Long-term bond strength of adhesive systems applied to etched and deproteinized dentin

Collagen-depletion strategies in dentin as alternatives to the hybrid layer concept and their effect on bond strength: a systematic review

Strategies aiming to improve the longevity of resin-dentin adhesive interface developed so far have only been able to retard the problem. Different approaches are thus needed. The objective of this review was to determine whether the use of collagen-depletion strategies after acid-etching procedures may improve the bond strength of resin-based materials to dentin. A systematic review was planned following 2021 PRISMA statement guidelines, with a search strategy performed in five electronic databases: PubMed/Medline, Scopus, EMBASE, SciELO and IADR Abstract Archive (last search: 17/01/2022). Inclusion criteria encompassed studies which evaluated a collagen-depletion strategy in acid-etched human dentin and tensile/shear bond strength tests. Risk of bias assessment was carried out by two reviewers, working independently on an adapted five-domain risk of bias (RoB) checklist for laboratory studies. Results were synthesized qualitatively, as a meta-analysis was not possible due to limited number of studies and their RoB. A total of eight studies were eligible for inclusion in the systematic review after inclusion/exclusion criteria application. Out of these, two evaluated the effect of using NaOCl followed by an antioxidant, and the remaining six evaluated different enzymatic treatments (bromelain, chondroitinase ABC, papain, and trypsin). None of the studies reported a decrease of bond strength when a collagen-depletion strategy was used, in comparison to traditional hybrid layers (control). All enzymatic treatment studies which respected the inclusion criteria improved the bond strength to dentin. Some specific collagen-depletion strategies seem to play a favorable role in improving immediate bond strengths to dentin. Further research with sound methodology is required to consolidate these findings, since limitations in RoB and a low number of studies were found. The assessment of further proteolytic agents and long-term outcomes is also required.

Evaluation of the effect of chlorhexidine and sodium hypochlorite in adhesive cementation of fiber posts - in vitro study

Abstract Introduction The attachment of fiberglass posts is achieved through an adhesive process. Failures in adhesion may occur due to the hydrolytic degradation of the adhesives, or to the degradation of the collagen fibres of the hybrid layer by intrinsic enzymes. Objective To evaluate the effect of chlorhexidine and sodium hypochlorite treatment on bond strength to dentin. Material and method Thirty bovine roots were randomly distributed into 3 groups (n=10): a) Control, b) 2% Chlorhexidine, and c) 5% Sodium Hypochlorite. Next, RelyX® ARC resin cement was used to cement the post. Each specimen resulted in samples from the three root thirds that were submitted to the pushout test (MPa) at 24 hours and 12 months. Bond strength values were analysed using the Kolmogorov-Smirnov, 3-way ANOVA and Tukey tests. The fracture mode of the pin was also analysed using stereomicroscopy. Result There were no significant differences between treatments at the immediate time (p=0.0644) or in the interaction of factors (p=0.1935). After one year, the experimental groups showed no significant differences in bond strength in relation to the control group, with the exception of the cervical third of the chlorohexidine group in which there was a significant loss of adhesion. As for the fracture mode, there was a predominance of the mixed type in all groups and thirds. Conclusion The use of chlorhexidine or hypochlorite provides neither benefits nor losses in the adhesive bond strength of fiberglass posts. However, there is an influence of the root thirds, with the worst bond strength in the apical third.

Effect of bromelain enzyme for dentin deproteinization on bond strength of adhesive system

Aims:

To assess the deproteinizing effect of bromelain enzyme and compare it with 5% sodium hypochlorite (NaOCl) on shear bond strength before application of the adhesive system.

Materials and Methods:

A total of 30 extracted human premolars were divided into three groups, each one consisted of 10 teeth. The occlusal surface was wet ground to expose superficial dentin. In Group 1, teeth were etched; in Group 2, teeth were etched and deproteinized with bromelain enzyme; in Group 3, teeth were etched and deproteinized with 5% NaOCl. Upon completion of the adhesive procedures, resin composite was inserted into the plastic tube and light-polymerized. All specimens were stored at 37°C in water for 24 h, and the specimens were transferred to the universal testing machine, and then subjected to shear bond strength analysis at a crosshead speed of 1.0 mm/min.

