Improvement of bonding to bleached bovine tooth surfaces by ascorbic acid treatment

Changes in physical properties of universal composites and CAD/CAM materials after bleaching and antioxidant applications: Scanning electron microscope and atomic force microscope evaluation

To evaluate the effects of vital bleaching agents and the subsequent application of ascorbic acid (AA) to universal composites and resin-based CAD/CAM blocks on the physical properties of materials. In the study; G-enial A'chord (GCA), Filtek Ultimate (FU), Clearfil Majesty (CM) composites, and LAVA Ultimate (LU), Cerasmart (GCC) CAD/CAM blocks were used. The materials were divided into two subgroups based on the applied bleaching type (n = 30/group): office bleaching (OB) and home bleaching (HB). After bleaching, AA was applied to the samples. Surface roughness, microhardness, and color change values of all samples were measured at three stages: initial (I), post-bleaching (B), and post-bleaching+AA application (BA). Statistical analysis was performed using 3-way Mixed ANOVA with Bonferroni correction (p < .05). The BA of the HB group of CM; the B of the HB group of LU; the B roughness values of both the OB and HB groups of GCC were significantly lower than I. The microhardness values of all the materials examined decreased significantly after both bleaching (p < .05). With regard to the AA application, it significantly decreased Ra values in the HB group of CM. In addition, it significantly increased the microhardness values in the HB groups of CM and GCC. Also, the ΔE001 and ΔE002 values for the FU and GCC HB groups were significantly higher than in the OB groups (p < .05). Bleaching and AA application affected the physical properties of the materials. The physical properties of the materials either remained unchanged or improved with the application of AA after bleaching. RESEARCH HIGHLIGHTS: This article presents in vitro results of a new approach that has not been studied before. Ascorbic acid, used to increase the bond strength between the material-tooth after bleaching, was used to eliminate the adverse effects of bleaching on the physical properties of aesthetic restorative materials. Additionally, the effects of all procedures on the materials were examined using scanning electron microscopy (SEM) and atomic force microscopy (AFM). As a result of the study, it was concluded that the application of ascorbic acid after bleaching improved the physical properties of some of the materials.

Efficacy of organic and antioxidant agents to regain bond strength to bleached enamel in different dental adhesive solvents

Materials like carbamide peroxide or hydrogen peroxide are commonly used for vital teeth bleaching. However, there have been concerns regarding their effect on composite-to-bleached enamel bonding strength. The study investigated the impact of organic and antioxidant agents on composite bond strength in bleached enamel with different dental adhesive solvents. Human third molar teeth were sectioned into buccal and lingual halves. The two main adhesive solvent groups evaluated were acetone and alcohol. Each main group was divided into six groups. The positive control group received no bleaching, the negative control group consisted of bleaching with no surface deoxidization; and other experimental categories involved post-bleach treatments with 95% ethanol, sodium ascorbate (10%), acetone solution, or sodium fluoride solution (1.1%). Following the surface treatment and enamel bonding procedure, nano-hybrid composite cylinders measuring 3 × 2 mm were directly cured over the bleached enamel substrate. The shear bond test was performed after 24-h storage and 12,000 thermocycles on a universal testing machine. In this study, one-way ANOVA was used along with Tukey's HSD tests at a significance level of 0.05. The negative control groups showed significantly lower bond strength than the positive control group. Ethanol surface treatment had superior mean bonding strength in acetone and alcohol-based adhesive solvent groups. The utilization of sodium ascorbate for surface treatment resulted in a significant enhancement of adhesion between the composite material and bleached enamel surface. Sodium fluoride application showed no significant recovery in shear bond strength in both dental adhesive groups. It was concluded that hydrogen peroxide severely compromised the immediate bond strength of composite resin. Surface treatment of bleached enamel with ethanol, sodium ascorbate, and acetone solutions is an effective option for restoring bond strength.

Effect of diode laser-assisted bleaching on the bond strength of different adhesive systems to enamel: Interfacial SEM analysis

