In vitro permeability of etch-and-rinse and self-etch adhesives used for immediate dentin sealing

Effects of Arginine-calcium carbonate pretreatment on the remineralizing and bonding performance of phosphorylated dentin

OBJECTIVES

To evaluate the effects of Arginine-calcium carbonate (Arg-CaCO₃) paste treatment of phosphorylated dentin on remineralizing and bonding performance during direct and indirect restorations under pulpal pressure.

METHODS

Under simulated pulpal pressure, dentin of healthy third molars were abraded and acid etched for 15s, then randomly divided into 4 groups: negative control group; Arg-CaCO₃ group (1min); 2.5% Sodium trimetaphosphate (STMP) group (3min); S-A group, 2.5% STMP + Arg-CaCO₃. After 24h, remineralization and dentin tubular occlusion were assessed by Attenuated total reflection fourier transform infrared spectroscopy (ATR-FTIR), Micro-Raman spectroscopy, Vickers hardness, Field-emission scanning electron microscope (FESEM) and Energy X-ray dispersive spectrometer (EDS). The liquid environment was the simulated body fluid (SBF) permeated from dentin tubules due to pulpal pressure. Stick specimens prepared with self-etch dentin adhesive were tested for microtensile bond strength (μTBS) and interfacial silver nanoleakage on both immediate direct restoration and indirect restoration with a 7-day temporary period. Data were analyzed by the Kruskal-Wallis test, Mann-Whitney test, Welch ANOVA or one-way ANOVA and Tukey post hoc test (p < 0.05).

RESULTS

The pretreatment of 2.5% STMP with Arg-CaCO₃ significantly increased relative mineral content by ATR-FTIR, Raman and FESEM-EDS, simultaneously enhancing dentin tubular occlusion (%) and mechanical property to the most considerable extent. Furthermore, the pretreatment significantly promoted the μTBS of indirect restoration and reduced nanoleakage after 7 days.

CONCLUSIONS

The application of Arg-CaCO₃ paste on phosphorylated dentin could improve intra- and extra-tubular mineralization and the stability of adhesion interface.

CLINICAL RELEVANCE

Without exceeding the amount of conventional tooth preparation, combining 2.5% STMP with Arg-CaCO₃ paste before the self-etch bonding system might be a promising clinical strategy to relieve dentin hypersensitivity and strengthen bonding performance efficiently and conveniently.

Influence of the Flowable Resin Layer on Bond Strength Between Resin Cement and a Universal Adhesive Applied in the Immediate Dentin-sealing Technique

OBJECTIVES

The present study evaluated the influence of a flowable resin layer on bond strength between resin cement and a universal adhesive applied using an immediate dentin sealing (IDS) technique.

METHODS AND MATERIALS

Coronary portions of bovine teeth were randomly divided into six groups (n=15). In the IDS.U group, the exposed dentin was immediately sealed with the Single Bond Universal adhesive (3M ESPE) following the self-etching protocol. In the IDS.UF group, a layer of Filtek Z350 (3M ESPE) flow resin was applied over the universal adhesive. In the DDS (control) group, the dentin was kept "fresh" and delayed dentin sealing was performed. After 24 hours in distilled water at 37°C, dentin surfaces were treated with pumice, phosphoric acid, and the application of the universal adhesive in the IDS.U and IDS. UF groups. The DDS group was treated with pumice and the universal adhesive was applied. The samples received cylinders of resin cement Rely X Ultimate (3M ESPE) made with the aid of starch tubes of 0.96 mm in diameter and 2 mm in length. They were submitted to the microshear bond strength test (μSBS) at 0.5 mm/min, after 24 hours (T1) and 3 months (T2). The fracture areas were evaluated qualitatively using a DSM 300 microscope (KOZO) with 45× magnification and classified as: adhesive, cohesive in cement, cohesive in dentin, or mixed. Samples were analyzed by scanning electron microscopy (SEM). The data were compared statistically between groups using the Kruskal-Wallis test, and intra-groups using the Mann-Whitney test (α=0.05).

