Bond strength of five current adhesives to caries-affected dentin

Biodentine or Mineral Trioxide Aggregate as Direct Pulp Capping Material in Mature Permanent Teeth with Carious Exposure? A Systematic Review and Meta-analysis

OBJECTIVE

To evaluate the success rate of direct pulp capping (DPC) with Biodentine in mature permanent teeth with carious vital pulp exposure compared to that of DPC with mineral trioxide aggregate (MTA) by means of a systematic review and meta-analysis.

DATA SOURCES

The two authors searched independently the literature published through July 31, 2020, in five electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science Core Collection, the Wiley Online Library, and the SCOPUS database).

STUDY SELECTION

The research protocol was previously registered in the PROSPERO database (CRD42020192511). Clinical studies that met the inclusion criteria were chosen and independently screened by the authors.

DATA EXTRACTION

A custom-designed spreadsheet was used to extract the data. The quality of each study was evaluated by means of the revised Cochrane risk of bias (ROB) tool or the ROB of nonrandomized studies of interventions tool.

DATA SYNTHESIS

Three randomized controlled trials and one retrospective study met the inclusion criteria. Only one study had a high risk of bias. The included studies reported data on a total of 95 participants with an age range of 8-51 years. No significant difference was observed in the overall treatment outcome when comparing Biodentine with MTA (Risk ratio=1.00, 95% confidence interval [0.93-1.07], p=1.00).

CONCLUSIONS

Biodentine had comparable clinical and radiographic success to that of MTA when used as a DPC agent in mature permanent teeth with carious vital pulp exposure. Additional high-quality studies are needed.

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.

Effect of caries-affected dentin on one-step universal and multi-step etch-and-rinse adhesives’ bond strength

Abstract Objective To evaluate the influence of caries-affected dentin on bond strength of a universal one-step and a multi-step etch-and-rinse adhesive system. Material and method Enamel of 60 third human molars with and without caries was removed to expose dentin. The teeth were randomly assigned to six groups: Single Bond Universal (3M ESPE, St. Paul, MN, USA) in etch-and-rinse and in self-etch mode and Prime & Bond NT (Dentsply Co, Konstanz, Germany), all on sound and caries-affected dentin. Smear layer of the 30 sound dentin specimens was standardized by polishing with 600-grit SiC paper under water cooling. Residual infected dentin of the 30 caries-affected specimens was removed with a number 4 CA carbide bur until no caries smooth tissue was detectable by tactile-visual inspection. Cylinders of a light cured composite resin (Filtek Z350 XT, 3M ESPE) were built up using starch tubes and microshear test was performed until failure. The data was analyzed by one-way ANOVA and Tukey’s post hoc test. Result Significant differences in microshear bond strength (μSBS) were observed for the caries-affected groups, but not for sound dentin. The μSBS of Single Bond Universal were not influenced by the application protocol on sound dentin, however they were lower in the caries-affected group with both application protocols. The μSBS for Prime & Bond NT was not influenced by the dentin conditions. Conclusion Caries-affected dentin decrease in bond strength of Single Bond Universal in comparison to sound dentin. The bond strength of Prime & Bond NT was not altered by substrate conditions.

Effects of Er:YAG laser on bond strength of self-etching adhesives to caries-affected dentin

The erbium:yttrium-aluminum-garnet (Er:YAG) laser may be effective the bond strength of adhesive systems on dentine surfaces, the chemical composition and aggressiveness of adhesive systems in clinical practice. The purpose of this study was to evaluate the effects of the Er:YAG laser system with the bonding ability of two different self-etching adhesives to caries-affected dentine in primary molars. Ninety mid-coronal flat dentine surfaces obtained from sound and caries-affected human primary dentine were treated with an Er:YAG laser or a bur. The prepared surfaces were restored with an adhesive system (Xeno V; Clearfil S³) and a compomer (Dyract Extra). The restored teeth were sectioned with a low-speed saw and 162 samples were obtained. The bond strength of the adhesive systems was tested using the micro-tensile test method. The data were statistically analyzed. A restored tooth in each group was processed for scanning electron microscopy evaluation. The values of the highest bond strength were obtained from the Clearfil S³-Er:YAG laser-sound dentine group in all groups. (24.57 ± 7.27 MPa) (P > 0.05). The values of the lowest bond strength were obtained from the Xeno V-Er:YAG laser-sound dentine group in all groups (11.01 ± 3.89 MPa). It was determined that the Clearfil S³ increased the bond strength on the surface applied with Er:YAG laser according to the Xeno V.

