Effect of Storage Time on Bond Strength and Nanoleakage Expression of Universal Adhesives Bonded to Dentin and Etched Enamel

Effects of different surface treatments on surface topography and bond strength in the repair of fiber-reinforced dentin composite

OBJECTIVE

This study aimed to evaluate the effects of different surface treatments on the repair bond strength between a fiber-reinforced dentin composite and a posterior composite.

METHODS

Forty fiber-reinforced dentin composite resin blocks (4 mm × 4 mm × 4 mm) were separated into eight groups (n = 5) according to the surface preparation methods: (G1) negative control group, (G2) adhesive application, (G3) 50% dimethylsulfoxide (DMSO) application, (G4) 50% DMSO + adhesive application, (G5) 37% phosphoric acid etch + adhesive application, (G6) air abrasion + adhesive application, (G7) 37% phosphoric acid etch + 50% DMSO application + adhesive application, and (G8) air abrasion +50% DMSO application + adhesive application group. The composite surfaces were repaired in two layers with a posterior composite. Composite sticks were subjected to a micro tensile bond strength (μTBS) test. Fractured surfaces were evaluated using a stereomicroscope (×25). Short fiber-reinforced composite samples' surfaces were investigated by scanning electron microscope (SEM). Shapiro Wilk, one-way ANOVA, and Tukey HSD tests were used for statistical evaluation.

RESULTS

The highest average (μTBS) values were observed in G8, whereas the lowest mean μTBS values were evident in the G1 group. Statistically significant μTBS values were found in all adhesive-applied groups when compared with the negative control group. Notably, the application of 50% DMSO without adhesive did not lead to a statistically significant increase in μTBS values. SEM images demonstrated that acid etching partially eliminated residues on the composite surface, while air abrasion had a detrimental effect on the integrity of fiber structures.

CONCLUSION

In the repair of fiber-reinforced dentin composite with a posterior composite, adhesive application is an effective approach. The treatment of 50% DMSO without adhesive did not confer a statistically significant advantage, and the supplemental use of acid etch or air abrasion did not show an additional benefit compared to adhesive-only repairs.

CLINICAL SIGNIFICANCE

Adhesive application emerges as a potent and effective strategy for the repair of bur-roughened fiber-reinforced dentin composites. With its limitations, the study highlights the efficacy of adhesive-only repairs without the necessity for additional surface treatments.

Adhesion and sealing of different universal adhesive systems associated with bulk-fill resins after using endodontic irrigation solutions: An in vitro study

This study aimed to evaluate the interface of universal adhesive (UA) with bulk-fill resin (BF) and dentin, after endodontic irrigation. The pulp chamber of 96 molars was irrigated with chlorhexidine 2% (CHX) or sodium hypochlorite 5.25% (NaOCl) and restored according to three restorative protocols. Microtensile bond strength (μTBS) and nanoleakage tests were performed after 24 h of thermocycling. Kruskal Wallis, Mann-Whitney and Wilcoxon were performed (p < 0.05). Comparing restorative systems, a difference was found only when irrigated with CHX after 24 h. CHX provided higher μTBS than NaOCl after 24 h for two restorative protocols; after thermocycling, NaOCl provided the greatest μTBS than CHX for one group. Decreased μTBS was observed for all restorative systems when CHX was used after thermocycling. NaOCl demonstrated the highest nanoleakage. The composition of UA influenced the immediate adhesion and sealing to BF when CHX was used; ageing has a deteriorating effect on adhesion and sealing for all restorative systems.

Novel biomimetic peptide-loaded chitosan nanoparticles improve dentin bonding via promoting dentin remineralization and inhibiting endogenous matrix metalloproteinases

OBJECTIVE

This study aims to synthesize novel chitosan nanoparticles loaded with an amelogenin-derived peptide QP5 (TMC-QP5/NPs), investigate their remineralization capability and inhibitory effects on endogenous matrix metalloproteinases (MMPs), and evaluate the dentin bonding properties of remineralized dentin regulated by TMC-QP5/NPs.

METHODS

TMC-QP5/NPs were prepared by ionic crosslinking method and characterized by dynamic light scattering method, scanning electron microscopy, transmission electron microscope, atomic force microscope, Fourier transform infrared spectroscopy, and differential scanning calorimetry. The encapsulation and loading efficiency of TMC-QP5/NPs and the release of QP5 were examined. To evaluate the remineralization capability of TMC-QP5/NPs, the mechanical properties, and the changes in structure and composition of differently conditioned dentin were characterized. The MMPs inhibitory effects of TMC-QP5/NPs were explored by MMP Activity Assay and in-situ zymography. The dentin bonding performance was detected by interfacial microleakage and microshear bond strength (μSBS).