The aim of this study was to investigate the effectiveness of diode laser-assisted bleaching on the shear bond strength (SBS) of different adhesive systems to enamel and examine the adhesive enamel interface under scanning electron microscope (SEM). 180 incisor teeth were randomly divided into three bleaching groups: (1) Unbleached control group, (2) Opalescence Boost (OB) 40%, and (3) Diode laser-assisted LaserWhite20 (LW20) 45%. After bleaching, each group was divided into two subgroups according to waiting time: immediately or 7 days' delay. The six groups were then divided into three subgroups based on the adhesive procedure: Single Bond 2 (SB2), Clearfil SE Bond (CSB), and Clearfil Universal Bond (CUB). After adhesive procedures, composite resin cylinders were bonded to the enamel surfaces. All specimens were subjected to a SBS test after 24 hr of storage in water. Data were analysed using three-way variance analysis (p < .05). Specimens were examined under a stereomicroscope and SEM. There was a significant difference between the groups bonded immediately and 7 days after bleaching (p < .05). SB2 after 7 days showed the highest SBS values (19.24 ± 2.18), whereas CUB showed the lowest values in both bleaching treatments and control groups (10.84 ± 1.66). SEM analysis of the unbleached specimens revealed long tags and uniform hybrid layer compared OB and LW20 bleaching groups. LW20 and OB bleaching adversely affected SBS to enamel when bonded immediately. Diode laser-assisted bleaching might be an alternative option due to the short working time but delaying bonding for 7 days after bleaching may not be enough for ideal adhesion. RESEARCH HIGHLIGHTS: Bleaching agents containing high concentration hydrogen peroxide reduces the enamel bond strength of adhesive systems. Postponing composite restorations for 7 days after bleaching may not be sufficient to achieve ideal adhesion. Diode laser-assisted bleaching may be preferred as an alternative bleaching method today due to its ability to shorten the operation time and cause minimal morphological changes on the enamel surface.

Comparative Evaluation of Two Antioxidants on Reversing the Immediate Bond Strength of Bleached Enamel: In Vitro Study

Background

Tooth bleaching causes a significant decrease in the bonding strength between the resin and human enamel. Nevertheless, the effects of different antioxidant types on the immediate bonding strength of resin and bleached enamel were significantly different. Therefore, the objective of this study was to compare the effects of 2 antioxidants for enhancing the bond strength of the resin to bleached enamel.

Material/Methods

There were 48 enamel blocks performed from 48 recently extracted maxillary central incisors. There were 8 groups: NC (negative control, no bleached specimens restored without antioxidants); NA (no antioxidant, bleached specimens bonded immediately without any antioxidants); SA30, SA60, and SA120 (bleached specimens accepted the management of 10% sodium ascorbate (SA) for 30 minutes, 60 minutes, and 120 minutes, respectively, before restored); PC30, PC60, and PC120 (bleached specimens received treatment of 5% proanthocyanidins (PC) for 30 minutes, 60 minutes, and 120 minutes, respectively, before restored). We measured the micro-tensile bond strength of specimens and used 2-way ANOVA to analyze the data.

Results

The mean±standard deviation bond strength measured were: NC, 29.99±4.00; NA, 14.90±1.97; SA30, 18.60±2.20; SA60, 22.57±2.71; SA120, 26.15±3.85; PC30, 16.78±2.29; PC60, 19.13±2.24, PC120, 23.90±2.01 MPa. In addition, the fracture types were mainly of an adhesive mode (88.75%), followed by mixed (7.5%), and cohesive (3.75%).

Conclusions

10% sodium ascorbate provided a comparatively more promising improvement for immediate bond strength than 5% proanthocyanidins when the same duration of antioxidant was applied.

Reversal of Compromised Bond Strength of Bleached Enamel Using Cranberry Extract as an Antioxidant: an In Vitro Study

Background and Objectives: Bleaching reduces the bond strength of enamel, if adhesive restorations are carried out immediately. Reversal of compromised bond strength of bleached enamel by application of antioxidant agents has been reported in the literature. The aim of the study is to assess the neutralizing effect of 6% cranberry (CB) solution on the bond strength of bleached enamel compared with that of 10% sodium ascorbate (SA) solution.

Materials and Methods: Enamel surfaces of 64 extracted human premolar teeth were randomly divided into four groups based on the antioxidant used. Further subgrouping was done in Groups II, III, and IV dividing each group into subgroup A and subgroup B of eight teeth each based on whether the bonding was performed immediately or after a delay of 14 days postbleaching respectively. Shear bond strength (SBS) of the specimens was measured using a Universal testing machine. The data were then tabulated and statistically analyzed using one-way ANOVA (analysis of variance) and Tukey’s post-hoc parametric tests. A p-value of <0.05 was considered statistically significant.

Results: The SBS measurements were compared among the four groups including the subgroups. The SBS was highest in the SA delayed bonding group and lowest in the bleached immediate bonding group.

Conclusion: A 10% SA solution has proven superior to 6% CB solution in the reversal of compromised bond strength following bleaching.

Protocols for sodium ascorbate application on intracoronary dentin bleached with high-concentrated agent

Purpose:

Composite resin restorations are normally replaced after the internal bleaching of endodontically treated-teeth because the bleaching agent does not alter the color of the restorative material. This study evaluated the effect of 10% sodium ascorbate (SA) applied at different protocols on bleached dentin.

Materials and Methods:

One-hundred slabs of intracoronary bovine dentin were divided into 5 groups: 2 controls-GI without bleaching (positive), GII bleached with 35% hydrogen peroxide (HP) (negative); and 3 experimentals – GIII. 35% HP + SA at protocol 1 (dripping, washing and drying the solution), GIV. 35% HP + SA at protocol 2 (dripping and aspirating the solution) and GV. 35% HP + SA at protocol 3 (dripping, rubbing and aspirating the solution). Sixty fragments were restored and subjected to shear bond strength test (n = 12). Forty fragments (n = 8) were prepared for chemical analysis (energy dispersive X-ray spectrometry) and surface morphology (scanning electron microscopy). Data were analyzed by ANOVA and Tukey test (P < 0.05).

