Bonding of acid-etch and self-etch adhesives to human fluorosed dentine

Bonding to Fluorosed Teeth: A Review of the Literature

Excessive fluoride availability during tooth formation can cause structural alterations in enamel and dentin. These alterations may negatively impact the adhesion of various dental materials to teeth with dental fluorosis. The aim of this review of literature is to identify updates in bonding to fluorosed teeth and summarize relevant recommendations. Findings from the available literature suggest that bonding procedures may be carried out reliably on most fluorosed teeth with consideration to the severity of fluorosis and the employment of additional bond-enhancing measures for the severely involved teeth.

Effects of dimethyl sulfoxide pretreatment on the bonding properties of fluorotic dentin of different severity: An in vitro study

STATEMENT OF PROBLEM

Bonding to fluorotic dentin is weaker than to sound dentin, but methods to improve bonding have not been well addressed.

PURPOSE

The purpose of this in vitro study was to investigate the effects of dimethyl sulfoxide (DMSO) pretreatment on the bond strength and resin-dentin surface of fluorotic dentin of different severity.

MATERIAL AND METHODS

Phosphoric acid-etched dentin specimens exhibiting mild fluorosis (ML-F), moderate fluorosis (MD-F), and severe fluorosis (SE-F) were randomly bonded with Single Bond 2 (SB2) pretreated with 50% DMSO (experimental groups) or deionized water (control groups). The bonded teeth were sectioned for microshear bond strength (μSBS) testing immediately or after aging, for micromorphology observation of the bonding interface under a scanning electron microscope, and for resin tags and microleakage evaluation under a confocal laser scanning microscope. The degree of conversion of the adhesive resin was calculated by Fourier transform infrared spectroscopy. According to varying bonding steps, the mineralized dentin powders of ML-F, MD-F, and SE-F were randomly divided into 4 subgroups (blank, PA, PA+SB2, and PA+DMSO+SB2) and incubated in artificial saliva to examine the level of enzymatic degradation product of type I collagen. Data were analyzed by using ANOVA and the Tukey test (α=.05).

RESULTS

Dental fluorosis and thermocycling had negative effects on μSBS (P<.001), while DMSO pretreatment preserved or even improved μSBS (P<.001). DMSO had no influence on the degree of conversion (P=.618). Significant effects were found for bonding steps (P<.001), but not that of dental fluorosis (P=.131) on the enzymatic degradation product of type I collagen. Images showed sparser and more expanded collagen fibril meshwork, deeper resin penetration, and less microleakage in the experimental groups.

CONCLUSIONS

DMSO pretreatment provided increased and durable dentin bonding to fluorotic dentin probably by dispersing collagen fibrils into a sparser network and inhibiting the degradation of type I collagen.

Effectiveness of sodium hypochlorite treatment on the bonding of four adhesive systems to fluorotic enamel

The study evaluated the effect of sodium hypochlorite (NaOCl) treatment on fluorotic enamel bonding of four adhesive systems. They were Single Bond 2 (SB2), Prime&Bond NT (PBN), Clearfil SE Bond (CSB), and Single Bond Universal (SBU). One hundred eighteen extracted moderate fluorotic molars were divided into eight groups according to NaOCl pretreatment and four adhesive systems. The microshear bond strength (μSBS), etching pattern, and penetration depth (PD) were observed. The statistical method was two-way ANOVA and least significant difference (LSD) test (α=0.05). The application of NaOCl significantly increased the μSBS of PBN and SBU (p<0.05). The enamel-etching pattern of CSB and SBU was deeper under SEM. A noticeable increase of PD was in SB2 and SBU after the application of NaOCl (p<0.05). Pretreatment of 5.25% NaOCl for the 60 s can increase μSBS of PBN and SBU, PD of SB2 and SBU, and improve enamel-etching pattern of CSB and SBU to fluorotic enamel.

Effect of 45S5 bioactive glass on the microshear bond strength of dental fluorosis

