Effects of photocuring strategy on bonding of dual-cure one-step self-etch adhesive to root canal dentin

Degree of conversion and dentin bond strength of light-cured multi-mode adhesives pretreated or mixed with sulfinate agents

The influence of sulfinate agents applied as a dentin pretreatment or a mixture with multi-mode one-step self-etch adhesives (1-SEAs) on the degree of conversion (DC) and micro-tensile bond strength (μTBS) of light-cured 1-SEAs was investigated. 1-SEAs Clearfil Universal Bond Quick (UBQ) or Scotchbond Universal Adhesive (SBU) were applied to dentin in etch&rinse or self-etch mode using various application strategies: 1) no pretreatment, 2) pretreatment with 90 wt% ethanol, 3) pretreatment with a sulfinate agent Clearfil DC Activator (UDC) or Scotchbond Universal DCA (SDC), or 4) a mixture of UBQ+UDC or SBU+SDC. μTBS was measured after 24 h. Additionally, DC was measured using attenuated total reflectance Fourier-transform infrared spectroscopy. Pretreatment with sulfinate agents resulted in the highest μTBS and DC, significantly improving them especially in etch&rinse mode. The mixture of sulfinate agents with 1-SEAs was less effective. Pretreatment with ethanol significantly improved μTBS in etch&rinse mode but compromised μTBS in self-etch mode.

Additive effects of touch-activated polymerization and extended irradiation time on bonding of light-activated adhesives to root canal dentin

STATEMENT OF PROBLEM

The bonding of light-activated adhesives to root canal dentin with an additional touch-polymerization activator has been insufficiently examined.

PURPOSE

The purpose of this in vitro study was to investigate the effect of touch-polymerization activators and extended light-irradiation time on the microtensile bond strength (μTBS) of light-activated adhesives.

MATERIAL AND METHODS

Post cavities were prepared in 50 extracted mandibular premolars and bonded using Prime&Bond Universal (PBU); PBU+Self Cure Activator (SCA); Clearfil SE Bond 2 (SEB); SEB+Clearfil DC Activator (DCA); or Clearfil Universal Bond Quick ER (UBQ). After light-irradiation for 10 or 20 seconds, the post cavities were filled with dual-activated resin core materials. Eight beams were prepared per specimen and subjected to the μTBS test. The μTBS data were analyzed by using 3-way ANOVAs with the Bonferroni correction (α=.05).

RESULTS

The 3-way ANOVAs indicated that the use of touch-polymerization activators (SCA and DCA) significantly increased the μTBS of PBU and SEB in both the coronal (P=.015) and apical (P=.001) regions. The extension of light-irradiation time to 20 seconds significantly improved their μTBS in the apical region (P<.001), but not in the coronal region (P=.09). Light-irradiation for 20 seconds increased the μTBS of UBQ significantly in the coronal region (P=.014).

CONCLUSIONS

Touch-polymerization activators improved the bond strength of light-activated adhesives to root canal dentin, especially when combined with an extended light-irradiation time.

Air-blowing strategies for improving the microtensile bond strength of one-step self-etch adhesives to root canal dentin

The effect of different air-blowing strategies using a prototype of a newly developed clinically applicable warm air-blowing device on the microtensile bond strength (μTBS) of one-step self-etch adhesives (1-SEAs) to human root-canal dentin was evaluated. Post cavities (8 mm depth, 1.5 mm diameter) were prepared and bonded with four 1-SEAs. Air-blowing was performed using normal air (23±1°C) for 10 or 20 s; warm air (60±1°C) for 10 or 20 s; or their combination for 10 s (5 s normal, 5 s warm) or 20 s (10 s normal, 10 s warm). After filling with corresponding core materials and 24-h water storage, μTBS test was performed. For three of the 1-SEAs, combined air-blowing for 20 s significantly increased μTBS compared to other air-blowing strategies (p<0.05). This suggests that the combination of normal and warm air-blowing for 20 s can enhance solvent evaporation from 1-SEAs, thus resulting in their improved bonding performance to root-canal dentin.

Bioblock technique to treat severe internal resorption with subsequent periapical pathology: a case report

A variety of therapeutic modalities can be used for the endodontic treatment of a traumatized tooth with internal root resorption (IRR). The authors present a case report of the successful restoration of a traumatized upper central incisor that was weakened due to severe IRR and subsequent periapical lesion formation. A 20-year-old female patient was referred to our clinic with severe internal resorption and subsequent periapical pathosis destroying the buccal bone wall. Root canal treatment had been initiated previously at another dental practice, but at that time, the patient's condition could not be managed even with several treatments. After cone-beam computed tomography imaging and proper chemomechanical cleaning, the tooth was managed with a mineral trioxide aggregate plug followed by root canal filling using short fiber-reinforced composite, known as the Bioblock technique. This report is the first documentation of the use of the Bioblock technique in the restoration of a traumatized tooth. The Bioblock technique appears to be ideal for restoring wide irregular root canals, as in cases of severe internal resorption, because it can uniquely fill out the hollow irregularities of the canal. However, further long-term clinical investigations are required to provide additional information about this new technique.