Results:

GI (3.169 ± 1.510a) had the highest means values, similar to GIV (2.752 ± 0.961a) and GV (2.981 ± 1.185a) (P < 0.05). Inferior values were obtained in GII (1.472 ± 0.342b) and GIII (2.037 ± 0.742ab) had intermediate values (P > 0.05). Oxygen concentration was reduced in groups treated with SA, and the surface exhibited residual granules of the solution.

Conclusion:

The 10% SA solution reestablishes the bond strength of restorative material to bleached dentin, especially if active protocols of application and aspiration were used.

Efficacy of quercetin flavonoid in recovering the postbleaching bond strength of orthodontic brackets: A preliminary study

Objectives:

To evaluate comparatively the effect of quercetin on postbleaching shear bond strength (SBS) and adhesive remnant index (ARI).

Materials and Methods:

Intact maxillary premolars were divided randomly into 12 groups of 10 each: (1) bonding the bracket immediately after bleaching, (2) bonding 1 week after bleaching, (3–8) application of three experimental concentrations of quercetin (0.1%, 0.5%, and 1%) at two time durations (5 and 10 min), (9–10) application of the solvent of quercetin at two time periods (5 and 10 min), (11) application of 10% sodium ascorbate for 10 min, and (12) bonding the brackets on nonbleached teeth. Bleaching was performed using 15% carbamide peroxide gel for 5 days (6 h daily). After incubation and thermocycling, the SBS of brackets was measured. The ARI too was recorded at ×20. The data were analyzed statistically (α =0.05).

Results:

Bleaching reduced the SBS below 10 Megapascal (MPa) level (P < 0.05) while all the postbleaching treatments (except the application of the solvent of quercetin) recovered the SBS back to values greater than 10 MPa (P < 0.05) and also back to nonbleached SBS levels (P > 0.01). All eight postbleaching treatments had rather similar efficacies (P = 0.1396). The concentration of quercetin (beta = 0.259, P = 0.042) but not its duration (beta = 0.213, P = 0.093) significantly improved its efficacy.

Conclusion:

Bleaching can weaken the bond strength of orthodontic brackets below acceptable levels. The application of quercetin or Vitamin C or delaying the bracket bonding improved the postbleaching SBS.

Effect of Two Antioxidants Agents on Microtensile Bond Strength to Bleached Enamel

Abstract This in vitro study evaluated the effect of sodium bicarbonate and sodium ascorbate on the microtensile bond strength of an etch-and-rinse system to bleached bovine enamel. Sixty bovine enamel blocks (4x4 mm) were flattened and randomly allocated into 5 groups: G1 (negative control): without treatment; G2 (positive control): bleached with 35% hydrogen peroxide (HP); G3: bleached and stored for 7 days in artificial saliva before restorative procedures; G4: bleached and treated with 10% sodium bicarbonate solution for 5 min; G5: bleached and treated with 10% sodium ascorbate hydrogel for 15 min. HP gel was applied twice (20 min each, except in G1) and the adhesive restorations were performed. After 24 h, the specimens were sectioned into sticks and submitted to microtensile bond strength testing with a crosshead speed of 0.5 mm/min (n=12). As a complementary visual observation, the enamel surfaces of the G1 and G2 specimens were evaluated with scanning electron microscopy. Data were analyzed by one-way ANOVA (p<0.05). The means (standard deviation) were: G1: 24.22±7.74; G2: 18.29±5.88; G3: 40.88±7.95; G4: 19.95±5.67 and G5: 24.43±6.43. Adhesive failures were predominant in all groups. The comparison between the treatments indicates that waiting 7 days after bleaching is still the most effective approach. When this waiting period is not possible, application of sodium ascorbate or sodium bicarbonate seems to be a good alternative. Therefore, the practicality of obtaining sodium bicarbonate in the bleaching kits and its higher stability enables its clinical use.

Correlation between antioxidant activity and bonding strength on bleached enamel

Objective: This study used the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) method to evaluate the percentage of antioxidant activity (%AA) of green tea (GT) and sodium ascorbate (SA) gel in three concentrations (10%, 20% and 30%), and the influence of these concentrations on the microshear bond strength (μ-SBT) values of bleached enamel, using 10% carbamide peroxide (CP).