RESULTS

There were no significant differences between groups for the bond strength values (p>0.05). The IDS.UF group showed higher values at 3 months, when compared to the values of 24 hours (p<0.001). All groups showed a predominance of adhesive fracture (86.7% to 100%). SEM showed dentinal tubules exposed in the IDS.U and DDS groups; in the IDS.UF group, the tubules were completely sealed.

CONCLUSIONS

The flow resin can be used on the adhesive when using the IDS technique because it increased the bond strength values after 3 months and promoted effective sealing of the dentinal tubules.

Effect of Application Deviations on Dentin Sealing of a Universal Adhesive: Permeability and Nanoleakage

OBJECTIVE

 The objective of this study was to evaluate the effect that deviations from the recommended protocol of a universal adhesive system, applied to dentin according to the self-etch (SE) and the etch-and-rinse (ER) techniques, has on permeability and nanoleakage.

MATERIALS AND METHODS

 Permeability: 60 extracted non-carious human third molars (N = 60) were sectioned to obtain 0.7-mm-thick dentin disks. The specimens were randomly assigned to three subgroups and treated with a universal adhesive system (Prime&Bond Active Universal) using the SE and ER techniques: (1) following the manufacturer's instructions with 5 seconds drying (MFR DRY 5S), (2) following the MFR DRY 10S, and (3) reduced application time of the adhesive to 5 seconds (APPL 5S). Nanoleakage: 12 additional 0.7-mm-thick dentin disks were prepared, treated and divided into six groups. They were immersed in 50 wt% ammoniacal silver nitrate and processed according to conventional methods for the analysis of nanoleakage under transmission electron microscopy.

STATISTICAL ANALYSIS

 The results were statistically analyzed by two-way analysis of variance and post-hoc Bonferroni's test.

RESULTS

 Significant differences in permeability reduction were observed among the treatment groups (0.001). The results obtained for APPL 5S were significantly lower than the results obtained for both the MFR DRY 5S (p = 0.003) and MFR DRY 10S (p = 0.001).

CONCLUSIONS

 The reduced application time to 5 seconds creates imperfect dentin tubule sealing, which may explain clinical reports of postoperative sensitivity and early degradation of the resin-dentin interface.

Effects of dentin surface preparations on bonding of self-etching adhesives under simulated pulpal pressure

Objectives

This study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure.

Materials and Methods

Human third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH₂O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests.

Results

Only the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives.

Conclusions

Superfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

Immediate Dentin Sealing: A Literature Review

Purpose

The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application.

Materials and Methods

The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies.

Results

After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation.

Conclusion

There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.

Dentin adhesives application deviations: Effects on permeability and nanoleakage

The purpose was to evaluate the effect that deviations from the recommended protocol of a two-step etch-and-rinse adhesive system has on permeability and nanoleakage. One hundred and twenty dentin disks were treated with a two-step etch-and-rinse adhesive system, according to the manufacturer's instructions, or using five simulated deviations from the recommended protocol: applying potassium oxalate, reducing the application time of the adhesive, avoiding adhesive drying, aggressively drying the adhesive, and double application of adhesive. Kruskal-Wallis and Tukey's post hoc comparisons were used to evaluate the permeability reduction (α=0.05). Twelve additional dentin disks were prepared for transmission electron microscope (TEM) analysis of nanoleakage. Aggressive drying, adding additional layers of adhesive or using oxalate reduced dentin permeability and yielded a better infiltration of the hybrid layer, whereas reducing the application time or less drying the adhesive did not to reduce dentin permeability, caused extensive nanoleakage, showing immediate compromised dentin sealing.

Dentin Permeability and Nanoleakage of Universal Adhesives in Etch-and-rinse vs Self-etch Modes

PURPOSE

This study evaluates the reduction in dentin permeability (P) and the expression of nanoleakage in resin-dentin interfaces made with universal adhesives, comparing the self-etch mode of application with the etch-and-rinse mode of application.

