Water concentration in self-etching primers affects their aggressiveness and bonding efficacy to dentin

Degradation and Stabilization of Resin-Dentine Interfaces in Polymeric Dental Adhesives: An Updated Review

Instability of the dentine-resin interface is owed to the partial/incomplete penetration of the resin adhesives in the collagen fibrils. However, interfacial hydrolysis of the resin-matrix hybrid layer complex activates the collagenolytic and esterase enzymes that cause the degradation of the hybrid layer. Adequate hybridization is often prevented due to the water trapped between the interfibrillar spaces of the collagen network. Cyclic fatigue rupture and denaturation of the exposed collagen fibrils have been observed on repeated application of masticatory forces. To prevent interfacial microstructure, various approaches have been explored. Techniques that stabilize the resin–dentine bond have utilized endogenous proteases inhibitors, cross linking agents’ incorporation in the exposed collagen fibrils, an adhesive system free of water, and methods to increase the monomer penetration into the adhesives interface. Therefore, it is important to discover and analyze the causes of interfacial degradation and discover methods to stabilize the hybrid layer to execute new technique and materials. To achieve a predictable and durable adhesive resin, restoration is a solution to the many clinical problems arising due to microleakage, loss of integrity of the restoration, secondary caries, and postoperative sensitivity. To enhance the longevity of the resin-dentine bond strength, several experimental strategies have been carried out to improve the resistance to enzymatic degradation by inhibiting intrinsic collagenolytic activity. In addition, biomimetic remineralization research has advanced considerably to contemporary approaches of both intrafibrillar and extrafibrillar remineralization of dental hard tissues. Thus, in the presence of biomimetic analog complete remineralization of collagen, fibers are identified.

Evaluation of Nanoleakage Depth and Pattern of Cervical Restorations Bonded with Different Adhesive Systems

Aim

To evaluate nanoleakage depth and pattern of cervical restorations bonded with different adhesive systems.

Materials and methods

Thirty-six extracted human premolar teeth were used for the study and grouped according to different bonding agents.

Group I: fifth generation dentin bonding agent—ONE COAT SL.

Group II: sixth generation dentin bonding agent—PARABOND.

Group III: seventh generation dentin bonding agent—ONE COAT 7.0.

For nanoleakage depth evaluation, 36 teeth were divided into three groups of 12 teeth each, according to adhesive systems used. For each adhesive system, teeth were subdivided into three subgroups of four teeth each, according to storage period, 24 hours, 1 month, and 3 months before the examination. In each tooth, two cavities were prepared (buccal and lingual), each cavity was lined with different adhesive systems and restored using a nanohybrid composite. The restored teeth were then immersed in water bath at temperature 37^oC for intended period of time and then stored in 50% silver nitrate for 24 hours and photo developing solution for 8 hours. After this, the teeth were cut in buccolingual direction and subjected to scanning electron microscope (SEM) analysis for nanoleakage depth analysis.

Results

Group II showed the highest nanoleakage at all three periods. At 24 hours, group III showed more leakage than group I (mean = 0.2869 > 0.2506). At 1 month storage period, there was no significant difference in the leakage. At 3 months storage period, group III showed less leakage than group I (mean = 0.5544 < 0.7313).

How to cite this article

Bhupanapadu N, Sattar MA, Deb A. Evaluation of Nanoleakage Depth and Pattern of Cervical Restorations Bonded with Different Adhesive Systems. Int J Clin Pediatr Dent 2022;15(3):299-303.

Bonding of universal adhesives to bur-cut dentin: Effect of double application and dentin moisture level

This study investigated how the double application of adhesives and dentin moisture level influence the microtensile bond strength (µTBS) of universal adhesives containing different hydrophilic monomers to bur-cut dentin. Four universal adhesives (Scotchbond Universal, Clearfil Universal Bond Quick, Prime&Bond Universal, BeautiBond Universal) were applied to wet and dry bur-cut dentin either in one or two layers. The µTBS test was performed after 25,000 thermal cycles, and scanning electron microscopy was used for the analysis of failure mode and interfacial ultrastructure. Double application significantly improved µTBS on wet dentin (p<0.001), but the effect was not significant on dry dentin (p>0.050). Double application also enhanced the formation of resin tags and limited voids within the adhesive layer of BeautiBond Universal. Dentin moisture had a significant effect on µTBS only if the adhesives were applied in a single layer (p=0.007). Except for Prime&Bond Universal, the tested universal adhesives performed better on dry dentin.

Evaluation of microleakage in class-II bulk-fill composite restorations

Background/purpose

Despite the clinical appeal of restoring deep class II cavities in single increment using bulk-fill resin composite, sealing of bulk-filled composite restorations is a concern. This study evaluated interfacial adaptation of bulk-fill composite restoration to axial wall and gingival floor of class II cavities using cross-polarization optical coherence tomography (CP-OCT).