Materials and methods: Eighty intact third molars were selected to perform the μ-SBT test, and were randomly divided into eight experimental groups: G1: positive control – no treatment; G2: negative control – bleached with CP; G3: PC +10% GT; G4: PC +20% GT; G5: PC +30% GT; G6: PC +10% SA; G7: PC +20% SA and G8: PC +30% SA. After applying the treatments, adhesive procedures were performed using Single Bond 2 and Filtek Z350XT. After 24 h, the samples were tested in a universal testing machine until fracture. The %AA was assessed in triplicate by DDPH method using a UV–VIS spectrophotometer.

Results: In the μ-SBT, ANOVA revealed no significant difference between the antioxidants evaluated (p = .625), but did reveal significant effects of the concentrations studied (p = .007). A negative correlation was observed between μ-SBT and solution concentrations. The values of %AA were from 90.58 to 96.75.

Conclusions: The reverse results occurred in μ-SBT values, only when the antioxidants were used in a 10% concentration and, %AA did not influence μ-SBT.

Comparative evaluation of superoxide dismutase, alpha-tocopherol, and 10% sodium ascorbate on reversal of shear bond strength of bleached enamel: An in vitro study

OBJECTIVE

The aim of this study was to investigate the neutralizer effect of antioxidant agents on the bond strength of bleached enamel.

MATERIALS AND METHODS

Sixty enamel slabs were prepared from 60 freshly extracted maxillary central incisors and were divided into six groups. The negative control group received no bleaching treatment and the other groups were bleached with 35% carbamide peroxide (Opalescence Quick; Ultradent, South Jordan, USA). In Group II, composite was built immediately after bleaching and cured without any antioxidants. In Group III, bleached specimens received composite build ups delayed by 1 week. In Groups IV, V, and VI bleached specimens received applications of superoxide dismutase (SOD), sodium ascorbate (SA), and tocopherol solutions, respectively, for 10 min. Following composite bonding, the micro shear bond strength (μSBS) was measured at a speed of 1 mm/min in universal testing machine.

STATISTICAL ANALYSIS USED

The μSBS values of all the groups were analyzed using the analysis of variance followed by Tukey honestly significant difference post-hoc test.

RESULTS

Bonding of composites to unbleached group (Group I) exhibited the highest mean SBS values and among the antioxidant-treated groups, the highest SBS values were seen with SOD (Group IV) treated samples (23.0040 ± 4.30565 MPa).

CONCLUSIONS

Application of SA, alpha-tocopherol, and SOD can effectively reverse the bond strength with bleached enamel. SOD gave a comparatively more promising reversal of bond strength than SA and alpha-tocopherol, and deserves further studies.

Effect of 10% Sodium Ascorbate on Shear Bond Strength of Bleached Teeth - An in-vitro Study

BACKGROUND

Patient often requires some additional interventions such as replacement of old restorations, laminates and veneers after bleaching, for aesthetic purposes. The residual oxygen inhibits polymerization of resin based materials which results in reduced bond strength of the restorations. Some techniques are available to solve the clinical problems related to the post bleach compromised bond strength.

OBJECTIVES

The purpose of this study is to evaluate, the role of 10% sodium ascorbate on reversing the compromised bond strength and compare enamel shear bond strength of 5th and 6th generation dentine bonding agents on bleached and unbleached teeth.

MATERIALS AND METHODS

Eighty freshly extracted human anterior teeth were assigned in to Group A and Group B of 40 teeth each. Samples in both groups were subdivided in to 4 subgroups of 10 teeth each. In Group A composite resins was bonded using 5th generation dentine bonding agent (3M Single Bond) and Group B was bonded using 6th generation (3M ESPE Adper SE Plus). Subgroups were subjected to the procedure as, A1;B1 etching and bonding (control), A2; B2 bleaching, etching and immediate bonding, A3; B3 bleaching,10% ascorbic acid treatment for 10 minutes after that etching and bonding immediately, A4; B4 bleaching, storage in artificial saliva for 4 days and then etching and bonding. Pola office, in office bleach (SDI (082216) was used for bleaching. The specimens were subjected to shear load in a Universal testing machine to evaluate bond strength.

RESULTS

A decrease in bond strength was seen with 6th generation adhesive system compared to 5th generation bonding system, which is statistically significant, p<0.001.

CONCLUSION

Treating the bleached enamel surfaces when treated with 10% sodium ascorbate, which reverses the compromised bond strength and is a good alternative to delayed bonding.

Antioxidants in Endodontics: A Strategic Review

Over the past few decades, the free radicals and antioxidants have attracted tremendous importance in the field of dentistry. Depending on the level of free radicals in the body, they can either be harmful or helpful. Antioxidants are the substances that interact with and stabilize free radicals thereby protecting cells from the damage caused by free radicals. The indigenous antioxidants may be useful in preventing the harmful effects of oxidative stress. The present article presents a review on the free radicals formation, their role in disease pathogenesis, antioxidants and their potential role in endodontics.

Effect of three different antioxidants on the shear bond strength of composite resin to bleached enamel: An in vitro study

Objective:

The effect of 10% sodium ascorbate, 10% grape seed extract, and 10% pine bark extract on the shear bond strength of composite resin to bleached enamel was evaluated.

