Dentin bond shear strength and microleakage for Syntac/Heliomolar: a comparison between the manufacturer's and total etch technique

Chlorhexidine release and water sorption characteristics of chlorhexidine-incorporated hydrophobic/hydrophilic resins

OBJECTIVES

The aim of this study was to evaluate chlorhexidine release from unfilled non-solvated methacrylate-based resins of increasing hydrophilicity and to examine relationships among Hoy's solubility parameters, water sorption, solubility and the rate of chlorhexidine release.

METHODS

Resin discs were prepared from light-cured, experimental resin blends (R1, R2, R3, R4 and R5) containing 0.0, 0.2, 1.0 and 2.0 wt.% chlorhexidine diacetate (CDA). Discs were immersed in distilled water at 37 degrees C, and mass changes were recorded at different periods. Spectral measurements were made to follow change in optical densities of storage solution to examine chlorhexidine release kinetics. After a 28-day period, water sorption, solubility, and the cumulative chlorhexidine release were obtained. Additionally, antibacterial study was performed by observing the presence of inhibition zone against Streptococcus mutans.

RESULTS

The most hydrophilic resin (R5) exhibited the highest chlorhexidine release rate. The most hydrophobic resin (R1) exhibited the lowest rate. However, no inhibition zone was produced by any specimens stored in water for 2 weeks. The addition of CDA increased solubility significantly but had no effect on water sorption. Significant positive correlations were seen between water sorption and the cumulative chlorhexidine release.

SIGNIFICANCE

Chlorhexidine release from resins may be related to water-induced swelling, which in turn is enhanced by the hydrophilicity of cured polymer matrix.

The effect of six years of water storage on resin composite bonding to human dentin

The aim of this in vitro study was to evaluate dentin bond strength and marginal adaptation of direct resin composite fillings after different storage times. Three hundred sixty cavities were prepared in discs of freshly extracted human third molars and filled with resin composites. Multistep self-etching adhesives (Syntac Classic, A.R.T. Bond, both with and without total etching), three-step etch-and-rinse adhesives (Scotchbond Multi-Purpose Plus, EBS), and two-step etch-and-rinse adhesives (Prime and Bond 2.0, Syntac Single-Component) were used for bonding. After 1, 90, and 2190 days of water storage and 24 h thermocycling (1150 cycles), push-out testing was performed. From the 6-year group, replicas were made after 1 day, 90 days, and 1, 2, 3, 4, 5, and 6 years, and examined regarding marginal adaptation under an SEM (x 200 magnification). In all groups under investigation, push-out bond strengths remained stable after 90 days; however, the strengths significantly decreased after 6 years of water storage. The two-step systems exhibited lower bond strengths than three-step systems after 6 years. Marginal analysis revealed a significant loss regarding the percentage of perfect margins having been stable after 2 years for the three-step etch-and-rinse systems. Overall, the older three-step systems proved to be more effective than the simplified adhesives Syntac Single-Component and Prime and Bond 2.0 with regard to bond strength and marginal adaptation.

The use of flowable composites as filled adhesives

OBJECTIVE

The effect of filled adhesives on bonding resin composites to dentin has not been fully understood. Due to their filler content, filled adhesives may act as stress breakers. The aim of this in vitro study was to evaluate the use of flowable composites of different viscosities on bonding to enamel and dentin without the use of an intermediate bonding resin.

MATERIALS AND METHODS

Enamel and dentin bond strengths of OptiBond FL, Syntac Classic, and EBS Multi combined either with their proprietary bonding agent or a flowable resin composite (Ultraseal XT Plus or Revolution) were measured. The tests were carried out with a microtensile device at a crosshead speed of 1mm/min after 24h of storage at 37 degrees C in water. Mean bond strengths were analyzed using the Wilcoxon test and multiple comparisons according to the Mann-Whitney U-test. The micro-morphology of corresponding resin-dentin interfaces of the same teeth were analyzed using SEM and TEM.

