Resistance of ten contemporary adhesives to resin–dentine bond degradation

Microtensile Bond Strength and Failure Mode of Different Universal Adhesives on Human Dentin

AIM

The aim of this study was to compare the microtensile bond strength (µTBS) and failure mode of 4 different universal adhesive systems (UAs) on human dentin.

MATERIALS AND METHODS

The study sectioned the occlusal thirds of 32 human third molars and divided them into 4 groups based on the adhesive system used. Group A: Palfique Universal Bond, Group B: Single Bond Universal, Group C: All-Bond Universal, and Group D: One Coat 7 Universal. The specimens underwent a 10,000-cycle thermocycling ageing process prior to testing (n = 32). Afterwards, 8 beams were obtained per group and subjected to µTBS testing using a digital universal testing machine at a speed of 1 mm/min. The microtensile bond strength values were analysed in Megapascals (MPa), and the failure mode was evaluated using a stereomicroscope. Welch's parametric ANOVA with robust variance and the Games-Howell post hoc test were used for µTBS comparisons, and Fisher's exact test was used to determine the association between adhesive type and failure mode. The significance level was set at P < .05.

RESULTS

Group D showed a significantly higher µTBS than groups A (P < .001) and B (P < .001), but no significant difference was observed with group C (P= .075). Furthermore, groups B and C showed significantly higher µTBS than group A (P< .001 and P < .001, respectively), but there was no significant difference between groups B and C (P = .132). Additionally, group A exhibited a significant association with an adhesive failure mode (P < .05), whereas groups B, C, and D were significantly associated with a mixed failure mode (P < .05).

CONCLUSION

The One Coat 7 Universal adhesive system showed higher microtensile bond strength values and higher chemical interaction with dentin compared to Palfique Universal Bond and Single Bond Universal. However, no significant differences were observed compared to All-Bond Universal.

Sealing of pulp chamber dentin in endodontics: Influence of bond strategy and time-point application

Context

Seal the dentin of the pulp chamber during endodontic treatment to avoid interfering with the restorative treatment performed afterward.

Aims

The aim was to evaluate the effect of three adhesive systems applied in different bonding strategies (etch-and-rinse, self-etch, and universal adhesive) and time-point application (immediately after the cavity access preparation or after endodontic obturation) on the hybrid layer formation and dentinal penetrability.

Materials and Methods

Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used and the time-point application: Adper Scotchbond Multi-purpose (AS), Clearfil SE (CF) and Scotchbond Universal (SU) in strategy of immediate endodontic sealing (IES) or delayed endodontic sealing (DES). In IES-AS, IES-CF, and IES-SU groups, dentin sealing was performed immediately after the cavity access, while in DES-AS, DES-CF, and DES-SU, after root canal obturation. The specimens were sectioned in the long axis, in a buccal-lingual direction, and the dentinal penetrability of the adhesive systems was evaluated using confocal microscopy images. Hybrid layer formation was analyzed by scanning electron microscopy images.

Statistical Analysis Used

Dentinal penetrability data were analyzed with the ANOVA test and the Kruskal-Wallis test was performed for hybrid layer data (α = 0.05).

Results

IES-CF showed the lowest dentinal penetrability (P < 0.05), while the other protocols were similar to each other (P > 0.05). No significant differences were found between groups regarding the hybrid layer formation (P > 0.05). Immediate and DES protocols do not influence the hybrid layer formation, regardless of the bond strategy used.

Conclusions

Sealing the pulp chamber dentin before endodontic treatment can improve the bond strength of the final restoration but the formation of the hybrid layer was not influenced by the bond strategy.

Universal Adhesive Application Modes Differentially Affect the Fracture Resistance of Resin Composite Restored Teeth

This study evaluated the fracture resistance of teeth with mesio-occluso-distal (MOD) resin composite restorations using universal adhesive (Single Bond Universal; SBU) in three different manipulation modes compared with those using two-step self-etch (Clearfil SE bond; CSE) and 3-step etch-and-rinse (Scotchbond Multi-Purpose; SBMP) adhesives at 24 hours and after thermocycling. One hundred and sixty maxillary premolars were assigned into eight groups of 20 each. Intact teeth and nonrestored cavity-prepared teeth served as controls. For the remaining specimens, cavities were restored with resin composite using different adhesives-SBU in self-etch, etch-and-rinse, or selective enamel etching modes; CSE in self-etch or selective enamel etching; and SBMP. Specimens from each group were either stored in 37°C water for 24 hours or further submitted to thermocycling for 30,000 cycles (n=10), then subjected to axial compression stress until fracture. Fracture patterns were observed microscopically. Data were statistically analyzed at a 95% confidence level. Among the restored teeth, mean failure load of the group using SBMP was the highest at both short-term and long-term evaluation periods (p<0.05). Fracture strengths of the SBU groups where enamel was etched with phosphoric acid prior to the adhesive application were similar and were greater than in those specimens without pre-etching (p<0.05). After thermal aging, a significant decrease in fracture resistance value was detected only for the group using SBU in etch-and-rinse application mode (p<0.05). For the self-etch strategy, SBU demonstrated lower load to fracture than CSE following thermocycling; all specimens failed at and beneath the crestal level (p<0.05). Application of SBU universal adhesive in selective enamel etching mode provided higher and more stable fracture resistance of teeth with MOD resin composite restorations than in self-etch mode.

Shear Bond Strength and Color Stability of Novel Antibacterial Nanofilled Dental Adhesive Resins

Experimental adhesives containing co-doped metaloxide nanoparticles were demonstrated to display strong and long-term antibacterial properties against Streptococcus mutans biofilms. The present study represents an effort to characterize the shear-bond strength (SBS) and color stability (CS) of these novel biomaterials. Experimental adhesives were obtained by dispersing nitrogen and fluorine co-doped titanium dioxide nanoparticles (NF_TiO2, 10%, 20% or 30%, v/v%) into OptiBond Solo Plus (OPTB). Dentin surfaces were wet-polished (600-Grit). Specimens (n = 5/group) of Tetric EvoCeram were fabricated and bonded using either OPTB or experimental (OPTB + NF_TiO2) adhesives. Specimens were stored in water (37 °C) for twenty-four hours (T1), three months (T2), and six months (T3). At T1, T2, or T3, specimens were removed from water storage and were tested for SBS. Disc-shaped specimens (n = 10/group; d = 6.0 mm, t = 0.5 mm) of adhesives investigated were fabricated and subjected to thermocycling (10,000 cycles, 5−55 °C, 15 s dwell time). Specimens’ colors were determined with a VITA Easyshade® V spectrophotometer (after every 1000 cycles). SBS data was analyzed using two-way ANOVA and post-hoc Tukey tests, while CS data was analyzed using one-way ANOVA and post-hoc Tukey tests (α = 0.05). Mean values of SBS ranged from 16.39 ± 4.20 MPa (OPTB + 30%NF_TiO2) to 19.11 ± 1.11 MPa (OPTB), from 12.99 ± 2.53 MPa (OPTB + 30% NF_TiO2) to 14.87 ± 2.02 (OPTB) and from 11.37 ± 1.89 (OPTB + 20% NF_TiO2) to 14.19 ± 2.24 (OPTB) after twenty-four hours, three months, and six months of water storage, respectively. Experimental materials had SBS values that were comparable (p > 0.05) to those from OPTB independently of nanoparticle concentration or time-point considered. Experimental materials with higher NF_TiO2 concentrations had less intense color variations and were more color stable than OPTB even after 10,000 thermocycles. In combination, the results reported have demonstrated that experimental adhesives can establish strong and durable bonds to human dentin while displaying colors that are more stable, thereby suggesting that the antibacterial nanotechnology investigated can withstand the harsh conditions within the oral cavity without compromising the esthetic component of dental restorations.

