Effect of Desensitizing Agents on the Bond Strength of Mild and Strong Self-etching Adhesives

The effect of desensitizing agents on the bond strength of dentin bonding agents: A systematic review

Background

Dentinal hypersensitivity (DH) is a common dental problem and is treated non-invasively using topical application of various desensitizing agents. When there is loss of tooth structure or tooth preparation is to be followed by a bonded restoration, it requires application of dentin bonding agent. However, the effect of desensitizers on bond strength is still controversial.

Aim and Objective

To evaluate the influence of different desensitizing agents on the bond strength of the dentin bonding agents.

Methods and Materials

PICO strategy was used to formulate the research question. In-vitro studies conducted on human teeth to evaluate the bond strength of dentin bonding agent following the application of desensitizing agent were included. Electronic databases PubMed and Cochrane and google scholar were searched using search terms alone or in combination from the year 2010 till 2020. Search was conducted using the key words and MeSH terms (hypersensitivity, bond strength, dental adhesives, dentin bonding agents). The title and abstract were read to verify the inclusion and exclusion criteria and if further any details required, full article was accessed to check the criteria and then included or excluded. Data extraction was done using a customized data extraction form. The risk of bias was evaluated using modified Cochrane Collaboration Quality Assessment tool.

Results

Total no of studies identified in the search were 146, after scrutiny 23 articles were eligible to be included in this study. Out of 23 articles, 17 articles were of medium bias and 6 articles were of high risk after risk of bias assessment.

Conclusion

According to the various articles included in this study, GLUMA and 8.0%Arginine and CaCO3 when used as desensitizing agents along with different bonding agents, were found to be highly compatible without interfering with the bond strength of the dentin adhesives.

Influences of desensitizing agents on bond strength of etch-and-rinse and self-etch adhesive system to dentin

Background:

Cervical lesions requiring adhesive restoration may present with dentin hypersensitivity, but the effect of desensitizer treatment on microtensile bond strength (MBS) is inconclusive.

Aim:

The aim of the present study was to assess the influence of two types of dentin desensitizing treatment on bond strength to dentin.

Materials and Methods:

Thirty-six extracted human mandibular first premolars were used to obtain superficial buccal cervical dentin. The samples were assigned to two groups (18/group): etch-and-rinse (ERS) (Optibond^® Solo) and self-etch (Palfique) adhesive systems. Eighteen teeth in each group were randomly assigned to three desensitizer treatments (6/treatment); control (no desensitization), Gluma™ desensitizerand Novamin-containing toothpaste (Sensodyne repair and protect™). Bonded dentin-composite specimens were stored in artificial saliva for 2 weeks prior to scanning electron microscope (SEM) evaluation and MBS testing. Univariate analysis of variance and Tukey tests were performed (α = 0.05) for the data analysis.

Results:

The mean MBS with self-etch system (SES) was significantly higher than ERS system, irrespective of the dentin desensitizer regimen. SEM showed no hybrid layer or resin tag formation in the SES group. Tubular occlusion was observed in all specimens treated with desensitizer.

Conclusion:

Mild self-etch adhesive can be used on dentin treated with Gluma or bioglass-containing desensitizer without compromising the bond strength.

Clinical Relevance:

Dentin desensitizer such as in-office Gluma or at-home Novamin-containing toothpaste could be used without compromising the bond strength of mild self-etch adhesive systems.

The effects of 45S5 bioactive glass and Er:YAG Laser on the microtensile bond strength of fluorosed teeth

This vitro study aimed to evaluate the effects of 45S5 bioactive glass (BAG) and Er:YAG laser as desensitization treatments on the microtensile bond strength (MTBS) of fluorosed teeth. The 120 noncarious fluorosis were to obtain superficial dentin, being classified into four groups according to the Thylstrup and Fejerskov Index (TFI). Specimens from each group were randomly divided into five subgroups. After fluorosed teeth hypersensitivity models were established, the following pretreatments were applied on dentine surface: Subgroup 1: deionized water (Control); Subgroup 2: BAG; Subgroup 3: Er:YAG laser; Subgroup 4: BAG + Er:YAG laser, and Subgroup 5: Er:YAG laser + BAG. One sample was randomly selected from each subgroup for scanning electron microscope (SEM). The remaining samples were bonded with composite resin by Adper Single Bond 2 adhesive. Then water bath at 37°C for 24 hr. After 5,000 thermocycling, MTBS was tested and fracture mode was analyzed. The difference of MTBS between BAG group and Control group was found statistically significant (p < .05) in fluorosis. The Er:YAG laser + BAG group showed lowest MTBS values in fluorosis. In conclusion, the pretreatment of BAG might be beneficial to the adhesive of fluorosed teeth. Er:YAG laser desensitization alone or using BAG first and then Er:YAG laser desensitization might not affect the adhesive of fluorosed teeth, while Er:YAG laser desensitization followed by the pretreatment of BAG would be not conducive to the adhesive of fluorosed teeth.