RESULTS

The control groups with adhesive systems used as per manufacturers' protocol showed bond strengths of 38.9-41.1 MPa to enamel and 28.8-33.4 MPa to dentin. With respect to bond strength to etched enamel, only Ultraseal XT Plus as bonding resin reached the level of the control groups. When used as bonding agents on dentin, both flowable composites produced lower microtensile bond strengths to etched and primed dentin than did the control groups. Micro-morphological analysis using SEM and TEM resulted in hybrid layer formation for both control and experimental groups. However, many areas of the resin-dentin interface showed insufficient penetration of the flowable composites at the top of the hybrid layer as well as numerous tubules obstructed by filler particles.

CONCLUSIONS

The flowable composites tested in this study should not be used to replace bonding agents. Flowable composites of thinner viscosity, such as Ultraseal XT Plus, may bond to enamel adequately without the requirement of an intermediate bonding resin.

Aggressiveness of contemporary self-etching systems

OBJECTIVE

This study examined, with the use of transmission electron microscopy (TEM), the aggressiveness of three self-etching adhesive systems in penetrating dentin smear layers of different thickness.

METHODS

Dentin disks were produced from extracted human third molars. For the control group, the middle dentin surface was cryofractured to create a bonding surface that was devoid of a smear layer. The experimental teeth were polished with wet 600 or 60-grit SiC paper to produce bonding surfaces with thin and thick smear layers. They were bonded using one of the three self-etching systems: Clearfil Mega Bond (Kuraray), Non-Rinse Conditioner and Prime&Bond NT (Dentsply DeTrey) and Prompt L-Pop (ESPE). Bonded specimens were then demineralized and embedded in epoxy resin for TEM examination.

RESULTS

For Mega Bond, thin authentic hybrid layers between 0.4-0.5 microm were found. Smear layer and smear plugs were retained as part of the hybridized complex. For Non-Rinse Conditioner/Prime&Bond NT, the authentic hybrid layers were between 1.2-2.2 microm thick. Smear layer and smear plugs were completely dissolved in dentin with thin smear layers, but were partially retained as part of the hybridized complex in those with thick smear layers. For Prompt L-Pop, authentic hybrid layers were 2.5-5 microm thick and smear layer and smear plugs were completely dissolved even in dentin with thick smear layers.

SIGNIFICANCE

Contemporary self-etching systems may be classified as mild, moderate and aggressive based on their ability to penetrate dentin smear layers and their depth of demineralization into the subsurface dentin. The more aggressive system completely solubilized the smear layer and smear plugs and formed hybrid layers with a thickness approaching those of phosphoric acid conditioned dentin.

MALDI-TOF MS analysis of a library of polymerizable cyclodextrin derivatives

Polymerizable cyclodextrin derivatives (PCDs) have been proposed as candidates for use in dental therapeutics (Bowen, 1996; Bowen and Reed, 1997). Here, PCD "libraries" were synthesized by quasi-random reactions of 6 moles of methacrylic anhydride plus 6 moles of cyclic glutaric anhydride per mole of beta-cyclodextrin (BCD) in solution. BCD has 21 reactive sites on each of its molecules. These proportions were based on probability calculations, which predicted that the products should have a minimum of 2 polymerizable substituents and acidic ligand groups on practically every one of the diverse product molecules. Matrix-assisted laser desorption/ionization (MALDI) time of flight (TOF) mass spectrometry (MS) gave valuable information regarding the masses of molecular ions representing the molecules that made up the PCD libraries. For the MALDI-TOF MS analyses, small samples were analyzed by the successive application of 3 solutions to the sample holder: the matrix in acetone, the products in water, and sodium trifluoroacetate in water. The resulting spectra had > 40 envelopes of mass peaks above background. The ionic-abundance peak heights had quasi-Gaussian configurations, with central peaks having masses in the neighborhood of 2000 g/mol (Daltons). Regardless of structural permutations within each peak, the range of these peaks was between about 1500 g/mol and 2900 g/mol. This range of masses was in accord with, but perhaps somewhat more narrow than, that predicted by the statistical method, which was based on equal reactivity of all hydroxyl groups. Analysis by MALDI-TOF MS gave valuable data regarding the masses, structures, and characteristics of the products formed and provided unanticipated information to facilitate improvements in future PCD syntheses.

Nanoleakage patterns of four dentin bonding systems

OBJECTIVES

The purpose of this study was to evaluate the nanoleakage patterns of four dentin bonding systems.

