Tensile bond strength of adhesive systems--effects of primer and thermocycling

Hydrophobic and antimicrobial dentin: A peptide-based 2-tier protective system for dental resin composite restorations

Dental caries, i.e., tooth decay mediated by bacterial activity, is the most widespread chronic disease worldwide. Carious lesions are commonly treated using dental resin composite restorations. However, resin composite restorations are prone to recurrent caries, i.e., reinfection of the surrounding dental hard tissues. Recurrent caries is mainly a consequence of waterborne and/or biofilm-mediated degradation of the tooth-restoration interface through hydrolytic, acidic and/or enzymatic challenges. Here we use amphipathic antimicrobial peptides to directly coat dentin to provide resin composite restorations with a 2-tier protective system, simultaneously exploiting the physicochemical and biological properties of these peptides. Our peptide coatings modulate dentin's hydrophobicity, impermeabilize it, and are active against multispecies biofilms derived from caries-active individuals. Therefore, the coatings hinder water penetration along the otherwise vulnerable dentin/restoration interface, even after in vitro aging, and increase its resistance against degradation by water, acids, and saliva. Moreover, they do not weaken the resin composite restorations mechanically. The peptide-coated highly-hydrophobic dentin is expected to notably improve the service life of resin composite restorations and to enable the development of entirely hydrophobic restorative systems. The peptide coatings were also antimicrobial and thus, they provide a second tier of protection preventing re-infection of tissues in contact with restorations. STATEMENT OF SIGNIFICANCE: We present a technology using designer peptides to treat the most prevalent chronic disease worldwide; dental caries. Specifically, we used antimicrobial amphipathic peptides to coat dentin with the goal of increasing the service life of the restorative materials used to treat dental caries, which is nowadays 5 years on average. Water and waterborne agents (enzymes, acids) degrade restorative materials and enable re-infection at the dentin/restoration interface. Our peptide coatings will hinder degradation of the restoration as they produced highly hydrophobic and antimicrobial dentin/material interfaces. We anticipate a high technological and economic impact of our technology as it can notably reduce the lifelong dental bill of patients worldwide. Our findings can enable the development of restorations with all-hydrophobic and so, more protective components.

Fracture Resistance of Endodontically Treated Maxillary Premolars Restored With Different Methods

Purpose:

The purpose of this in vitro study was to evaluate the resistance and patterns of fracture of endodontically treated maxillary premolars (ETPs) restored with different methods.

Methods and Materials:

Mesio-occluso-distal cavities were prepared in 50 extracted caries-free human maxillary premolars after endodontic treatment. The teeth were divided into five groups (n=10), according to the restorative method. G1: intact teeth (control group); G2: conventional composite resin; G3: conventional composite resin with a horizontal glass fiber post inserted between buccal and palatal walls; G4: bulk-fill flowable and bulk-fill restorative composites; and G5: ceramic inlay. For direct restorations, Filtek Z350 XT, Filtek Bulk Fill Flowable Restorative, and Filtek Bulk Fill Posterior Restorative were used. Indirect restorations were fabricated from a pressable lithium disilicate glass-ceramic (IPS e-max Press) and adhesively cemented (RelyX Ultimate). All specimens were subjected to thermocycling (5°C to 55°C/5000 cycles) and additionally submitted to cyclic loading 50,000 times in an Electro-Mechanical Fatigue Machine. Next, the specimens were subjected to a compressive load at a crosshead speed of 1 mm/min until fracture. The fractured specimens were analyzed to determine the fracture pattern using a stereomicroscope, and then representative specimens were carbon coated to allow for the studying of the fracture surface under scanning electron microscopy. One-way analysis of variance (ANOVA) was used to compare fracture resistance of the groups. The results of fracture patterns were submitted to the Fisher exact test (α=0.05).

Results:

All specimens survived fatigue. Mean (standard deviation) failure loads (N) for groups were as follows: G1: 949.6 (331.5); G2: 999.6 (352.5); G3: 934.5 (233.6); G4: 771.0 (147.4); and G5: 856.7 (237.5). The lowest fracture resistance was recorded for G4, and the highest ones were recorded for G2, followed by that of G1 and G3. One-way ANOVA did not reveal significant differences between groups (p>0.05). The highest repairable fracture rates were observed in G1 (100%) and G3 (80%).

Conclusions:

ETPs restored with conventional composite resin with or without horizontal fiber post, bulk-fill composite, and ceramic inlay showed fracture resistance similar to that of sound teeth. Conventional composite resin restorations exhibited the highest prevalence of unrepairable fractures, and the insertion of a horizontal fiber post decreased this prevalence. Intact teeth showed 100% of repairable fractures. It is difficult to extrapolate the results directly to a clinical situation due to the limitations of this study.

Microleakage and Shear Bond Strength of Composite Restorations Under Cycling Conditions

OBJECTIVES

The aim of this study was to evaluate microleakage and shear bond strength of composite restorations under different cycling conditions.