Flared Roots Reinforced With Bulk-fill Flowable Composite - Case Report

This article presents a case report for the treatment of a patient with a flared root. The patient was treated with a bulk-fill flowable composite. This innovative approach seems to be efficient in reinforcing flared roots. The advantages and disadvantages of the technique are presented.

The effect of warm air-blowing on the microtensile bond strength of one-step self-etch adhesives to root canal dentin

PURPOSE

The use of warm air-blowing to evaporate solvents of one-step self-etch adhesive systems (1-SEAs) has been reported to be a useful method. The purpose of this study was to evaluate the effect of warm air-blowing on root canal dentin.

METHODS

Four 1-SEAs (Clearfil Bond SE ONE, Unifil Core EM self-etch bond, Estelink, BeautiDualbond EX) were used. Each 1-SEA was applied to root canal dentin according to the manufacturers' instructions. After the adhesives were applied, solvent was evaporated using either normal air (23±1°C) or warm air (80±1°C) for 20s, and resin composite was placed in the post spaces. The air from the dryer, which could be used in normal- or hot-air-mode, was applied at a distance of 5cm above the root canal cavity in the direction of tooth axis. The temperature of the stream of air from the dryer in the hot-air-mode was 80±1°C, and in the normal mode, 23±1°C. After water storage of the specimens for 24h, the μTBS were evaluated at the coronal and apical regions. The μTBSs were statistically analyzed using three-way ANOVA and Student's t-test with Bonferroni correction (α=0.05).

RESULTS

The warm air-blowing significantly increased the μTBS of all 1-SEAs at the apical regions, and also significantly increased the μTBS of two adhesives (Estelink and BeautiDualBond EX) at coronal regions.

CONCLUSIONS

The μTBS of 1-SEAs to root canal dentin was improved by using warm air-blowing.

Reinforcement of teeth with simulated coronal fracture and immature weakened roots using resin composite cured by a modified layering technique

OBJECTIVE

The purpose of this study was to evaluate the strengthening effect of resin composite, cured by a modified layering protocol, for teeth with simulated coronal fracture and weakened immature roots.

METHODS

Fifty maxillary teeth were decoronated and their apices sectioned to standardize the length to 12 mm. Prepared teeth were equally distributed into five groups. Group 1VF root apices were flared with Pesso drills up to size 6. The roots were flared until a dentin thickness of only 1 ± 0.2 mm remained. Root ends were filled with mineral trioxide aggregate. The canals were backfilled with Vertise Flow following a modified layering protocol using two light-transmitting posts size 6 and 3. Next, a DT light post size 2 was cemented using the same material. Groups 2TS/MF and 3ED/PF were prepared and cured in the same way as group 1VF but filled with Clearfil Tri-S Bond/Majesty Flow and ED Primer II/Panavia F2.0 respectively. Group 4UF was similarly prepared but left unfilled (control). In group 5NW, roots were unflared but similarly filled as in group 3ED/PF. After 24 hours of storage, the fracture load was measured. The degree of cure for each tested material was indirectly measured using microhardness at different root levels (cervical, middle, and apical). Data were analyzed using one-way analysis of variance followed by Newman-Keuls post hoc test.

RESULTS

Fracture load results revealed that groups 1VF and 2TS/MF had no statistically significant difference from group 5NW (p>0.05). For each tested material, no significant difference was found among microhardness values at different root levels.

CONCLUSION

It may be possible to reinforce the teeth with coronal fracture and immature weakened roots to be comparable with unweakened ones when composite is applied and cured by the modified layering technique.

Effects of curing mode and moisture on nanoindentation mechanical properties and bonding of a self-adhesive resin cement to pulp chamber floor

OBJECTIVE

This study aimed to investigate the effect of dentin surface moisture and curing mode on microtensile bond strength (MTBS) and nanoindentation characteristics of a self-adhesive resin cement.

METHODS

Forty-four extracted human molars were distributed into four groups according to dentin surface moisture (dry or wet) and curing mode of the resin cement (light or chemical). Clearfil SA Cement (Kuraray Noritake Dental, Japan) was used for cementation of composite cores to the pulp chamber dentin. The specimens were sectioned into beams for MTBS test at the pulpal floor. Nanoindentation hardness and creep of the cement layer were measured under 100 mN load with 30s hold segment. Data were statistically analyzed using two-way ANOVA and Weibull distribution of MTBS (α=0.05).