Which self-etch acidic composition may result in higher dental bonds at the long-term? A network meta-analysis review of in vitro studies

OBJECTIVES

This review evaluated the effects of the acidic composition of self-etch (SE) adhesives at the long-term bond strengths to dentin and enamel.

DATA

The review followed the PRISMA Extension Statement for network meta-analysis. Studies were identified by a systematic search in PubMed, Web of Science, and Scopus databases.

STUDY SELECTION

The inclusion criteria were in vitro studies that evaluated bond strength data of samples analyzed at both immediate and long-term (after aging simulation) periods and that were bonded to sound dentin/enamel using SE adhesives, with at least one group of adhesives being based on 10-MDP (10-methacryloyloxy-decyl-dihydrogen-phosphate; control) and the other group being comprised of alternative acidic monomers. Statistical analyses were conducted using two methods: standard pairwise meta-analysis (SPMA) and Bayesian network meta-analysis (NMA). Heterogeneity was assessed by using the Cochran Q test and I² statistics.

RESULTS

From 5220 studies identified, 87 met the eligibility criteria and 83 were meta-analyzed. Seventeen adhesives were based on 10-MDP and 44 systems were based on alternative acids. The resin-dentin/enamel bonds were predominantly reduced after aging (∼84% of cases). From the SPMA findings, the following acidic compositions showed lower bond strength values (effect size: mean difference [MD] with 95% confidence interval [95% CI]) than 10-MDP: 4-META (MD -4.99, 95% CI: -7.21, -2.78; p<0.001); sulfonic acids (MD -9.59, 95% CI -12.19, -6.98; p<0.001); unspecified phosphate esters (MD -8.89, 95% CI -17.50, -0.28; p = 0.04); or mixed acids (MD -11.0, 95% CI -13.62, -8.38; p<0.001). The dental bonds were benefited from the presence of 10-MDP upon longer aging (>6 months). From the NMA probabilistic findings, adhesives based on 10-MDP and phosphonic acids ranked as having the best and the worst bonding potential to dentin, respectively. More than one composition (phosphonic acids and mixed acids) ranked similarly to 10-MDP in enamel. The studies scored as having moderate risk of bias (58.6%), followed by low (39.1%) and high (2.3%) risk of bias.

CONCLUSION

10-MDP is an outstanding acidic monomer that contributes to higher bonds to dentin at the long-term. In enamel, there is no evidence that one acidic composition prevails over the other.

CLINICAL SIGNIFICANCE

The acidic composition of SE adhesives affects the resistance of dental bonds after simulated aging, with 10-MDP playing a significant role in the adhesion to dentin but not to the enamel.

REGISTRATION NUMBER

This report is registered at the Open Science Framework (osf.io/urtdf).

Long-term microtensile bond strength of self-etch adhesives and influence of 7-s phosphoric acid etching on adhesion of a 3-step etch-and-rinse adhesive to the dentine of primary teeth

BACKGROUND

The immediate microtensile bond strength (µTBS) of self-etch (SE) adhesives to primary dentine is promising, but evidence about the durability is scarce.

AIM

To assess the long-term µTBS of SE adhesives to primary dentine and to examine the effect of 7-s etching on µTBS of a 3-step etch-and-rinse (ER) adhesive.

DESIGN

The enamel of 115 caries-free human primary teeth was ground flat, and bonding was performed according to group assignment: G-aenial™ Bond/GC [GB], Clearfil™ SE Bond/Kuraray [CS], OptiBond™ XTR/Kerr [OX], Scotchbond™ Universal/3M™ [SU], Prime&Bond^® NT™/Dentsply [PB], and OptiBond™ FL/Kerr [OF]. After storage (24 h, 6 mos., 12 mos.), 1,762 beams were cut for µTBS testing. Fracture analysis was performed using light/fluorescence microscopy. Resin-dentine interfaces were exemplarily analyzed using SEM.

RESULTS

After 24 h, OX and SU showed significantly higher estimated mean µTBS than GB, which exhibited the lowest µTBS at all stages (p < .05). μTBS within each adhesive group showed slight variations over time (p > .05). OF_SE produced acceptable µTBS. Etching increased the mean immediate µTBS for OF (p > .05) and the percentage of cohesive fractures.

CONCLUSIONS

SE adhesives achieved durable μTBS to primary dentine. 7-s etching may improve the immediate µTBS of a 3-step ER adhesive.

Riboflavin and Its Effect on Dentin Bond Strength: Considerations for Clinical Applicability-An In Vitro Study

Bioactive collagen crosslinkers propose to render the dentin hybrid layer less perceptive to hydrolytic challenge. This study aims to evaluate whether bond strength of dental resin composite to dentin benefits from riboflavin (RB)-sensitized crosslinking when used in a clinically applicable protocol. A total of 300 human dentin specimens were prepared consistent with the requirements for a macro-shear bond test. RB was applied on dentin, either incorporated in the primer (RBp) of a two-step self-etch adhesive or as an aqueous solution (RBs) before applying the adhesive, and blue light from a commercial polymerization device was used for RB photoactivation. Bonding protocol executed according to the manufacturer's information served as control. Groups (n = 20) were tested after 1 week, 1 month, 3 months, 6 months or 1 year immersion times (37 °C, distilled water). The different application methods of RB significantly influenced bond strength (p < 0.001) with a medium impact (η2p = 0.119). After 1 year immersion, post hoc analysis identified a significant advantage for RB groups compared to RBp (p = 0.018), which is attributed to a pH-/solvent-dependent efficiency of RB-sensitized crosslinking, stressing the importance of formulation adjustments. We developed an application protocol for RB-sensitized crosslinking with emphasis on clinical applicability to test its performance against a gold-standard adhesive, and are confident that, with a few adjustments to the application solution, RB-sensitized crosslinking can improve the longevity of adhesive restorations in clinics.

Is the presence of 10-MDP associated to higher bonding performance for self-etching adhesive systems? A meta-analysis of in vitro studies

OBJECTIVE

The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other acidic functional monomers, comparing the bonding performance of both compositions.

METHODS

This study is registered in PROSPERO (CRD42020175715) and it followed the PRISMA Statement. The literature search was performed in PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO from the starting coverage date through 30 June 2021. Study eligibility criteria consisted of in vitro studies that evaluated the bond strength (microtensile, microshear, tensile or shear testing) to sound dentin/enamel of a minimum of two distinct SE systems, with at least one material containing 10-MDP and one other being comprised of a distinct acidic composition. Statistical analyses were carried out with RevMan 5.3.5 and using random-effects models with the significance level at p < 0.05. Also, Bayesian network meta-analysis (NMA) was conducted using MetaInsight V3 tool.

