The effect of simulated intrapulpal pressure on bond strength to enamel and dentine

Simulated Hydrostatic Pulpal Pressure Effect on Microleakage-An Initial Study

PURPOSE

This study's purpose was to evaluate the effect of simulated in vitro hydrostatic pulpal pressure (HPP) on microleakage.

METHODS AND MATERIALS

Extracted third molars (n=12) were sectioned 5 mm below the cementoenamel junction, pulp tissue removed, and the sectioned crowns mounted on a Plexiglas plate penetrated by an 18-gauge stainless steel tube. The mounted specimen mesial surface received a 2×4×6 mm Class V preparation followed by restoration with a strongly acidic, one-step dental adhesive and a flowable microfilled resin, following all manufacturers' instructions. Restorations were finished to contour, and tubing was attached to a 20-cm elevated, 0.2% rhodamine G reservoir to the specimen steel tube for 48 hours. Specimens then received a nail polish coating to within 1 mm of the restoration margins and were placed in 2% methylene blue (MB) dye for 24 hours, followed by rinsing, embedding in epoxy resin, and sectioning into 1 mm slices using a diamond saw. Controls were intact molars (n=12) processed as above but without HPP. Specimen slices were evaluated using laser confocal microscopy with images exported to ImageJ software with microleakage assessed as the MB linear penetration as a percentage of the total interfacial wall length. Mean values were evaluated with the Kruskal Wallis/Dunn test at a 95% confidence level.

RESULTS

The control specimens demonstrated significantly greater (p<0.0001) MB penetration than experimental specimens with simulated HPP. Under this study's conditions, simulated HPP significantly decreased MB dye penetration.

CONCLUSION

Studies accomplished without simulated HPP may overestimate microleakage results.

Effect of preheating of low shrinking resin composite on intrapulpal temperature and microtensile bond strength to dentin

The effect of preheating of the silorane-based resin composite on intrapulpal temperature (IPT) and dentin microtensile bond strength (μTBS) was evaluated. For the IPT, teeth (n = 15) were sectioned to obtain discs of 0.5 mm thickness (2 discs/tooth). The discs were divided into three groups (n = 10/group) according to the temperature of the Filtek LS™ silorane-based resin composite during its placement, either at room temperature (23 ± 1 °C) or preheated to 54 °C or 68 °C using a commercial Calset™ device. Discs were subjected to a simulated intrapulpal pressure (IPP) and placed inside a specially constructed incubator adjusted at 37 °C. IPT was measured before, during and after placement and curing of the resin composite using K-type thermocouple. For μTBS testing, flat occlusal middentin surfaces (n = 24) were obtained. P90 System Adhesive was applied according to manufacturer’s instructions then Filtek LS was placed at the tested temperatures (n = 6). Restorative procedures were done while the specimens were connected to IPP simulation. IPP was maintained and the specimens were immersed in artificial saliva at 37 °C for 24 h before testing. Each specimen was sectioned into sticks (0.9 ± 0.01 mm²). The sticks (24/group) were subjected to μTBS test and their modes of failure were determined using scanning electron microscope (SEM). For both preheated groups, IPT increased equally by 1.5–2 °C upon application of the composite. After light curing, IPT increased by 4–5 °C in all tested groups. Nevertheless, the IPT of the preheated groups required a longer time to return to the baseline temperature. One-way ANOVA revealed no significant difference between the μTBS values of all groups. SEM revealed predominately mixed mode of failure. Preheating of silorane-based resin composite increased the IPT but not to the critical level and had no effect on dentin μTBS.

Bond durability of self-etch adhesive to ethanol-based chlorhexidine pretreated dentin after storage in artificial saliva and under intrapulpal pressure simulation

OBJECTIVE

To evaluate the bond strength durability of a single-step self-etch adhesive to dentin pretreated with either ethanol-based chlorhexidine (ECHX) or water-based chlorhexidine (WCHX) after storage in artificial saliva and under intrapulpal pressure simulation (IPPS).

METHODS

The occlusal enamel of 30 freshly extracted premolars was trimmed to expose midcoronal dentin. Roots were sectioned to expose the pulp chamber. Specimens were distributed over three groups (n=10) according to the dentin pretreatment used. In the first group, Adper Easy One (3M ESPE) was applied to the dentin surfaces according to the manufacturer's instructions (control group). In the second group, dentin was pretreated before bonding with 1 mL of 2% CHX diacetate dissolved in 100% ethanol (ECHX). The third group received the same pretreatment; however, CHX was dissolved in distilled water (WCHX). Pretreatment and bonding were carried out while the specimens were subjected to IPPS. Resin composite (Valux Plus, 3MESPE) buildups were made. After curing, specimens were stored in artificial saliva and under IPPS at 37°C in a specially constructed incubator (n=5/group) either for 24 hours or six months prior to testing. Thereafter, bonded specimens were sectioned into sticks with a cross section of 0.9 ± 0.01 mm(2) and subjected to microtensile bond strength (μTBS) testing (n=25/subgroup) using a universal testing machine. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA , and Bonferroni post hoc tests (p≤0.05). Failure modes were determined using a scanning electron microscope.