Influence of desensitizing agents in management of noncarious cervical lesion and bonded restorations: A preliminary 12-week report

OBJECTIVES

The primary objective of this study was to investigate the effectiveness in reducing dentin hypersensitivity in noncarious cervical lesions (NCCLs) by home-based desensitizing toothpaste (TP), in-office Gluma desensitizer application, and resin-modified glass-ionomer cement (RMGIC) restoration. The secondary objective was to evaluate the long-term outcome of the glass-ionomer cement restoration following the application of bioactive glass-containing desensitizer TP.

MATERIALS AND METHODS

A total of 73 patients or 151 teeth were included in the study and randomly allotted to one of the four different treatment groups. Pre- and postoperative symptom and air-blast/tactile sensitivity scores were recorded for statistical analysis. Postoperative sensitivity was analyzed at 1, 4, and 12 weeks after treatment. Nonparametric statistical tests were employed.

RESULTS

Kruskal-Wallis test noted a significant reduction in postoperative sensitivity at all time periods with the RMGIC group compared to other treatment options. Significantly higher patient dropout was observed in desensitizing TP regimen.

CONCLUSIONS

This interim 12-week report on dentin hypersensitivity management of NCCLs concludes that resin-modified glass-ionomer restoration was able to achieve a significant instant reduction in sensitivity and patient satisfaction compared to other noninvasive at-home and in-office procedures.

CLINICAL RELEVANCE

This interim 12-week report on dentin hypersensitivity management of noncarious cervical lesions concludes that resin-modified glass-ionomer restoration was able to achieve a significant reduction in sensitivity, and patient satisfaction was higher compared to other noninvasive at-home and in-office procedures.

Microleakage in Class V Composite Restorations after Desensitizing Surface Treatment with Er:YAG and CO2 Lasers

Aims: Glutaraldehyde, CO₂ and Er:YAG lasers can be used for treatment of dentin hypersensitivity. However, their application may have adverse effects on the clinical service of restorations. This study aimed to assess the microleakage in composite restorations following surface treatment with Glutaraldehyde desensitizer, CO₂ and Er:YAG laser irradiation for treatment of dentin hypersensitivity. Materials and methods: This experimental study was conducted on 60 extracted sound human teeth. Class V cavities were prepared measuring 3×3 mm using a diamond bur. Specimens were randomly divided into 4 groups of 15. Group one:no surface treatment, Group two:applying Glutaraldehyde desensitizer, Groups of three and four were irradiated with CO₂ and Er:YAG lasers, respectively. Surfaces were restored with bonding agent (Single Bond 2, 3M, USA) and Z250 composite (3M, USA). Specimens were thermocycled and immersed in 1% methylene blue solution for 24 hours. Microleakage scores were assessed under a stereomicroscope at ×20 magnification. Data were analyzed using SPSS and the Kruskal Wallis test (P=0.05). Results: There was no significant difference between microleakage of groups in enamel margins (P=0.694). The difference in microleakage at the dentin margin was significant between groups (P=0.018). Conclusions: Application of Glutaraldehyde-desensitizer and CO₂ laser irradiation of surfaces prior to composite restoration do not increase microleakage at the enamel or dentin margins but tooth surface treatment with Er:YAG laser significantly increased the microleakage at the dentin margins.

In Vitro Evaluation of Dentin Hydraulic Conductance After 980 nm Diode Laser Irradiation

BACKGROUND

Dentin hypersensitivity treatments are based on the physical obliteration of the dentinal tubules to reduce hydraulic conductance. The aim of the present study is to evaluate the hydraulic conductance of bovine root dentin after irradiation with a 980-nm diode laser, with or without associated fluoride varnish.

METHODS

Sixty bovine root dentin specimens were divided into six groups (n = 10 in each group): G1, G3, and G5 (0.5 W, 0.7 W, and 1 W diode laser, respectively); G2, G4, and G6 (fluoride varnish application + 0.5 W, 0.7 W, and 1 W diode laser, respectively). The dentin hydraulic conductance was evaluated at four time periods with a fluxmeter: 1) with smear layer, 2) after 37% phosphoric acid etching, 3) after the treatments, and 4) after 6% citric acid challenge. After the dentinal fluid flow measurements, specimens were also evaluated for mineral composition using energy dispersive X-ray spectroscopy (EDS).

RESULTS

Analysis demonstrated a better result with increased irradiation power (P < 0.001), especially if the diode laser irradiation was associated with the application of fluoride varnish (P < 0.001), ensuring a greater reduction in permeability. Considering the groups treated only with laser irradiation, the 1 W group was superior when compared with the 0.5 W and 0.7 W irradiated groups immediately after treatment (P < 0.001). After citric acid testing, all groups showed similar results, except when comparing the 1 W groups with the 0.5 W groups (P = 0.04). EDS results of the irradiated groups showed an increase in the proportion of calcium and phosphorus ions, which demonstrates a superficial composition modification after laser treatments.

CONCLUSION

Laser irradiation of exposed dentin promoted significant reduction in the dentin hydraulic conductance, mainly with higher energy densities and association with fluoride varnish.