RESULTS

From 740 relevant studies evaluated in full-text analysis, 210 were incorporated to the systematic review and 206 in meta-analysis. The majority of studies was classified as having medium risk of bias (56.7%), followed by low (35.2%) and high (8.1%) risk of bias. Data from a total of 64 adhesive systems were collected, which favored the 10-MDP-based group at both dentin (overall effect: 6.98; 95% CI: 5.61, 8.36; p < 0.00001) and enamel (overall effect: 2.79; 95% CI: 1.62, 3.96; p < 0.00001) substrates. Microtensile testing was more frequently used (73.4%) in the included studies. Adhesives based on 10-MDP showed greater bonding performance than adhesives comprised of monomers such as PENTA, 6-MHP, 4-META, 4-MET, pyrophosphate esters, mixed composition or monomers derived from sulfonic acid (p ≤ 0.01); whereas similar bond strength values were verified between 10-MDP-based materials and those containing PEM-F, acrylamide phosphates, 4-AET, MAC-10, or monomers derived from polyacrylic and phosphonic acids (p ≥ 0.05). Adhesives based on GPDM were the only ones that resulted in greater bonding potential than the 10-MDP-based group (p = 0.03). Dental bonds in dentin were favored with the application of 2-step 10-MDP-based adhesives; whereas in enamel the dental bonds were favored for both 2-steps versions of adhesives, regardless of the presence of 10-MDP. Indirect evidence from NMA revealed that 1-step 10-MDP-free and universal 10-MDP-free adhesives seemed to perform worst in dentin and enamel, respectively.

SIGNIFICANCE

Adhesives containing 10-MDP showed higher bonding performance than materials formulated with other acidic ingredients, although this result relied on the type of mechanical testing, type of the substrate, acidic composition of the adhesive, and the application category of the SE system. This review summarized the effects of the foregoing factors on the adhesion to dental substrates.

Comparison of microtensile bond strength and resin-dentin interfaces of two self-adhesive flowable composite resins by using different universal adhesives: Scanning electron microscope study

The aim of this in-vitro study was to evaluate microtensile bond strength (μTBS) of two different self-adhesive composites (SACs) on the permanent dentin by applying five different universal adhesive systems. In this study, two different SACs [Vertise Flow (VF), Fusio Liquid Dentin (FLD)] and five different bonding systems [Clearfil Universal Bond Quick (CUB), Single Bond Universal (SBU), All Bond Universal (ABU), Prime Bond Universal (PBU), Futurabond U (FBU)] were used. A total of 22 groups were created in which SACs were applied without adhesive and with five different universal bonding agents in total-etch (TE) and self-etch (SE) modes. Two hundred and forty test sticks were obtained using 48 healthy human molar teeth in total with groups having 10 samples each. The μTBS test was applied to each sample in the Universal test device and the data obtained were analyzed statistically by variance analysis and Tukey HSD test. In addition, the resin-dentin interface and fractures modes in the groups were examined by SEM. Upon examining the μTBS results, the highest values were seen in the use of SBU adhesive in TE mode in VF group, while the lowest values were seen in the FLD control group. The difference between the control and experimental groups was found statistically significant (p < .05). Upon comparing the control groups with each other, it was seen that VF group had higher μTBS values than FLD group and the difference between the groups was found statistically significant (p < .05). The μTBS results and SEM images of the study showed that the use of SACs with universal adhesive systems provides a more effective bond strength.

Effects of different etching modes on the nanoleakage of universal adhesives: A systematic review and meta-analysis

PURPOSE

The aim of this systematic review was to evaluate how etching modes affect the nanoleakage of universal adhesive from in vitro studies.

MATERIALS AND METHODS

PubMed/MEDLINE, Web of Science, Scopus and Science Direct electronic databases were searched for in vitro studies that evaluated the nanoleakage of universal adhesives. A total of 511 (after duplicate removal) potentially relevant records were identified in the literature search. The titles and abstracts of the retrieved studies were screened by two independent researchers according to the main concept. Subsequently, the full text of potentially relevant studies was screened using the exclusion criteria. Thirteen studies were subjected to qualitative analysis, and 5 of them were selected for a detailed meta-analysis.

RESULTS

Seven universal adhesives were evaluated in this review. The meta-analysis demonstrated that the etch-and-rinse technique significantly reduced the nanoleakage of the Peak Universal and G-Bond Plus adhesives, whereas the self-etch mode reduced the nanoleakage of All-Bond Universal. In comparison, the etching technique did not significantly alter the nanoleakage of either Prime&Bond Elect or Scotchbond Universal which was characterized by the smallest nanoleakage.

CONCLUSIONS

Etching modes significantly, in various ways, influence the nanoleakage of universal adhesives.

CLINICAL SIGNIFICANCE

Contrary to the drive to simplify bonding technologies, an appreciation of their adhesive components and how these perform according to bonding technique could yield a knowledge-based practical approach that ultimately improves the longevity of direct composite restorations.

Effect of Baicalein on Matrix Metalloproteinases and Durability of Resin-Dentin Bonding

OBJECTIVE

In an attempt to increase resin-dentin bonding quality, this study used baicalein as a preconditioner in an etch-and-rinse adhesive to evaluate its effect on matrix metalloproteinases (MMPs) and adhesive durability.

METHODS

As a MMP inhibitor and potential collagen cross-linking agent, baicalein was used as a preconditioner in an etch-and-rinse adhesive system. The degree of conversion was evaluated by Fourier-transform infrared spectroscopy. EnzChek gelatinase/collagenase assay kits were then used to detect the MMP inhibitory effect of different concentrations of baicalein (0.1, 0.5, 2.5, and 5.0 μg/mL) on dentin powders. During in vitro bonding procedures, flat dentin surfaces on sound third molars were preconditioned with 2.5 μg/mL baicalein after being acid-etched; this step was followed by continuation of adhesive processes and build-up of resin composite. After resin-dentin stick preparation, bonding strength, failure mode, and interface nanoleakage were respectively evaluated via microtensile testing, stereomicroscopy, and field emission scanning electron microscopy either immediately or after storage in artificial saliva for three or six months. Data were analyzed by two-way analysis of variance and Tukey test (α=0.05).

RESULTS

Baicalein at a concentration of 0-5.0 μg/mL did not influence the conversion of adhesives. However, it inhibited the activities of dentin-bond gelatinase and collagenase, especially at a concentration of 2.5 μg/mL, while effectively increasing microtensile bonding strength and decreasing nanoleakage in vitro, both immediately and after aging.

CONCLUSIONS

Baicalein used as preconditioner in an etch-and-rinse adhesive system has an anti-MMP function and effectively improves resin-dentin bonding durability in vitro, which has potential value in clinical bonding procedures.

Fatigue resistance of dentin bonds prepared with two- vs. three-step adhesives: Effect of carbodiimide

The application of a cross-linker to demineralized dentin is reportedly effective at extending the durability of dentin bonds.

OBJECTIVE

To compare the effect of a cross-linker pretreatment on the fatigue crack growth resistance of resin-dentin bonds prepared with a two- vs. three-step adhesive system.

METHODS

Bonded interface Compact Tension (CT) specimens were prepared using commercial two- and three-step etch-and-rinse adhesives and compatible hybrid resin-composite. For the treated groups, adhesive bonding was preceded by a 1min application of an experimental carbodiimide (EDC) conditioner to the acid-etched dentin. The control groups received no such treatment. The fatigue crack growth resistance was examined after storage in artificial saliva at 37°C for 0, 3 and 6 months.

RESULTS

There was no significant difference in the immediate fatigue crack growth resistance the control and EDC-treated groups at 0 months for either adhesive system. After 3 and 6 months of storage, the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the controls. Although the EDC treatment was equally effective in deterring degradation for both adhesives, bonds prepared with the three-step system exhibited the lowest resistance to fatigue crack growth overall.

