The Impact of Silver Diamine Fluoride Only or Simultaneously With Potassium Iodide Treatment on the Bond Durability of Resin Composite Material on Primary Teeth

We aim to evaluate the bond strength between resin composite and primary demineralized dentin, pretreated with silver diamine fluoride (SDF) and simultaneous SDF with potassium iodide (KI) after thermal aging. In this in vitro study, human carious-free primary molars were randomly assigned into three groups and prepared by exposing the superficial dentin. The primary dentin of each molar was demineralized. The first group (the control) received saline treatment before bond application. SDF was pretreated for the second group, whereas SDF and KI were used for the third. After that, the pretreated dentin was immediately built with resin composite bonded with a universal adhesive and kept wet for 24 hours. Then, the pretreated molars were prepared into beam specimens for microtensile bond strength (µTBS), 16 for each group, and subjected to thermal aging. Lastly, they were tested using a universal testing machine, and the resulting data were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's post hoc test. It was found that the SDF-KI group had a significant difference with both the control and SDF groups (p < 0.05), while the control and SDF groups showed no significant differences (p = 0.310). The SDF-KI group had the highest mean value of 11.73 ± 4.39 megapascal (MPa). In contrast, the control group had the lowest mean value of 9.31 ± 3.41 MPa. Post hoc pairwise comparison results showed that SDF-KI pretreatment had a significantly higher strength value than the control and SDF groups. Pretreatment of demineralized primary dentin with SDF-KI does not negatively affect the immediate loading of resin composite. However, under the limitation of this study, KI application after SDF pretreatment is recommended to enhance the bond's durability of resin composite to demineralized dentin.

Multi-Parameter Characterization of HEMA/BPA-free 1- and 2-step Universal Adhesives Bonded to Dentin

PURPOSE

This study aimed to investigate the bonding effectiveness of two HEMA/BPA-free universal adhesives (UAs) to flat dentin, to characterize their adhesive-dentin interfacial ultrastructure, and to measure their water sorption (Wsp), water solubility (Wsl), and hydrophobicity.

MATERIALS AND METHODS

The immediate and aged (50,000 thermocycles) microtensile bond strength (μTBS) to flat dentin of the HEMA/BPA-free UAs Healbond Max (HbMax; Elsodent) and Healbond MP (HbMP; Elsodent) as well as the reference adhesives OptiBond FL (Opti-FL; Kerr), Clearfil SE Bond 2 (C-SE2; Kuraray Noritake), and Scotchbond Universal (SBU; 3M Oral Care) was measured. The adhesive-dentin interfaces of HbMax and HbMP were characterized by TEM. Wsp and Wsl of all adhesive resins and of the primer/adhesive resin mixtures of HbMax, Opti-FL, and C-SE2 were measured. Hydrophobicity was determined by measuring the contact angle of water dropped on adhesive-treated dentin.

RESULTS

In terms of µTBS, HbMax and HbMP performed statistically similarly to Opti-FL and C-SE2, but outperformed SBU. Aging only significantly reduced the μTBS of SBU when applied in E&R bonding mode. TEM revealed typical E&R and SE hybrid-layer ultrastructures at dentin, while electron-lucent globules of unknown origin, differing in size and shape, were observed within the adhesive resin of HbMP and even more frequently in that of HbMax. Higher Wsp was measured for the primer/adhesive resin mixtures than for the adhesive resins. Opti-FL was more hydrophobic than all other adhesives tested.

CONCLUSION

The HEMA/BPA-free UAs bonded durably to flat dentin with bond strengths comparable to those of the gold-standard E&R/SE adhesives and superior to that of the HEMA/BPA-containing 1-step UA.

Effect of Chlorhexidine-containing Etch-and-Rinse Adhesives on Dentin Microtensile Bond Strength after Biological Loading

PURPOSE

This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model.

MATERIALS AND METHODS

The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm2, crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM.

RESULTS

CTRL exhibited significantly higher μTBS at baseline in comparison to PRIM (p = 0.000), BOND (p = 0.002), and PEAK (p = 0.000). After undergoing the caries model, CTRL demonstrated significantly lower μTBS compared to DENT (p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL.

CONCLUSIONS

CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives.

Bond Durability of a Repaired Resin Composite Using a Universal Adhesive and Different Surface Treatments

PURPOSE

To evaluate the long-term effect of different surface treatments on the repair microtensile bond strength (µTBS) of resin composite using a universal adhesive.

