Influence of ethanol-wet dentin, adhesive mode of application, and aging on bond strength of universal adhesive

Microtensile bond strength of resin composite to dentin using different adhesive systems and directions of electric current

Thisstudy aimed to evaluate the effect of the electric current direction application on the resin composite-dentin bond strength using three adhesive systems. Human molar teeth were distributed according to the adhesive system (two-step self-etch - Clearfil SE Bond, Kuraray [CSE]; one-step self-etch - Single Bond Universal, 3M ESPE [SBU]; and two-step etch-and-rinse - Adper Single Bond 2, 3M ESPE [SB2]), electric current direction (without electric current - control, direct and reverse electric currents - 35µA), and storage time (24h - immediate and 6 months). Resin composite blocks (Filtek Z350XT, 3M ESPE) were bonded to dentin. The teeth/resin composites specimens were stored in distilled water at 37ºC for 24 hours and 6 months for the microtensile bond strength (µTBS) test (n = 10; ~12 sticks for each tooth). Failure patterns were analyzed on a stereomicroscope and classified as cohesive-dentin, cohesive-resin, adhesive or mixed. Adhesive penetration into dentin and hybrid layer formation were evaluated in a scanning electron microscope (n = 6). Data were submitted to a three-way ANOVA followed by Tukey's post hoc test (α = 0.05). There are no differences in µTBS when the adhesive systems were applied under direct and reverse electric currents, but both electric currents increased the µTBS for all adhesive systems. SBU showed the lowest µTBS values for control groups in both storage times and direct electric current in 6 months of storage. The adhesive failure pattern was more frequently observed in all groups. The electric current formed long resin tags for all adhesive systems. Storage for 6 months did not significantly decrease µTBS values. Both directions of electric current (positive and negative charges) at 35µA can increase the µTBS of the adhesive systems tested to dentin.

Effects of carbodiimide combined with ethanol-wet bonding pretreatment on dentin bonding properties: an in vitro study

Purpose

This study evaluated the combined effects of Carbodiimide (EDC) and ethanol-wet bonding (EWB) pretreatment on the bond strength and resin-dentin surface.

Methods

Phosphoric acid-etched dentin specimens were randomly divided into five groups based on the following pretreatments: deionized water (control), EWB, 0.3M EDC in water (EDCw), EDC water solution combined EWB (EDCw + EWB), and 0.3M EDC in ethanol (EDCe). A scanning electron microscope (SEM) was used to observe the morphology of collagen fibrils on the demineralized dentin matrix in each group after pretreatment. The adhesives Prime & Bond NT (PB) (Dentsply De trey, Konstanz, Germany) or Single bond 2 (SB) (3M ESPE, St. Paul, MN, USA) was applied after pretreatments, and a confocal laser scanning microscope (CLSM) was used to evaluate the quality of resin tags. The degree of conversion (DC) of the adhesive was investigated by Fourier transform infrared spectroscopy (ATR-FTIR). The dentin was first bonded with resin and bathed in water at 37 °C for 24 h. Half of them were subjected to 10, 000 cycles in a thermocycler between 5 °C and 55 °C before a microshear bond strength (µSBS) test. The statistical methods were Analysis of Variance (ANOVA) and a Tukey post hoc test at α = 0.05.

Results

The µSBS was significantly affected by pretreatments (p < 0.001), adhesives (p < 0.001), and aging conditions (p < 0.001) as revealed by the three-way ANOVA. The EDCw, EDCw + EWB, and EDCe groups significantly increased the µSBS; the EDCw + EWB and EDCe groups produced the highest µSBS. In the EDC-containing groups, the SEM showed at the collagen fibrils in the dentin matrix formed a three-dimensional network structure in the tubules after cross-linking into sheets, and the hybrid layer formed thicker resin tags under a CLSM. In the EDC-containing groups, the CLSM observed an increase in the length of resin tags. PB showed a higher DC and bonding strength than SB, and the five pretreatment groups tested did not affect the DC of the two adhesives.