RESULTS

TMC-QP5/NPs were successfully synthesized, with uniform size, good stability and biosafety. The encapsulation and loading efficiency of TMC-QP5/NPs was respectively 69.63 ± 2.22% and 13.21 ± 0.73%, with a sustained release of QP5. TMC-QP5/NPs could induce mineral deposits on demineralized collagen fibers and partial occlusion of dentin tubules, and recover the surface microhardness of dentin, showing better remineralization effects than QP5. Besides, TMC-QP5/NPs significantly inhibited the endogenous MMPs activity. The remineralized dentin induced by TMC-QP5/NPs exhibited less interfacial microleakage and higher μSBS, greatly improved dentin bonding.

SIGNIFICANCE

This novel peptide-loaded chitosan nanoparticles improved resin-dentin bonding by promoting dentin remineralization and inactivating MMPs, suggesting a promising strategy for optimizing dentin adhesive restorations.

Does extended air-drying time improve bond strength of universal adhesives to enamel?

OBJECTIVE

To investigate the effect of extended air-drying time on the microshear bond strength (MSBS) of universal adhesives to enamel.

MATERIALS AND METHODS

The distal and mesial specimens from third molars were wet-ground and randomly assigned to three groups according to adhesives tested (n = 60): Clearfil Bond Universal, Gluma Bond Universal, and G-Premio Bond. The adhesives were applied in etch-and-rinse or self-etch modes, followed by air-drying for 5, 15, or 25 s. Composite buildups were constructed and subjected to the MSBS test after 24-h or thermocycling. MSBS results were evaluated using a four-way ANOVA. The thickness of the adhesive layer and the degree of solvent evaporation were further evaluated.

RESULTS

At 24-h, MSBS of G-Premio Bond significantly improved with the 25 s air-drying in both of the etching modes when compared to the 5 s air-drying. After thermocycling, the extended air-drying did not produce a significant difference on the MSBS, regardless of the application strategy. Extended air-drying (25 s) evaporated almost all of the volatile part of Gluma Bond Universal and G-Premio Bond.

CONCLUSIONS

Extended air-drying times increased solvent evaporation but did not contribute to the bonding effectiveness of the adhesives, regardless of the etching mode.

CLINICAL SIGNIFICANCE

Air-drying applications for more than 5 s had no significant effect on enamel bonding performance of universal adhesives.

Effect of matrix metalloproteinase inhibitors on bonding durability of universal adhesives

This study aimed to evaluate the effect of different matrix metalloproteinase inhibitors (MMPIs) on the microtensile bond strength (μTBS) and nanoleakage of universal adhesives. One hundred twenty non-carious human molars were prepared and randomly assigned to two groups: Scotchbond Bond Universal (SBU) and Gluma Bond Universal (GBU). The samples in each group were assigned to five subgroups (n=12) based on one control (water) and four MMPIs (Benzalkonium-chloride (BAC), Batimastat (BB94), Chlorhexidine (CHX), and Epigallocatechin-gallate (EGCG)). Each adhesive was applied in self-etch (SE) mode or etch-and-rinse (ER) mode. Dentin/composite sticks were fabricated and subjected to the μTBS test after 24 h or 6 months. At 6 months, MMPIs did not affect the μTBS of the adhesives, regardless of etching mode. Nanoleakage was more pronounced in ER mode than in SE mode for all subgroups. All MMPIs, with the exception of CHX, decreased the nanoleakage of GBU in ER mode.

