Effect of dentin location and long-term water storage on bonding effectiveness of dentin adhesives

Prodelphinidins enhance dentin matrix properties and promote adhesion to methacrylate resin

OBJECTIVE

Investigate the bioactivity and stability of Rhodiola rosea (RR) fractions as a natural source of prodelphinidin gallate (PDg) on dentin collagen via analysis of the viscoelastic and resin-dentin adhesive properties of the dentin matrix.

METHODS

The biomimicry and stability of RR subfractions (F1, F2, F3 and F4) with collagen were determined by dynamic mechanical analysis (DMA). DMA used a strain sweep method to assess the dentin matrix viscoelastic properties [storage (E'), loss (E"), and complex (E*) moduli and tan δ] after treatment, 7-, 30- and 90-days of storage in simulated body fluids (SBF). Resin-dentin interface properties were assessed after 1 and 90-days in SBF by microtensile bond strength test and confocal laser scanning microscopy. Data were analyzed using two and one-way ANOVA and post-hoc tests (α = 0.05).

RESULTS

RR fractions increased dentin matrix complex (96 - 69 MPa) and storage (95 - 68 MPa) moduli, compared to the control (∼9 MPa) in the ranking order: F2 ≥ F3 = F1 = F4 > control (p < 0.001). Treatment did not affect tan δ values. After 30- and 90-days, RR-treated dentin E*, E' and tan δ decreased (p < 0.001). F2 fraction yielded the highest microtensile bond strength (43.9 MPa), compared to F1, F4 (35.9 - 31.7 MPa), and control (29 MPa). RR-treated interfaces mediated stable surface modifications and enhanced collagen-methacrylate resin interactions at the bioadhesive interface.

SIGNIFICANCE

Prodelphinidin gallates from RR are potent and reasonably stable biomimetic agents to dentin. Higher potency of F2 fraction with the dentin matrix and the adhesive interface is associated with a degree of polymerization of 2-3 and gallo(yl) motifs.

Advanced statistical analyses to reduce inconsistencies in bond strength data focused on donor factors: A six-factor analysis using linear mixed and nonlinear regression models

PURPOSE

This study aimed to investigate the effects of the age and sex of tooth donors on dentin bond strength.

METHODS

A total of 38 extracted teeth (12 male and 26 female donors; age range: 17-82 years) were used in this study. In addition to donor age and sex, four other microtensile bond strength (μTBS) test specimen factors were evaluated: dentin position, bonding area, presence of voids at the interface, and computed tomography (CT) values of dentin. The μTBS was measured immediately (24 h) and 6 months after storage in water. After the μTBS testing, linear mixed and nonlinear regression models were used to analyze the effects of these factors on the μTBS data.

RESULTS

The results from the linear mixed model revealed that the bonding area (P = 0.02), presence of voids at the interface (P = 0.04), and storage time (P < 0.001) significantly affected bond strength. In contrast, no correlation was observed between the μ TBS and dentin position (P = 0.08) or sex (P = 0.07). The results of the nonlinear regression model with robust variance-covariance estimators revealed that age significantly affected bond strength (P < 0.001). In addition, a significant positive correlation was found between μTBS and age (P < 0.001), with nonlinearity (P = 0.002). However, no correlation was observed between the μTBS and CT values (P = 0.69) without nonlinearity (P = 0.39).

CONCLUSIONS

These findings suggest that bond strength increases with age until 60 years but not afterward.

Novel hydrolytic resistant antibacterial monomers for dental resin adhesive

OBJECTIVES

To evaluate the properties of novel hydrolytic resistant antibacterial monomers and to determine the properties of resin adhesives containing these monomers.

METHODS

Methacrylamide-based QAC (Quaternary Ammonium Compound) monomers, 1-(11-Methacryla-midoundecyl)pyridine-1-ium bromide (MAUPB) and 1-(12-Methacryl-amidododecyl)pyridine-1-ium bromide (MADPB), and their methacrylate-derivatives, N-(1-Methacryloylundecanyl)pyridinium bromide (MUPB) and N-(1-Methacryloyldodecanyl)pyridinium bromide (MDPB), were synthesized and characterized. The minimum inhibitory (MIC) and bactericidal (MBC) concentrations were determined against S.mutans and E.faecalis. Cytotoxicity of unpolymerized monomers were evaluated using L-929 and MDPC-23. Each monomer was incorporated into experimental resins (BisGMA/TEGDMA/CQ/EDMAB or BisGMA/HEMA/CQ/EDMAB) at 10wt%. FTIR Spectra were collected for degree of conversion (DC%) measurement. Bacterial attachment on resin disks were determined by fluorescent microscope. Mechanical properties of experimental resins were evaluated by flexural strength & modulus and shear bond strength testing.