Conclusions

In etch-and-rinse bonding system, EDC combined with EWB pretreatment can improve the quality of the hybrid layer and enhance the mechanical properties of demineralized dentin matrix. Pretreatment with EDC-ethanol solution may be a new clinically friendly option for enhancing dentin bonding durability.

Effect of Active Bonding Application after Selective Dentin Etching on the Immediate and Long-Term Bond Strength of Two Universal Adhesives to Dentin

The objective was to evaluate the influence of active bonding applications (ABA) for different time intervals after selective dentin etching (SDE) for 3 s on the microtensile bond strength (μTBS) to dentin of two universal adhesive systems (UAs): one containing 2-hydroxyethyl methacrylate (HEMA) (Scotchbond Universal, SBU), and one that was HEMA-free (Prime&Bond Universal, PBU). Dentin bovine specimens were divided into four groups: self-etch as control (SE), SDE + ABA for 15 s (SDE15), SDE + ABA for 20 s (SDE20), and SDE + ABA for 25 s (SDE25). The μTBS test was performed after a water storage of 24 h and 6 months. Scanning electron microscopy (SEM) was used in order to examine the resin−dentin interface. For the PBU, the µTBS was significantly influenced only by the aging factor (p < 0.026). A statistically significant decrease in the µTBS after 6 months of aging was observed only for the SDE15 group. For SBU, µTBS was significantly influenced by the protocol application and the aging time (p ≤ 0.041). The groups SDE15, SDE20, and SDE25 achieved statistically significant higher values (after 24 h and 6 months). No considerable variances were noticed in the homogeneity and continuity of the hybrid layer (HL) among the groups. In conclusion, SDE and ABA improved the µTBS only of a HEMA-containing universal adhesive.

An in vitro evaluation of microleakage of resin based composites bonded to chlorhexidine-pretreated dentin by different protocols of a universal adhesive system

Purpose

This study compared microleakage of different resin based composite (RBC) materials bonded to dentin, after chlorhexidine (CHX) application, by different adhesion protocols of a universal adhesive system.

Methods

Class V cavities were prepared on the buccal and lingual surfaces of 40 premolar teeth. The “etch-and-rinse” technique of a universal bond adhesive system (Single Bond Universal Adhesive) was used on buccal preparations, while the “self-etch” protocol was used on the lingual surfaces. Two RBCs, one bulk fill (Filtek Bulk Fill [FBF]) and one conventional (Filtek Z350 XT [Z350XT]), were used. Teeth were divided into two groups of 20 teeth each, 10 per each RBC (n = 10): (1) control; and (2) pretreatment with 2% CHX. For FBF groups, teeth were restored with a single increment; however, for Z350XT, a layering technique was used. Teeth were aged by thermo-cycling and prepared for microleakage testing. Dye penetration was evaluated and scored from 0 to 4. Data were analyzed at a significance level of P < 0.05.

Results

The highest microleakage mean scores were found in the control group of the etched margins for both RBCs (2.80 ± 1.033 FBF and 2.10 ± 1.370 Z350XT). The CHX-pretreated group showed significantly lower microleakage than the control for FBF only (P = 0.008). No significant difference was found between groups for the “self-etch” protocol (χ² = 0.884, P = 0.08). No significant differences were found between FBF and Z350XT in all study groups (P > 0.2).

Conclusions

When the “self-etch” protocol of the universal adhesive system was used, dentin microleakage was not affected by CHX-pretreatment when teeth were restored with bulk fill or conventional RBCs. In the “etch-and-rinse” protocol, CHX application improved the marginal seal before restoration with bulk fill material. However, in the absence of CHX, the “etch-and-rinse” protocol negatively affected marginal integrity.