Long-Term In Vitro Adhesive Properties of Two Universal Adhesives to Dentin

The composition of universal adhesives, as well as the adhesive strategy, may influence bonding effectiveness and durability. This study aimed to evaluate the microtensile bond strength (µTBS) and nanoleakage (NL), immediately and after 6-month aging, and in situ degree of conversion (DC), of two universal adhesives (Scotchbond Universal Adhesive, SBU; Xeno Select, XEN) applied with etch-and-rinse (ER) and self-etch (SE) strategies, in comparison with a two-step SE adhesive (Clearfil SE Bond, CSE). Dentin surfaces of fifty human third molars were randomly assigned to the following adhesives: two universal adhesives, SBU and XEN, applied in ER or SE mode and CSE, used as control. Teeth were sectioned into beams to be tested under µTBS, half of them after 24 h, and the rest after 6 months of water aging. Selected beams from each tooth were used for NL evaluation and in situ DC quantification. SBU and CSE showed significantly higher mean µTBS and lower nanoleakage than XEN, regardless of the evaluation time and adhesion strategy. XEN-SE yielded the lowest degree of conversion. Therefore, adhesive properties of universal adhesives to dentin are material dependent, regardless of the adhesion strategy, exhibiting XEN a significantly worse performance than SBU.

Effect of phytic acid on bond strength and interfacial integrity of universal adhesive to deep dentin

Abstract This study investigated the effect of phytic acid (IP6) in different concentrations and application times on microtensile bond strength (µTBS) and interfacial integrity of universal adhesive to deep dentin. Flat deep dentin surfaces of 48 human molars were either etched with 37% phosphoric acid (PA) for 15 sec (control); or received no acid treatment and universal adhesive was applied directly in a self-etch mode (SE); or divided according to IP6 concentration (C) into two main groups: C1, 0.5%, and C2, 1%. Specimens of IP6 groups were further subdivided into three subgroups according to application time of IP6 (T) where; T1, 15 sec; T2, 30 sec and T3, 60 sec. Single Bond Universal Adhesive was then applied and resin composite blocks were built-up. Forty Specimens were then sectioned to produce resin/dentin beams that were used for µTBS testing using a universal testing machine. The remaining eight specimens were sectioned into slabs that were immersed into ammonical silver nitrate solution and nanoleakage was observed using a field emission scanning electron microscope (FE-SEM). The results showed that the application of IP6 in 0.5% and 1% produced significantly higher µTBS and less nanoleakage compared to PA and SE groups. Also, the application of IP6 for 60 sec recorded the highest µTBS and the lowest nanoleakage followed by 30 sec, and 15 sec respectively. Therefore, conditioning of deep dentin with IP6 enhances µTBS and interfacial integrity of universal adhesive to deep dentin in comparison to PA etching or using the universal adhesive in SE mode.

A multi-functional dentine bonding system combining a phosphate monomer with eugenyl methacrylate

OBJECTIVE

The tooth-resin composite interface is frequently associated with failure because of microbial contamination, hydrolytic and collagenolytic degradation. Thus, designing a dentine bonding system (DBS) with an intrinsically antimicrobial polymerisable monomer is of significance especially if it can be used with self-etching primers enabling resistance to degradation of the interface.

METHODS

Experimental adhesives were developed incorporating eugenyl methacrylate (EgMA) at concentrations of 0,10 or 20 wt%, designated as EgMA0, EgMA10 and EgMA20, respectively, for use as a two-step self-etch DBS with the functional monomer bis[2-(methacryloyloxy) ethyl] phosphate (BMEP) in the primer. The curing, thermal and wettability properties of the adhesives were determined, and hybrid layer formation was characterised by confocal laser scanning microscopy, microtensile bond strengths (µTBS) and nanoleakage by back-scattered SEM. In situ zymography was used to assess MMP inhibitory activity of the BMEP-EgMA DBS.

RESULTS

EgMA in the adhesives lowered the polymerisation exotherm and resulted in higher Tg, without negatively affecting degree of conversion. Water sorption and solubility were significantly lower with higher concentrations of EgMA in the adhesive. The formation of a distinct hybrid layer was evident from confocal images with the different adhesives, whilst EgMA20 yielded the highest µTBS post water storage challenges and lowest nanoleakage after 6 months. The experimental DBS exhibited minimal to no MMP activity at 3 months.

SIGNIFICANCE

The hydrophobic nature of EgMA and high cross-link density exerts considerable benefits in lowering water uptake and polymerisation exotherm. The application of EgMA, adhesives in conjunction with BMEP in a multi-functional self-etching DBS can resist MMP activity, hence, enhance longevity of the dentine-resin composite interface.

Assessing the antimicrobial properties of copper-iodide doped adhesives in an In vitro caries model: A pilot study

Context:

Recurrent caries are the leading cause of composite resin failure.

Aims:

The purpose of this pilot study was to test the efficacy of a novel copper iodide (CuI) containing dental adhesive in an in vitro caries model.

