents (delta(h)). Solvents with low delta(h) values may permit new interpeptide H-bonding in collagen that increases its tensile properties. Solvents with high delta(h) values prevent the development of these new interpeptide H-bonds.

Micromechanical properties of demineralized dentin collagen with and without adhesive infiltration

In a previous study, we reported the upper limit of Young's modulus of the unprotected protein at the dentin/adhesive interface to be 2 GPa. In this study, to obtain a more exact value of the moduli of the components at the d/a interface, we used demineralized dentin collagen with and without adhesive infiltration. The prepared samples were analyzed using micro-Raman spectroscopy (micro RS) and scanning acoustic microscopy (SAM). Using an Olympus UH3 SAM (Olympus Co., Tokyo), measurements were recorded with a 400 MHz burst mode lens (120 degrees aperture angle; nominal lateral resolution, 2.5 microm). A series of calibration curves were prepared using the relationship between the ultrasonically measured elastic moduli of a set of known materials and their SAM response. Finally, both the bulk and bar wave elastic moduli were computed for a set of 13 materials, including polymers, ceramics, and metals. These provided the rationale for using extensional wave measurements of the elastic moduli as the basis for extrapolation of the 400 MHz SAM data to obtain Young's moduli for the samples: E = 1.76 +/- 0.00 GPa for the collagen alone; E = 1.84 +/- 0.65 GPa for the collagen infiltrated with adhesive; E = 3.4 +/- 1.00 GPa for the adhesive infiltrate.

Six-month storage-time evaluation of one-bottle adhesive systems to dentin

PURPOSE

The goal of this study was to evaluate the 1-week, 3-month, and 6-month performance of eight commercially available one-bottle adhesive systems to dentin.

MATERIALS AND METHODS

Lingual and buccal surfaces from human third molars were ground wet on 600-grit SiC paper to obtain a flat dentinal surface. The specimens were randomly divided into 24 groups (n = 10), which were established to measure the shear bond strengths of Bond-1 (B1), ONE-STEP (OS), OptiBond SOLO (OP), Prime & Bond 2.1 (PB), Single Bond (SB), STAE (ST), Syntac Sprint (SS), and Tenure Quick (TQ) after 1-week, 3-month, and 6-month water storage at 37 degrees C. One-bottle adhesives were applied according to manufacturers' instructions and Z100 composite cylinders were applied on the bonded dentinal surfaces. The 3-month water-storage groups were thermocycled for 1500 cycles at 5 degrees C and 55 degrees C and 6-month groups for 3000 cycles. After storage periods, specimens were tested in shear in a universal testing machine (0.5 mm/min).

RESULTS

were statistically analyzed by analysis of variance and Tukey test. Results: The changes in shear bond strengths were not uniform over time. Over the test period, OS, PB, SB, and SS exhibited bond strength stability, however, SS presented low bond strengths on all tested periods. A significant decrease in bond strength was observed for B1, OP, ST, and TQ after the 6-month storage period.