Microleakage effect on class V composite restorations with two adhesive systems using different bleaching methods

OBJECTIVE

The main objective of this study was to evaluate the effects of an at-home and two in-office (chemically activated and KTP laser-activated) bleaching methods on the microleakage of composite resin restorations bonded with etch-and-rinse and self-etch adhesive systems.

MATERIALS AND METHODS

Class V cavity preparations were performed on 96 premolars and teeth were divided into two groups according to the two adhesive systems (etch-and-rinse and self-etch). After cavities were restored with an adhesive systems and composite resin, they were submitted to thermocycling procedures. Teeth were divided into four sub-groups according to the bleaching systems (control, at-home bleaching, chemically activated office bleaching and KTP laser-activated office bleaching). After the bleaching procedure, teeth were evaluated for marginal leakage. All data were analyzed using the Mann-Whitney U and Kruskal-Wallis tests (p < 0.05).

RESULTS

The results of the present study showed that the control group presented lower microleakage values compared with the groups treated with bleaching agents, except for the chemically activated in-office bleaching. When the scores of microleakage at the enamel and gingival margins of the four groups were compared, the differences among the groups were found to be statistically significant (p < 0.05). Comparing the gingival and enamel margins in each group, statistically significant differences were found in the at-home group (p < 0.05) and no significant differences were seen in the other groups (p > 0.05). No significant difference was found between the adhesive systems after treatment with the same bleaching techniques.

CONCLUSION

Under the conditions of this study, microleakage of composite resin restorations differs according to the bleaching methods used and no difference was found between the adhesive systems.

Micro-tensile bond strength and interfacial characterization of an adhesive bonded to dentin prepared by contemporary caries-excavation techniques

OBJECTIVES

To evaluate the micro-tensile bond strength (μTBS) and interfacial characteristics of adhesive-dentin bonds produced after caries-removal with contemporary techniques.

METHODS

Carious molars were cut at the base of the fissure, exposing 'sound' and 'carious' dentin at different spots. After caries-excavation, a composite was bonded using a 2-step self-etch adhesive. The μTBS was measured and the mode of fracture analyzed using a stereomicroscope and imaged by Feg-SEM, while additional non-fractured specimens were histologically analyzed after Masson's trichrome staining in order to identify potentially incompletely resin-enveloped collagen.

RESULTS

μTBS to residual caries-excavated dentin was lower than to sound dentin. The different caries-removing techniques had a significant effect on the μTBS. Er:YAG laser guided by a LIF-feedback system (Kavo) resulted in the lowest μTBS (26.8% lower than to 'sound' dentin) and a distinct layer of incompletely resin-enveloped collagen at the interface. Although different degrees of collagen exposure were seen for other caries-removing techniques, such as a thick layer for CeraBur (Komet-Brasseler), some unprotected collagen areas for Cariex (Kavo), or completely resin-enveloped collagen for a tungsten-carbide-bur (Komet), the μTBS appeared not directly affected (10%, 16.6%, and 15.3% lower than to 'sound' dentin, respectively). Carisolv (MediTeam) resulted in the highest μTBS (only 1% reduction compared to that to 'sound' dentin), followed by the tungsten-carbide-bur aided by Caries Detector (Kuraray) (4.8% reduction). Enzymatic caries excavation using the experimental SFC-VIII (3M-ESPE) aided by a disposable plastic instrument resulted in a 19.4% reduction in μTBS as compared to that to 'sound' dentin.