Subjects and Methods:

Streptococcus mutans and Lactobacillus acidophilus were grown individually on the complex medium for 48 h at 37°C. The pH of the mixed medium was 7.0 initially and tested every 24 h. 40 extracted teeth were prepared with standardized cavity preparations and coated with control or experimental CuI adhesives and imaged using a micro-computed tomography (microCT). Four study groups were evaluated: (1) control (2) 0.5 μg/ml CuI (3) 1.0 μg/ml CuI, 4) 5.0 μg/ml CuI. After incubation, the teeth were re-imaged using the microCT. Utilizing AnalyzePro software the three-dimensional data sets were overlaid and demineralization was measured and statistics were run.

Statistics:

Stratified ANOVA models were run to determine if there were differences between the control and experimental adhesive groups. Similarly, pH and bacterial concentrations were evaluated to ensure the viability of polymicrobial specimen.

Results and Conclusions:

Significant differences were found between the control group and the 1.0 and 5.0 CuI adhesive groups. No differences in pH were noted between the groups. Overlaid changes in demineralization were recorded as volume loss. CuI adhesives with 5 mg/ml or higher have the potential to limit tooth demineralization after bacterial penetration of a dental restoration in an in vitro caries model. Further testing is needed.

Evaluation of resveratrol-doped adhesive with advanced dentin bond durability

OBJECTIVES

This paper aimed to evaluate the influence of resveratrol-doped adhesive on the durability and antibiofilm capability of dentin bonding.

METHODS

Experimental adhesives were prepared by incorporating resveratrol into a universal adhesive at concentrations of 0 (control), 0.1, 1, and 10 mg/mL. The microtensile bond strength, fracture modes, and adhesive-dentin interface nanoleakage were assessed after 24 h of water storage, 10,000 times of thermocycling or 1-month of collagenase ageing. Relevant antibiofilm capability on Streptococcus mutans (S. mutans), in situ zymography, degree of conversion, and cytotoxicity of resveratrol-doped adhesives were also determined.

RESULTS

Irrespective of thermocycled or collagenase ageing, the resveratrol-doped adhesive (1 mg/mL) maintained the bond strength and reduced the nanoleakage expression. Meanwhile, the inhibitory ability on endogenous protease activity and S. mutans biofilm formation with acceptable biocompatibility were obtained.

CONCLUSIONS

This study suggested that the resveratrol-doped adhesive achieved effective improvement on dentin bond durability and secondary caries management.

CLINICAL SIGNIFICANCE

The application of the resveratrol-doped adhesive indicates promising benefits to increase the lifetime of composite restorations.

Root canal pre-treatment and adhesive system affect bond strength durability of fiber posts ex vivo

OBJECTIVES

To investigate the effect of different pre-treatments on the long-term bond strength of fiberglass posts luted either with dual-curing self-etch adhesives and core build-up composites or with a self-adhesive resin (SAR) cement.

MATERIALS AND METHODS

In total, 180 human root-filled teeth received post-space preparations and three different dentin pre-treatments (PTs): PT1, ethanol (99%); PT2, ethanol-tertiary-butanol-water-solution (AH Plus Cleaner, Dentsply Sirona; York, USA); and PT3, distilled water (control). Five luting systems were used: FU, Futurabond U (Voco; Cuxhaven, Germany); CL, Clearfil DC Bond (Kuraray Noritake; Okayama, Japan); GR, Gradia Core SE Bond (GC Europe NV; Leuven, Belgium); LU, LuxaBond Universal (DMG; Hamburg, Germany); and RX, RelyX Unicem 2 (3M; Minnesota, USA). Roots were cut into six slices (1 mm thick). From each root canal region, three slices were submitted to immediate and three to post-storage push-out testing. The latter were subjected to thermocycling (5-55°C, 6.000 cycles) and stored for six months in saline solution (0.9%, 37°C). Data were analysed using repeated measures ANOVA and chi-square tests (MV±SD).

RESULTS

Bond strength was significantly affected by material (p<0.0005), pre-treatment (p=0.016), and storage (p<0.0005; repeated-measures ANOVA). LU (18.8±8.1MPa) revealed significantly higher bond strength than RX (16.08±6.4MPa), GR (15.1±4.6MPa), CL (13.95±5.2MPa), and FU (13.7±6.3MPa). PT1 (16.5±6.9MPa) revealed significantly higher bond strength than PT3 (14.5±5.7MPa).

