Effect of Mode of Application on the Microtensile Bond Strength of a Self-etch and Etch-and-Rinse Adhesive System

Efficacy of adhesive strategies for restorative dentistry: A systematic review and network meta-analysis of double-blind randomized controlled trials over 12 months of follow-up

PURPOSE

The efficacy of etch-and-rinse, selective enamel-etching, and self-etching protocols for universal adhesives in follow-ups of over 12 months was compared in a network meta-analysis.

STUDY SELECTION

Randomized controlled trials (RCTs) published from 1998 to 2022 that compared marginal staining, marginal adaptation, retention and fractures, post-operative sensitivity, or recurrence of caries that took place over 12-months post-restoration were selected. A network meta-analysis determined the performance of each adhesive protocol.

RESULTS

After screening 981 articles, 16 RCTs were subjected to data extraction. Of which, 674 patients with 2816 restorations, were included in the network meta-analysis. The pooled risk of marginal discoloration following self-etching was significantly higher than that following etch-and-rinse at over 12, 24, and 36 months, which was time-dependent. The pooled risks of unfavorable marginal adaptation and unfavorable retention and fractures following self-etching were also significantly higher than that following etch-and-rinse, with the rates of unfavorable retention and fractures in non-carious cervical lesions increasing in a time-dependent manner. The pooled risks of marginal discoloration, unfavorable marginal adaptation, retention and fractures were similar between etch-and-rinse and selective enamel-etching protocols. Post-operative hypersensitivity and recurrence of caries were not significantly different among etch-and-rinse, selective enamel-etching, and self-etching protocols.

CONCLUSIONS

In follow-ups over 12 months, esthetic and functional outcomes of restorations completed with an etch-and-rinse adhesive protocol were superior to the ones achieved with a self-etching strategy without selective enamel-etching. Selective enamel etching is recommended for self-etching systems. Biological responses were similar for all three adhesive strategies.

Effect of Different Application Modalities on the Bonding Performance of Adhesive Systems to Dentin: A Systematic Review and Meta-Analysis

Diverse types of dental adhesives exhibit different cytotoxic outcomes on cells in vitro. Currently, no standard adhesive application technique has so far been decisive for clinicians for better durability of resin-dentin bonds of adhesive systems. The purpose of this study was to systematically review the literature to evaluate the bonding performance of adhesive systems to dentin by using different application modalities. The systematic research strategy was conducted by two reviewers among multiple databases: PubMed, Scopus, Web of Science, Embase, and Scielo. In vitro studies reporting the effects of additional steps for the application of adhesive systems on the bond strength to dentin were selected. Meta-analysis was performed using Review Manager Software version 5.3.5 using the random effects model. The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic review. The electronic research through different databases generated a total of 8318 references. After the examination of titles and abstracts, a total of 106 potentially relevant studies accessed the full-text evaluation phase. After full-text examination, 78 publications were included for the qualitative analysis, and 68 studies were included in the meta-analysis. Regarding the etch-and-rinse adhesive systems, the application modalities that improved the overall bond strength were the application of a hydrophobic resin layer (p = 0.005), an extended application time (p < 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p = 0.05), the agitation technique (p = 0.02), and the active application of the adhesive (p < 0.001). For self-etch adhesive systems, the techniques that improved the overall bond strength were the application of a hydrophobic resin layer (p < 0.001), an extended application time (p = 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p < 0.001), the agitation technique (p = 0.01), and the active application of the adhesive (p < 0.001). The in vitro evidence suggests that the application of adhesive systems using alternative techniques or additional strategies may be beneficial for improving their bond strength to dentin. The application modalities that favored the overall bond strength to dentin were an extended application time, a double-layer application, an application assisted by an electric current, the active application of the adhesive, and the application of a hydrophobic resin layer. Worth mentioning is that some techniques are intended to increase the degree of the conversion of the materials, and therefore, improvements in the biocompatibility of the materials can be expected.

Bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin irradiated with a novel CO2 9.3 μm short-pulsed laser for dental restorative procedures

The objective of this study was to evaluate the influence of CO₂ 9.3 μm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO₂ 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa).

An in vitro evaluation of shear bond strength of silorane and bis-GMA resin-based composite using different curing units

AIM

To evaluate shear bond strength of silorane and bis-GMA based composite resins using self-etch and total-etch adhesive systems, and compare the effect of Quartz-tungten-halogen (QTH) and Light emitting diode (LED) on the shear bond strength of the experimental materials.

MATERIALS AND METHODS

Flat dentin surfaces were exposed on intact extracted molars and composite resin was built 2 mm in diameter. Teeth were divided randomly into four groups. Groups 1 and 2 were restored with P90 system adhesive and Filtek P90 and cured with QTH and LED units respectively. Groups 3 and 4 were restored with total etch adhesive and Filtek Z100 and cured with QTH and LED units respectively. Specimens were subjected to shear bond strength testing using Instrom Universal testing machine.

RESULTS

Data was subjected to one-way analysis of variance. Total-etch groups gave significantly higher shear bond strength values than the self-etch groups. No significant difference in shear bond strength was found between Groups 3 and 4, while Group 1 showed significantly higher values than Group 2.

CONCLUSION

Type of light curing unit is not a significant factor affecting shear bond strength for bis-GMA RBCs using total-etch technique; while for curing silorane resin based composite (RBCs), conventional halogen curing units showed better results.

Degree of Conversion of Simplified Contemporary Adhesive Systems as Influenced by Extended Air-Activated or Passive Solvent Volatilization Modes

This study evaluated the effect of five methods of solvent volatilization on the degree of conversion (DC) of nine one-bottle adhesive systems using Fouriertransform infrared/attenuated total reflectance (FTIR/ATR) analysis. Nine adhesives were tested: Adper Single Bond 2 (SB), Adper Easy One (EO), One Up Bond F Plus (OUP), One Coat Bond SL (OC), XP Bond (XP), Ambar (AM), Natural Bond (NB), GO, and Stae. The adhesive systems were applied to a zinc-selenide pellet and 1) cured without solvent volatilization, 2) left undisturbed for 10 seconds before curing, 3) left undisturbed for 60 seconds before curing, 4) air-dried with an air stream for 10 seconds before curing, and 5) air-dried with an air stream for 60 seconds before curing. FTIR/ATR spectra were obtained, and the DC was calculated by comparing the aliphatic bonds/reference peaks before and after light activation for 10 seconds (FlashLite 1401). The DC means of each material were analyzed by one-way analysis of variance and post hoc Tukey test (p&lt;0.05). The DC of GO and Stae adhesive systems was not affected by the five evaporation conditions. Air-drying for 60 seconds before curing yielded the highest DC for SB, EO, and OC. Extended solvent volatilization time (60 seconds) either with or without air-drying before curing provided the highest DC for AM, NB, XP, and OUP. Thus, the monomer conversion of adhesive systems was material dependent. In general, the 60-second passive or active air-drying modes to volatilize solvents before curing enhanced the degree of conversion for the one-bottle simplified adhesive systems.