Materials and methods

Box-shaped class II cavities were prepared in extracted molars and divided into three groups (n = 7) according to adhesive used; Clearfil SE Bond 2 (SE2), Tetric-N Bond Self-Etch (TSE) or Tetric-N Bond Universal (TNU). All adhesives were applied in self-etch mode and according to manufacturers' recommendation. Then, preparations were bulk-filled with Filtek Bulk Fill Posterior Restorative resin composite and immersed in a contrast agent. Tomographic images of axial wall and gingival floor of each restoration were obtained by CP-OCT (IVS-300, Santec) with a central wavelength of 1330 nm and were imported to an image analysis software to quantify microleakage.

Results

Mann–Whitney U test showed statistically significant difference in microleakage percentage between the groups at both axial wall and gingival floor (p < 0.05). SE2 group had the lowest percentage of microleakage (p < 0.05), as only few cross-sections showed areas of reflections from contrast agent penetrating into axial wall (8.23 ± 6.8) and gingival floor (7.07 ± 4.1), followed by TNU group (18.13 ± 12.9 axially and 30.61 ± 11.9 gingivally). Microleakage was frequently observed at the axial wall and gingival floor of TSE group, showing the highest percentages of 25.50 ± 12.5 and 36.97 ± 10.2, respectively (p < 0.05).

Conclusion

All tested groups exhibited different extent of interfacial microleakage, however, two-step self-etch adhesive yielded superior adaptation in comparison to one-step self-etch adhesive and universal adhesive.

Influence of 10-MDP concentration on the adhesion and physical properties of self-adhesive resin cements

Objectives

Self-adhesive resin cements contain functional monomers that enable them to adhere to the tooth structure without a separate adhesive or etchant. One of the most stable functional monomers used for chemical bonding to calcium in hydroxyapatite is 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP). The aim of this study was to evaluate the influence of the10-MDP concentration on the bond strength and physical properties of self-adhesive resin cements.

Materials and Methods

We used experimental resin cements containing 3 different concentrations of 10-MDP: 3.3 wt% (RC1), 6.6 wt% (RC2), or 9.9 wt% (RC3). The micro-tensile bond strength of each resin cement to dentin and a hybrid resin block (Estenia C&B, Kuraray Noritake Dental) was measured, and the fractured surface morphology was analyzed. Further, the flexural strength of the resin cements was measured using the three-point bending test. The water sorption and solubility of the cements following 30 days of immersion in water were measured.

Results

The bond strength of RC2 was significantly higher than that of RC1. There was no significant difference between the bond strength of RC2 and that of RC3. The water sorption of RC3 was higher than that of any other cement. There were no significant differences in the three-point bending strength or water solubility among all three types of cements.

Conclusions

Within the limitations of this study, it is suggested that 6.6 wt% 10-MDP showed superior properties than 3.3 wt% or 9.9 wt% 10-MDP in self-adhesive resin cement.

Resin-Dentin Bonding Interface: Mechanisms of Degradation and Strategies for Stabilization of the Hybrid Layer

Several studies have shown that the dentin-resin interface is unstable due to poor infiltration of resin monomers into the demineralized dentin matrix. This phenomenon is related to the incomplete infiltration of the adhesive system into the network of exposed collagen fibrils, mainly due to the difficulty of displacement and subsequent replacement of trapped water between interfibrillar spaces, avoiding adequate hybridization within the network of collagen fibrils. Thus, unprotected fibrils are exposed to undergo denaturation and are susceptible to cyclic fatigue rupture after being subjected to repetitive loads during function. The aqueous inclusions within the hybrid layer serve as a functional medium for the hydrolysis of the resin matrix, giving rise to the activity of esterases and collagenolytic enzymes, such as matrix metalloproteinases, which play a fundamental role in the degradation process of the hybrid layer. Achieving better interdiffusion of the adhesive system in the network of collagen fibrils and the substrate stability in the hybrid layer through different strategies are key events for the interfacial microstructure to adequately function. Hence, it is important to review the factors related to the mechanisms of degradation and stabilization of the hybrid layer to support the implementation of new materials and techniques in the future. The enzymatic degradation of collagen matrix, together with resin leaching, has led to seeking strategies that inhibit the endogenous proteases, cross-linking the denudated collagen fibrils and improving the adhesive penetration removing water from the interface. Some of dentin treatments have yielded promising results and require more research to be validated. A longer durability of adhesive restorations could resolve a variety of clinical problems, such as microleakage, recurrent caries, postoperative sensitivity, and restoration integrity.

Rubbing time and bonding performance of one-step adhesives to primary enamel and dentin

Objectives:

This study investigated whether increasing the concentration of acidic monomers in one-step adhesives would allow reducing their application time without interfering with the bonding ability to primary enamel and dentin.

Material and methods:

Experimental one-step self-etch adhesives were formulated with 5 wt% (AD5), 20 wt% (AD20), or 35 wt% (AD35) acidic monomer. The adhesives were applied using rubbing motion for 5, 10, or 20 s. Bond strengths to primary enamel and dentin were tested under shear stress. A commercial etch-and-rinse adhesive (Single Bond 2; 3M ESPE) served as reference. Scanning electron microscopy was used to observe the morphology of bonded interfaces. Data were analysed at p<0.05.

Results:

In enamel, AD35 had higher bond strength when rubbed for at least 10 s, while application for 5 s generated lower bond strength. In dentin, increased acidic monomer improved bonding only for 20 s rubbing time. The etch-and-rinse adhesive yielded higher bond strength to enamel and similar bonding to dentin as compared with the self-etch adhesives. The adhesive layer was thicker and more irregular for the etch-and-rinse material, with no appreciable differences among the self-etch systems.