The aim of this in vitro study was to estimate the effect of the species concentration of 45S5 bioactive glass (BAG) used as pretreatment on the microshear bond strength (MSBS) of dental fluorosis (DF). Based on the Thylstrup and Fejerskov index, 80 teeth were randomly divided equally into four groups: TFI 0, sound dentin; TFI 1-3, mild fluorosis; TFI 4-5, moderate fluorosis; and TFI 6-9, severe fluorosis. Each group was randomized into five subgroups. After preparing the dentin hypersensitivity model of DF, the dentin was pretreated as follows, Subgroup 1: deionized water (Control group); Subgroup 2: 1% BAG; Subgroup 3: 5% BAG; Subgroup 4: 10% BAG, and Subgroup 5: 20% BAG. Stochastically one specimen was selected from each subgroup for scanning electron microscope and energy dispersive spectrometer analysis. After being made of resin-tooth bonding samples, the remains were in water bath at 37 °C for 24 hr. Subsequently, samples from each subgroup were randomly selected to test MSBS without aging, or after a thermocycle of 5,000 and 10,000 times, respectively. The fracture modes were analyzed. Compared with the group of 1% BAG and Control, the exposure area of tubules in 5%, 10%, and 20% BAG group had significant difference (p < .05). MSBS results indicated that there were significant differences between 10% BAG with other groups. The 20% BAG group showed the lowest MSBS among all groups. Pretreatment of 10% BAG solution may be conductive to enhance the bond strength of DF, while 20% BAG solution adversely.

Diagnosis and treatment options for anterior white spot lesions

White spot lesions on teeth present as white opacities due to enamel surface and/or subsurface demineralisation. Unfortunately, dentistry has seen a marked jump in prevalence and severity of white spot lesions over the past decade. In response to the rise in white spot lesions, the dental industry has been pushed to create less invasive alternatives for the removal of these lesions, particularly when located anteriorly. There are numerous different causes of white spot lesions that influence how the enamel substructure is affected and which treatment option is selected. Once, the only treatment option for white spot lesions was drilling the defects away, but with a better understanding of the science and the aetiology, we have now been able to create minimally invasive, preventive alternatives. It is vital that the cause, size and depth of the white spot lesions are ascertained before providing treatment options to a patient, as treatment results will vary depending on the enamel substructure available. This paper will explore the main causes of white spot lesions and the recommended treatments for them.

Shear Bond Strength of Three Composite Resins to Fluorosed and Sound Dentine: In Vitro Study

Introduction

This in vitro study compared the shear strength of three composite resin systems to fluorosed and normal dentin.

Methods

Silorane FiltekTM P90, FiltekTMZ250 XT in combination with the adhesive system AdperTM Single bond 2, and Amelogen® Plus in association with Peak Universal Bond® were tested. Fifteen normal and 15 fluorosed dentine disks were prepared per material. The shear bond strength test was performed using a universal machine.

Results

One-way ANOVA revealed significant differences in bond strength between the tested composite resins. All tested materials had significantly different adhesion at the fluorosed and the nonfluorosed interface. FiltekTM Z250 XT and Silorane had lower adhesion values to fluorosed than to normal dentin. In contrast, Amelogen® Plus presented a better average resistance at the fluorosed interface.

Conclusion

Amelogen® Plus presented a better average shear bond strength on the fluorosed dentine. FiltekTMZ250 XT showed the best adhesion forces and shear bond strength with sound dentine. Further studies are needed to better understand the sealing of these systems.

Dental hypomineralization treatment: A systematic review

INTRODUCTION

Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects.

OBJECTIVE

To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization.

MATERIALS AND METHODS

PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews.

RESULTS

From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements.

CONCLUSIONS

Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion).

CLINICAL SIGNIFICANCE

Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.

Effect of phosphoric acid concentration used for etching on the microtensile bond strength to fluorotic teeth

To evaluate the effects of different etching concentrations of phosphoric acid on the microtensile bond strength of Adper Single Bond 2 to fluorotic teeth.Deidentified extracted teeth were collected, including 30 sound teeth, 30 teeth with mild fluorosis, 30 teeth with moderate fluorosis, and 30 teeth with severe fluorosis. The teeth in each group were randomly divided into 3 subgroups (n = 10) that were subjected to acid etching using 35%, 40%, or 45% phosphoric acid. Adper Single Bond 2 (3M, Saint Paul, MN) was used as the adhesive for bonding Z250 universal resin (3M) to the etched dental enamel. Microtensile testing was used to determine the bond strength. After the microtensile test, the fractured specimens were examined under scanning electron microscopy (SEM).Both dental fluorosis and concentrations of phosphoric acid significantly affected the microshear bond strength of Adper Single Bond 2 to dental enamel. The maximum bond strength was achieved by using 40% phosphoric acid. Failure analysis showed that most failures occurred at the bonding interface. The rates of failures at the bonding interface decreased as the degree of fluorosis increased and as the concentration of phosphoric acid increased from 35% to 45%.The bond strength of fluorosis tooth was lower than that of healthy tooth, the bond strength increased with the increasing concentration of phosphoric acid, but an excessively high acid concentration can conversely lead to an apparent decline in bond strength.