SIGNIFICANCE

The dentin bonding receptiveness depends to a large extent on the caries-excavation method employed.

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.

Effect of Er,Cr: YSGG Laser on the Microtensile Bond Strength of Two Different Adhesives to the Sound and Caries-affected Dentin

The microtensile bond strength of a three-step etch-and-rinse and a two-step self-etch adhesive is not negatively affected by Er,Cr:YSGG laser irradiation in sound and caries-affected dentin.

Influence of different tooth types on the bond strength of two orthodontic adhesive systems

The aim of this investigation was to evaluate the effects of different tooth types on the shear bond strength (SBS) of two orthodontic resin adhesive systems in vitro.

Two hundred extracted sound human teeth were used in the study. Ten teeth of each tooth type were the mounted in acrylic resin leaving the buccal surface of the crowns parallel to the base of the moulds. In each experimental group, the adhesives (Transbond XT™ and Light Bond™) were applied to the etched enamel surfaces. The orthodontic composite resins were then applied to the surface in cylindrical-shaped plastic matrices. For SBS testing, a force transducer (Ultradent™) was applied at a crosshead speed of 1 mm/minute at the interface between the tooth and composite until failure occurred. Data were analysed using two-way analysis of variance (ANOVA), Kruskal–Wallis one-way ANOVA, a Bonferroni adjusted Mann–Whitney U-test, and an independent t-test.

Generally, it was found that tooth type had a significant effect on SBS (P < 0.05) with Light Bond™ showing a higher SBS than Transbond XT™ (P < 0.05). The highest bond strengths were observed for the upper central incisor and lower molars with Light Bond™ (P < 0.05) and the lowest mean bond strengths for the upper molars and lower canine with Transbond XT™ (P <0.05). The results demonstrated that enamel SBS was significantly altered by both tooth type and adhesive system. Thus, the findings of this study confirm that enamel bond strength is not uniform for all teeth. These results may also explain the variability in the enamel-bonding efficacy of adhesives.

Bond strength of two total-etching bonding systems on caries-affected and sound primary teeth dentin

AIM

As bond strength of currently available adhesive systems in caries-affected teeth dentin on primary tooth dentin was not well known, the bond strength of two bonding systems (PQI and OptiBond Solo Plus) was evaluated on caries-affected and sound primary molar tooth dentin and observed the micromorphology of the adhesive-dentin interfaces.

METHODS

By grinding both the sound (n = 30) and caries-affected (n = 30) approximal surfaces of teeth, flat dentin surfaces were obtained. The prepared surfaces were bonded with one of the each adhesive systems and a composite resin. After storing the bonded specimens in water at 37 degrees C for 24 h, the samples were sectioned and the bond strength of the adhesive systems was tested by the microshear test method. The data were statistically analysed.

RESULTS

Microshear bond strengths of PQI group for caries-affected and sound primary tooth dentin were 9.43 +/- 2.44 (MPa) and 9.32 +/- 2.95 (MPa) (P > 0.05), respectively, and the bond strengths of OptiBond Solo Plus group for caries-affected and sound primary tooth dentin were 15.33 +/- 3.59 (MPa) and 11.96 +/- 2.30 (MPa) (P < 0.05), respectively. Micromorphological features between sound and caries-affected dentin were similar in both PQI and OptiBond Solo Plus groups.

CONCLUSION

Both the adhesives showed significantly different bond strengths in caries-affected dentin but showed similar bond strengths in sound dentin.

Microtensile Bond Strength of Resin Composite Bonded to Caries-affected Dentin with Three Adhesives

Compared to two other adhesives, a self-etch adhesive resulted in higher microtensile bond strength values when used to bond a resin composite to both sound and caries-affected dentin.

Shear Bond Strength of Two Resin Cements to Human Root Dentin Using Three Dentin Bonding Agents

The application of 15% EDTA solution was shown to be an alternative to the commonly used 37% phosphoric acid in the bonding procedures of resin cements. The self-etching adhesive tested was found to improve bond strength more than one-bottle adhesives.