Conclusion:

Overall, increasing the acidic monomer concentration only led to an increase in bond strength to enamel when the rubbing time was at least 10 s. In dentin, despite the increase in bond strength with longer rubbing times, the results favoured the experimental adhesives compared to the conventional adhesive. Reduced rubbing time of self-etch adhesives should be avoided in the clinical setup.

Influence of application method on surface free-energy and bond strength of universal adhesive systems to enamel

The aim of the present study was to determine the influence of different adhesive application methods and etching modes on enamel bond effectiveness of universal adhesives using shear bond strength (SBS) testing and surface free-energy (SFE) measurements. The adhesives Scotchbond Universal, All-Bond Universal, Adhese Universal, and G-Premio Bond were used. Prepared bovine enamel specimens were divided into four groups, based on type of adhesive, and subjected to the following surface treatments: (i) total-etch mode with active application; (ii) total-etch mode with inactive application; (iii) self-etch mode with active application; and (iv) self-etch mode with inactive application. Bonded specimens were subjected to SBS testing. The SFE of the enamel surfaces with adhesive was measured after rinsing with acetone and water. The SBS values in total-etch mode were significantly higher than those in self-etch mode. In total-etch mode, significantly lower SBS values were observed with active application compared with inactive application; in contrast, in self-etch mode there were no significant differences in SBS between active and inactive applications. A reduction in total SFE was observed for active application compared with inactive application. The interaction between etching mode and application method was statistically significant, and the application method significantly affected enamel bond strength in total-etch mode.

Influence of nanogel additive hydrophilicity on dental adhesive mechanical performance and dentin bonding

OBJECTIVE

To assess the influence of hydrophilicity of reactive nanogels on the mechanical performance of dental adhesives and microtensile bond strength (μTBS) to dentin after 24h or 3 months of aging.

METHODS

A series of three nanogels were synthesized: NG1-IBMA/UDMA; NG2-HEMA/BisGMA; NG3-HEMA/TE-EGDMA. The nanogels were dispersed in solvent, HEMA or BisGMA/HEMA. The degree of conversion (DC) of the materials was measured and the flexural modulus of these polymers was evaluated in dry or wet conditions. For μTBS analysis, a model adhesive was used without nanogel (control) or with the incorporation of nanogels. μTBS was evaluated after storage in distilled water for 24h or 3 months. The analysis of the fracture was performed after μTBS testing. Data were analyzed using ANOVA and Tukey's test (α=0.05).

RESULTS

Water significantly increased the modulus of NG1 and NG2 dispersed in solvent, while significantly decreased the stiffness of NG3. All polymers dispersed in HEMA and BisGMA/HEMA had significantly lower modulus when stored in water. NG2 showed the highest DC in solvent and BisGMA/HEMA. In HEMA, NG1 and NG3 produced the highest DC. After three months, NG2 showed the best μTBS. The μTBS of NG2-containing adhesive resin significantly increased after 3 months, while storage had no effect in the control group, NG1 and NG3.

SIGNIFICANCE

The more hydrophobic IBMA/UDMA nanogel showed higher bulk material mechanical property results, but the best dentin bond strength values, and notably strength values that improved upon storage, were obtained with the amphiphilic nanogel based on BisGMA/HEMA.

Self-Etch Adhesive Systems: A Literature Review

This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

Effect of long-term simulated pulpal pressure on the bond strength and nanoleakage of resin-luting agents with different bonding strategies

This study evaluated the effects of simulated hydrostatic pulpal pressure (SPP) on the microtensile bond strength (μTBS) to dentin and nanoleakage patterns produced by self-adhesive luting agents after 12 months. Three self-adhesive luting agents (RelyX Unicem [UN], RelyX U100 [UC], and Clearfil SA Luting [SA]) and three conventional luting agents (Rely X ARC [RX], Panavia F [PF], and a two-step self-etching adhesive system [Clearfil SE Bond] associated with Panavia F [PS]) were evaluated. One hundred twenty-three human molars were abraded to expose occlusal surfaces. Resin cements were used to lute cylindrical composite blocks to the teeth either subjected or not to SPP. Sixty specimens were subjected to 15 cm H2O of SPP for 24 hours before and 24 hours or 12 months after cementation procedures. Afterward, restored teeth were serially sectioned into beams with a cross-sectional area of 1 mm(2) at the bonded interface and were tested in tension (cross-head speed of 1 mm/min). Failure mode was determined using scanning electron microscopy (SEM). Data were statistically analyzed by three-way analysis of variance and post hoc Tukey test (p=0.05). Two additional teeth in each group were serially sectioned into 0.9-mm-thick slabs, which were submitted to a nanoleakage protocol with AgNO3 and analyzed with scanning and transmission electron microscopes. The μTBS values of the etch-and-rinse group (RX) were negatively influenced by SPP and long-term water storage with SPP. After 12 months, UC and SA presented premature failures in all specimens when submitted to SPP. SPP increased silver deposition in most groups in both evaluation times. The hydrostatic pulpal pressure effect was material dependent. The storage time without SPP did not affect bond strength. However, long-term SPP influenced the performance of the etch-and-rinse and self-adhesive cements regarding μTBS and nanoleakage pattern, except to UN.