Effect of a filled adhesive as the desensitizer on bond strength of "Self-Adhesive Cements To" differently severity of fluorosed dentin

The objectives were to evaluate the efficacy of a filled adhesive named Prime & Bond NT (P&B NT) as the dentin desensitizer in occluding fluorosis dentinal tubules and compare the shear bond strength (SBS) of RelyX U200 self-adhesive resin cement (RXU) and RelyX Luting self-adhesive resin-modified glass ionomer cement (RMGIC) before and after P&B NT pretreatment. 176 non-carious fluorosis were classified into four subgroups by the Thylstrup and Fejerskov index (TFI): normal group (TFI = 0), mild group (TFI = 1-3), moderate group (TFI = 4-5), severe group (TFI = 6-9). 160 composite cylinders (4 × 5 mm) were fabricated, then every severity of fluorosed dentin was subjected to four treatments: P&B NT + RXU (n = 40), RXU (n = 40), P&B NT + RMGIC (n = 40), RMGIC (n = 40). The specimens were immersed in water at 37°C for 24 hr first and half of them underwent 5,000 thermocycling before shear bond strength test. A factorial design (factorial 4 × 2 × 2 × 2) was developed to make statistical analysis. Scanning electron microscope (SEM) analysis (n = 16) in cross section and longitudinal section view characterized the occlusion situation of dentinal tubules. P&B NT might occlude dentinal tubules as the dentin desensitizer for normal teeth and mild-moderate fluorosis. P&B NT significantly increased the SBS of RXU (p < .05) but had no statistical significance on the SBS of RMGIC (p > .05). RXU could benefit from P&B NT desensitization to achieve a better quality of adhesion.

Relationship between thin-film bond strength as measured by a scratch test, and indentation hardness for bonding agents

OBJECTIVES

To evaluate thin-film bond strength between a bonding agent and human dentin, using a scratch test, and the characteristics and accuracy of measurement.

METHODS

One-step bonding agents (BeautiBond; Bond Force; Adper Easy Bond; Clearfil tri-S Bond) and two-step bonding agents (Cleafil SE Bond; FL-Bond II) were investigated in this study. Flat dentin surfaces were prepared for extracted human molars. The dentin surfaces were ground and bonding agents were applied and light cured. The thin-film bond strength test of the specimens was evaluated by the critical load at which the coated bonding agent failed and dentin appeared. The scratch mark sections were then observed under a scanning electron microscope. Indentation hardness was evaluated by the variation in depth under an applied load of 10gf. Data were compared by one-way ANOVA with the Scheffé's post hoc multiple comparison test (p<0.05). In addition, thin-film bond strength and indentation hardness were analyzed using analysis of correlation and covariance.

RESULTS

The thin-film bond strength of two-step bonding agents were found to be significantly higher than that of one-step bonding agents with small standard deviations. Scratch marks consistently showed adhesive failure in the vicinity of the bonding agent/dentin interface. The indentation hardness showed a trend that two-step bonding agents have greater hardness than one-step bonding agents. A moderately significant correlation (r(2)=0.31) was found between thin-film bond strength and indentation hardness.

SIGNIFICANCE

Thin-film bond strength test is a valid and reliable means of evaluating bond strength in the vicinity of the adhesive interface and is more accurate than other methods currently in use. Further, the thin-film bond strength is influenced by the hardness of the cued bonding agent.

Direct comparison of the bond strength results of the different test methods: a critical literature review

OBJECTIVE

The goal of this paper is to undertake a literature search collecting all dentin bond strength data obtained for six adhesives with four tests (shear, microshear, tensile and microtensile) and to critically analyze the results with respect to average bond strength, coefficient of variation, mode of failure and product ranking.

METHOD

A PubMed search was carried out for the years between 1998 and 2009 identifying publications on bond strength measurements of resin composite to dentin using four tests: shear, tensile, microshear and microtensile. The six adhesive resins were selected covering three step systems (OptiBond FL, Scotch Bond Multi-Purpose Plus), two-step (Prime & Bond NT, Single Bond, Clearfil SE Bond) and one step (Adper Prompt L Pop).

RESULTS

Pooling results from 147 references showed an ongoing high scatter in the bond strength data regardless which adhesive and which bond test was used. Coefficients of variation remained high (20-50%) even with the microbond test. The reported modes of failure for all tests still included high number of cohesive failures. The ranking seemed to be dependant on the test used.

SIGNIFICANCE

The scatter in dentin bond strength data remains regardless which test is used confirming Finite Element Analysis predicting non-uniform stress distributions due to a number of geometrical, loading, material properties and specimens preparation variables. This reopens the question whether, an interfacial fracture mechanics approach to analyze the dentin-adhesive bond is not more appropriate for obtaining better agreement among dentin bond related papers.