METHODS AND MATERIALS

Class V cavities were prepared in the buccal and lingual surfaces of 30 human molars (n=60). A further 60 molars were used to prepare flat enamel and dentin specimens (n=60 each). Cavities and specimens were divided into six groups and pretreated with an adhesive (self-etch/Clearfil SE Bond or etch-and-rinse/Optibond FL). Composite was inserted in the cavities or adhered to the specimens' surfaces, respectively, and submitted to cycling (control: no cycling; thermal cycling: 10,000 cycles, 5°C to 55°C; thermal/erosive cycling: thermal cycling plus storage in hydrochloric acid pH 2.1, 5 minutes, 6×/day, 8 days). Microleakage was quantified by stereomicroscopy in enamel and dentin margins after immersion in silver nitrate. Specimens were submitted to shear bond strength testing. Statistical analysis was done by two-way analysis of variance and Kruskal-Wallis tests (p<0.05).

RESULTS

Microleakage in enamel margins was significantly lower in the control group compared with thermal cycling or thermal/erosive cycling. Erosive conditions increased microleakage compared with thermal cycling (significant only for Clearfil SE Bond). No significant differences were observed in dentin margins. Bond strength of enamel specimens was reduced by thermal cycling and thermal/erosive cycling when Clearfil SE Bond was used and only by thermal/erosive cycling when Optibond FL was used. No differences were observed among dentin specimens.

CONCLUSIONS

Thermal/erosive cycling can adversely affect microleakage and shear bond strength of composite resin bonded to enamel.

Bond durability in erbium:yttrium-aluminum-garnet laser-irradiated enamel

This study sought to evaluate the influence of thermocycling and water storage on the microtensile bond strength of composite resin bonded to erbium:yttrium-aluminum-garnet (Er:YAG)-irradiated and bur-prepared enamel. Eighty bovine incisors were selected and sectioned. Specimens were ground to produce a flat enamel surface. Samples were randomly assigned according to cavity preparation device: (I) Er:YAG laser and (II) high-speed turbine, and were subsequently restored with composite resin. They were subdivided according to the duration of water storage (WS)/number of thermocycles (TCs): 24 h WS/no TCs; 7 days WS/500 TCs; 1 month WS/2,000 TCs; 6 months WS/12,000 TCs. The teeth were sectioned into 1.0 mm(2)-thick slabs and subjected to tensile stress in a universal testing machine. Data were submitted to two-way analysis of variance (ANOVA) and Tukey's test at a 0.05 significance level. The different periods of water storage and thermocycling did not influence the microtensile bond strength (microTBS) values in the Er:YAG laser-prepared groups. In bur-prepared enamel, the group submitted to 12,000 TCs/6 months' WS (IID) showed a significant decrease in bond strength values when compared to the group stored in water for 24 h and not submitted to thermocycling (IIA), but values were statistically similar to those obtained in all Er:YAG laser groups and in the bur- prepared groups degraded with 500 TCs/1 week WS (IIB) or 2,000 TCs/1 month WS (IIC). It may be concluded that adhesion of an etch-and-rinse adhesive to Er:YAG laser-irradiated enamel was not affected by the methods used to simulate degradation of the adhesive interface and was similar to adhesion in the bur-prepared groups in all periods of water storage and thermocycling.

Assessment of in vitro methods used to promote adhesive interface degradation: a critical review

One factor that has a great influence on clinical performance of dental restorations is their resistance to degradation. Morphological changes in the structure of tooth-restoration interface aged in the oral environment have been reported. However, even though the in vivo performance is the ultimate testing environment for predicting the behavior of restorations because of the complexity of intraoral conditions, in vitro models such as thermocycling, mechanical loading, pH cycling, and aging of materials in distilled water, NaOCl, and food-simulating solutions may provide important information about the fundamental mechanisms involved in resin-tooth interface degradation. Most recently, the effect of host-derived enzymes and the storage in deproteinizing solutions (such as aqueous NaOCl) on the degradation of resin-dentin bonds has also been described. This review considers the importance of these in vitro methods on bond durability interface in an attempt to understand the behavior of restoratives over time. The first section is focused on the mechanism of in vivo biodegradation, whereas the second looks at studies that have described the influence of water storage, NaOCl storage, host-derived matrix metalloproteinases, thermocycling, mechanical loading, pH cycling, and food-simulating solutions on the degradation of the adhesive interface. It is obvious that these methodologies do not occur separately in the oral cavity, but that each one has a specific importance in the mechanisms of bond degradation.

CLINICAL SIGNIFICANCE

The in vitro methods used to simulate bond degradation may describe important points related to the clinical performance of restorations. This article evaluates the mechanism of the in vivo biodegradation of adhesive interfaces as well as the influences that various testing methods have on these bonds.

Adhesion to Er:YAG Laser-prepared Dentin After Long-term Water Storage and Thermocycling

Simulation of thermal stress and long-term degradation presented in the oral environment adversely affected the adhesion of an etch & rinse adhesive system to Er:YAG laser-irradiated dentin.