Adhesive interfacial interaction affected by different carbon-chain monomers

OBJECTIVES

The functional monomer 10-methacryloxydecyl dihydrogen phosphate (10-MDP), recently used in more self-etch adhesives, chemically bonds to hydroxyapatite (HAp) and thus tooth tissue. Although the interfacial interaction of the phosphoric-acid functional group of 10-MDP with HAp-based substrates has well been documented, the effect of the long carbon-chain spacer of 10-MDP on the bonding effectiveness is far from understood.

METHODS

We investigated three phosphoric-acid monomers, 2-methacryloyloxyethyl dihydrogen phosphate (2-MEP), 6-methacryloyloxyhexyl dihydrogen phosphate (6-MHP) and 10-MDP, that only differed for the length of the carbon chain, on their chemical interaction potential with HAp and dentin, this correlatively using X-ray diffraction (XRD) and transmission electron microscopy (TEM). Commercial 6-MHP and 10-MDP containing adhesives were investigated as well.

RESULTS

XRD revealed that on HAp only 10-MDP produced monomer-calcium salts in the form of 'nano-layering', while on dentin all monomers produced 'nano-layering', but with a varying intensity in the order of 10-MDP>6-MHP>2-MEP. TEM confirmed that 10-MDP formed the thickest hybrid and adhesive layer. XRD and TEM revealed 'nano-layering' for all commercial adhesives on dentin, though less intensively for the 6-MHP containing adhesive than for the 10-MDP ones.

SIGNIFICANCE

It is concluded that not only the phosphoric-acid group but also the spacer group, and its length, affect the chemical interaction potential with HAp and dentin. In addition, the relatively strong 'etching' effect of 10-MDP forms more stable monomer-Ca salts, or 'nano-layering', than the two shorter carbon-chain monomers tested, thereby explaining, at least in part, the better bond durability documented with 10-MDP containing adhesives.

Clinical Effectiveness of a Hydrophobic Coating Used in Conjunction With a One-step Self-etch Adhesive: An 18-month Evaluation

The purpose of this randomized clinical trial was to evaluate the clinical performance of a one-step self-etch adhesive in noncarious cervical lesions with inclusion of a hydrophobic bonding layer not included in the original bonding system as a test of potentially improved bonding. Patients with noncarious cervical lesions received two or four restorations after being randomly assigned to two adhesive technique protocols (n=32): EB, application of Adper Easy Bond (3M ESPE) following manufacturer's instructions; and EB+B, application of Adper Easy Bond, immediately followed by the application of a hydrophobic resin coat (Scotchbond Multi-Purpose Bonding Agent, 3M ESPE). All restorations were restored with a microhybrid composite (Filtek Z250, 3M ESPE). Clinical effectiveness was recorded in terms of retention, marginal discoloration, marginal integrity, postoperative sensitivity, recurrent caries, periodontal health, and pulpal vitality, according to the modified USPHS criteria, for 18 months. Data were analyzed using chi-square, Fisher exact, and McNemar tests at α=0.05. Two restorations of each group were debonded after six months, leading to an overall clinical success rate of 93.8% for both groups. At the 18-month evaluation period, no new restoration was debonded. However, one restoration of the EB group displayed recurrent caries at the dentin margin, decreasing the overall success rate to 90.6% in comparison to 93.8% of EB+B. The success rate between EB and EB+B was not statistically significant (p=0.5). The application of a hydrophobic resin coat over EB did not increase bonding effectiveness in noncarious cervical lesions after 18 months.

Bond durability of adhesives containing modified-monomer with/without-fluoride after aging in artificial saliva and under intrapulpal pressure simulation

OBJECTIVE

To evaluate the dentin bond strength durability of adhesives containing modified-monomer with/without-fluoride after storage in artificial saliva and under intrapulpal pressure simulation (IPPS).

MATERIALS AND METHODS

The occlusal enamel of 48 freshly extracted teeth was trimmed to expose midcoronal dentin. Roots were sectioned to expose the pulp chamber and to connect the specimens to the pulpal-pressure assembly. Specimens were assigned into four groups (n=12) according to adhesive system utilized: a two-step etch-and-rinse adhesive system (SB, Adper Single Bond 2, 3M ESPE), a two-step self-etch adhesive system (CSE, Clearfil SE Bond, Kuraray Medical Inc), and two single-step self-etch adhesives with the same modified monomer (bis-acrylamide)-one with fluoride (AOF, AdheSE One F, Ivoclar-Vivadent) and the other without (AO, AdheSE One, Ivoclar-Vivadent). Bonding was carried out while the specimens were subjected to 15-mm Hg IPPS. Resin composite (Valux Plus, 3M ESPE) buildups were made. After curing, specimens were aged in artificial saliva and under 20-mm Hg IPPS at 37°C in a specially constructed incubator either for 24 hours or six months prior to testing. Bonded specimens (n=6/group) were sectioned into sticks (n=24/group) with a cross section of 0.9 ± 0.01 mm(2) and subjected to microtensile bond strength (μTBS) testing using a universal testing machine. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA tests, and a t-test (p<0.05). Failure modes were determined using a scanning electron microscope.