SIGNIFICANCE

An EDC treatment applied during dentin bonding could help maintain the durability of bonds prepared with two or three-step adhesive bonding systems.

Laboratory evaluation of the effect of unfilled resin after the use of self-etch and total-etch dentin adhesives on the Shear Bond Strength of composite to dentin

BACKGROUND

Based on the frequent application of composite resins as tooth-colored fillings, this method is considered a viable alternative to dental amalgam. However, this method has the low bond strength of the composite to dentin. To solve this issue, various dental adhesive systems with different characteristics have been developed by dentistry experts.

AIM

To assess the effect of an additional layer of unfilled resin in self-etch and total-etch dentin adhesives on the shear bond strength (SBS) of composite to dentin. Moreover, we assessed the effects of sample storage in artificial saliva on the SBS of composite to dentin.

METHODS

Methods: This experimental study was conducted on 160 freshly extracted human first or second premolar teeth, which were randomly divided into 16 groups. The teeth were prepared from Mashhad University of Medical Sciences, Mashhad, Iran (2008-2009). Scotchbond Multi-purpose (SBMP), single bond (SB), Clearfil SE Bond, and Clearfil S3 Bond were applied to dentin surface with or without the placement of hydrophobic resin (Margin Bond) in accordance with the instructions of the manufacturers. To expose the coronal dentin, the teeth were abraded with 600 grit SiC paper. Immediately after restoration, half of the samples were tested in terms of SBS, while the other samples were evaluated in terms of SBS after three months of storage in artificial saliva. SBS rates of dental composites evaluated by universal testing machine and samples were studied by optical stereomicroscopy to verify the failure type. Data analysis was performed in SPSS V.16 using Kolmogorov-Smirnov test, independent-samples t-test, ANOVA, and Duncan's logistic regression test.

RESULTS

In this study, a significant reduction was observed in the SBS rates of SB and S3 bond adhesive systems after storage with and without hydrophobic resin (p>0.000). Without storage in normal saline, a significant increase was observed in the SBS rate of the SE bond (p=0.013). In addition, SBS rate of SBMP significantly increased after storage with hydrophobic resin (p=0.001). Finally, the highest and lowest rates of SBS were observed in the SE and S3 bonds in all the experimental groups, respectively.

CONCLUSION

The effects of using a hydrophobic resin layer on shear bond strength values seem to be effective. The mild self-etch adhesive exhibited the best resin-dentine bond strength after aging.

Degree of Conversion of Self-etch Adhesives: In Situ Micro-Raman Analysis

Purpose: Degree of conversion (DC) affects the physicochemical properties of dental adhesives. The aim of this study was to measure the DC within the hybrid layer of four one-step self-etch adhesives using Raman microspectroscopy. The hypothesis tested was that there was no difference among the tested adhesives.

Methods and Materials: The selected one-step self-etch adhesives (Clearfil S3 Bond Plus, I-BOND, G-BOND, and Adper Easy Bond) were applied on human dentin disks and polymerized in accordance with the manufacturers' instructions. Specimens were transversally cut to expose the bonded interfaces to the micro-Raman beam, and Raman spectra were collected along the dentin/adhesive interface. Measurements were performed at 1-μm intervals. The relative intensities of bands associated with the C=C bond (at 1640 cm−1) and an internal stable peak (1610 cm−1) were determined to calculate the degree of conversion within the hybrid layer. Data were statistically analyzed with Kolmogorov-Smirnov and Bartlett tests and Kruskal-Wallis and Mann-Whitney U-tests.

Results: The DC ranked as follows: G-BOND (93%±6%) ≥ Adper Easy Bond (92%±6%) ≥ I-BOND (89%±7%) &gt; Clearfil S3 Bond Plus (80%±14%) (p&lt;0.05).

Conclusions: Based on the results of this study, all of the tested self-etch adhesives showed a clinically acceptable DC that was material dependent.

In Vivo and In Vitro Effects of Chlorhexidine Pretreatment on Immediate and Aged Dentin Bond Strengths

This study evaluated the effect of 2% chlorhexidine (CHX) pretreatment of dentin on the immediate and aged microtensile bond strength (μTBS) of different adhesives to dentin in vivo and in vitro. Class I cavities were prepared in 80 caries-free human third molars of 40 patients in a split-mouth fashion. In each tooth pair, one tooth received 2% CHX pretreatment after which both teeth were randomly assigned to one of the following groups with respect to the type of adhesive system applied: Adper Single Bond 2 (etch-and-rinse), Clearfil SE Bond (two-step self-etch), Clearfil S(3) Bond (one-step self-etch), and Adper Prompt-L-Pop (all-in-one self-etch). The teeth were restored with resin composite and extracted for μTBS testing either immediately or after six months in function. In vitro specimen pairs were prepared as with the clinical protocol in intact, freshly extracted human molars, and thereafter, subjected to testing immediately or after 5000× thermocycling. Data were analyzed with four-way analysis of variance (ANOVA). Bonferroni test was utilized for pair-wise comparisons. The immediate bond strength values were significantly higher than "aged" ones for all tested adhesives (p=0.00). The in vitro immediate bond strength values were statistically higher than in vivo bond strength values (p<0.05). While the bond strength of in vitro aged, CHX-treated samples were higher than their in vivo counterparts (p<0.05), no difference was observed in non-CHX treated groups (p>0.05). In the absence of CHX pretreatment, all adhesives showed significantly higher immediate bond strength values than CHX-treated groups, while all "aged", non-pretreated adhesives exhibited significantly lower bond strength values (both p<0.05). By contrast, chlorhexidine pretreatment resulted in significantly higher aged bond strengths, regardless of the adhesive system and testing condition. Aging-associated decline in dentin bond strength of etch-and rinse and self-etch adhesives can be counteracted by chlorhexidine application.

Effect of carbodiimide on the fatigue crack growth resistance of resin-dentin bonds

Recent studies have shown that ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) inactivates endogenous dentin proteases, thereby preventing collagen degradation and improving the durability of adhesive bonds to dentin. Bond durability is routinely assessed by monotonic microtensile testing, which does not consider the cyclic nature of mastication.

OBJECTIVE

To characterize the effect of an EDC pretreatment on the fatigue crack growth behavior of resin-dentin bonds.

METHODS

Bonded interface Compact Tension (CT) specimens were prepared using a three-step etch-and-rinse adhesive and hybrid resin-composite. Adhesive bonding of the treated groups included a 1 min application of an experimental EDC conditioner to the acid-etched dentin. The control groups did not receive EDC treatment. The fatigue crack growth resistance was examined after storage in artificial saliva for 0, 3 and 6 months.

RESULTS

There was no significant difference in the immediate fatigue crack growth resistance of the EDC-treated and control groups at 0 months. However, after the 3 and 6 months storage periods the EDC-treated groups exhibited significantly greater (p≤0.05) fatigue crack growth resistance than the control specimens.

SIGNIFICANCE

Although the EDC treatment maintained the fatigue crack growth resistance of the dentin bonds through 6 months of storage, additional studies are needed to assess its effectiveness over longer periods and in relation to other cross-linking agents.

Evaluation of Bond Strength of Self-Etching Adhesives Having Different pH on Primary and Permanent Teeth Dentin

Purpose

The purpose of this in vitro study was to evaluate the dentin shear bond strength of 4 self-etching adhesives having a different pH on primary and permanent teeth dentin.