MATERIALS AND METHODS

Thirty-six resin composite blocks were fabricated and aged in 37°C distilled water for 1 month. The blocks were randomly assigned to different surface treatments: no treatment (control); diamond bur grinding (D); diamond bur + phosphoric acid cleaning (DP); diamond bur + silane application (DSi); diamond bur + phosphoric acid + silane (DPSi); and grit blasting with 50 µm H3PO4 particles + phosphoric acid + silane (APSi). Thereafter, Single Bond Universal adhesive was applied and repaired with the same composite. Composite-composite stick-shaped specimens were fabricated and subjected to the µTBS test either after 37°C water storage for 24 h or thermocycling for 10,000 cycles. Roughness of different surface-prepared specimens was measured by profilometer. Data were analysed using ANOVA and Duncan's post-hoc test (α = 0.05). Failure mode and micromorphology of different surface-prepared specimens were observed with SEM and EDS analysis.

RESULTS

The highest µTBS was found in DPSi group at 24 h, and was significantly higher than others. The bond strengths in all thermocycled groups were significantly lower than those measured at 24 h. The highest µTBS was also found in the DPSi group, but this did not significantly differ from the DSi group.

CONCLUSION

Thermocycling significantly reduced the repair bond strength. Diamond bur roughening with application of silane and universal adhesive yielded the highest repair bond strength for the aged resin composite.

Eight-year Microtensile Bond Strength to Dentin and Interfacial Nanomechanical Properties of a One-step Adhesive

PURPOSE

To evaluate the microtensile bond strength (µTBS) of a one-step self-etch adhesive (1-SEA) to dentin and its interfacial nanomechanical properties after 8 years of water storage.

MATERIALS AND METHODS

Flat coronal dentin surfaces of extracted human third molars were bonded with a 1-SEA (Clearfil S3 Bond Plus, CS3+) and built up with a hybrid resin composite (Clearfil AP-X). After storage in water for 24 h or 8 years, non-trimmed stick-shaped specimens were fabricated from the central part of each bonded tooth and subjected to the µTBS test at a crosshead speed of 1.0 mm/min. Failure modes and the morphology of debonded interfaces were analyzed using a scanning electron microscope (SEM). In addition, the elastic modulus (E) and hardness (H) of the adhesive layer and the resin composite were determined by an instrumented nanoindentation test. The acquired µTBS, E, and H data were statistically analyzed using t-tests to examine the effect of storage time (α = 0.05).

RESULTS

The 8-year µTBS was slightly lower than that after 24 h, but the difference was not significant (p = 0.123). The SEM observation of debonded surfaces after 8 years revealed extrusions and lacunas. E and H of the adhesive layer and the resin composite significantly decreased over the 8-year water storage (p < 0.001).

CONCLUSIONS

Although 8 years of water storage did not decrease the µTBS of CS3+ significantly, the observed failure mode patterns and significantly decreased nanomechanical properties indicated resin degradation of the adhesive and the resin composite.

High bonding strength between zirconia and composite resin based on combined surface treatment for dental restorations

Zirconia is the preferred material for dental restorations; however, dental restorations are usually affected by zirconia fractures due to chipping and delamination of the veneer ceramic. One effective solution for repairing chemically inert zirconia frameworks is to strongly chemically bond them with the composite resin via surface modification. Thus, the bonding strength between the zirconia and composite resin determines the performance of dental restoration. Herein, we investigate the shear bond strength between zirconia ceramic and two ceramic repair systems before and after thermal cycling based on different surface pretreatments, including air-abrasion and a novel silane coupling agent. When treated with combined sandblasting, novel silane and 10-methacryloyloxydecyl hydrogen phosphate act as a bonding agent for the zirconia surface, and the maximum shear bond strength achieves 27.5 MPa, as measured by a universal testing machine through the average of 16 separate measurements. The results show that the combined treatment resists the interface damage caused by expansion and contraction during thermal cycling. The long-term bond durability is due to the micro-mechanical bond force formed by resin and ceramic, and the chemical bonds of Zr-O-Si at the interface. Results indicate that selective pretreating the surface results in high bond strength between the zirconia and the composite resin, which is meaningful to optimize dental restoration.