RESULTS

The μTBS values of SB and CSE fell significantly after six-month storage in artificial saliva and under IPPS, yet these values remained significantly higher than those for the other two adhesives with modified monomers. There was no significant difference in the bond strength values between fluoride-containing and fluoride-free self-etch adhesive systems (AOF and AO) after 24 hours or six months. Modes of failure were mainly adhesive and mixed.

CONCLUSIONS

Based on the results of this study, 1) Fluoride addition did not affect dentin bond durability; and 2) despite the fact that the single-step adhesive system with modified monomer showed stability, bond strengths associated with these systems remained lower than those of multistep adhesive systems.

A review of the developments of self-etching primers and adhesives -Effects of acidic adhesive monomers and polymerization initiators on bonding to ground, smear layer-covered teeth

This paper reviews the developments of self-etching primers and adhesives, with a special focus on the effect of acidic adhesive monomers and polymerization initiators on bonding to ground, smear layer-covered teeth. Ionized acidic adhesive monomers chemically interact with tooth substrates and facilitate good bonding to ground dentin. Polymerization initiators in self-etching primers further promote effective bonding to ground dentin. To promote bonding to both dentin and enamel, phosphonic acid monomers such as 6-methacryloyloxyhexyl phosphonoacetate (6-MHPA) were developed. These novel adhesive monomers also have a water-soluble nature and are hence endowed with sufficient demineralization capability. A new single-bottle, self-etching, 2-hydroxyethyl methacrylate (HEMA)-free adhesive comprising 6-MHPA and 4-acryloyloxyethoxycarbonylphthalic acid (4-AET) was developed. This novel adhesive enabled strong adhesion to both ground enamel and dentin, but its formulation stability was influenced by pH value of the adhesive. To develop hydrolytically stable, single-bottle, self-etching adhesives, hydrolytically stable, radical-polymerizable acidic monomers with amide or ether linkages have been developed.

A review--micromorphological evidence of degradation in resin-dentin bonds and potential preventional solutions

Resin adhesion to dentin was first achieved in 1982 through mechanical hybridization between resin and collagen fibrils using an adhesive resin containing a functional monomer. Over the last 2 decades, newly developed adhesive resins have attempted to improve the bond strength at least in the first 24 h after bonding. Although much is known about the initial bond strength, learned through morphological analysis, the long-term durability of bonds has not yet been established analytically. However, numerous recent studies have shown chemical biodegradation of resin-dentin bonds under various testing regimes. In general, studies have shown that dentin bond strength decreases over time due to degradation of the resin and the collagen fibrils within the bonds. Furthermore, crystal formation around cured bonding resins has been reported in a number of adhesives after long-term water storage. However, the extent and process of degradation or crystallization is adhesive type specific. This review mainly summarizes the most recent and state of the art work in degradation of the bonding of dental restorative compounds with dentin based on micromorphological data of scanning and transmission electron microscopy.

An all-in-one adhesive does not etch beyond hybrid layers

Continuous etching of aggressive all-in-one adhesives occurs in wet dentin tubules after polymerization of the adhesives. This study challenged the hypothesis that unpolymerized acidic monomers from an aggressive all-in-one self-etching adhesive continue to etch beyond dentin hybrid layers. Dentin surfaces bonded with Adper Prompt L-Pop were sectioned into 0.3-mm-thick slabs. Some of the slabs were stored in water (pH 6.8) or glycine buffer (pH 11.1) for six weeks and then examined by CLSM, SEM, and TEM. The rest were immersed in a biomimetic remineralizing medium for up to 4 months. Morphologic analysis indicated no difference in demineralization thickness between the two 6-week storage groups. However, increased permeability and loss of integrity occurred along the base of the hybrid layers in the glycine buffer group, but not in the water storage group. These findings were also confirmed by the results of biomimetic remineralization along the bases of those hybrid layers.

Effect of dentinal water on bonding of self-etching adhesives

This study examined the effect of dentinal water on bonding, comparing one-bottle and two-step self-etching adhesives using microtensile bond test and scanning electron microscope. The bond strength of resin to dentin was measured for wet dentin (control) and dry dentin substrates. Wet dentin is the normal substrate for bond testing, whereas dry dentin was dehydrated in a desiccator at different drying times (5 to 60 min) before bonding. After bond testing, the fractured surfaces were examined. Although no correlation was found for two-step self-etching adhesives, the bond strength of the dry-dentin was significantly increased with the increase in the drying-time for one-bottle adhesives. With increased drying-time, the amount of water-bubbles was decreased for one-bottle adhesives; however, no bubble formation was seen in two-step adhesives in any group. The hydrophilic resin adhesive may entrap the water from dentin by osmosis during and after bonding. This effect may depend on the "hydrophilicity" of adhesives.

Bond strength and morphology of enamel using self-etching adhesive systems with different acidities

Objectives:

To assess the bond strength and the morphology of enamel after application of self-etching adhesive systems with different acidities. The tested hypothesis was that the performance of the self-etching adhesive systems does not vary for the studied parameters.