RESULTS

The antibacterial activity of MDPB≥MUPB>MADPB>MAUPB. The TC50 of MAUPB> MADPB>MUPB >MDPB. Incorporation of MAUPB in BisGMA/TEGDMA-based resin, had no significant effect on DC%, while significantly increase DC% in BisGMA/HEMA-based Resin. MUPB and MAUPB containing resins showed less viable bacterial attachment than pure resins. After 3-month storage, resins containing MAUPB illustrated higher flexural strength than their corresponding resins containing MUPB. BisGMA/HEMA-based resin containing MAUPB illustrated significantly higher resin-dentin shear bond strength than that of MUPB and pure resin.

CONCLUSIONS

Methacrylamide monomer containing QAC, MAUPB, possessed antibacterial properties and superior physical and mechanical properties when incorporated in resin adhesives as compared to their corresponding methacrylate monomer, MUPB.

CLINICAL SIGNIFICANCE

Methacrylamide-based QAC monomers are potentially used to formulate antibacterial hydrolytic resistant resin adhesives and enhance resin-dentin bond strength.

Autonomous-Strengthening Adhesive Provides Hydrolysis-Resistance and Enhanced Mechanical Properties in Wet Conditions

The low-viscosity adhesive that is used to bond composite restorative materials to the tooth is readily damaged by acids, enzymes, and oral fluids. Bacteria infiltrate the resulting gaps at the composite/tooth interface, demineralize the tooth, and further erode the adhesive. This paper presents the preparation and characterization of a low-crosslink-density hydrophilic adhesive that capitalizes on sol-gel reactions and free-radical polymerization to resist hydrolysis and provide enhanced mechanical properties in wet environments. Polymerization behavior, water sorption, and leachates were investigated. Dynamic mechanical analyses (DMA) were conducted using water-saturated adhesives to mimic load transfer in wet conditions. Data from all tests were analyzed using appropriate statistical tests (α = 0.05). The degree of conversion was comparable for experimental and control adhesives at 88.3 and 84.3%, respectively. HEMA leachate was significantly lower for the experimental (2.9 wt%) compared to control (7.2 wt%). After 3 days of aqueous aging, the storage and rubbery moduli and the glass transition temperature of the experimental adhesive (57.5MPa, 12.8MPa, and 38.7 °C, respectively) were significantly higher than control (7.4MPa, 4.3 MPa, and 25.9 °C, respectively). The results indicated that the autonomic sol-gel reaction continues in the wet environment, leading to intrinsic reinforcement of the polymer network, improved hydrolytic stability, and enhanced mechanical properties.

Aging Methods-An Evaluation of Their Influence on Bond Strength

Objectives  To evaluate the effect of different artificial aging methods on the bond strength of a resin composite associated with a universal adhesive (Scotchbond Universal) used under two etching approaches (self-etch [SE] or etch-and-rinse [ER]) to enamel and dentin substrates.

Materials and Methods  A total of 96 noncarious human third molars were prepared and randomly divided according to three factors ( n = 6): substrate (enamel and dentin), adhesive approach (SE and ER), and aging method (water storage for 24 hours, 6 months, or 1 year; subjected to 10,000, 20,000, or 30,000 thermal cycles; and sodium hypochlorite [NaOCl] storage for 1 or 5 hours).

Statistical Analysis  Microshear bond strength tests were conducted, and the collected data (MPa) were subjected to three-way analysis of variance (ANOVA) with post hoc Bonferroni tests ( p < 0.05) and Weibull analysis. The failure pattern was also evaluated.

Results  Three-way ANOVA revealed that the factors “substrate” ( p = 0.00) and “aging method” ( p = 0.00) had a significant effect on the bond strength, but the factor “adhesive approach” did not ( p = 0.84). The bond strength in the enamel group for the SE approach was negatively affected under 20,000 and 30,000 thermal cycles. Weibull presented the highest m in the NaOCl storage for the 5 hours group to enamel using the SE and to dentin using ER approaches. Adhesive/mixed failures were predominant for all groups.