RESULTS

After 24 hours of storage, control and WCHX groups revealed significantly higher μTBS than the ECHX group. After six-month storage in artificial saliva and IPPS, only the WCHX group maintained its μTBS value. The predominant mode of failure was the mixed type, except for the ECHX group, which was mostly adhesive.

CONCLUSION

Pretreatment of the dentin with ECHX had a negative effect on bonding of the tested single-step self-etch adhesive; however, WCHX showed bond stability under IPPS.

Bond durability of adhesives containing modified-monomer with/without-fluoride after aging in artificial saliva and under intrapulpal pressure simulation

OBJECTIVE

To evaluate the dentin bond strength durability of adhesives containing modified-monomer with/without-fluoride after storage in artificial saliva and under intrapulpal pressure simulation (IPPS).

MATERIALS AND METHODS

The occlusal enamel of 48 freshly extracted teeth was trimmed to expose midcoronal dentin. Roots were sectioned to expose the pulp chamber and to connect the specimens to the pulpal-pressure assembly. Specimens were assigned into four groups (n=12) according to adhesive system utilized: a two-step etch-and-rinse adhesive system (SB, Adper Single Bond 2, 3M ESPE), a two-step self-etch adhesive system (CSE, Clearfil SE Bond, Kuraray Medical Inc), and two single-step self-etch adhesives with the same modified monomer (bis-acrylamide)-one with fluoride (AOF, AdheSE One F, Ivoclar-Vivadent) and the other without (AO, AdheSE One, Ivoclar-Vivadent). Bonding was carried out while the specimens were subjected to 15-mm Hg IPPS. Resin composite (Valux Plus, 3M ESPE) buildups were made. After curing, specimens were aged in artificial saliva and under 20-mm Hg IPPS at 37°C in a specially constructed incubator either for 24 hours or six months prior to testing. Bonded specimens (n=6/group) were sectioned into sticks (n=24/group) with a cross section of 0.9 ± 0.01 mm(2) and subjected to microtensile bond strength (μTBS) testing using a universal testing machine. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA tests, and a t-test (p<0.05). Failure modes were determined using a scanning electron microscope.

RESULTS

The μTBS values of SB and CSE fell significantly after six-month storage in artificial saliva and under IPPS, yet these values remained significantly higher than those for the other two adhesives with modified monomers. There was no significant difference in the bond strength values between fluoride-containing and fluoride-free self-etch adhesive systems (AOF and AO) after 24 hours or six months. Modes of failure were mainly adhesive and mixed.

CONCLUSIONS

Based on the results of this study, 1) Fluoride addition did not affect dentin bond durability; and 2) despite the fact that the single-step adhesive system with modified monomer showed stability, bond strengths associated with these systems remained lower than those of multistep adhesive systems.

Influence of caries infiltrant contamination on shear bond strength of different adhesives to dentin

OBJECTIVES

To analyze whether the contamination with a caries infiltrant system impairs the adhesive performance of etch-and-rinse and self-etching adhesives on dentin.

MATERIALS AND METHODS

Dentin contamination with the caries infiltrant system (Icon, DMG) was simulated by applying either hydrochloric acid (15 % HCl, Icon Etch, 15 s), the resin infiltrant (Icon infiltrant, 4 min), or both prior to the application of the respective adhesives (each group n = 10). In the control groups, the etch-and-rinse adhesive (Optibond FL, Kerr) and the self-etching adhesive (iBOND Self Etch, Hereaus) were applied without former contamination with the infiltrant system. Additionally, the adhesive performance of the resin infiltrant alone was tested. Shear bond strength of a nano-hybrid composite was analyzed after thermocycling (5,000×, 5-55°C) of the specimens and analyzed by ANOVA/Scheffé post hoc tests (p < 0.05) and Weibull statistics. Failure mode was inspected under a stereomicroscope at × 25 magnification.

RESULTS

Contamination with the resin infiltrant alone did not impair shear bond strength, while contamination with hydrochloric acid or with hydrochloric acid and the resin infiltrant reduced shear bond strength (MPa) of the adhesives (Optibond FL: 20.5 ± 3.6, iBOND Self Etch: 17.9 ± 2.6) significantly. Hydrochloric acid contamination increased the number of adhesive failures. The adhesive performance of the caries infiltrant system alone was insufficient.