Material and methods:

Composite resin (Filtek Z250) buildups were bonded to untreated (prophylaxis) and treated (burcut or SiC-paper) enamel surfaces of third molars after application of four self-etching and two etch-and-rinse adhesive systems (n=6/condition): Clearfil SE Bond (CSE); OptiBond Solo Plus Self-Etch (OP); AdheSe (AD); Tyrian Self Priming Etching (TY), Adper Scotchbond Multi-Purpose Plus (SBMP) and Adper Single Bond (SB). After storage in water (24 h/37°C), the bonded specimens were sectioned into sticks with 0.8 mm² cross-sectional area and the microtensile bond strength was tested at a crosshead speed of 0.5 mm/min. The mean bond strength values (MPa) were subjected to two-way ANOVA and Tukey's test (α=0.05). The etching patterns of the adhesive systems were also observed with a scanning electron microscope.

Results:

The main factor adhesive system was statistically significant (p<0.05). The mean bond strength values (MPa) and standard deviations were: CSE (20.5±3.5), OP (11.3±2.3), AD (11.2±2.8), TY (11.1±3.0), SBMP (21.9±4.0) and SB (24.9±3.0). Different etching patterns were observed for the self-etching primers depending on the enamel treatment and the pH of the adhesive system.

Conclusion:

Although there is a tendency towards using adhesive systems with simplified application procedures, this may compromise the bonding performance of some systems to enamel, even when the prismless enamel is removed.

Durability of enamel bonding using one-step self-etch systems on ground and unground enamel

OBJECTIVE

To examine the morphological, early and long-term microtensile bond strengths (microTBS) of one-step self-etch systems to unground and ground enamel.

MATERIALS AND METHODS

Resin composite (Filtek Z250) buildups were bonded to the buccal and lingual enamel surfaces (unground, bur-cut or SiC-roughened enamel) of third molars after adhesive application using the following adhesives: Clearfil S3 Bond (CS3); Adper Prompt L-Pop (ADP); iBond (iB) and, as the control, Clearfil SE Bond (CSE). Six tooth halves were assigned for each condition. After storage in water (24 hours/37 degrees C), the bonded specimens were sectioned into beams (0.8 mm2) and subjected to microTBS (0.5 mm/min) either immediately (IM) or after six (6 M) or 12 months (12 M) of water storage. The data were analyzed by three-way repeated measures ANOVA and Tukey's test (alpha = 0.05). Surface conditioning was observed under scanning electron microscopy (SEM).

RESULTS

The microTBS in the Si-C paper and diamond bur groups were similar and higher than the unground group. No significant difference was observed among the different storage periods, except for CS3, which showed an increase in the microTBS after 12 M. The etching pattern was more retentive on ground enamel.

CONCLUSIONS

One-step self-etch adhesives showed higher bond strengths on ground enamel and no reductions in resin-enamel bonds were observed after 12 M of water storage.

SEM evaluation of the hybrid layer after cavity preparation with Er:YAG laser

This study compared the thickness of the hybrid layer formed using Scotchbond Multi-Purpose Plus, Single Bond 2, Prime & Bond 2.1 and Xeno III on a dentin surface prepared with a diamond bur in a high speed handpiece or prepared with an Er:YAG laser used with two parameters of pulse energy (200 and 400 mJ) and two parameters of frequency (4 and 6 Hz). Flat dentin surfaces obtained from 20 human third molars were treated with the two methods and were then prepared with the dentin adhesive systems according to the manufacturers' instructions. After a layer of composite was applied, the specimens were sectioned, flattened, polished and prepared for Scanning Electronic Microscopy observation. Five different measurements of the hybrid layer thickness were obtained along the bonded surface in each specimen. The results were statistically analyzed using Analysis of Variance and Student-Newman-Keuls tests (p < or = 0.05). When analyzing the hybrid layer thickness and comparing the cavity preparation method, four groups were formed: Group I (diamond bur) > Group II (Laser 200 mJ/4 Hz) = Group III (Laser 200 mJ/6 Hz) > Group IV (Laser 400 mJ/4 Hz) > Group V (Laser 400 mJ/6 Hz). When comparing the dentin adhesive systems, there were no statistically significant differences. These results showed that the four tested dentin adhesive systems produced a 2.90 +/- 1.71 microm hybrid layer in dentin prepared with a diamond bur. This hybrid layer was regular and routinely found. In the laser groups, the dentin adhesive systems produced hybrid layers ranging from 0.41 +/- 1.00 microm to 2.06 +/- 2.49 microm, which were very irregular and not routinely found. It was also concluded that the Er:YAG laser, with the parameters used in this experiment, has a negative influence on the formation of a hybrid layer and cavity preparation methods influence formation of the hybrid layer.

Bonding of one-step and two-step self-etching primer adhesives to dentin with different tubule orientations

OBJECTIVES

To determine the microshear bond strengths of five 'all-in-one' adhesives and two 2-step self-etching primer adhesives to dentin with different tubule orientations and to compare bond strengths between the adhesives.