Conclusion  Thermocycling aging (20,000 and 30,000 cycles) significantly reduced the bond strength to enamel using the SE approach. On the contrary, storage with the NaOCl method proved to increase bond strength under the evaluated conditions.

Influence of central and peripheral dentin on micro-tensile bond strength estimated using a competing risk model

The bonding performance of dental adhesives is most frequently evaluated using the micro-tensile bond strength (μTBS) test. Despite lacking evidence, peripheral specimens are often discarded to avoid regional variability. This study, therefore, examined whether μTBS to central and peripheral dentin differed. Dentin surfaces of extracted human molars were bonded with various self-etch adhesives, built up with a resin composite, cut into beams, and stressed in tension. Failure mode was classified as adhesive, cohesive in dentin, or other using scanning electron microscopy. Since cohesive failures in dentin were frequent and could confound μTBS results, the data from central/peripheral dentin were analyzed using a Weibull competing risk (CR) model distinguishing failure modes, and its outcomes were compared to a conventional failure mode non-distinguishing Weibull model. Based on the strength data of cohesively failed specimens, the CR model also estimated the strength of dentin. For comparison, the ultimate tensile strength (UTS) of dentin was measured in both regions. The conventional model suggested that peripheral μTBS was higher than central μTBS. Conversely, the CR model disclosed no significant difference in μTBS between the regions but indicated a higher strength of peripheral dentin. This finding was confirmed by UTS measurements, and further supported by the significantly higher incidence of cohesive failures in central dentin. Therefore, peripheral specimens can be used in the μTBS test as well as central ones, but a CR model should be used for statistical analysis if cohesive failures in dentin are frequent, as the strength of peripheral dentin is higher.

Does Q-MIX pretreatment improve the dentin bond durability of a two-step self-etch adhesive?

This study aims to analyze and assess the effects of three particular dentin pretreatment solutions on the bond durability of a two-step self-etch adhesive (Optibond XTR) applied to dentin after ageing for 2 years. Thirty-five third molars which were extracted (n = 5 for μTBS, n = 2 for nanoleakage) were divided into five groups: Group 1:Control (no pretreatment), Group 2:17% EDTA, Group 3:2% CHX, Group 4:17% EDTA plus 2% CHX, Group 5: Q-Mix. After the pretreatments of dentin, the dentin adhesive was applied as per the guidelines provided by the manufacturer. Half of the specimens were subjected to μTBS tests for 24 hr, while the remaining half were subjected to the tests after being kept for 2 years in water storage. Also, nanoleakage was evaluated with FE-SEM by examining silver nitrate deposits. The data obtained were evaluated using a two-way analysis of variance and Tukey Post Hoc test. The dentin pretreatments did not affect the 24 hr and 2 years μTBS values for OptiBond XTR. At 24 hr, the EDTA + CHX group (50.3 ± 4.9) showed that the highest μTBS value was obtained. Water ageing significantly reduced the μTBS results and after 2 years the highest μTBS value was obtained from the Q-Mix group (37.7 ± 5.2). Different dentin pretreatments do not alter the 24-hr μTBS and were not able to preserve the bond strength after 2 years of ageing. Q-Mix was able to slow down the regression in the strength of the dentin bond as well as nanoleakage over time.

Synthesis and characterization of new hydrolytic-resistant dental resin adhesive monomer HMTAF

Hydrolytic and enzymatic degradation of resin adhesives over time has been mainly attributed to secondary caries formation of methacrylate-based tooth-colored resin-based composite restorations. Ability of resin adhesive monomers to infiltrate into demineralized dentin forming stiff polymer matrix and potentially bonding to tooth structure is also a crucial property. The only commercially available antibacterial monomer, 12-methacryloyloxydodecyl pyridinium bromide (MDPB), is a quaternary ammonium methacrylate. This methacrylate monomer undergoes hydrolytic degradation, and could not bond to tooth structure. In this study, a new hydrolytic resistant monomer HMTAF was synthesized. It is methacrylamide-based monomer that, unlike methacrylate, is highly resistant to hydrolysis. Its molecular structure has particular functional groups; quaternary ammonium fluoride salt with potential antibacterial fluoride-releasing activity, hydroxyl and amide group with hydrogen bonding potential to dentin collagen. Hydroxyl group also increases monomer hydrophilicity for better penetration into water-saturated dentin and sufficient resin-dentin bond. The synthesized HMTAF and its polymer showed no hydrolytic degradation in acidic environment, while MDPB and its polymer were partially decomposed under this challenge. The conversion of monomer HMTAF to polymer was illustrated by FT-IR. The results indicated that HMTAF is highly resistant to hydrolysis, polymerizable and non-cytotoxic to Vero cell lines. It is a potential monomer to be incorporated into resin adhesives for improving hydrolytic and enzymatic resistance.