Methods

The occlusal enamel was removed from 60 freshly extracted third molar and 60 primary second molar human teeth, which were randomly separated into 4 groups (n = 15). Four adhesive systems were applied: G-Bond (GC Corporation, Tokyo, Japan, pH: 1.5), Futura Bond M (Voco, Cuxhaver, Germany, pH: 1.4), Adper Prompt L-Pop (3M/ESPE, St Paul, MN, USA, pH: 0.8), and Clearfil S3 Bond (Kuraray Medical, Tokyo, Japan, pH: 2.7) according to the manufacturer's instructions. After the application of dentin bonding agents, a composite resin material (Z250 Restorative A2, 3M ESPE, St. Paul, MN, USA) for permanent teeth and a compomer resin material (Dyract Extra A2, Dentsply, Konstanz, Germany) for primary teeth was applied onto the prepared dentin surfaces. The data were obtained by using a universal test machine at a crosshead speed of 1 mm/min.

Results

The mean values were compared using Tukey's multiple comparison test. Although there was no difference between adhesives on the permanent teeth, Clearfil S3 adhesive showed higher bond (18.07 ± 0.58 MPa) ( P>0.05). Lower bond strength values were obtained from primary teeth and especially G-Bond adhesive (9.36 ± 0.48 MPa) ( P<0.05).

Conclusions

Self-etching adhesives with different pH and solvent types can be used successfully for permanent teeth dentin but adhesives with low pH did not provide greater shear bond strength values.

Influence of Organic Acids from the Oral Biofilm on the Bond Strength of Self-Etch Adhesives to Dentin

Abstract: The aim of this study was to evaluate the microtensile bond strength of self-etch adhesive systems to dentin after storage in acids from oral biofilm. Three adhesive systems were used in the study: a two-step self-etch adhesive for use with a silorane-based resin composite (Filtek P90 adhesive system - P90), a two-step self-etch adhesive (Clearfil SE Bond - CSE) and a one-step self-etch adhesive (Adper Easy One - AEO). The bond strength of these products was evaluated by bonding resin composite (Filtek Z350 for CSE and AEO; and Filtek P90 for P90) to 90 bovine dentin tooth fragments, according to the manufacturer's instructions. After 24 h of water storage at 37 °C, the specimens were sectioned into beams (1 mm2) divided and stored in distilled water, lactic acid and propionic acid, for 7 and 30 days. After storage, the specimens were tested for microtensile bond strength. Data were analyzed by three-way ANOVA and Tukey´s test (α=0.05). CSE presented the highest microtensile bond strength after storage in distilled water for 7 and 30 days. The microtensile bond strength of all adhesive systems was lower after storage in lactic acid and propionic acid than after water storage. Significant difference was not found between storage times.

Influence of a hydrophobic resin coating on the immediate and 6-month dentin bonding of three universal adhesives

OBJECTIVE

To test the influence of a hydrophobic resin coating (HC) on the immediate (24h) and 6-month (6m) microtensile dentin bond strengths (μTBS) and nanoleakage (NL) of three universal adhesives applied in self-etch (SE) or in etch-and-rinse (ER) mode.

METHODS

Sixty caries-free extracted third molars were assigned to 12 experimental groups resulting from the combination of the factors "adhesive system" (Scotchbond Universal Adhesive [SBU], 3M ESPE; All-Bond Universal [ABU], Bisco Inc.; and G-Bond Plus [GBP], GC Corporation); "adhesive strategy" (SE or ER); "hydrophobic resin coating" [HC] (with or without Heliobond, Ivoclar Vivadent); and "storage time" (24h or 6m). Specimens were prepared for μTBS testing - (24h) half of the beams were immediately tested under tension; and (6m) the other half was stored in distilled water (37°C) for 6m prior to testing. For each tooth, two beams were randomly selected for NL evaluation for both evaluation times. Data were analyzed for each adhesive system using three-way ANOVA and Tukey's post-hoc test (α=0.05).

RESULTS

μTBS: (24h): In SE mode, HC resulted in statistically greater mean μTBS for all adhesives. (6m): When HC was not used the mean μTBS for SBU/ER, ABU/ER, GBP/ER and SBU/SE decreased significantly. NL: (24h): SBU/ER, ABU/ER and GBP/SE resulted in a significant reduction in NL when HC was applied. (6m): No significant reduction was observed for SBU/ER or for SBU/SE regardless of the use of HC.

SIGNIFICANCE

The application of a hydrophobic resin coating improved the 24h and the 6m performances of all three adhesives systems in SE mode.

In vitro analysis of riboflavin-modified, experimental, two-step etch-and-rinse dentin adhesive: Fourier transform infrared spectroscopy and micro-Raman studies

To modify two-step experimental etch-and-rinse dentin adhesive with different concentrations of riboflavin and to study its effect on the bond strength, degree of conversion, along with resin infiltration within the demineralized dentin substrate, an experimental adhesive-system was modified with different concentrations of riboflavin (m/m, 0, 1%, 3%, 5% and 10%). Dentin surfaces were etched with 37% phosphoric acid, bonded with respective adhesives, restored with restorative composite–resin, and sectioned into resin–dentin slabs and beams to be stored for 24 h or 9 months in artificial saliva. Micro-tensile bond testing was performed with scanning electron microscopy to analyse the failure of debonded beams. The degree of conversion was evaluated with Fourier transform infrared spectroscopy (FTIR) at different time points along with micro-Raman spectroscopy analysis. Data was analyzed with one-way and two-way analysis of variance followed by Tukey's for pair-wise comparison. Modification with 1% and 3% riboflavin increased the micro-tensile bond strength compared to the control at 24 h and 9-month storage with no significant differences in degree of conversion (P<0.05). The most predominant failure mode was the mixed fracture among all specimens except 10% riboflavin-modified adhesive specimens where cohesive failure was predominant. Raman analysis revealed that 1% and 3% riboflavin adhesives specimens showed relatively higher resin infiltration. The incorporation of riboflavin in the experimental two-step etch-and-rinse adhesive at 3% (m/m) improved the immediate bond strengths and bond durability after 9-month storage in artificial saliva without adversely affecting the degree of conversion of the adhesive monomers and resin infiltration.

Longitudinal Evaluation of Bond Strength to Enamel of Dental Adhesive Systems Associated with Nd:YAG Laser

OBJECTIVES

This study evaluated the durability of bond strength to enamel using total-etch (Single Bond/SB) and self-etch (Clearfil SE Bond/CSEB) adhesives associated with neodymium:yttrium-aluminu-garnet (Nd:YAG) laser irradiation through the uncured adhesives.

METHODS

Bovine incisors were worn to expose an area of enamel and were divided into four groups: group 1 (control) SB + polymerization; group 2 (control) CSEB + polymerization; group 3 (laser) - SB + Nd:YAG laser (174.16 J/cm(2)) + polymerization; and group 4 (laser) CSEB + Nd:YAG (174.16 J/cm(2)) + polymerization. Blocks of composite were fabricated and stored for 24 hours or 12 months, sectioned into beams, and submitted to microtensile tests. Results were analyzed by three-way analysis of variance (ANOVA) (adhesive, technique, and storage time) and Tukey tests.