MATERIAL AND METHODS

Human adult molar teeth were sectioned to obtain dentin pieces with tubule orientations perpendicular or parallel/oblique to the bonded surface. Two 2-step self-etching primer adhesives (Clearfil SE Bond (CSE), Optibond Solo Plus SE Bond (Op. SE)) and five all-in-one adhesives (Clearfil S(3) Bond (S(3)), Optibond All-in-One Bond (Op. AIO), G-Bond, Go!, and Xeno IV) were applied to dentin in accordance with the manufacturers' instructions. Resin composite cylinders were bonded to superficial and deep dentin using microtubes (0.75 mm internal diameter and 1.5 mm high). Bonded specimens were stored in water at 37 degrees C for 24 h, then stressed in shear at a cross-head speed of 1 mm/min until bond failure. Maximum load at failure (N) was recorded and converted to MPa. Statistical analyses were carried out using independent samples t-test and one-way ANOVA with Tukey's HSD test.

RESULTS

Though bond strengths varied slightly, four all-in-one adhesives (Op. AIO, G-Bond, Go!, and Xeno IV) showed no significant differences in microshear bond strengths regardless of dentin depth (superficial or deep) or dentin tubule orientation (perpendicular or parallel/oblique). CSE, Op. SE, and S(3) showed significantly lower bond strengths to deep dentin with a tubule orientation perpendicular to the surface.

CONCLUSION

Most of the all-in-one adhesive systems used in this study appear to bond equally well to dentin independently of tubule orientation and depth. One two-step self-etching primer adhesive bonded significantly better than the all-in-one adhesives.

Durability of enamel bonding using two-step self-etch systems on ground and unground enamel

This study examined the early and long-term microtensile bond strengths (MTBS) and interfacial enamel gap formation (IGW) of two-step self-etch systems to unground and ground enamel. Resin composite (Filtek Z250) buildups were bonded to proximal enamel surfaces (unground, bur-cut or SiC-treated enamel) of third molars after the application of four self-etch adhesives: a mild (Clearfil SE Bond [SE]), two moderate (Optibond Solo Plus Self-Etch Primer [SO] and AdheSE [AD]) and a strong adhesive (Tyrian Self Priming Etchant + One Step Plus [TY]) and two etch-and-rinse adhesive systems (Single Bond [SB] and Scotchbond Multi-Purpose Plus [SBMP]). Ten tooth halves were assigned for each adhesive. After storage in water (24 hours/37 degrees C), the bonded specimens were sectioned into beams (0.9 mm2) and subjected to microTBS (0.5 mm/minute) or interfacial gap width measurement (stereomicroscope at 400x) either immediately (IM) or after 12 months (12M) of water storage. The data were analyzed by three-way repeated measures ANOVA and Tukey's test (alpha=0.05). No gap formation was observed in any experimental condition. The microTBS in the Si-C paper and diamond bur groups were similar and greater than the unground group only for the moderate self-etch systems (SO and AD). No reductions in bond strength values were observed after 12 months of water storage, regardless of the adhesive evaluated.

Effect of Double-application or the Application of a Hydrophobic Layer for Improved Efficacy of One-step Self-etch Systems in Enamel and Dentin

The double-application and placement of a hydrophobic resin coat can improve the performance (μTBS) of one-step self-etch systems to tooth substrates, mainly in dentin.

Restoration interface microleakage using one total-etch and three self-etch adhesives

This study evaluated the efficacy of a total-etch and three self-etch adhesives in reducing microleakage after three months water storage and thermocycling. Thirty freshly extracted caries-free human premolars and molars were used. Class V standardized preparations were performed on the facial and lingual surfaces, with the gingival margin placed 1 mm below the CEJ. The teeth were randomly divided into four groups; Group I: Xeno III one-step self-etch adhesive (Dentsply/Caulk), Group II: Prime & Bond NT total-etch adhesive (Dentsply/Caulk), Group III: i-Bond one-step self-etch adhesive (Heraeus Kulzer) and Group IV: Clearfil SE Bond two-step self-etch adhesive (Kuraray Medical). The teeth were restored using 2 mm increments of shade A2 resin composite (Esthet-X, Dentsply/Caulk). Each layer was cured using the Spectrum 800 curing light (Dentsply/Caulk) for 20 seconds at 600mW/cm2. The teeth were stored in distilled water for 90 days. Samples were thermocycled 500x between 5 degrees C and 55 degrees C with a dwell time of 30 seconds, then placed in a 0.5% methylene blue dye solution for 24 hours at 37 degrees C. Samples were sectioned longitudinally and evaluated for microleakage at the occlusal and gingival margins under a stereomicroscope at 20x magnification. Dye penetration was scored: 0 = no penetration; 1 = partial dye penetration along the occlusal or gingival wall; 2 = dye penetration along the occlusal or gingival wall; 3 = dye penetration to and along the axial wall. A Mann-Whitney test was used to demonstrate significantly more dye penetration in Group III than in the other groups at both the occlusal and gingival scores (p < 0.0001). When comparing the occlusal and gingival scores for each group, the Wilcoxon Rank test showed no significant difference in dye penetration for Xeno III (p > 0.05), Prime & Bond NT (p = 0.059) and I Bond (p = 0.083), and Clearfil SE Bond yielded more dye penetration at the occlusal than at the gingival wall (p = 0.001).