The effect of the air-blowing step on the technique sensitivity of four different adhesive systems

PURPOSE

To evaluate the technique sensitivity of four different adhesive systems using different air-blowing pressure.

METHODS

Four adhesive systems were employed: Clearfil SE Bond [SE] (Kuraray, Japan), G-Bond [GB] (GC Corporation, Japan), Adper Prompt L-Pop [LP] (3M ESPE, USA) and an experimental adhesive, SSB-200 [SSB] (Kuraray, Japan). Twenty-four extracted molars were used. After grinding the coronal enamel surface, the teeth were divided into two equal groups. The first group's teeth were randomly assigned for bonding with the different adhesives using gentle air-blowing (g). For the teeth of the second group, the four adhesive systems were applied using strong air-blowing (s). After storage overnight in 37 degrees C water, the bonded specimens were sectioned into sticks (1 mm x 1 mm wide), which were subjected to microtensile bond strength testing (microTBS) at a crosshead speed of 1 mm/min. The load at failure of each specimen was recorded and the data were analyzed by one-way ANOVA and Tukey HSD tests. The surfaces of the fractured specimens were observed using SEM to determine the failure mode.

RESULTS

The results of the microTBS test showed that the highest bond strengths tended to be with SE for both gentle and strong air-blowing, and the significantly lowest for SSB with strong air streaming. Comparing the two techniques, significant differences were noted only for SSB-200 (P < 0.05). For each material, the SEM evaluation did not show distinct differences in the nature of the fractures between the two techniques, except for SSB-200.

CONCLUSIONS

The adhesives tested are not technique sensitive, except SSB-200, with regards to the air-blowing step.

Shear Bond Strengths of Self-etching Adhesives to Caries-affected Dentin on the Gingival Wall

The purpose of this study was to evaluate the bonding ability of five current self-etching adhesives to caries-affected dentin on the gingival wall. Seventy extracted human molars with approximal dentin caries were employed in this study. In order to obtain caries-affected dentin on the gingival wall, grinding was performed under running water. Following which, specimens mounted in acrylic blocks and composite resins of the bonding systems were bonded to dentin with plastic rings and then debonded by shear bond strength. With Clearfil SE Bond, bonding to caries-affected dentin showed the highest bond strength. With Optibond Solo Plus Self-Etch, bonding to caries-affected dentin showed higher shear bond strength than AQ Bond, Tyrian SPE & One-Step Plus, and Prompt-L-Pop (p<0.05). Further, the bond strengths of Clearfil SE Bond and Optibond Solo Plus Self-Etch to sound dentin were higher than those of Prompt-L-Pop, AQ Bond, and Tyrian SPE & One-Step Plus (p<0.05). In conclusion, besides micromechanical interlocking through hybrid layer formation, bond strength of self-etch adhesives to dentin may be increased from additional chemical interaction between the functional monomer and residual hydroxyapatite. The results of this study confirmed that differences in bond strength among self-etching adhesives to both caries-affected and sound dentin were due to chemical composition rather than acidity.

The effect on shear bond strength of different antimicrobial agents after acid etching