RESULTS

ANOVA revealed significant differences for adhesive × technique and technique × storage time (p<0.05). The mean values (MPa) for interaction adhesive × technique (standard deviation) were as follows: SB/control = 35.78 (6.04)a; SB/laser = 26.40 (7.25)b, CSEB/control = 26.32 (5.71)b, CSEB/laser = 23.90 (7.49)b. For interaction technique × storage time the mean values were as follows: control/24 hours = 32.58 (6.49)a; control/12 months = 29.52 (8.38)a; laser/24 hours = 29.37 (5.71)a; laser/12 months = 20.92 (6.5)b. Groups with the same letters showed no statistically significant differences.

CONCLUSION

Scanning electron microscope analysis showed evident areas of micromorphological alterations in lased samples after 12 months of water storage. Nd:YAG laser irradiation of enamel through unpolymerized total-etch adhesive significantly reduced bond strength compared with the control. Bond strength decreased when enamel samples irradiated with Nd:YAG laser through unpolymerized adhesives were stored in water for 12 months.

Clinical evaluation of resin-based composites in posterior restorations: a 3-year study

OBJECTIVES

The aim of this study was to evaluate the clinical performance of a nanohybrid and a microhybrid composite in class I and II restorations after 3 years.

SUBJECTS AND METHODS

A total of 82 class I and class II restorations were performed in 31 patients (10 males and 21 females) using Grandio and QuiXfil with self-etch adhesives (Futurabond and Xeno III). The restorations were clinically evaluated by 2 operators 1 week after placement (baseline) and at 6 months and 1, 2, and 3 years using modified United States Public Health Service (USPHS) criteria. At the 3-year follow-up, 62 class I and class II cavities were reevaluated in 23 patients (7 males and 16 females). Statistical analysis was performed using Pearson's χ(2) and Fisher's exact tests (p < 0.05).

RESULTS

At the 6-month follow-up, all restorations received Alfa scores with respect to each evaluation criterion. At the 1-year follow-up, 2 QuiXfil restorations had to be replaced and Grandio restorations started to deteriorate in terms of marginal adaptation. At the end of 2 years, 9 Grandio restorations showed significant deterioration of the surface properties, demonstrating Bravo scores. At the end of 3 years, no significant differences were observed regarding color match, marginal adaptation, secondary caries, marginal discoloration, and anatomic form loss between the evaluated materials in 25 class I and 37 class II restorations. At the 3-year follow-up, Grandio restorations had 21% Bravo scores and showed significant deterioration of the surface properties, which were still clinically acceptable according to USPHS criteria. Three QuiXfil and 1 Grandio restorations were replaced because of secondary caries and loss of retention.

CONCLUSIONS

Both the nanohybrid (Grandio) and the microhybrid (QuiXfil) composites were clinically functional after 3 years.

Effect of sonic application mode on the resin-dentin bond strength and nanoleakage of simplified self-etch adhesive

OBJECTIVES

This study aims to evaluate the effect of different application modes on the immediate and 6-month resin-dentin bond strength (μTBS) and nanoleakage in the hybrid and adhesive layers.

MATERIALS AND METHODS

Three 1-step self-etch adhesives (One Coat 7.0 (OC), Clearfil S(3) Bond (CS), and FuturaBond NR (FB)) were applied on a flat superficial dentin surface of 30 human molars under manual mode or sonic vibration at a frequency of 170 Hz (SV). Composite build-ups were constructed incrementally; specimens were sectioned to obtain resin-dentin sticks with cross-sectional area of 0.8 mm(2) and tested in tension (0.5 mm/min) immediately (IM) or after 6 months (6M) of water storage. Two bonded sticks, from each tooth at each storage time, were immersed in a silver nitrate solution, photo-developed, and analyzed under scanning electron microscopy. The amount of nanoleakage was measured using the ImageTool 3.0 software. Data, from each adhesive, were analyzed by two-way ANOVA and Tukey's test (α = 0.05).

RESULTS

OC and CS showed higher μTBS and lower nanoleakage in the IM period when applied with SV groups. For FB, no significant difference was observed between the two modes of application. All materials showed lower nanoleakage in the SV groups. Higher nanoleakage was observed after 6M for OC and FB.

CONCLUSIONS

The sonic application mode at an oscillating frequency of 170 Hz can improve the resin-dentin μTBS, reduce the nanoleakage, and retard the degradation of the resin-dentin μTBS of Clearfil S(3) Bond and One Coat 7.0 adhesives.

CLINICAL SIGNIFICANCE

Sonic application mode at an oscillating frequency of 170 Hz can be helpful and easy to use in dental practice to guaranty long-lasting restorations.

Effect of thermal aging on the tensile bond strength at reduced areas of seven current adhesives

The purpose of this study was to determine the micro-tensile bond strength (MTBS) to dentin of seven adhesive systems (total and self-etch adhesives) after 24 h and 5,000 thermocycles. Dentin surfaces of human third molars were exposed and bonded with two total-etch adhesives (Adper Scotchbond 1 XT and XP Bond), two two-step self-etch adhesives (Adper Scotchbond SE and Filtek Silorane Adhesive System) and three one-step self-etch adhesives (G-Bond, Xeno V and Bond Force). All adhesive systems were applied following manufacturers' instructions. Composite buildups were constructed and the bonded teeth were then stored in water (24 h, 37 °C) or thermocycled (5,000 cycles) before being sectioned and submitted to MTBS test. Two-way ANOVA and subsequent comparison tests were applied at α = 0.05. Characteristic de-bonded specimens were analyzed using scanning electron microscopy (SEM). After 24 h water storage, MTBS values were highest with XP Bond, Adper Scotchbond 1 XT, Filtek Silorane Adhesive System and Adper Scotchbond SE and lowest with the one-step self-etch adhesives Bond Force, Xeno V and G-Bond. After thermocycling, MTBS values were highest with XP Bond, followed by Filtek Silorane Adhesive System, Adper Scotchbond SE and Adper Scotchbond 1 XT and lowest with the one-step self-etch adhesives Bond Force, Xeno V and G-Bond. Thermal aging induced a significant decrease in MTBS values with all adhesives tested. The resistance of resin-dentin bonds to thermal-aging degradation was material dependent. One-step self-etch adhesives obtained the lowest MTBS results after both aging treatments, and their adhesive capacity was significantly reduced after thermocycling.

Degree of conversion of two-step etch-and-rinse adhesives: In situ micro-Raman analysis

OBJECTIVES

DC of three commercial two-step etch-and-rinse adhesives across the dentine-adhesive interface was investigated using micro-Raman spectroscopy. The hypothesis tested was that no difference in DC would exist among the adhesives tested.

METHODS

Adper Scotchbond 1XT (3M ESPE), Prime&Bond NT (Dentsply DeTrey), and Ambar (FGM) were applied on human dentine disks (n=9). Composite increments of 2mm were then applied on the adhesive surface. Raman spectra were collected along the dentine-adhesive interface. The relative intensities of the peaks associated with the mineral (PO(4)(3-) at 960cm(-1)) and the adhesive (CC at 1640cm(-1); phenyl CC at 1610cm(-1)) were used to identify the adhesive within the hybrid layer and calculate its DC.

RESULTS

Adper Scotchbond 1XT and Ambar showed similar DC (79±7% and 77±7%, respectively), while a lower DC was found for Prime&Bond NT (70±7%; p<0.05).

CONCLUSIONS

The hypothesis tested was rejected because differences were found among the adhesives tested. The difference in DC among the three adhesive systems can be attributed to different monomer compositions and solvents. Further studies are needed to correlate DC with other mechanical properties of these adhesives.