Zinc-Calcium-Fluoride Bioglass-Based Innovative Multifunctional Dental Adhesive with Thick Adhesive Resin Film Thickness

Apart from producing high bond strength to tooth enamel and dentin, a dental adhesive with biotherapeutic potential is clinically desirable, aiming to further improve tooth restoration longevity. In this laboratory study, an experimental two-step universal adhesive, referred to as Exp_2UA, applicable in both the etch-and-rinse (E&R) and self-etch (SE) modes and combining a primer, containing 10-methacryloyloxydecyldihydrogen phosphate as a functional monomer with chemical binding potential to hydroxyapatite, with a bioglass-containing hydrophobic adhesive resin, was multifactorially investigated. In addition to primary property assessment, including measurement of bond strength, water sorption, solubility, and polymerization efficiency, the resultant adhesive-dentin interface was characterized by transmission electron microscopy (TEM), the filler composition was analyzed by energy-dispersive X-ray spectroscopy, and the bioactive potential of the adhesive was estimated by measuring the long-term ion release and assessing its antienzymatic and antibacterial potential. Four representative commercial adhesives were used as reference/controls. Application in both the E&R and SE modes resulted in a durable bonding performance to dentin, as evidenced by favorable 1 year aged bond strength data and a tight interfacial ultrastructure that, as examined by TEM, remained ultramorphologically unaltered upon 1 year of water storage aging. TEM revealed a 20 μm thick hydrophobic adhesive layer with a homogeneous bioglass filler distribution. Adequate polymerization conversion resulted in extremely low water sorption and solubility. In situ zymography revealed reduced endogenous proteolytic activity, while Streptococcus mutans biofilm formation was inhibited. In conclusion, the three-/two-step E&R/SE Exp_2UA combines the high bonding potential and bond degradation resistance with long-term ion release, rendering the adhesive antienzymatic and antibacterial potential.

Enamel and Dentin Bond Durability of Self-Adhesive Restorative Materials

PURPOSE

To use shear bond strength (SBS) and shear fatigue strength (SFS) testing to determine the durability of adhesion of self-adhesive restorative materials compared to composite resin bonded with a universal adhesive.

MATERIALS AND METHODS

A universal adhesive, Prime & Bond Active, was used in self-etch mode to bond Z-100 composite resin to enamel and dentin. Three commercially available restorative materials and one experimental material with self-adhesive properties, Activa (A), Fuji II LC(F), and Equia Forte (E) and ASAR-MP4 (S) were also bonded to enamel and dentin. The SBS and SFS were determined for all materials. A staircase method was used to determine the SFS with 10 Hz frequency for 50,000 cycles or until failure occurred.

RESULTS

On enamel, S generated similar values to the adhesive/composite materials and higher values than F, E, and A. On dentin, the composite/universal adhesive showed significantly higher SBS and SFS than the self-adhesive materials. S, F, and E generated higher values than A on dentin.

CONCLUSION

SBS and SFS values to enamel were similar for all materials tested except Activa which generated lower enamel values. On dentin surfaces, the self-adhesive materials generated similar SBS and SFS, with the exception of Activa. Those values were lower than that generated with composite resin and a universal adhesive.

The Effects of Surface Conditioning and Aging on the Bond Strength Between Composite Cement and Zirconia-reinforced Lithium-Silicate Glass-Ceramics

PURPOSE

To determine the effects of ceramic-surface conditioning and aging on the bond strength between composite cement and zirconia-reinforced lithium-silicate glass-ceramics (ZLS) under simulated clinical conditions.

MATERIALS AND METHODS

ZLS disks (Celtra Duo, Dentsply Sirona, n = 110 test group n = 10, diameter: 8.3 mm, height: 3.4 mm) were assigned to four surface-conditioning groups: (I) 30 s of ~5% hydrofluoric-acid etching (Vita Ceramics Etch, Vita; HF), silanization (Calibra Silane; SIL); (II) successive contamination with saliva and silicone (CONT), HF, SIL; (III) CONT, tribochemical silicatization (CoJet), SIL; (IV) HF, SIL, application and light polymerization of an adhesive (Prime&Bond Active), CONT, reapplication and light polymerization of the adhesive. The ZLS disks were bonded to composite-resin cylinders in acrylic tubes (inner diameter: 3.3 mm) using self-adhesive composite cement (Calibra Universal). The tensile-bond strength (TBS) was measured after both 24 h and 6 months of water storage (WS). Additional aging protocols were tested for group I (3-day WS; 30-day WS including 7500 thermocycles between 6.5 and 60°C; 150-day WS including 37,500 thermocycles).

RESULTS

After 24 h, the mean TBS ranged between 21 MPa (group III) and 30-35 MPa (remaining groups). With the exception of 3-day WS, TBS was statistically significantly reduced by aging. The greatest reduction was observed for silicatized specimens (group III, mean TBS after aging: 9.8 MPa).