METHODS AND MATERIALS

To measure dentin P at the baseline and after adhesive polymerization, 80 extracted noncarious human third molars (N=80) were sectioned to obtain 0.7-mm-thick midcoronal dentin disks. The specimens were randomly assigned to 8 groups according to the different adhesive systems and application modes used: Scotchbond Universal (SBU; etch-and-rinse [ER] mode vs self-etch [SE] mode), OptiBond XTR (OPT; etch-and-rinse mode vs self-etch mode), Clearfil Universal Bond Quick (CL; etch-and-rinse mode vs self-etch mode), and Adhese Universal (ADH; etch-and-rinse mode vs self-etch mode). A two-way analysis of variance with interaction was used to evaluate the P reduction differences among the groups (α=0.05). Sixteen additional 0.7-mm-thick dentin disks were similarly prepared and treated, immersed in 50 wt% ammoniacal silver nitrate, and then processed according to conventional methods for analysis under transmission electron microscopy.

RESULTS

The differences in P reduction among the adhesives were significant (p=0.029). For OPT and ADH (p=0.0304 and p=0.0120, respectively), the P reduction was higher in the ER mode than in the SE mode. For CL and SBU, no differences in P reduction was observed between the two application modes (p>0.05). All the groups showed some pattern of nanoleakage.

CONCLUSIONS

No adhesive system completely reduced dentin P. Dentin sealing was higher for OPT and ADH in the ER mode, while for SBU and CL, there was no difference between the two modes. All the adhesive systems showed nanoleakage.

Interaction effect of Nd:YAG laser and universal adhesive system for dentin sealing

Background

To evaluate the influence of the association of the universal adhesive system to different energy densities of the Nd:YAG laser on the hydraulic conductance of dentin.

Material and Methods

Fifty bovine dentin discs were made. The samples were stratified into four groups (n = 10) according to the treatment performed; SBU- Adper Single Bond Universal (3M ESPE), SBU_60 - SBU associated with the Nd:YAG laser (60mJ, 10Hz, 0.6W - 47.77 J / cm²), SBU_80 - SBU associated with the Nd:YAG laser (80mJ, 10Hz, 0.8 W - 63.69 J / cm2) and C – dentin without treatment (smear layer). Hydraulic conductance measurements were taken 24 hours after the treatments (HC1) and after erosive challenge (HC2). Scanning electron microscopy (SEM) and energy dispersive X-ray spectrometry (EDX) helped to visualize the dentin after the different treatments. Scheffe and Games-Howell statistical tests were used to analyze hydraulic conductance (α = 0.05).

Results

The treated dentin (SBU, SBU_60, and SBU_80) reduced HC1 when compared to dentin with smear layer (C) (p< 0.001). The erosive challenge has increased HC2 in SBU_60 and C (p< 0.001), and did not promote a significant difference in SBU_80 and SBU. The SEM / EDX analyzes showed an irregular and semi-permeable barrier on the surfaces of the treated dentin.

Conclusions

The association of universal adhesive with Nd:YAG can be an effective alternative for the occlusion of dentinal tubules, whereas higher energy per pulse Nd:YAG (SBU_80) can increase the resistance to permeability when exposed to the erosive challenge.

Key words:Dentin, permeability of dentin, Nd:YAG Laser, adhesives.

Avoidance of Interaction between Impression Materials and Tooth Surface Treated for Immediate Dentin Sealing: An In Vitro Study

Immediate dentin sealing (IDS) is an advantageous approach for realizing adhesive restorations, but it interferes with the polymerization of impression material due to the oxygen-inhibition layer (OIL), which leaves residues of impression material on the teeth. The aim of this study is to identify a clinical surface cleaning protocol after IDS in order to achieve defect-free impressions. Sixty extracted human teeth were cut to expose fresh dentin and the IDS protocol was performed. Samples were divided into six groups where different surface cleaning protocols were made before taking impressions: G1S and G1P groups, IDS and silicone (S) or polyether (P) impressions; G2S and G2P, treatment with prophy paste and impressions; G3S and G3P, final cleaning phase with surfactant agent and impressions. Teeth were evaluated with a scanning electron microscope to identify the areas (expressed in mm²) where residual impression material was present. The results demonstrate a reduction of residues in the G2 groups and the total disappearance in G3 groups with statistically significant differences between them. Superficial cleaning protocols with the prophy paste and surfactant agent lead to the elimination of the interaction with impression materials and OIL. These results suggest a safe clinical protocol for obtaining defect-free impressions after IDS.