CONCLUSIONS

A universal adhesive in self-etch mode combined with a core build-up material revealed higher bond strength than a SAR cement, both interacted positively with Ethanol pre-treatment.

CLINICAL RELEVANCE STATEMENT

Ethanol (99%) rinsing can be recommended as part of post and core pre-treatment for the investigated luting systems.

Influence of reduced application time on bonding durability of universal adhesives to demineralized enamel

OBJECTIVES

This study aimed to assess the effect of application time on the microshear bond strength (μSBS) of three universal adhesives in demineralized and sound enamel before and after aging.

MATERIALS AND METHODS

Bovine teeth (192) were prepared where buccal surfaces were ground and divided into two groups (sound enamel and demineralized enamel). The specimens in each group were divided into 12 subgroups by combining 3 adhesive agents (All-Bond Universal, Scotchbond Universal, and Tokuyama Universal Bond) × 4 adhesion strategy. Each adhesive was applied with either prolonged (PA) or reduced (RA) application time in etch-and-rinse or self-etch mode. Bonded composites were subjected to μSBS testing after 24-h or 2-year water storage. The results were evaluated using four-way ANOVA and Tukey's post-hoc test (α = 0.05).

RESULTS

The μSBS of adhesives to sound enamel in both etching modes was mostly similar to demineralized enamel, regardless of application time and aging time. At 24-h, all adhesives with PA in self-etch mode showed higher μSBS when compared with RA, except Tokuyama Universal Bond, but after 2-year aging, no significant difference was found in μSBS between RA and PA. The μSBS of adhesives with PA in etch-and-rinse mode depended on used adhesive and enamel condition compared to RA, regardless of μSBS testing time.

CONCLUSIONS

PA of adhesives did not reveal a significant difference in μSBS to enamel, regardless of substrate type and etching mode.

CLINICAL RELEVANCE

After 2-year aging, the bond strength of universal adhesives presented no significant difference between PA and RA treatments.

Electric current effects on bond strength, nanoleakage, degree of conversion and dentinal infiltration of adhesive systems

To evaluate the effect of three adhesive systems applied under electric current on microtensile bond strength (μTBS) and degree of conversion (DC). Molar teeth were restored with the aid of three adhesive systems (Adper Single Bond 2-SB2; Clearfil SE Bond-CSE; and Single Bond Universal-SBU) under different electric current intensities (0 μA; 25 μA; and 50 μA). Composite resin blocks were built up in increments (2 mm) and sectioned into 1 × 1 mm beams. The μTBS was tested after 24 h and 1 y distilled water storages. Samples (n = 10) from 24 h to 1 y storages were immersed in a 50% ammoniacal silver nitrate solution and submitted to scanning electron microscopy. The silver nitrate in the hybrid layer was quantified (ImageJ software). The adhesive systems' dentinal infiltration was analyzed using confocal laser scanning microscopy. Fourier transform near infrared spectroscopy was used to measure the DC. The μTBS data were submitted to two-way ANOVA (time vs. electric current) and Bonferroni's test (α = 0.05). Quantitative nanoleakage data were submitted to two-way ANOVA (electric current vs. adhesive) and Bonferroni's test (α = 0.05). DC data were submitted to one-way ANOVA and Tukey's test (α = 0.05) for each adhesive system. The electric current statistically increased the μTBS for SB2 and CSE in 24 h storage, as well as for SB2, CSE and SBU in 1 y storage. No significant difference was observed between storage time for CSE and SBU. When compared to the control, electric currents (25 μA and 50 μA) showed significantly higher DC mean values for SB2 and SBU, and had no effect on CSE. The electric currents (25 μA and 50 μA) reduced the adhesive system's nanoleakage after 1-year storage, and improved the infiltration of SB2 and CSE. Both electric current intensities improved dentinal interface stability.