Statistical Analysis Used:

Data were statistically analyzed using one-way analysis of variance and unpaired t-test at a significance level of 0.05. The statistical analysis was performed using SPSS version 12.0.1 for Windows (SPSS Inc., Chicago, IL, USA).

Results:

The bond strength results were significantly influenced by the application of bromelain enzyme. Statistically significant differences were not demonstrated in control group and NaOCl-treated group. The highest bond strength was seen in bromelain enzyme-treated group.

Conclusions:

Within the limitations of the present study, it was concluded that removal of unsupported collagen fiber with bromelain enzyme after acid etching results in improved bond strength.

Effect of dentin biomodification using naturally derived collagen cross-linkers: one-year bond strength study

Purpose. This study investigated the long-term resin-dentin bond strength of dentin biomodified by proanthocyanidin-rich (PA) agents. Materials and Methods. Forty molars had their coronal dentin exposed, etched, and treated for 10 minutes with 6.5% grape seed extract (GSE), 6.5% cocoa seed extract ethanol-water (CSE-ET), 6.5% cocoa seed extract acetone-water (CSE-AC), and distilled water (CO). Samples were restored either with One-Step Plus (OS) or Adper Single-Bond Plus (SB). Bond strength test was performed immediately or after 3, 6, and 12 months. Results. Higher μTBS were observed for GSE immediately (SB- 62.9 MPa; OS- 51.9 MPa) when compared to CSE-ET (SB- 56.95 MPa; OS- 60.28 MPa), CSE-AC (SB- 49.97 MPa; OS- 54.44 MPa), and CO (SB- 52.0 MPa; OS- 44.0 MPa) (P < 0.05). CSE outcomes were adhesive system and solvent dependant. After 12 months storage SB results showed no difference among treatment types (GSE- 57.15 MPa; CSE/ET- 54.04 MPa; CSE/AC- 48.22 MPa; CO- 51.68 MPa; P = 0.347),while OS results where treatment dependent (GSE- 42.62 MPa; CSE/ET- 44.06 MPa; CSE/AC- 41.30 MPa; CO- 36.85 MPa; P = 0.036). Conclusions. GSE and CSE-ET agents provided enhanced immediate adhesion and stabilization to demineralized dentin after long-term storage, depending on adhesive system.

Bonding efficacy of an acetone/based etch-and-rinse adhesive after dentin deproteinization

Objectives: to evaluate the effect of sodium hypochlorite (NaOCl) treatment on dentin bonding by means of shear bond strength (SBS) measurements when using Prime&Bond NT (PB NT) adhesive. Ultrastructure of the interfaces was examined by scanning electron microscopy (SEM). Study design: Extracted human third molars were sectioned and ground to expose flat surfaces of superficial or deep dentin. Specimens were randomly assigned to two equal groups, and bonded as follows: (1) according to the manufacturers’ directions, after 35% H3PO4 etching, (2) 5% NaOCl treated for 2 minutes, after 35% H3PO4 etching. Each sample was embedded in a Watanabe shear test assembly for a single plane lap shear. After PB NT bonding, specimens were stored in water for 24 h at 37ºC and thermocycled (500x). Samples were tested in shear to failure using a universal testing machine at 0.75 mm/min. Data were analyzed with ANOVA and Newman-Keuls multiple comparison test procedures. Two samples of each group were randomly selected to investigate the morphologic aspect of the resin/dentin interface with SEM. Results: After etching and after aqueous sodium hypochlorite (NaOClaq) application, SBS values were similar on superficial than deep dentin (p>0.05). SEM findings shows for H3PO4 etching conditioned samples a detectable hybrid layer and long resin tags; for NaOCl treated specimens, it may be observed a non apparent hybrid layer, and the adhesive contact directly with the neck of the cylindrical resin tags. Conclusions: The use of 5% NaOCl for 2 min after dentin demineralization when PB NT was employed did not improve the bond strength to dentin, probably due to nanofiller content and/or oxidative changes on collagen-depleted dentin.

Key words:Sodium hypochlorite, shear bond strength, SEM, Prime&Bond NT, superficial dentin, deep dentin.

Influence of sodium hypochlorite and edta on the microtensile bond strength of a self-etching adhesive system

Chemical substances used during biomechanical preparation of root canals can alter the composition of dentin surface and affect the interaction with restorative materials.