Materials and Methods:

Ninety recently extracted human premolars were divided into six groups of 15 teeth each. Except Group I (negative control), the labial enamel surface of all specimens in the other groups were bleached with 37.5% hydrogen peroxide. After bleaching, Group II specimens were stored in artificial saliva for 3weeks before composite bonding. Immediately following bleaching; Groups III, IV, and V specimens were treated with antioxidants 10% sodium ascorbate, 10% grape seed extract, and 10% pine bark extract, respectively, for 10 min and bonded with composite resin. In Group VI (positive control), the composite bonding was done immediately after bleaching. All specimens were stored in deionized water for 24 h at 37΀C before shear bond strength testing. The data obtained were tabulated and statistically analyzed using analysis of variance (ANOVA) and Duncan's multiple range test.

Results:

The unbleached teeth showed the highest shear bond strength followed by the bleached teeth treated with the antioxidant 10% pine bark extract.

Conclusion:

Within the limitations of this study, it was observed that the use of antioxidants effectively reversed the compromised bond strength of bleached enamel. Among the antioxidants, 10% pine bark extract application after bleaching showed better bond strength.

Effect of Sodium Ascorbate and Delayed Bonding on the Bond Strength of Silorane and Two-step Self-etch Adhesive Systems in Bleached Enamel

Background and aims. Studies have shown decreased bond strength of composite resin to human and bovine bleached enamel. This study evaluated the effect of sodium ascorbate and delayed bonding on the bond strength of two adhesive systems to bleached enamel.

Materials and methods. The labial surfaces of 150 sound bovine incisor teeth were abraded with abrasive paper. The teeth were randomly divided into 8 groups: A: control; B: bleached with 35% hydrogen peroxide; C: bleached with 35% hydrogen peroxide + sodium ascorbate gel; and D: bleached with 35% hydrogen peroxide + delayed bonding. In groups A‒D, silorane adhesive system and Filtek silorane composite resin were used. In groups E‒H, the same preparation methods of groups A-D were used. Two-step self-etch Clearfil SE Bond adhesive systems and AP-X composite resin were administered. Shear bond strength of each group was measured. Two samples were prepared for each surface preparation for ultra-structural evaluation. Two-way ANOVA and Tukey test were used for data analysis at P<0.05.

Results. The interaction between the adhesive system type and surface preparation protocol was significant (P=0.014), withsignificant differences in shear bond strengths in terms of the adhesive systems (P<0.01). There were significant differences in shear bond strength in terms of surface preparation techniques irrespective of the adhesive system (P<0.01).

Conclusion. The results showed that bleaching with 35% hydrogen peroxide decreased the shear bond strength values with both adhesive systems, and a one-week delay in bonding and 10% sodium ascorbate for10 minutes restored the bond strength in both adhesive systems.

Effects of antioxidants on the microleakage of composite resin restorations after external tooth bleaching

OBJECTIVE

To compare the effects of three antioxidants (sodium ascorbate, sodium ascorbate combined with a surfactant, and catalase) on the microleakage of composite resin restorations after external tooth bleaching with 10% carbamide peroxide.

MATERIALS AND METHODS

Buccal cavities were prepared on the surface of 60 intact premolars, which were randomly divided into six groups. All cavities were filled with composite resin. In group 1, teeth were not bleached; in group 2, cavities were filled immediately after bleaching; in group 3, cavities were delay-filled for 3 weeks; in group 4, cavities were treated with sodium ascorbate after bleaching and then filled; in group 5, cavities were treated with sodium ascorbate combined with surfactant after bleaching and then filled; and in group 6, cavities were treated with catalase after bleaching and then filled. Microleakage of the restorations was measured from sections using a stereomicroscope.

RESULTS

Group 1 displayed the least amount of microleakage, while group 2 showed the greatest amount of microleakage (P < 0.05). Groups 3 and 4 were similar to group 2 (P > 0.05). However, groups 5 and 6 showed a significantly lower amount of microleakage compared to group 2 (P < 0.05).

CONCLUSION

Microleakage increased significantly after external bleaching with 10% carbamide peroxide, and decreased when the bleached teeth were treated with sodium ascorbate combined with Tween(®) 80, or with catalase. Catalase was more effective in decreasing microleakage, while delayed filling or treatment with sodium ascorbate alone did not effectively decrease the microleakage.

Influence of exposure time to saliva and antioxidant treatment on bond strength to enamel after tooth bleaching: an in situ study

Objectives

This study evaluated the influence of different exposure times to saliva in situ in comparison with an antioxidant treatment on composite resin bond strength to human enamel restored after tooth bleaching.