Restoration's thickness and bonding tooth substrate are determining factors in minimally invasive adhesive dentistry

Purpose To explore fracture strength and failure behaviour of minimally invasive CAD-CAM composite resin overlay restorations.Methods Eighty bi- and tri-layer cylindrical overlay model including the restoration bonded over bovine tooth dentin (Groups D) and enamel-dentin (Groups E) were assembled (diameter 9 mm). Restorations were milled from CAD-CAM composite resin blocks (Brilliant Crios, Coltène/Whaledent AG) in different thicknesses (0.5mm, 1mm, 1.5mm, 2mm) and equally distributed in four Groups D and four Groups E (n=10). All specimens were submitted to an Hertzian load-to-failure contact test with spherical indenter. Critical loads were recorded in Newton and data were analysed using Kruskal-Wallis test for multiple and Mann-Whitney test for 2-samples comparisons (p < 0.05). Fragments were examined using SEM. The stress distribution for specimens with restorations of 0.5 mm and 2 mm was also investigated with FEA.Results For all specimens, the mean static loads in Newton increased with an increase in restoration thickness. On contrary, restorations with the same thickness displayed higher resistance values when bonded over enamel than dentin, except for the 2-mm thick restorations. A damage competition was detected between cone/median cracks originating at the loading contact area of the restorations and radial cracks beginning at their inner surface, with the former prevailing in restorations bonded on enamel and the latter being dominant for restorations bonded on dentin.Conclusions For bonded ultra-thin resin composite restorations (0.5 mm to 1.5 mm) enamel as bonding substrate assures higher critical loads to fracture than dentin. This influence gradually decreases as restoration thickened.

New perspective to improve dentin-adhesive interface stability by using dimethyl sulfoxide wet-bonding and epigallocatechin-3-gallate

OBJECTIVES

To determine whether dentin-adhesive interface stability would be improved by dimethyl sulfoxide (DMSO) wet-bonding and epigallocatechin-3-gallate (EGCG).

METHODS

Etched dentin surfaces from sound third molars were randomly assigned to five groups according to different pretreatments: group 1, water wet-bonding (WWB); group 2, 50% (v/v) DMSO wet-bonding (DWB); groups 3-5, 0.01, 0.1, and 1 wt% EGCG-incorporated 50% (v/v) DMSO wet-bonding (0.01%, 0.1%, and 1%EGCG/DWB). Singlebond universal adhesive was applied to the pretreated dentin surfaces, and composite buildups were constructed. Microtensile bond strength (μTBS) and interfacial nanoleakage were respectively examined after 24 h water storage or 1-month collagenase ageing. In situ zymography andStreptococcus mutans (S. mutans) biofilm formation were also investigated.

RESULTS

After collagenase ageing, μTBS of groups 4 (0.1%EGCG/DWB) and 5 (1%EGCG/DWB) did not decrease (p > 0.05) and was higher than that of the other three groups (p < 0.05). Nanoleakage expression of groups 4 and 5 was less than that of the other three groups (p < 0.05), regardless of collagenase ageing. Metalloproteinase activities within the hybrid layer in groups 4 and 5 were suppressed. Furthermore, pretreatment with 1%EGCG/DWB (group 5) efficiently inhibited S. mutans biofilm formation along the dentin-adhesive interface.

SIGNIFICANCE

This study suggested that the synergistic action of DMSO wet-bonding and EGCG can effectively improve dentin-adhesive interface stability. This strategy provides clinicians with promising benefits to achieve desirable dentin bonding performance and to prevent secondary caries, thereby extending the longevity of adhesive restorations.

Influence of Acid Etching and Universal Adhesives on the Bond Strength to Dentin

Abstract The purpose of this study was to evaluate the influence of the application mode of three universal adhesive systems on interfacial physical properties of indirect composite restorations adhesively cemented to dentin cavities. Seventy-eight bovine lower incisors were selected and a slice of dentin (thickness: 2 mm) between the buccal surface and pulp chamber was obtained for each tooth. Conical cavities were made on this surface. The internal walls of the cavities were then coated with a hydrophilic gel, filled with composite resin and photopolymerized. The dentin/cone sets were divided into 6 groups (n=10) according to type of universal adhesive (TETRI: Tetric N Bond, FUT: Futura Bond U, SBU: Single Bond Universal) and acid etching on dentin (A: with acid etching; WA: without acid etching). The acid etching and the adhesive systems were applied to the surface of the dentin. All composite resin cones were sandblasted (Al2O3, 20 s) and silanized. After surface treatment, the cones were cemented (RelyX Ultimate) into the dentin cavity and photopolymerized. After thermocycling (10,000 cycles), samples were submitted to marginal adaptation analysis (using caries detector dye), push-out test (0.5 mm/min), and failure mode analysis. Additional samples were prepared for nanoleakage analysis (SEM). The data (MPa) were analyzed by two-way ANOVA and Tukey’s post-test (5%). The groups in which the dentin was acid etched showed significantly lower bond strength values in the push-out test (p<0.01). Dentin acid etching significantly reduced the bond strength between universal adhesive systems and dentin in indirect restorative procedures.