Systematic review of the chemical composition of contemporary dental adhesives

Dental adhesives are designed to bond composite resins to enamel and dentin. Their chemical formulation determines to a large extent their adhesive performance in clinic. Irrespective of the number of bottles, an adhesive system typically contains resin monomers, curing initiators, inhibitors or stabilizers, solvents and sometimes inorganic filler. Each one of these components has a specific function. The aim of this article is to systematically review the ingredients commonly used in current dental adhesives as well as the properties of these ingredients. This paper includes an extensive table with the chemical formulation of contemporary dental adhesives.

Effect of Pulp Pressure on the Micropermeability and Sealing Ability of Etch & Rinse and Self-etching Adhesives

Etch & rinse adhesives are much more micropermeable and affected by pulp fluid compared with self-etching adhesives. Pulp pressure reduces dentin sealing with etch & rinse adhesives but not with self-etching adhesives. Pulp pressure has no effect on enamel sealing, which is lower when self-etching adhesive is used.

Use of Hoy's solubility parameters to predict water sorption/solubility of experimental primers and adhesives

Self-etching primers and adhesives contain very hydrophilic acidic monomers that result in high water sorption/solubilities of their polymers. However, the chemical composition of these products varies widely. The purpose of this work was to vary the chemical composition of experimental self-etching primers and adhesives to determine if the water sorption/solubility of the polymers were affected in a predictable manner. The Hoy's solubility parameters of these mixtures were calculated to permit ranking of the degree of hydrophilicity of the polymers. Water sorption/solubility was measured according to ISO 4049. The results showed highly significant (R(2) = 0.86, P < 0.001) correlations between water sorption and Hoy's solubility parameter for polar forces (delta(p)) of the polymers. Similar correlations were obtained between polymer solubility and delta(p). When these results were compared with previously published results obtained with more hydrophobic resins, excellent correlations were obtained, indicating that Hoy's delta(p) values may be used to predict the water sorption behavior of methylmethacrylate polymers.

Increases in Dentin-bond Strength If Doubling Application Time of an Acetone-containing One-step Adhesive

When treating dentin surfaces with Futurabond one-step self-etch bonding agent, in order to obtain higher microtensile bond strength, doubling the application time of the adhesive should be considered.

Long-term TEM analysis of the nanoleakage patterns in resin-dentin interfaces produced by different bonding strategies

OBJECTIVES

The aim of this study was to evaluate the ability of etch-and-rinse and self-etching adhesive systems to prevent time- and water-induced nanoleakage in resin-dentin interfaces over a 6-month storage period.

METHODS

Five commercial adhesives were tested, which comprise three different strategies of bonding resins to tooth hard tissues: one single-step self-etching adhesive (One-up Bond F (OB), Tokuyama); two two-step self-etching primers (Clearfil SE Bond (SE) and an antibacterial fluoride-containing system, Clearfil Protect Bond (CP), Kuraray Inc.); two two-step etch-and-rinse adhesives (Single Bond (SB), 3M ESPE and Prime&Bond NT (PB), Dentsply). Restored teeth were sectioned into 0.9 mm thick slabs and stored in water or mineral oil for 24 h, 3 or 6 months. A silver tracer solution was used to reveal nanometer-sized water-filled spaces and changes that occurred over time within resin-dentin interfaces. Characterization of interfaces was performed with the TEM.

RESULTS

The two two-step self-etching primers showed little silver uptake during the 6-month experiment. Etch-and-rinse adhesives exhibited silver deposits predominantly within the hybrid layer (HL), which significantly increased for SB after water-storage. The one-step self-etching adhesive OB presented massive silver accumulation within the HL and water-trees protruding into the adhesive layer, which increased in size and quantity after water-storage. After storage in oil, reduced silver deposition was observed at the interfaces for all groups.

SIGNIFICANCE

Different levels of water-induced nanoleakage were observed for the different bonding strategies. The two-step self-etching primers, especially the antibacterial fluoride-containing system CP, showed the least nanoleakage after 6 months of storage in water.

Effects of solvent drying time on micro-shear bond strength and mechanical properties of two self-etching adhesive systems

OBJECTIVES

The all-in-one adhesives are simplified forms of two-step self-etching adhesive systems that must be air dried to remove solvent and water before curing. It was investigated whether those two systems perform equally well and if their performance is affected by air-drying of the solvent containing agent.

METHODS

Two adhesive systems (both by Kuraray Medical) were evaluated; Clearfil Tri-S bond (TS) and Clearfil SE bond (SE). Micro-shear bond strengths to human dentin after solvent air-drying times of 2, 5 or 10 s for each group were measured (n=10). The indentation creep and hardness of the bonding layer were also determined for each group.

RESULTS

The lowest micro-shear bond strength, nano-indentation hardness and creep stress exponents were obtained for 2 s air dried specimens of each material. After 10 s air blowing, SE showed superior properties compared to TS groups (p<0.05).

SIGNIFICANCE

When properly handled, two step self-etching material performs better than the all-in-one adhesive. Air-drying is a crucial step in the application of solvent containing adhesives and may affect the overall clinical performance of them, through changes in the bond strength and altering nano-scale mechanical properties.