Microtensile Bond Strength of Adhesive Systems in Different Dentin Regions on a Class II Cavity Configuration

The aim of this study was to evaluate microtensile bond strength (µTBS) of self-etch and etch-and-rinse adhesives systems compared in different dentin regions (central-CD or proximal-PD) in a class II cavity configuration. A class II (mesial-oclusal-distal) cavity configuration was simulated on 20 extracted human third-molars (4 mm wide/3 mm deep). Etch-and-rinse adhesive (Scotchbond Multi Purpose, n=5, SBMP and Optibond FL, n=5, OPFL) and self-etch adhesives (Clearfil SE Bond, n=5, CSE and Optibond XTR, n=5, OPXTR) were applied. Class II restorations were performed by incremental technique and photo-activated (Bluephase/G2). Samples were sectioned to beam shape (1 mm² cross-section), placed on Geraldeli's device for µTBS test (0.5 mm/min cross-head speed). Fracture patterns were analyzed on stereomicroscope and classified as cohesive-resin, adhesive, mixed/resin or mixed/dentin. Samples (n=4) were prepared for scanning electron microscope observation. Data were submitted to one-way ANOVA with Split-Plot arrangement and Tukey's test (α=0.05). There were no statistically significant differences among SBMP, OPFL, CSE and OPXTR on CD (p>0.05). However, on PD for SBMP and OPFL, µTBS values were significantly lower compared to CSE and OPXTR (p<0.05). In all groups, mixed failure pattern was more frequently observed, except for SBMP/CD (adhesive). In class II type cavity configuration, PD location negatively influenced bond strength of etch-and-rinse adhesive systems. Opposite to self-etching adhesives, which presented higher bond strength values compared to etch-and-rinse adhesives in PD.

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.

Effect of a functional monomer (MDP) on the enamel bond durability of single-step self-etch adhesives

The present study aimed to determine the effect of the functional monomer, 10-methacryloxydecyl dihydrogen phosphate (MDP), on the enamel bond durability of single-step self-etch adhesives through integrating fatigue testing and long-term water storage. An MDP-containing self-etch adhesive, Clearfil Bond SE ONE (SE), and an experimental adhesive, MDP-free (MF), which comprised the same ingredients as SE apart from MDP, were used. Shear bond strength (SBS) and shear fatigue strength (SFS) were measured with or without phosphoric acid pre-etching. The specimens were stored in distilled water for 24 h, 6 months, or 1 yr. Although similar SBS and SFS values were obtained for SE with pre-etching and for MF after 24 h of storage in distilled water, SE with pre-etching showed higher SBS and SFS values than MF after storage in water for 6 months or 1 yr. Regardless of the pre-etching procedure, SE showed higher SBS and SFS values after 6 months of storage in distilled water than after 24 h or 1 yr. To conclude, MDP might play an important role in enhancing not only bond strength but also bond durability with respect to repeated subcritical loading after long-term water storage.

Aging of adhesive interfaces treated with benzalkonium chloride and benzalkonium methacrylate

Inhibition of endogenous dentin matrix metalloproteinases (MMPs) within incompletely infiltrated hybrid layers can contribute to the preservation of resin-dentin bonds. This study evaluated the bond stability of interfaces treated with benzalkonium chloride (BAC) and benzalkonium methacrylate (MBAC), and the inhibitory properties of these compounds on dentin MMP activity. Single-component adhesive ALL-BOND UNIVERSAL, modified with BAC or MBAC at concentrations of 0, 0.5, 1.0, and 2.0%, was used for microtensile bond strength (μTBS) evaluation after 24 h, 6 months, and 1 yr. Beams produced from human dentin were treated with 37% phosphoric acid, dipped in 0.5% BAC, 1.0% BAC, or water (control) for 60 s, and then incubated in SensoLyte generic MMP substrate to determine MMP activity. A significant decrease in the μTBS after 6 months and 1 yr was observed for the control group only. No significant differences among groups were shown at 24 h. After 6 months and 1 yr, the control group demonstrated significantly lower μTBS than all treatment groups. When applied for 60 s, 0.5% BAC inhibited total MMP activity by 31%, and 1.0% BAC inhibited total MMP activity by 54%. Both BAC and MBAC contributed to the preservation of resin-dentin bonds, probably because of their inhibitory properties of endogenous dentin proteinases.