METHODS

The dentin bonding systems used in this study were: Single Bond, One Coat Bond, Prime & Bond NT/Non Rinse Conditioner (NRC), and PermaQuik. Flat occlusal dentin surfaces from extracted human molars were finished with wet 600-grit silicon carbide paper, and bonded with one of the dentin bonding systems. After 24 h storage at 37 degrees C in water, margins were finished with polishing discs and the surrounding tooth surfaces coated with nail varnish. The samples were immersed in a 50% (w/v) solution of silver nitrate for 24 h, and exposed to photodeveloping solution for 8 h. The samples were cut longitudinally, polished, and mounted on stubs, carbon coated and observed in a Field Emission-SEM using backscattered electron mode.

RESULTS

Different nanoleakage patterns were observed with the different adhesive systems. However, accumulations of silver particles were often noted at the base of the hybrid layer for all materials. Single Bond and One Coat Bond demonstrated uptake of silver particles both within the hybrid layer and the adhesive resin. Prime & Bond NT/NRC showed silver staining throughout almost the entire thickness of the hybrid layer. The leakage pattern of PermaQuik revealed loose silver deposition within the hybrid layer. The composition of each adhesive system may play a role in forming the different leakage patterns.

SIGNIFICANCE

The current dentin bonding systems used in this study do not achieve perfect sealing at the restoration/dentin interface, which may influence the durability of the bond to dentin.

Dentin shear bond strength of compomers and composites

OBJECTIVE

The aim of this study was to compare the shear bond strengths and fracture characteristics of two compomers bonded with a single step bonding agent with two modern composites, a microfil and hybrid, bonded with a fourth generation bonding agent.

METHODS

Freshly extracted human third molars were sectioned parallel to the occlusal surface to expose midcoronal dentin, prepared with 320-grit surface finish, and bonded (N = 11 samples/group) following manufacturer's directions with the compomers (Dyract, DeTrey Konstanz, Germany or Compoglass, Vivadent, Schaan Liechtenstein) or the dentin bonding agent SMP+ (Scotchbond Multi-Purpose Plus, 3M Dental Products, St. Paul MN) with Silux Plus or Z100 (3M Dental Products, St. Paul, MN). The samples were tested using a single plane lap shear bond strength test at 5 mm/min until failure. Statistical analysis was performed using ANOVA with Scheffe multiple comparison testing. Fracture surfaces of the debonded surfaces were examined using SEM to determine the failure mode of each specimen.

RESULTS

Bond strengths for the compomers were 12.7 +/- 2.9 MPa for Dyract and 8.9 +/- 4.1 MPa for Compoglass and were not significantly different. Bond strengths for the dentin bonded composites were significantly stronger than the compomer Compoglass, but were not different from one another, despite the use of different composites. The averages values for SMP + /Silux Plus and SMP + /Z100 were 15.7 +/- 4.5 MPa and 15.2 +/- 5.6 MPa, respectively. SEM analysis showed that all materials exhibited mixed failure patterns. Compoglass specimens exhibited 5 of 11 failures classified as adhesive, while each of the other materials showed only 1 of 11 adhesive failures.

SIGNIFICANCE

Compomers have undergone rapid development over the last several years, but their bond strengths have not yet reached the same level as modern dentin bonded composites. Difference in composite filler type and amount had little influence on the bond strength determined in this work.

Comparison of three methods of critical evaluation of microleakage along restorative interfaces

This in vitro study compared microleakage along the dentin-restorative interface by use of a conventional single-surface and two stereoscopical protocols. The extent of microleakage in class V cylindric cavities that were restored with Scotchbond 2/P-50 was assessed after thermocycling and silver staining were performed. Specimens were randomized into three groups of 10 teeth for the three different protocols to be investigated. The categories were group 1, a single longitudinal section through the midline of the restoration, group 2, a multiple-surface protocol based on computer reconstruction of digitized images from multiple serial abrasions, and group 3, a clearing protocol based on immersion of demineralized specimens in methyl salicylate. The severity of microleakage for all groups was recorded on an ordinal scale and based on linear leakage length. The median leakage score for groups 1 through 3 was 2, 4, and 4, respectively. When comparisons were performed with nonparametric statistical analysis, both the clearing and the multiple-surface protocols recorded significantly more severe leakage than those detected from a conventional, single longitudinal, midline sectioning technique, (x2 = 8.595, p < 0.02). Furthermore microleakage patterns generated from the two stereoscopical protocols revealed extensive microleakage that advanced unilaterally or bilaterally through the dentin-restorative interface along the embrasure regions into the axial wall of the restorations. No significant difference was noted between the two stereoscopical protocols (Q = 0.260, p > 0.05), which suggested that the clearing protocol, which is less labor-intensive than the multiple-surface protocol, may be recommended for future comparative microleakage studies that involve the dentin-restorative interface.