Material and Methods

Forty human teeth specimens measuring 5x5 mm were prepared and randomly allocated into 5 groups with 8 specimens each: Gct (control group, restored on unbleached enamel); Gbl (restored immediately after bleaching); Gsa (bleached, treated with 10% sodium ascorbate gel for 60 min and restored); G7d (bleached, exposed to saliva in situ for 7 days and restored); and G14d (bleached, exposed to saliva in situ for 14 days and restored). Restored samples were cut into 0.8 mm² sticks that were tested in microtensile. Specimens were microscopically analyzed and failure modes were classified as adhesive, cohesive, or mixed. Pretest and cohesive failures were not considered in the statistical analysis, which was performed with one-way ANOVA and Tukey's post-hoc test (α=0.05), with the dental specimen considered as the experimental unit.

Results

Mean bond strength results found for Gbl in comparison with Gct indicated that bleaching significantly reduced enamel adhesiveness (P<0.01). However, no statistically significant differences were found between Gct, Gsa and G7d (P>0.05). Bond strength found for G14d was significantly higher than for Gsa (P<0.01). Fractures modes were predominantly of a mixed type.

Conclusions

Bonding strength to bleached enamel was immediately restored with the application of sodium ascorbate and exposure to human saliva in situ for at least 7 days. Best results were obtained with exposure to human saliva in situ for 14 days. Treatment with sodium ascorbate gel for 60 min may be recommended in cases patients cannot wait for at least 7 days for adhesive techniques to be performed.

Effect of Sodium Ascorbate on Dentin Bonding After Two Bleaching Techniques

The purpose of this study was to analyze the influence of 10% sodium ascorbate (SA) on the hybrid layer, resin tag length, and bond strength to dentin after bleaching. Six groups were tested: G C, control; G SA, sodium ascorbate (SA) + restoration; G CP, bleaching with carbamide peroxide (CP) + restoration; G CP+SA, bleaching with CP + SA+ restoration; G HP, bleaching with 35% hydrogen peroxide (HP) + restoration; and G HP+SA, HP + SA + restoration. After dental bleaching, the dentin was exposed and the antioxidant solution was applied to groups G SA, G CP+SA, and G HP+SA, before bonding procedures. The teeth were sectioned in the mesiodistal direction. One section was decalcified, and the specimens were embedded in paraffin and sectioned in the longitudinal direction with a thickness of 6 μm. Fifteen slices of each specimen were selected according to a systematic sample of slices with an interval proportional to the total number of slices obtained for each tooth. The specimens were stained using the Brown & Brenn method, and an optic microscope was used to analyze the hybrid layer thickness and resin tag length. The remaining tooth segment was sectioned into stick-shaped specimens and used for microtensile bond strength testing (0.5 mm/min). Statistical analysis was performed using two-way analysis of variance and Fisher test. The results for hybrid layer + tag formation (in micrometers) were G C, 13.27 Aa; G SA, 11.85 Ba; G CP, 6.84 Bb; G CP+SA, 9.02 Ab; G HP, 7.28 Bb; and G HP+SA, 9.22 Ab; bond strength results (in MPa) were G C, 49.5 Aa; G SA, 51.7 Aa; G CP, 37.16 Bb; G CP+SA, 47.69 Aa; G HP, 32.39 Ab; and G HP+SA, 39.67 Ab. Tooth bleaching with CP or HP impairs the formation of the hybrid layer and resin tags and reduces the microtensile bond strength. Statistically, the use of SA significantly increases the hybrid layer thickness and resin tag length. The microtensile bond strength values for carbamide peroxide increased, but the microtensile bond strength for hydrogen peroxide was not affected.

Effect of Epigallocatechin Gallate on shear bond strength of composite resin to bleached enamel: an in vitro study

Objectives

The aim of this study was to determine the effect of epigallocatechin gallate (EGCG) on the shear bond strength of composite resin to bleached enamel.

Materials and Methods

Ninety enamel surfaces of maxillary incisors were randomly divided into 9 groups as follows: G1: control (no bleaching); G2: bleaching; G3: bleaching and storage for seven days; G4 - 6: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 10 minutes, respectively; G7 - 9: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 20 minutes, respectively. The specimens were bleached with 30% hydrogen peroxide gel and a composite resin cylinder was bonded on each specimen using a bonding agent. Shear bond strength of the samples were measured in MPa. Data was analyzed using the two-way ANOVA and Tukey HSD tests (α = 0.05).

Results

The maximum and minimum mean shear bond strength values were observed in G1 and G2, respectively. Time and concentration of EGCG showed no significant effects on bond strength of the groups (p > 0.05). Multiple comparison of groups did not reveal any significant differences between the groups except for G2 and all the other groups (p < 0.05).

Conclusions

There is a significant decrease in bond strength of composite resin to enamel immediately after bleaching. A delay of one week before bonding and the use of EGCG increased bond strength of composite resin to bleached enamel.

The effect of bleaching of teeth on the bond strength of brackets: An in vitro study

AIM

To determine the reversal effect of 10% sodium ascorbate, on the bond strength of previously bleached teeth with hydrogen peroxide.