RESULTS

Moisture, curing mode or their interaction did not significantly affect mean MTBS values that ranged 17.6-22.6 MPa (p>0.05); however, the lowest characteristic strength was found in moist chemically cured group. Hardness ranged 437-512 MPa, and was not affected by the experimental factors (p>0.05). Nanoindentation creep ranged 9.3-10.9% with the chemically cured groups showing the highest values, indicating lower cross-linking and deformation resistance of their polymer network.

SIGNIFICANCE

Additional moisture on dentin surface did not contribute to adhesion of the anhydrous self-adhesive resin cement to dentin. Light-curing, despite attenuation through the composite core, was beneficial and improved nanoindentation creep resistance of the cement. The difference was not, however, reflected in the mean bond strength or hardness values.

Effect of solvent evaporation strategies on regional bond strength of one-step self-etch adhesives to root canal dentine

AIM

To evaluate the efficacy of different solvent evaporation strategies on bonding of one-step self-etch adhesives to root canal dentine.

METHODOLOGY

Two dual-cure resin core systems (Clearfil DC Bond/Clearfil DC Core Automix and Clearfil Tri-S Bond Plus/Clearfil DC Core Plus; Kuraray Noritake Dental, Tokyo, Japan) were equally applied in 24 post spaces from extracted human mandibular premolars. After the adhesive application, specimens were randomly assigned into four water/solvent evaporation strategies as follows (I) insertion of absorbent paper point for 10 s: P, (II) 10 s air-blowing: A, (III) as (II) followed by insertion of absorbent paper point: AP, (IV) as (III) followed by 10 s additional air-blowing: APA. Then, the adhesives were light cured, and resin core materials were placed into the post space, followed by light curing for 60 s. After water storage for 24 h, 0.6 × 0.6 mm-thick beams were prepared to measure the regional μTBS. The mode of failure was also observed. The μTBS values were statistically analysed using three-way anova and Duncan HSD test (α = 0.05).

RESULTS

In the coronal region, there were no significant differences in μTBS between each evaporation strategy (P > 0.05), except P group. However, in the apical region, APA and AP groups significantly increased in μTBS compared with A and P groups (P < 0.05). Only in the APA group of Clearfil Tri-S Bond Plus/Clearfil DC Core Plus, was there no significant difference in μTBS between the coronal and apical regions (P > 0.05).

CONCLUSION

The use of paper points with additional air-blowing for removing excessive adhesive and evaporating residual water/solvent would be effective in producing higher bond strength for the tested one-step self-etch adhesives and fewer blister formations in deeper regions of the post space.

Effect of waiting interval on chemical activation mode of dual-cure one-step self-etching adhesives on bonding to root canal dentin

OBJECTIVES

The purpose of this study was to evaluate the effect of waiting interval on the chemical activation of dual-cure one-step self-etching adhesives before placing resin core materials on the regional bond strength to root canal dentin.

MATERIALS AND METHODS

Forty-eight post spaces prepared in human lower premolars were applied with four dual-cure one-step self-etching adhesives Estelite Core Quick: ECB/ECQ, Clearfil DC Core Automix: CDB/CDC, Unifil Core EM: UNB/UNC, BeautiCore: BTB/BTC as the manufacturers' instructions. These adhesives were cured with light activation for 10 s, or chemical activation with 0, 10, and 30 s waiting intervals prior to placing resin core material. Resin core materials were then placed into the post space and light-cured for 60 s. After 24h water storage, each specimen was serially sliced into 8, 0.6 mm × 0.6 mm thick beams for the μTBS test. The regional μTBS data were analyzed using three-way ANOVA and Dunnett's T3 test (p < 0.05).

RESULTS

For the chemical activation with 10 and 30 s waiting intervals, ECB and CDB exhibited significantly improved μTBS, whereas for UNB and BTB, the μTBS were not significantly different but increased with waiting interval. On the other hand, light-activation of all the adhesives produced significantly higher μTBS to root canal dentin than chemical activation (p < 0.05), except for the UNB group.

CONCLUSIONS

For the chemical activation of dual-cure one-step self-etching adhesives, a waiting interval prior to placing resin core material improved μTBS to root canal dentin. Polymerising the adhesives before polymerisation reaction of resin core material would be effective for bonding to root canal dentin.

CLINICAL RELEVANCE

For chemical activation mode as well as light activation mode, pre-curing of adhesive layer before proceeding polymerisation of resin filling material would produce higher bonding performance to dentin in the cavity.

Esthetic and functional consideration in restoring endodontically treated teeth

The selection of the best restoration for an endodontically treated tooth in the aesthetic zone depends on strength and the ability to recreate the form, function, and aesthetics of the natural tooth. The increased use of all-ceramic materials is a result of improved ceramic materials and adhesive systems. However, the advent of the current variety of translucent ceramic systems makes the shade of the abutment important in achieving the desired aesthetic outcome. This article discusses the different types of posts used in the restoration.