Variability in microleakage observed in a total-etch wet-bonding technique under different handling conditions

Using a stereoscopic clearing protocol and scanning electron microscopy, we investigated the extent and nature of microleakage in a total-etch, current-generation dentin adhesive by a wet-bonding technique under different handling conditions. The hypotheses were that inadequate light curing of the primer or incomplete drying of the primer solvent might adversely affect the sealing ability of an acetone-containing adhesive system. The study consisted of three experimental groups: (I) a control group with an adequate light source and with the primer solvent completely dried; (II) an "inadequate-light" group; and (III) an "incomplete evaporation of primer solvent" group. The extent of microleakage after silver staining and clearing of the specimens was scored based on a modified five-point scale. Nonparametric statistical analysis (Kruskal-Wallis ANOVA) followed by a multiple comparison test (Dunn test) indicated significant differences among the three groups (p < 0.05). SEM examination of the restorative interface revealed that microleakage appeared to be initiated from the bonding resin-hybrid layer interface in all three groups, representing the weak link in the adhesive system. In addition, microleakage was characterized by 5 zones, each delineating a stage in a continuous array of progressively deleterious microleakage patterns variously distributed among the three groups. It was suggested that, while the bonding resin-hybrid layer interface represented the intrinsic weakness in an already much improved dentin adhesive, extrinsic factors such as the adequacy of the curing light and, more importantly, complete removal of the primer solvents can and should be avoided to preserve the structural integrity of the marginal seal.

Effects of dentin surface treatments on the fracture toughness and tensile bond strength of a dentin-composite adhesive interface

It has been proposed that the fracture toughness test provides an appropriate method for assessing the fracture resistance of the dentin-composite interface. The plane-strain fracture toughness test was therefore applied to a dentin-composite interface, with use of a specific dentinal adhesive, so that the effects of various dentin surface treatments on dentin-bond integrity could be studied. Interfacial fracture toughness (KIC) values were determined following 24h and 180 days of specimen aging in distilled water at 37 degrees C. Tensile bond strength (TBS) results following 24-hour aging were also obtained for comparison with the 24-hour KIC results. In general, the fracture resistance of the dentin-composite interface was highest when the dentin surface was conditioned with acid but not air-dried, intermediate when the dentin surface was conditioned with acid and subsequently air-dried, and lowest when the dentin was not conditioned with acid. The tensile bond strength results differed from the fracture toughness results in indicating differences in surface preparation effects and the type of interfacial failure observed.

Structural evidence of a sealed tissue interface with a total-etch wet-bonding technique in vivo

The resin-dentin interface of in vivo specimens restored with the All-Bond 2 system by use of a total-etch wet-bonding technique on vital deep human dentin was investigated by: (a) SEM examination of cryofractured specimens; (b) SEM examination of acid-rinsed, highly polished, embedded specimens; and (c) TEM examination of demineralized ultrathin sections. Ultrastructural features that were pertinent to the formation of an effective clinical seal were characterized. It is suggested that the establishment of an effective seal of the patent dentinal tubules following total etching is accomplished by: (1) the formation of an outer zone of a solid resin plug surrounded by a circumferential cuff of resin-impregnated dentin; and (2) the formation of an inner zone of a hollow resin sheath with resin globules along the internal walls of the tubules, closely adapting to the odontoblast process. The structural appearance and functional implications of these two zones were strikingly similar, with the sealing of exposed dentinal tubules in arrested carious lesions or cervical abfraction lesions. It appeared that there is a common denominator in physiologic isolation defense mechanisms and the total-etch, wet-bonding technique in the All-Bond 2 system in preserving the biological and morphological integrity of the pulpo-dentinal complex.