Immediate dentin sealing for indirect bonded restorations

PURPOSE

The aim of this article is to review available literature on the clinical procedure of immediate dentine sealing for indirect bonded restorations.

STUDY SELECTION

More than 40 articles reporting the technique, studies, outcomes, etc. were reviewed after PUBMED/MEDLINE search, most of them addressing the specific situation of dentin bonding for indirect restorations.

RESULTS

It is known that tooth preparation for indirect bonded restorations can result in significant dentin exposures. Immediate application and polymerization of the dentin bonding agent to the freshly cut dentin, prior to impression making is therefore recommended by some authors. Literature indicates that this procedure, immediate dentine sealing (IDS), appears to achieve improved bond strength, fewer gap formations, decreased bacterial leakage, and reduces post-cementation sensitivity. This rational approach to adhesion is also reported to have a positive influence on tooth structure preservation, patient comfort, and long term survival of indirect bonded restorations.

CONCLUSION

In the extensive literature regarding advantages of using IDS technique significant differences have been shown when compared to Delayed Dentine Sealing. Although more research is required in this field, presently there are NO scientific reasons not to recommend IDS in routine practice.

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.

Correlation between microleakage and screw loosening at implant-abutment connection

PURPOSE

This study aimed to evaluate the correlation between microleakage and screw loosening at different types of implant-abutment connections and/or geometries measuring the torque values before and after the leakage tests.

MATERIALS AND METHODS

Three different abutment types (Intenal hex titanium, internal hex zirconium, morse tapered titaniuım) with different geometries were connected to its own implant fixture. All the abutments were tightened with a standard torque value then the composition was connected to the modified fluid filtration system. After the measurements of leakage removal torque values were re-measured. Kruskal-wallis test was performed for non-parametric and one-way ANOVA was performed for parametric data. The correlation was evaluated using Spearman Correlation Test (α=0.05).

RESULTS

Significantly higher microleakage was found at the connection of implant-internal hex zirconium abutment. Observed mean torque value loss was also significantly higher than other connection geometries. Spearman tests revealed a significant correlation between microleakage and screw loosening.

CONCLUSION

Microleakage may provoke screw loosening. Removing torque values rationally decrease with the increase of microleakage.

Effect of biofilm formation, and biocorrosion on denture base fractures

PURPOSE

The aim of this study was to investigate the destructive effects of biofilm formation and/or biocorrosive activity of 6 different oral microorganisms.

MATERIALS AND METHODS

Three different heat polymerized acrylic resins (Ivocap Plus, Lucitone 550, QC 20) were used to prepare three different types of samples. Type "A" samples with "V" type notch was used to measure the fracture strength, "B" type to evaluate the surfaces with scanning electron microscopy and "C" type for quantitative biofilm assay. Development and calculation of biofilm covered surfaces on denture base materials were accomplished by SEM and quantitative biofilm assay. According to normality assumptions ANOVA or Kruskal-Wallis was selected for statistical analysis (α=0.05).

RESULTS

Significant differences were obtained among the adhesion potential of 6 different microorganisms and there were significant differences among their adhesion onto 3 different denture base materials. Compared to the control groups after contamination with the microorganisms, the three point bending test values of denture base materials decreased significantly (P<.05); microorganisms diffused at least 52% of the denture base surface. The highest median quantitative biofilm value within all the denture base materials was obtained with P. aeruginosa on Lucitone 550. The type of denture base material did not alter the diffusion potential of the microorganisms significantly (P>.05).

CONCLUSION

All the tested microorganisms had destructive effect over the structure and composition of the denture base materials.