CLINICAL SIGNIFICANCE

Insufficient polymerization of an adhesive can result in a weak hybrid layer, and the presence of unreacted monomers may result in degradation of the polymeric network, decreasing the strength and longevity of the bond. In the present study, Adper Scotchbond 1XT and Ambar performed significantly better than Prime&Bond NT.

Characterization of micro- and nanophase separation of dentin bonding agents by stereoscopy and atomic force microscopy

The aim was to study the effect of solvents on the phase separation of four commercial dental adhesives. Four materials were tested: Clearfil™ SE Bond (CSE), Clearfil Protect Bond (CPB), Clearfil S3 Bond (CS3), and One-Up Bond F Plus (OUB). Distilled water or ethanol was used as a solvent (30 vol%) for microphase separation studies, by stereoscopy. For nanophase images, the mixtures were formulated with two different solvent concentrations (2.5 versus 5 vol%) and observed by atomic force microscopy. Images were analyzed by using MacBiophotonics ImageJ to measure the area of bright domains. Macrophase separations, identified as a loss of clarity, were only observed after mixing the adhesives with water. Nanophase separations were detected with all adhesive combinations. The area of bright domains ranged from 132 to 1,145 nm² for CSE, from 15 to 285 nm² for CPB, from 149 to 380 nm² for CS3, and from 26 to 157 nm² for OUB. In water-resins mixtures, CPB was the most homogeneous and OUB showed the most heterogeneous phase formation. In ethanol-resin mixtures, CSE attained the most homogeneous structure and OUB showed the most heterogeneous phase. Addition of 5 vol% ethanol to resins decreased the nanophase separation when compared with the control materials.

Biomodification to dentin by a natural crosslinker improved the resin-dentin bonds

OBJECTIVES

Transient collagen cross-linking treatment by proanthocyanidins (PA), a natural crosslinker, was proved to increase the cross-linking degree and ultimate tensile strength of demineralised dentin. The present study aimed to investigate whether transient pretreatment by PA-based preconditioner can improve the resin-dentin bonds of various etch and rinse adhesives. The influence of solvent type, PA concentration and treatment duration were examined.

METHODS

PA-based preconditioners were prepared by adding powdered grape seed extract, rich in PA, to various solvents at different concentrations. They were used on demineralised dentin before the application of the bonding agent. Bond strength, failure modes and degree of conversion were evaluated via microtensile testing, field emission scanning electron microscopy and Fourier transform infrared spectroscopy, respectively.

RESULTS

Collagen cross-linking treatment by PA-based preconditioners presented a concentration- and time-dependent increase in dentin bond strength even in reduced, clinically applicable treatment duration. PA preconditioning improved bond strength of the tested water/ethanol-based adhesive better than the water/acetone-based system. Mixed fracture was the most prevalent failure mode happened on the top of the hybrid layer in PA-pretreated specimens, whilst at the bottom in non-treated controls. The degree of conversion was not significantly affected by PA pretreatment.

CONCLUSIONS

Transient PA preconditioning improved resin-dentin bonds without compromise on the curing behaviours of the tested adhesives.

Meta-analytical review of parameters involved in dentin bonding

Bond-strength testing is the method most used for the assessment of bonding effectiveness to enamel and dentin. We aimed to disclose general trends in adhesive performance by collecting dentin bond-strength data systematically. The PubMed and EMBASE databases were used to identify 2,157 bond-strength tests in 298 papers. Most used was the micro-tensile test, which appeared to have a larger discriminative power than the traditional macro-shear test. Because of the huge variability in dentin bond-strength data and the high number of co-variables, a neural network statistical model was constructed. Variables like 'research group' and 'adhesive brand' appeared most determining. Weighted means derived from this analysis confirmed the high sensitivity of current adhesive approaches (especially of all-in-one adhesives) to long-term water-storage and substrate variability.

Bonding to glass ionomer cements using resin-based adhesives

OBJECTIVE

This study compared the microshear bond strengths (MSBS) of four self-etching adhesives (Adper Scotchbond SE [SSE], Clearfil SE Bond [CSE], Clearfil S3 Bond [CS3] and One Coat 7.0 [OC]) and an etch-and-rinse adhesive (Adper Single Bond Plus [SB]) when bonded to two conventional glass ionomer cements (GICs) (Fuji IX GP EXTRA and Riva Self Cure). The null hypothesis tested was there is no difference in the adhesive ability of an etch-and-rinse adhesive and self-etching adhesives when bonded to GIC for up to 6 months.

METHODS

The GICs were embedded in type III dental stone and wet ground with 1200-grit SiC paper. Twenty specimens were bonded for each adhesive according to manufacturers' instructions with a 1.5-mm bonding diameter. Specimens were stored at 100% humidity for 24 hours, 1 month, or 6 months. Microshear bond strengths were obtained using a crosshead speed of 1 mm/min. The results were calculated and analyzed using analysis of variance (ANOVA) and Tukey HSD test.

RESULTS

SB had significantly lower MSBS than the four self-etching adhesives for all storage periods. MSBS at 6 months for SB was significantly lower than at 1 month. There were no significant differences in MSBS among the self-etching adhesives. Cohesive failure within GIC was the most common failure mode observed.

CONCLUSIONS

SB showed a lower bond strength than the self-etching adhesives when bonded to conventional GICs for all storage periods. This might be a result of the phosphoric acid etching. However, cohesive strength of GIC was a limiting factor for the MSBS outcomes.

Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin

Objective

The aims of this study were to evaluate the tensile bond strengths between indirect composites and dentin of 3 recently developed self-adhesive resin cements and to determine mode of failure by SEM.

Material and Methods

Exposed dentin surfaces of 70 mandibular third molars were used. Teeth were randomly divided into 7 groups: Group 1 (control group): direct composite resin restoration (Alert) with etch-and-rinse adhesive system (Bond 1 primer/adhesive), Group 2: indirect composite restoration (Estenia) luted with a resin cement (Cement-It) combined with the same etch-and-rinse adhesive, Group 3: direct composite resin restoration with self-etch adhesive system (Nano-Bond), Group 4: indirect composite restoration luted with the resin cement combined with the same self-etch adhesive, Groups 5-7: indirect composite restoration luted with self-adhesive resin cements (RelyX Unicem, Maxcem, and Embrace WetBond, respectively) onto the non-pretreated dentin surfaces. Tensile bond strengths of groups were tested with a universal testing machine at a constant speed of 1 mm/min using a 50 kgf load cell. Results were statistically analyzed by the Student's t-test. The failure modes of all groups were also evaluated.

Results

The indirect composite restorations luted with the self-adhesive resin cements (groups 5-7) showed better results compared to the other groups (p<0.05). Group 4 showed the weakest bond strength (p>0.05). The surfaces of all debonded specimens showed evidence of both adhesive and cohesive failure.

Conclusion

The new universal self-adhesive resins may be considered an alternative for luting indirect composite restorations onto non-pretreated dentin surfaces.

Adjunctive use of an anti-oxidant agent to improve resistance of hybrid layers to degradation

OBJECTIVE

To determine the role of an anti-oxidant agent (ascorbic acid-AA) on resin-dentin bonds resistance to degradation of two adhesives.