Comparison of bond strength of universal adhesives using different etching modes: A systematic review and meta-analysis

This review aims to evaluate whether the etch-and-rinse or self-etch mode is the better protocol for dentin adhesion by universal adhesives. A total of 15 articles were included in the meta-analysis. Two reviewers performed a literature search up to October 2020in four databases: PubMed, Web of Science, Embase, and the Cochrane Library. Without considering the difference in aging mode, the analysis of the immediate and long-term bond strength of dentin showed that there was no statistical significance between the etch-and-rinse and self-etch mode of universal adhesive, and the long-term bond strength decreased relative to the immediate. In vitro studies suggest that prior acid etching did not improve bond performance. Whether from the perspective of long-term bonding performance or simplifying operating procedures, the self-etch mode is preferred.

Bond Strength of Universal Adhesives to Dentin: A Systematic Review and Meta-Analysis

Currently, the availability of a wide variety of universal adhesives makes it difficult for clinicians to choose the correct system for specific bonding situations to dentin substrate. This study aimed to determine whether there are any alternative techniques or additional strategies available to enhance the bond strength of universal adhesives to dentin through a systematic review and meta-analysis. Two reviewers executed a literature search up to September 2020 in four electronic databases: PubMed, ISI Web of Science, Scopus, and EMBASE. Only in vitro studies that reported the dentin bond strength of universal adhesives using additional strategies were included. An analysis was carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic. A total of 5671 potentially relevant studies were identified. After title and abstract examination, 74 studies remained in systematic review. From these, a total of 61 studies were included in the meta-analysis. The bond strength of universal adhesives to dentin was improved by the use of one of the following techniques: Previous application of matrix metalloproteinases (MMP) inhibitors (p < 0.001), prolonged application time (p = 0.007), scrubbing technique (p < 0.001), selective dentin etching (p < 0.001), non-atmospheric plasma (p = 0.01), ethanol-wet bonding (p < 0.01), prolonged blowing time (p = 0.02), multiple layer application (p = 0.005), prolonged curing time (p = 0.006), and hydrophobic layer coating (p < 0.001). On the other hand, the use of a shortened application time (p = 0.006), and dentin desensitizers (p = 0.01) impaired the bond strength of universal adhesives to dentin. Most of the analyses performed showed a high heterogenicity. The in vitro evidence suggests that the application of universal adhesives using some alternative techniques or additional strategies may be beneficial for improving their bonding performance to dentin. This research received no external funding. Considering that this systematic review was carried out only with in vitro studies, registration was not performed.

Comparison of microleakage between different restorative materials to restore marginal gap at crown margin

Background

An occurrence of secondary caries around the indirect restoration margin is reported to remain a leading cause of failures.

Objective

This study aimed to test the interfacial microleakage of conventional glass-ionomer (CGI), resin-modified glass ionomer (RMGI) and Nano-hybrid composite (CR) restorations at a full veneer margin crown.

Methods

Ninety human extracted molar teeth were divided into three groups (n = 30). Each group was subdivided into three subgroups (n = 10) according to the extent of the structural defects; The structural defect in G1 had a depth of 1.5 mm, width and length at 2 mm and 1 mm intrusion within the crown cervical margin. The corresponding structural defect dimension values for G2 were 2, 5, 4 and 2 mm with defects extending onto the root structure. Meanwhile, G3: structural deficiency of 2 mm depth, 3 mm width and 3 mm length and with 1.5 mm extension into the prepared teeth. These structural defects in each subgroup were restored with CGI, RMGI and CR. Artificial carious lesion formation was induced at the cervical finish line with a demineralizing solution. The artificial carious lesions were restored as per the group distribution. Subsequently, teeth samples were prepared and cemented with Nickel-chromium full coverage restorations utilizing glass-ionomer luting cement. Teeth samples were thermocycled, isolated with nail varnish, and immersed in 0.1% methylene blue for 24 h. The teeth samples were sectioned longitudinally, dye penetration was evaluated with a stereomicroscope. The data were analyzed with Kruskal–Wallis and Mann–Whitney U tests.

Results

CGI-G1 recorded the highest micro-leakage score at 1.450; while CR-G3 recorded the least score (0.350). At a cementum-restoration interface, CR-G1 (0.850) documented the lowest micro-leakage; RMGI-G3 had a greater value at 1.700.