Effect of Different Matrix Metalloproteinase Inhibitors on Microtensile Bond Strength of an Etch-and-Rinse and a Self-etching Adhesive to Dentin

Aim

This study aimed to analyze the effect of different matrix metalloproteinase (MMP) inhibitors on the microtensile bond strength (microTBS) of an etch-and-rinse and a self-etching adhesive after 9 months of aging.

Methods and Materials

Flat human dentin surfaces were bonded either with an etch-and-rinse adhesive (Optibond FL) or a self-etching adhesive (Clearfil SE Bond). Dentin surfaces were left untreated or were pretreated with MMP inhibitors (2% chlorhexidine digluconate [CHX], 0.05% green tea extract, 1 mM ferrous sulfate, or 0.2 mM galardin) prior to application of the adhesive. Composite buildups were made incrementally. Pretreated groups were tested after 9 months of storage in artificial saliva (37°C) and compared with untreated groups, which were tested immediately (initial microTBS) and upon aging (9-month microTBS). Data were analyzed by linear mixed-model regression. Failure mode analysis was performed microscopically and statistically analyzed by repeated-measures analysis of variance (p&lt;0.05).

Results

MicroTBS of the etch-and-rinse adhesive but not of the self-etching adhesive was significantly decreased by aging. For Optibond FL, pretreatment with 2% CHX, 0.05% green tea extract, and 0.2 mM galardin revealed bond strength values (MPa) similar to the initial microTBS (32.1±14.8) and significantly higher compared with the microTBS (20.3±13.6) of aged untreated dentin. No significant differences were observed between groups bonded with Clearfil SE Bond (initial microTBS: 28.3±12.4; 9-month microTBS: 25.3±11.8). Application of the MMP inhibitors decreased the number of adhesive failures compared with untreated controls after 9 months of aging, but this effect was not significant.

Conclusion

The MMP inhibitors prevented the decrease in microTBS upon aging of the etch-and-rinse but not of the self-etching adhesive.

Status of ten self-etch adhesives for bonding to dentin of primary teeth

OBJECTIVE

Aim of this in vitro study was to compare self-etch adhesives regarding microtensile bond strength (μ-TBS) to dentin of primary teeth.

METHODS

Fifty freshly extracted primary molars were ground to expose caries-free dentin. Specimens were bonded with ten self-etch adhesives (iBond self-etch/Heraeus, Xeno V+/Dentsply, G-Bond, Gaenial Bond/GC, BeautiBond/Shofu, AdheSE One F/Ivoclar Vivadent, Adper Easy Bond/3M ESPE, Clearfil SE Bond/Kuraray, OptiBond XTR/KerrHawe, Prime&Bond NT/Dentsply). After 24-h storage (distilled water, 37°C), resin-dentin beams were cut and 848 resin-dentin sticks were subjected to μ-TBS tests. Fracture analysis was carried out at 40× magnification under a fluorescence microscope and under a SEM.

RESULTS

Three adhesives (iBond SE, Clearfil SE Bond, Prime&Bond NT) did not suffer pre-test failures (PTF). AdheSE One F revealed the largest portion of PTF (28%; P < 0.05). Clearfil SE Bond and OptiBond XTR exhibited more cohesive fractures than the other adhesives (77.3% vs 64.8%; P < 0.05). iBond SE, Gaenial Bond, Clearfil SE, and OptiBond XTR achieved μ-TBS of >60 MPa, whereas Xeno V+ and AdheSE One F ranged only at ~20 MPa (P < 0.05).

CONCLUSION

Within the limits of this study, the self-etch adhesives under investigation proved different extents of initial μ-TBS to primary dentin with iBond SE, Gaenial Bond, Clearfil SE, and OptiBond XTR having been most successful.