CONCLUSION

Both ceramic surface conditioning and aging had a statistically significant effect on the bond strength between composite cement and ZLS. A treatment protocol based on tribochemical silicatization cannot be recommended for the adhesive cementation of ZLS.

Air Entrapment in Demineralized Dentin Adversely Affects Bonding

PURPOSE

The present study evaluated the influence of air entrapment within demineralized dentin on bond strength, nanoleakage, and degree of conversion.

MATERIALS AND METHODS

A vacuum pump with adjustable pressure was used to control the gaseous pressure of a sealed container during the application of a two-step etch-and-rinse adhesive to demineralized dentin. Atmospheric pressure was used as control, and reduced pressures (0.08, 0.06, 0.04 MPa) as experimental variables. Simulated pulpal pressure was adopted during the bonding procedures. After making composite buildups and 24-h water storage, 48 specimens were occlusogingivally sectioned into beams for microtensile bond strength testing, interfacial morphology observation, and nanoleakage evaluation immediately (6 for each group) or after artificial aging (6 for each group); 20 specimens (5 for each group) were occlusogingivally sectioned into slices for degree of conversion testing. Failure modes were compared using the chi-squared test. The other data were analyzed using ANOVA.

RESULTS

When air within composite-dentin interface was thinned with reduced pressures, more thorough adhesive infiltration was achieved, and less distinct nanoleakage as well as higher bond strength were observed compared with control groups, regardless of artificial aging. Mixed failure was predominantly identified, and its percentage was higher in the reduced pressure groups than in the controls. Adhesive application at reduced pressure improved the degree of conversion.

CONCLUSION

Air entrapment in the demineralized dentin adversely affects composite-dentin bonds. Adhesive application at reduced pressure is helpful for reducing entrapped air, thereby improving the durability of composite-dentin bonds.

The durability of adhesion to Er,Cr:YSGG laser-irradiated enamel

BACKGROUND AND AIMS

Adhesion durability of resin adhesives with Er,Cr:YSGG laser irradiated-enamel has been rarely investigated in the literature. Thus, the present study evaluated the influence of long-term water storage (12-month) on resin bond strength with the enamel irradiated with Er,Cr:YSGG laser irradiation deployed different settings.

MATERIALS AND METHODS

The flattened enamel samples of 35 bovine teeth, which were embedded into acrylic blocks, were randomly divided into 7 groups (n = 5), according to surface treatments using Er,Cr:YSGG laser with different parameters 6 W/20 Hz, 6 W/35 Hz, 6 W/50 Hz, 3 W/20 Hz, 3 W/35 Hz, 3 W/50 Hz or no laser treatment (Bur-treating as a control). Adper Single Bond 2 was applied to the prepared enamel and the composites were placed and cured. Resin-enamel sticks with an approximate cross-sectional area of 0.8 mm2 were obtained, and microtensile bond strength (µTBS) tests were performed at 24-hour and 12-month of water storage after bonding. The µTBS data were analyzed with two-way ANOVA and Tukey tests (p < 0.05).

RESULTS

24-hour water storage after bonding, the µTBS to laser-irradiated enamel in the 6W/ 20 Hz group was significantly lower than those of bur-treated. However, 3 W/50 Hz showed significantly higher µTBS than those of bur-treated. Two-way ANOVA revealed that 12-month water storage did not influenced µTBS.

CONCLUSION

It may be concluded that, initial bond strength to Er,Cr:YSGG laser irradiated-enamel might be significantly influenced by power and pulse frequency settings. However, resin bonding to laser-irradiated enamel was stable over 12-month water storage regardless of tested laser parameters.

Relationship between mechanical properties and bond durability of short fiber-reinforced resin composite with universal adhesive

The purpose of this study was to determine the relationship between mechanical properties and bond durability of short fiber-reinforced resin composite with universal adhesive. As controls, micro-hybrid and nano-hybrid resin composites were tested. The universal adhesives used were Scotchbond Universal, Adhese Universal, and G-Premio Bond. The fracture toughness and flexural properties of resin composites, and shear bond strength and shear fatigue strength of universal adhesive with resin composite using both total-etch and self-etch modes were determined. In the results, short fiber-reinforced resin composite showed significantly higher fracture toughness than did micro-hybrid and nano-hybrid resin composites. The flexural strength and modulus of short fiber-reinforced and nano-hybrid resin composites were significantly lower than were those of micro-hybrid resin composites. Regardless of etching mode, the shear bond strength of universal adhesives with short fiber-reinforced resin composite did not show any significant differences from micro-hybrid and nano-hybrid resin composites. The shear fatigue strength of universal adhesives with short fiber-reinforced resin composite and micro-hybrid resin composites were significantly higher than that of nano-hybrid resin composites. The results of this study suggest that the mechanical properties of short fiber-reinforced resin composite improve their bond durability with universal adhesive.