MATERIALS AND METHODS

Sixty extracted maxillary premolars were selected and they were divided randomly into three groups. Group A teeth were etched and bonded; Group B bleached, etched and immediately bonded; Group C was subjected to bleaching, followed by treatment with 10% sodium ascorbate solution, then etched and bonded; Then all the three groups were subjected to testing procedure for bond strength.

RESULTS

The bond strength analysis was carried out by using instron, universal testing machine. In this study Group A had the maximum bond strength of 12.24 Mpa followed by Group C 11.62 Mpa and Group B 10.96 Mpa.

CONCLUSION

Group C the experimental group which was treated with 10% sodium ascorbate following bleaching with 35% hydrogen peroxide provided higher bond strength compared to Group B which was bonded immediately after bleaching even though it was not statistically significant.

Effect of Ascorbic Acid on Shear Bond Strength of Orthodontic Brackets Bonded with Resin-modified Glass-ionomer Cement to Bleached Teeth

BACKGROUND AND AIMS

Bleaching can considerably reduce shear bond strength (SBS) of orthodontic brackets bonded with composite adhesives. Application of antioxidants is a method to reverse the negative effect of bleaching on composite-to-enamel bond. However, the efficacy of antioxidants in increasing the SBS of brackets bonded using resin-modified glass-ionomer cement (RMGIC) has not been studied, which was the aim of this study.

MATERIALS AND METHODS

Fifty freshly extracted human maxillary first premolars were bleached with 35% hydrogen peroxide (Pola Office Bleaching, SDI). Sodium ascorbate 10% was applied to the experimental specimens (n=25). All the specimens were etched with 37% phosphoric acid (Ivoclar/Vivadent) and bonded using RMGIC (Fuji Ortho LC, GC). The specimens were subjected to incubation (37°C, 24h) and thermocycling (1000 cycles, 5-55°C, dwell time = 1 min). The SBS was measured at 0.5 mm/min debonding crosshead speed. The adhesive remnant index (ARI) was scored under ×10 magni-fication. Data were analyzed using Mann-Whitney U test, one- and independent-samples t-test, and Fisher'sexact test (α=0.05).

RESULTS

The mean SBS of experimental and control groups were 11.97 ± 4.49 and 7.7 ± 3.19 MPa, respectively. The dif-ference was statistically significant (P=0.000 by t-test). SBS of both control (P=0.014) and experimental (P=0.000) groups were significantly higher than the minimum acceptable SBS of 6 MPa, according to one-sample t-test.

CONCLUSION

Application of ascorbic acid can guarantee a strong bond when RMGIC is to be used. However, RMGIC might tolerate the negative effect of bleaching with minimum SA treatments (or perhaps without treatments), which de-serves further studies.

Surface morphological changes in human enamel following bleaching: an in vitro scanning electron microscopic study

OBJECTIVE

The purpose of this study was to evaluate, using scanning electron microscopy (SEM), the morphological and structural changes of the enamel induced by three bleaching agents namely old McInnes solution, modified McInnes solution and 10% carbamide peroxide gel at different time intervals.

MATERIALS AND METHODS

Fifteen freshly extracted noncarious human central incisors with intact enamel surface were selected. The teeth were sectioned at the cementoenamel junction separating the crown portion from the root using a diamond separating disk. Following this, the samples were subjected to three different bleaching agents: Group 1: Old McInnes solution, group 2: modified McInnes solution and group 3: 10% carbamide peroxide for a period of 15, 30 and 60 minutes, 24 and 30 hours time interval. The sample stubs were subjected to scanning electron microscope and were photographed at 2000 and 10,000 magnifications.

CONCLUSION

The present study revealed no indication of either etching or significant change in surface morphology of enamel when evaluated under scanning electron microscope after 6 weeks treatment with various bleaching agents.

CLINICAL SIGNIFICANCE

Morphological alterations in bleached enamel are both concentration and time dependent.

Antioxidant activity by DPPH assay of potential solutions to be applied on bleached teeth

The aim of this study was to assess, using the DPPH assay, the antioxidant activity of several substances that could be proposed to immediately revert the problems caused by bleaching procedures. The percentage of antioxidant activity (AA%) of 10% ascorbic acid solution (AAcidS), 10% ascorbic acid gel (AAcidG), 10% sodium ascorbate solution (SodAsS), 10% sodium ascorbate gel (SodAsG), 10% sodium bicarbonate (Bicarb), Neutralize® (NE), Desensibilize® (DES), catalase C-40 at 10 mg/mL (CAT), 10% alcohol solution of alpha-tocopherol (VitE), Listerine® (LIS), 0.12% chlorhexidine (CHX), Croton Lechleri (CL), 10 % aqueous solution of Uncaria Tomentosa (UT), artificial saliva (ArtS) and 0.05% sodium fluoride (NaF) was assessed in triplicate by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical assay. All substances exhibited antioxidant activity, except for CL. AAcidS, AAcidG and VitE exhibited the highest AA% (p<0.05). On the contrary, CHX, NE, LIS and NaF showed the lowest AA% (p<0.05). In conclusion, AAcidS, AAcidG, SodAsS, SodAsG and VitE presented the highest antioxidant activity among substances tested in this study. The DPPH assay provides an easy and rapid way to evaluate potential antioxidants.