The effect of different adhesive system applications on push-out bond strengths of glass fiber posts

PURPOSE

Over the past years, the adhesion of fiber posts luted with simplified adhesive systems has been a matter of great interest. The aim of this study was to assess the post retentive potential of a self-adhesive resin cement using different adhesive systems to compare the push-out bond strengths of fiber posts.

MATERIALS AND METHODS

The post spaces of 56 mandibular premolar roots were prepared and divided into 4 experimental groups and further divided into 2 subgroups according to testing time (n=7). The fiber posts (Rely X Fiber Post) were luted with a self-adhesive resin cement (RelyX Unicem) and one of the following adhesive systems: no adhesive, a total-etch adhesive resin (Single Bond), a two-step self-etch adhesive resin (Clearfil SE Bond) and a one-step self-etch adhesive resin (Clearfil S3 Bond). Each root was cut horizontally, and 1.5 mm thick six root segments were prepared. Push-out tests were performed after one week or three months (0.5 mm/min). Statistical analysis were performed with three-way ANOVA (α=.05).

RESULTS

Cervical root segments showed higher bond strength values than middle segments. Adhesive application increased the bond strength. For one week group, the total-etch adhesive resin Single Bond showed higher bond strength than the self-adhesive resin cement RelyX Unicem applied without adhesive resin at middle region. For 3 months group, the two-step self-etch adhesive resin Clearfil SE Bond showed the highest bond strength for both regions. Regarding the time considered, Clearfil SE Bond 3 months group showed higher bond strength values than one week group.

CONCLUSION

Using the adhesive resins in combination with the self-adhesive resin cement improves the bond strengths. The bond strength values of two-step self-etch adhesive resin Clearfil SE Bond improved as time passes.

Strategies to prevent hydrolytic degradation of the hybrid layer-A review

OBJECTIVE

Endogenous dentin collagenolytic enzymes, matrix metalloproteinases (MMPs) and cysteine cathepsins, are responsible for the time-dependent hydrolysis of collagen matrix of hybrid layers. As collagen matrix integrity is essential for the preservation of long-term dentin bond strength, inhibition of endogenous dentin proteases is necessary for durable resin-bonded restorations.

METHODS

Several tentative approaches to prevent enzyme function have been proposed. Some of them have already demonstrated clinical efficacy, while others need to be researched further before clinical protocols can be proposed. This review will examine both the principles and outcomes of techniques to prevent collagen hydrolysis in dentin-resin interfaces.

RESULTS

Chlorhexidine, a general inhibitor of MMPs and cysteine cathepsins, is the most tested method. In general, these experiments have shown that enzyme inhibition is a promising approach to improve hybrid layer preservation and bond strength durability. Other enzyme inhibitors, e.g. enzyme-inhibiting monomers, may be considered promising alternatives that would allow more simple clinical application than chlorhexidine. Cross-linking collagen and/or dentin matrix-bound enzymes could render hybrid layer organic matrices resistant to degradation. Alternatively, complete removal of water from the hybrid layer with ethanol wet bonding or biomimetic remineralization should eliminate hydrolysis of both collagen and resin components.

SIGNIFICANCE

Understanding the function of the enzymes responsible for the hydrolysis of hybrid layer collagen has prompted several innovative approaches to retain hybrid layer integrity and strong dentin bonding. The ultimate goal, prevention of collagen matrix degradation with clinically applicable techniques and commercially available materials may be achievable in several ways.

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.

Long-term nano-mechanical properties of biomodified dentin-resin interface components

Failures of dental composite restorative procedures are largely attributed to the degradation of dentin-resin interface components. Biomodification of dentin using bioactive agents may improve the quality and durability of the dentin-resin bonds. The aim of this study was to nanomechanically assess the reduced modulus of elasticity (Er) and nano-hardness (H) of major components of the dentin-resin interface (hybrid layer, adhesive layer and underlying dentin) biomodified by collagen cross-linkers at 24h, 3 and 6 months following restorative procedure. Demineralized dentin surfaces were biomodified with 5% glutaraldehyde (GD) or 6.5% grape seed extract (GSE) prior to placement of adhesive systems and composite resin. Nano-measurements of the interface components in a fluid cell showed that both agents increased the Er and H of underlying dentin after 3 and 6 months when compared to a control. The mechanical properties of the adhesive and hybrid layers decreased over time. Biomodification of the dentin-resin interface structures using GD and GSE can increase the mechanical properties of the interface over time and may contribute to the long-term quality of adhesive restorations.