Conclusions

The hybrid CR could be effectively used to restore the restoration of a marginal gap around crown margins.

Reinforced Universal Adhesive by Ribose Crosslinker: A Novel Strategy in Adhesive Dentistry

Enzymatic biodegradation of demineralized collagen fibrils could lead to the reduction of resin-dentin bond strength. Therefore, methods that provide protection to collagen fibrils appear to be a pragmatic solution to improve bond strength. Thus, the study's aim was to investigate the effect of ribose (RB) on demineralized resin-dentin specimens in a modified universal adhesive. Dentin specimens were obtained, standardized and then bonded in vitro with a commercial multi-mode adhesive modified with 0, 0.5%, 1%, and 2% RB, restored with resin composite, and tested for micro-tensile bond strength (µTBS) after storage for 24 h in artificial saliva. Scanning electron microscopy (SEM) was performed to analyze resin-dentin interface. Contact angles were analyzed using a contact angle analyzer. Depth of penetration of adhesives and nanoleakage were assessed using micro-Raman spectroscopy and silver tracing. Molecular docking studies were carried out using Schrodinger small-molecule drug discovery suite 2019-4. Matrix metalloproteinases-2 (MMP-2) and cathepsin-K activities in RB-treated specimens were quantified using enzyme-linked immunosorbent assay (ELISA). The significance level was set at α = 0.05 for all statistical analyses. Incorporation of RB at 1% or 2% is of significant potential (p < 0.05) as it can be associated with improved wettability on dentin surfaces (0.5% had the lowest contact angle) as well as appreciable hybrid layer quality, and higher resin penetration. Improvement of the adhesive bond strength was shown when adding RB at 1% concentration to universal adhesive (p < 0.05). Modified adhesive increased the resistance of collagen degradation by inhibiting MMP-2 and cathepsin-K. A higher RB concentration was associated with improved results (p < 0.01). D-ribose showed favorable negative binding to collagen. In conclusion, universal adhesive using 1% or 2% RB helped in maintaining dentin collagen scaffold and proved to be successful in improving wettability, protease inhibition, and stability of demineralized dentin substrates. A more favorable substrate is created which, in turn, leads to a more stable dentin-adhesive bond. This could lead to more advantageous outcomes in a clinical scenario where a stable bond may result in longevity of the dental restoration.

Six-month performance of restorations produced with the ethanol-wet-bonding technique: a randomized trial

This double-blind randomized controlled clinical trial evaluated the effectiveness of dentin pretreatment with 100% ethanol (EWBT - ethanol wet bonding technique) and different adhesive protocols in noncarious cervical lesions (NCCL) after 6 months. Patients presenting at least one NCCL were included. NCCLs (n=148) were randomly assigned to 4 groups: NE (Non-EWBT + three-step etch-and-rinse (Scotchbond Multi Purpose, 3M ESPE [MP]), E (EWBT + MP); EB (EWBT + [Bond - third step of MP]), and EU (EWBT + universal adhesive (Single Bond Universal, 3M ESPE). Conventional acid-etching (Condac 37%, FGM) and nanohybrid resin composite (Z350, 3M ESPE) were used. Trained and calibrated examiners (Kappa = 0.61) evaluated the restorations at baseline (7 days) and 6-month recall using the USPHS modified criteria. Data were subjected to Chi square (α = 0.05). Differences in the success rate were found for the treatments (p = 0.003). EB presented the lowest success rate compared with the other groups (p < 0.02). No significant differences were detected among NE, E, and EU (p > 0.49). The survival rates were 97.23%, 97.30%, 78.95%, and 97.30% for NE, E, EB, and EU, respectively. Regarding postoperative sensitivity, a significant reduction was found for groups E (p = 0.027) and EU (p < 0.01) after 6 months. After 6 months, EWBT associated to the hydrophobic adhesive system had the highest failure rate.