METHODS

Flat dentin surfaces from 48 human molars were bonded as per manufacturer's instructions with: a two-step etch-and-rinse self-priming adhesive (Single Bond-SB) and a two-step self-etch adhesive (Clearfil SE Bond-CSE). Half of the specimens were bonded with the same adhesives, but after the addition of 10% AA into their formulation. Resin composite build-ups were constructed incrementally and sectioned into resin-dentin beams (1.0mm(2)) that were stored under four conditions: (1) water immersion for 24h; (2) water immersion for 1 year; (3) water immersion for 4 years; and (4) chemical challenging (immersion in 10% NaOCl for 5 h). Beams were pulled to failure in tension at 0.5mm/min. Mean microtensile bond strength (MTBS) data were analysed with ANOVA and multiple comparisons tests (P<0.05). Analysis of debonded dentin beams was performed by scanning electron microscopy (SEM).

RESULTS

After 24 h, SB and CSE performed equally, regardless of AA incorporation. Inclusion of AA on CSE formulation decreased MTBS following one-year water storage, but maintained SB bond strength values even after four years of water storage. NaOCl challenge diminished MTBS for both adhesives, but when AA was added to SB, this reduction was significantly lower.

CONCLUSIONS

The inclusion of AA on adhesive's formulation exerts a protective role on resin-dentin bonds resistance to degradation when SB is used. Bonding durability of CSE may be compromised by the addition of sodium ascorbate.

Long-term effect of carbodiimide on dentin matrix and resin-dentin bonds

OBJECTIVES

To characterize the interaction of 1-Ethyl-3-[3-dimethylaminopropyl] carbodiimide Hydrochloride (EDC) with dentin matrix and its effect on the resin-dentin bond.

METHODS

Changes to the stiffness of demineralized dentin fragments treated with EDC/N-hydroxysuccinimide (NHS) in different solutions were evaluated at different time points. The resistance against enzymatic degradation was indirectly evaluated by ultimate tensile strength (UTS) test of demineralized dentin treated or not with EDC/NHS and subjected to collagenase digestion. Short- and long-term evaluations of the strength of resin-dentin interfaces treated with EDC/NHS for 1 h were performed using microtensile bond strength (microTBS) test. All data (MPa) were individually analyzed using ANOVA and Tukey HSD tests (alpha = 0.05).

RESULTS

The different exposure times significantly increased the stiffness of dentin (p < 0.0001, control-5.15 and EDC/NHS-29.50), while no differences were observed among the different solutions of EDC/NHS (p = 0.063). Collagenase challenge did not affect the UTS values of EDC/NHS group (6.08) (p > 0.05), while complete degradation was observed for the control group (p = 0.0008, control-20.84 and EDC/NHS-43.15). EDC/NHS treatment did not significantly increase resin-dentin muTBS, but the values remained stable after 12 months water storage (p < 0.05).

CONCLUSIONS

Biomimetic use of EDC/NHS to induce exogenous collagen cross-links resulted in increased mechanical properties and stability of dentin matrix and dentin-resin interfaces.

Slow progression of dentin bond degradation during one-year water storage under simulated pulpal pressure

OBJECTIVES

To evaluate the dentin bond durability of simplified adhesives after one-year (1 y) under water storage and simulated pulpal pressure.

METHODS

Class I cavities were prepared in sixty human third molars with the pulpal wall located in mid-coronal dentin. The roots were cut off to expose the pulpal chamber, and the teeth were assembled in a pulpal pressure simulator device. A two-step etch-and-rinse adhesive (Single Bond 2/SB), a two-step self-etch adhesive (Clearfil SE Bond/CSE), a three-step self-etch adhesive (Adper Scotchbond SE/SSE) and three all-in-one adhesives (Adper Easy Bond/EB, Clearfil S(3) Bond/S3 and Adhese One/AO) were applied according to manufacturers instructions. No enamel pre-etching was used for the self-etch systems. The cavities were filled with a composite (Z250, 3M ESPE) in four to five horizontal increments and individually cured. Immediately after the final cure, pulpal pressure was set to 15 cm H(2)O. After 24 h and 1 y under simulate pulpal pressure the teeth were cut following a 'nontrimming' microtensile test technique (n=30) and tested in tension. Kruskall-Wallis and post hoc multiple comparisons were used at alpha=0.05. Weibull statistics was applied to SB, CSE and EB. Fractographic analysis of debonded specimens was performed using scanning electron microscopy.

RESULTS

At 24 h and 1 y periods, SB showed higher bond strength means than all the others adhesives tested. CSE was not statistically different from EB at 24 h and from EB and SB at 1 y. EB showed bond strength statistically higher than the other three self-etch adhesives, which were not statistically different from each other at 24 h. AO showed significantly lower bond strength than all tested materials after 1 y. For all adhesives the mean bond strength at 1 y were not statistically different from the values measured at 24 h (p>0.05). Shifts in failure mode patterns and Weibull modulus decrease indicate some degree of bond degradation after the 1 y storage period.

CONCLUSION

One-year of simulated pulpal pressure did not affect dentin bond strength of simplified adhesives in Class I restorations. Signs of degradation were only revealed by fractographic analysis and reliability parameters.

Bond strength and nanoroughness assessment on human pretreated cementum surfaces

OBJECTIVES

To determine the bond strength of seven adhesive systems to human cementum, and to assess the promoted surface roughness.

METHODS

Extracted human canines were used for the present study. The mesial surface from the cervical third of the roots were ground flat with wet 600-grit silicon carbide paper and bonded. Seven adhesive systems were employed: an etch-and-rinse adhesive (Single Bond), two two-step self-etching (Clearfil SE Bond and Resulcin Aquaprime) and four one-step self-etching (One-up Bond F, Prompt-L-Pop, Etch and Prime 3.0 and NRC+Prime&Bond NT). Composite build-ups were constructed and stored in a humid environment for 24h at 37 degrees C. Specimens were sectioned into 1mm(2) beams and tested for microtensile bond strength (MTBS). Additional surfaces were conditioned for atomic force microscopy (AFM) analysis. Results were analyzed with ANOVA and Student-Newman-Keuls tests (P<0.05).

RESULTS

Single Bond showed the highest MTBS values. No differences were found between Resulcin Aquaprime, One-up Bond and Prompt-L-Pop. Clearfil SE Bond, Etch and Prime and NRC+Prime&Bond NT obtained the lowest bond strength values. H(3)PO(4) acid treatment of cementum and Resulcin Aquaprime showed the highest nanoroughness parameters and One-up Bond the lowest.

CONCLUSION

The etch-and-rinse adhesive and the two-step self-etching adhesive with the lowest pH value promoted the highest bond strength to human cementum surfaces.

The use of warm air stream for solvent evaporation: effects on the durability of resin-dentin bonds

This study evaluated the effect of a warm (W) or cold (C) air-dry stream for solvent evaporation on the immediate (IM) and six-month (6M) resin-dentin bond strength (microTBS) and silver nitrate uptake pattern (SNU) of two-step etch-and-rinse adhesive system (Adper Single Bond [SB] and Prime & Bond 2.1 [PB]). The adhesives were applied on demineralized dentin surfaces and a warm or cold air-dry stream (10 seconds) was applied followed by light-activation (10 seconds). After 24-hours of water storage, the specimens were serially sectioned in the "x" and "y" directions to obtain bonded sticks around 0.8 mm2 to be tested immediately or after six months of water storage. The specimens at each period were immersed in a 50% solution of silver nitrate, photodeveloped and analyzed by SEM for SNU. Higher IM microTBS values were observed for SB under W conditions. Both adhesives showed reductions in microTBS after 6M in both air temperatures. Regarding SEM, a low silver nitrate uptake was observed in the W groups either in IM or 6M for both adhesives.