The effects of application time of a self-etching primer and debonding methods on bracket bond strength

OBJECTIVE

To test the manufacturer's recommendation for the application rubbing time of a self-etching primer (Transbond Plus, 3M Unitek) and to compare the resulting bond strength of a resin composite (Transbond XT, 3M Unitek) in the traditional laboratory tension on all four wings with a simulation of the clinical single-wing lift-off debonding instrument (LODI; 3M Unitek).

MATERIALS AND METHODS

Flattened stainless-steel maxillary incisor orthodontic brackets (Victory Series, 3M Unitek) were bonded to 108 flattened bovine incisors. The enamel was rubbed with the self-etching primer for 0, 5 (the manufacturer's recommendation), and 10 seconds during a 10-second application. Traditional four-wing and LODI simulated debonding forces and the adhesive remnant index (ARI) were recorded.

RESULTS

One-way analysis of variance testing among rubbing times and debonding methods indicated a significant difference in strength with 0 and 5 seconds of rubbing and between traditional and LODI simulated tension. The bond strengths were higher in the ARI  =  1 subset compared to the ARI  =  3-5 subsets.

CONCLUSIONS

The manufacturer's recommendation for primer rubbing time produced the highest bond strength. Less force is required for debonding when tension is applied to one wing (LODI simulation) vs on all four wings.

Effect of 10% sodium ascorbate on bleached bovine enamel surface morphology and microhardness

Sodium ascorbate has recently been suggested to compensate decreased bond strength of composite resin to bleached tooth surfaces. The aim of present study was to evaluate the effect of 10% sodium ascorbate on bleached bovine enamel morphology and microhardness considering the possibility of its effect on enamel surface characteristics. A total of 69 bovine enamel slabs were prepared and mounted in acrylic resin. Subsequent to polishing, they were randomly divided into 3 groups of 23 specimens each; 3 for Scanning Electron Microscopy (SEM) analysis and 20 for hardness test. In group 1 the specimens were immersed in distilled water as control group; in group 2 the specimens were bleached with 35% carbamide peroxide for 30 min a week for 3 consecutive weeks; and in group 3 the specimens were exposed to 10% sodium ascorbate for 30 min subsequent to bleaching similar to group 1. After 3 weeks Vickers hardness of the specimens was measured at 3 points with equal distances from each other under a force of 50 g. The mean of the hardness values of each specimen was calculated and data was analyzed by one-way ANOVA (P < 0.05). The highest and lowest microhardness values were observed in group 1 and group 2, respectively. However, there were no statistically significant differences in microhardness between the groups (P = 0.12). The use of 35% carbamide peroxide alone or with 10% sodium ascorbate does not affect bovine enamel hardness. SEM analysis showed a network of sodium ascorbate adsorbed to the bleached enamel surface.

Root dentin body moisture changes caused by ascorbic acid

OBJECTIVES

To quantify in vitro the root dentin moisture (DM) when soaked in 10% ascorbic acid solution (Group A) and distilled water (Group B) for up to 14 days.

METHODS

Forty-four extracted human mandibular single-rooted teeth were sectioned perpendicular to the long axis at the CEJ to access the root dentin. The samples were divided into Groups A and B. Baseline (day 0) DM was measured using a digital grain moisture meter. One sample was placed in each tube, which was then filled with solution. All tubes were kept at 37 degrees C and 100% humidity. DM was measured after 1, 3, 7, and 14 days. The baseline DM value was used as a covariate in the generalized estimating equation (GEE) analysis to account for the difference in the baseline DM between the two groups.

RESULTS

The mean DM (%) values+/-standard deviation on days 0, 1, 3, 7, and 14 were 11.4+/-1.08, 17.1+/-0.87, 18.2+/-0.76, 18.4+/-0.77, and 17.9+/-0.90 in Group A, and 10.2+/-0.95, 12.8+/-0.90, 13.3+/-0.95, 13.0+/-0.91, and 13.2+/-0.89 in Group B, respectively. Group A had significantly higher baseline DM than Group B (p=0.006). After adjusting for differences in the baseline, the GEE analysis indicated that, on average, Group A had a significantly higher increase in DM than Group B, with means+/-standard deviation of 4.35+/-0.26.

CONCLUSIONS

The moisture increase in the ascorbic acid group was greater than that in the distilled water group. Soaking root dentin in the unreplenished ascorbic acid solution or distilled water beyond 3 days did not further increase DM.