CONCLUSION

The contamination with the caries infiltrant system impaired the shear bond strength of conventional dental adhesives.

CLINICAL RELEVANCE

Contamination of the caries infiltrant system on dentin should be avoided due to the detrimental effect of hydrochloric acid etching.

Effect of placement agitation and drying time on dentin shear bond strength: an in vivo study

The current study measured the bond strength of a self-etch system to dentin with and without agitation and with varying drying times of primer in vital dentin. The null hypotheses tested were that primer agitation and primer drying time did not affect the dentin shear bond strength. Sixty human maxillary and mandibular premolars scheduled to be extracted for orthodontic reasons were selected. The adhesive/resin combination used was Clearfil SE (Kuraray, Osaka, Japan)/TPH Spectrum (Dentsply DeTrey, Konstanz, Germany). The occlusal surfaces of the teeth were flattened using straight fissure diamond abrasive points ISO-012. Samples were divided into six groups of 10 teeth each. Primer was applied following the manufacturer's instructions with and without agitation followed by air-drying time of 0 (without air drying), five and 10 seconds. Clearfil SE Bond was applied and cured for 10 seconds. TPH Spectrum composite, shade A2 (Dentsply DeTrey), was placed over cured adhesive and was cured for 40 seconds. The teeth were restored to their original anatomy. The teeth were extracted after one week and the samples were kept in distilled water until testing at room temperature. The samples were tested in shear at a 1 mm/minute crosshead speed using an LR100 Universal Testing Machine. The data was analyzed using ANOVA and Tukey post-hoc tests (p < 0.05). Varying the drying time of the primer from zero (0) to 10 seconds did not significantly affect the bond strength values in vivo. At five seconds drying time, agitation significantly improved the shear bond strength to dentin. Agitation showed no effect when primer was not dried or it was dried for 10 seconds.

Shear bond strength of self-etching adhesive systems to Er:YAG laser-prepared dentine with and without pulpal pressure simulation

OBJECTIVE

This study was conducted to study the role of pulpal pressure on the shear bond strength of composite resin bonded to Er:YAG laser-prepared or bur-prepared dentine surfaces using a self-etching adhesive system.

MATERIALS AND METHODS

The occlusal surfaces of 80 human third molars were ground flat to expose the dentine. The dentine was prepared using either a carbide bur or an Er:YAG laser at 350 mJ/pulse and 10 Hz (fluence 44.5 J/cm(2)). Clearfil SE Bond was then applied with or without pressure. Rods of composite resin were bonded to dentine surfaces and shear bond tests were carried out.

RESULTS

When the Clearfil SE Bond was used without pressure, the difference between the shear bond strength values of bur-prepared and laser-prepared dentine surfaces was significant. When the Clearfil SE Bond was used with pressure, the difference of shear bond strength values was not significant between the two types of surface preparation.

CONCLUSION

The absence of smear layer formation during the preparation of the dentine by the Er:YAG laser did not improve the adhesion values of self-etching adhesive systems.

Adhesive performance of dentin bonding agents appliedin vivo andin vitro. Effect of intrapulpal pressure and dentin depth

The purpose of this study was to evaluate the influence of intrapulpal pressure and dentin depth on bond strengths of an etch-and-rinse and a self-etching bonding agent to dentin in vitro and in vivo. Twenty-four pairs of premolars were randomly divided into four groups (n = 6) according to the dentin bonding agent, Single Bond and Clearfil SE Bond, and intrapulpal pressure, null or positive. Each tooth of the pair was further designated to be treated in vivo or in vitro. The intrapulpal pressure was controlled in vivo by the delivery of local anesthetics containing or not a vasoconstrictor, while in vitro, it was achieved by keeping the teeth under hydrostatic pressure. Class I cavities were prepared and the dentin bonding agents were applied followed by incremental resin restoration. For the teeth treated in vitro, the same restorative procedures were performed after a 6 month-storage period. Beams with 1 mm(2) cross-sectional area were prepared and microtensile tested. Clearfil SE Bond was not influenced by any of the variables of the study, while bond strengths produced in vitro were significantly higher for Single Bond. Overall, lower bond strengths were produced in deep dentin, which reached statistical significance when Single Bond was applied under physiological or simulated intrapulpal pressure. In conclusion, in vitro bonding may overestimate the immediate adhesive performance of more technique-sensitive dentin bonding systems. The impact of intrapulpal pressure on bond strength seems to be more adhesive dependent than dentin morphological characteristics related to depth.