The aim of the present study was to determine whether the application of different primers containing antibacterial agents (Micro Prime, Seal&Protect, and Gluma Desensitizer) can affect the shear bond strength (SBS) of an orthodontic resin composite. Seventy-two crowns of extracted lower human incisors were mounted in acrylic resin leaving the buccal surface of the crowns parallel to the base of the moulds. The teeth were randomly distributed into three experimental and one control group, each containing 18 teeth. In each experimental group, the primers were applied to the etched enamel surfaces. In the control group, no antibacterial primer was used. An orthodontic composite resin was applied to the surface into cylindrical-shaped plastic matrices after application of an orthodontic adhesive primer (Transbond XT). For shear bond testing, a stubby-shaped force transducer apparatus (Ultradent) was applied at a crosshead speed of 1 mm/minute to each specimen at the interface between the tooth and the composite until failure occurred. A Kruskal-Wallis one-way ANOVA and a Mann-Whitney U-test with a Bonferroni adjustment were used for statistical analysis. There was no significant difference between Seal&Protect (27.98 +/- 8.73 MPa) and the control (35.15 +/- 7.85 MPa) (P > 0.05). However, Gluma (21.61 +/- 7.96 MPa) and Micro Prime (14.89 +/- 5.55 MPa) caused a decrease in bond strength (P < 0.05). No statistically significant difference was observed between Seal&Protect and Gluma (P > 0.05). As triclosan containing Seal&Protect did not cause a significant decrease in bond strength, it can potentially be used under an orthodontic resin composite to obtain an antibacterial effect. However, further in vivo studies are required.

Analysis of tensile bond strengths using Weibull statistics

Tensile strength tests of restorative resins bonded to dentin, and the resultant strengths of interfaces between the two, exhibit wide variability. Many variables can affect test results, including specimen preparation and storage, test rig design and experimental technique. However, the more fundamental source of variability, that associated with the brittle nature of the materials, has received little attention. This paper analyzes results from micro-tensile tests on unfilled resins and adhesive bonds between restorative resin composite and dentin in terms of reliability using the Weibull probability of failure method. Results for the tensile strengths of Scotchbond Multipurpose Adhesive (3M) and Clearfil LB Bond (Kuraray) bonding resins showed Weibull moduli (m) of 6.17 (95% confidence interval, 5.25-7.19) and 5.01 (95% confidence interval, 4.23-5.8). Analysis of results for micro-tensile tests on bond strengths to dentin gave moduli between 1.81 (Clearfil Liner Bond 2V) and 4.99 (Gluma One Bond, Kulzer). Material systems with m in this range do not have a well-defined strength. The Weibull approach also enables the size dependence of the strength to be estimated. An example where the bonding area was changed from 3.1 to 1.1 mm diameter is shown. Weibull analysis provides a method for determining the reliability of strength measurements in the analysis of data from bond strength and tensile tests on dental restorative materials.

Effect of nonvital bleaching with 10% carbamide peroxide on sealing ability of resin composite restorations

AIM

To (i) determine the effect of nonvital bleaching with 10% carbamide peroxide on the sealing ability of resin composite restorations bonded with a self-etching adhesive system; and (ii) compare the effects of antioxidant treatment and delayed restoration after bleaching on marginal seal.

METHODOLOGY

Forty-eight noncarious maxillary incisors were divided into four groups (n=12) after conventional root canal treatment was completed. In group 1, access cavities were restored with a self-etching adhesive system and resin composite. In the remaining three groups, 10% carbamide peroxide bleaching gel was placed into the access cavities for periods of 8 h per day for 1 week. They were then restored in the same manner as group 1. Group 2 consisted of specimens restored immediately after bleaching. Group 3 specimens were treated with the antioxidant, 10% sodium ascorbate, whereas group 4 specimens were immersed in artificial saliva for 1 week before restoration. Ten specimens in each group were then subjected to dye leakage; the remaining 2 specimens were examined in a SEM (Jeol/JSM 5200, Tokyo, Japan). The dye penetration was assessed with the standard scoring system. Statistical analysis was carried out using the Kruskal-Wallis and the Mann-Whitney tests.

RESULTS

Groups 1, 3 and 4 exhibited similar leakage patterns and significantly less leakage than group 2 (P<0.0083). SEM examination of groups 1, 3 and 4 specimens demonstrated close adaptation of resin composite to cavity walls, whereas group 2 specimens did not.

CONCLUSION

Nonvital bleaching with 10% carbamide peroxide adversely affected the immediate sealing ability of resin composite restoration; both 10% sodium ascorbate treatment and a 1-week delay in restoration following bleaching improved the reduced sealing ability of resin composite.