[Research on bond durability among different core materials and zirconia ceramic cemented by self-adhesive resin cements]

OBJECTIVE

This research estimated shear bond durability of zirconia and different substrates cemented by two self-adhesive resin cements (Clearfil SA Luting and RelyX U100) before and after aging conditioning.

METHODS

Machined zirconia ceramic discs were cemented with four kinds of core material (cobalt-chromium alloy, flowable composite resin core material, packable composite resin, and dentin) with two self-adhesive resin cements (Clearfil SA Luting and RelyX U100). All specimens were divided into eight test groups, and each test group was divided into two subgroups. Each subgroup was subjected to shear test before and after 10 000 thermal cycles.

RESULTS

All factors (core materials, cements, and thermal cycle) significantly influenced bond durability of zirconia ceramic (P<0.00 1). After 10 000 thermal cycles, significant decrease was not observed in shear bond strength of cobalt-chromium alloy luted with Clearfil SA Luting (P>0.05); observed shear bond strength was significantly higher than those of other substrates (P<0.05). Significantly higher shear bond strength was noted in Clearfil SA Luting luted with cobalt-chromium alloy, flowable composite resin core material, and packable composite resin than that of RelyX U100 (P<0.05). However, significant difference was not observed in shear bond strength of dentin luted with Clearfil SA Luting and RelyX U100 (P>0.05).

CONCLUSIONS

Different core materials and self-adhesive resin cements can significantly affect bond durability of zirconia ceramic. 
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Influence of duration of phosphoric acid pre-etching on bond durability of universal adhesives and surface free-energy characteristics of enamel

The purpose of this study was to evaluate the influence of duration of phosphoric acid pre-etching on the bond durability of universal adhesives and the surface free-energy characteristics of enamel. Three universal adhesives and extracted human molars were used. Two no-pre-etching groups were prepared: ground enamel; and enamel after ultrasonic cleaning with distilled water for 30 s to remove the smear layer. Four pre-etching groups were prepared: enamel pre-etched with phosphoric acid for 3, 5, 10, and 15 s. Shear bond strength (SBS) values of universal adhesive after no thermal cycling and after 30,000 or 60,000 thermal cycles, and surface free-energy values of enamel surfaces, calculated from contact angle measurements, were determined. The specimens that had been pre-etched showed significantly higher SBS and surface free-energy values than the specimens that had not been pre-etched, regardless of the aging condition and adhesive type. The SBS and surface free-energy values did not increase for pre-etching times of longer than 3 s. There were no significant differences in SBS values and surface free-energy characteristics between the specimens with and without a smear layer. The results of this study suggest that phosphoric acid pre-etching of enamel improves the bond durability of universal adhesives and the surface free-energy characteristics of enamel, but these bonding properties do not increase for phosphoric acid pre-etching times of longer than 3 s.

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.

Effect of thermocycling and water storage on bond longevity of two self-etch adhesives

Despite recent improvements in adhesive systems and their bond strength to enamel and dentin, the resin-tooth interface appears to be the weakest part of tooth-colored restorations; in addition, there are concerns regarding bond durability of self-etch adhesives (SEAs). This in vitro study investigated the bond durability of 2 such adhesives following thermocycling and water storage. Forty-eight intact human third molars were sectioned mesiodistally and mounted in acrylic resin so that buccal and lingual surfaces were positioned horizontally. All enamel and dentin surfaces were ground flat and polished on silicon carbide papers. Samples were separated into 2 groups (n = 24). A 1-step SEA was applied to one group, while a 2-step SEA was applied to the other, according to manufacturers' instructions. Half of the specimens in each group underwent shear bond strength (SBS) testing after 24 hours of incubation, while the other half were tested after 3000 thermal cycles and 6 months of water incubation. SBS data were analyzed using 2-way ANOVA, 1-way ANOVA, and a post hoc Tukey test at a significance level of 0.05. Under the limitations of the present study, the 2-step SEA demonstrated higher baselines and aged bond strength to dental tissues compared to the 1-step SEA; in addition, the enamel bond strength of the 2-step SEA improved after aging.