Enamel Etching for Universal Adhesives: Examination of Enamel Etching Protocols for Optimization of Bonding Effectiveness

OBJECTIVE

The purpose of this study was to evaluate whether different enamel etching methods with reduced etching times would improve the bonding effectiveness of universal adhesives.

METHODS AND MATERIALS

Three enamel etching methods, phosphoric acid ester monomer (PPM) etching, phosphoric acid (PPA) etching, and polyalkenoic acid (PLA) etching, and three universal adhesives, G-Premio Bond (GP), Prime&Bond elect (PE), and Scotchbond Universal Adhesive (SU), were evaluated. Initial bond strengths and fatigue strengths of universal adhesives to ground enamel and ground enamel etched for less than one, five, 10, and 15 seconds using different etching methods were determined. The bonded fatigue specimens were loaded using a sine wave at a frequency of 20 Hz for 50,000 cycles or until failure occurred with a staircase method. Atomic force micrograph (AFM) observations along with measurements of surface Ra roughness and modified surface area of enamel with different etching protocols were also conducted.

RESULTS

The bond fatigue durability of universal adhesives to enamel with PPA etching from less than one to 15 seconds and PLA etching for 15 seconds was significantly higher than that to ground enamel. The bond fatigue durability to enamel with PPM etching was not increased compared with ground enamel. The surface Ra roughness and surface area obtained with AFM of enamel increased after PPA and PLA etching, and those values were significantly higher than those of ground enamel. Furthermore, surface Ra roughness and surface area with PPA etching were significantly higher than those with PLA etching. However, surface Ra roughness and surface area of enamel with PPM etching were similar to those of ground enamel regardless of etching time.

CONCLUSION

PPA etching for less than one to 15 seconds and PLA etching for 15 seconds improve universal adhesive bonding, surface Ra roughness, and surface area of enamel. However, PPM etching is not effective, regardless of etching time, in improving bonds strengths, increasing surface roughness, and increasing surface area.

Analysis of the bond interface between self-adhesive resin cement to eroded dentin in vitro

The purpose of this study was to evaluate the bonding interface between a self-adhesive resin cement to in vitro eroded dentin. Seventy-two third molars were used and divided into two groups: sound dentin and in vitro eroded dentin. The in vitro erosion was performed following a demineralization protocol, in which the specimens were immersed in a demineralizing solution for 2 minutes per cycle and remineralizing solution for 10 minutes per cycle for 9 days. Both groups were submitted to four dentin surface treatments: control group (without any treatment), 2% chlorhexidine, 20% polyacrylic acid, and 0.1 M EDTA (n = 9). Blocks of resin-based composite were bonded with RelyX U200 self-adhesive resin cement applied on the pretreated dentin surfaces. The teeth were sectioned into beams (1mm²) and submitted to microtensile bond strength testing to evaluate the bond strength of self-adhesive resin cement to dentin after 24 hours and 8 months of immersion in artificial saliva. Three specimens of each group were longitudinally cut and evaluated using confocal laser scanning microscopy to analyze the dentin/cement interface. Eroded dentin showed higher bond strength values when compared to sound dentin for the 2% chlorhexidine group (p = 0.03), 24 hours after adhesion. When considering eroded dentin, the 0.1M EDTA group showed higher bond strength values with a statistically significant difference only for the control group (p = 0.002). After 8 months of storage, the present results showed that there was no statistically significant difference between the two substrates for all experimental groups (p>0.05). Analysis of the microscopy confocal showed different types of treatments performed on dentin generally increased tags formation when compared to the control group. The eroded dentin showed a significant increase in density and depth of resinous tags when compared to sound dentin. The storage of samples for 8 months seems to have not caused significant degradation of the adhesive interface.

Assessment of Bonding Effectiveness of Adhesive Materials to Tooth Structure using Bond Strength Test Methods: A Review of Literature

Background

The rapid developments in the field of adhesive dental materials have led to improvements in many aspects of clinical dentistry. Adhesive bond strength plays an important role in determining the clinical performance and longevity of dental restorations. Nevertheless, bond strength tests have never been well-standardized, although a number of important recommendations have been made.

Objective

The aim of this paper is to critically review the validity of different bond strength testing methods for assessment of bonding effectiveness of adhesive materials to tooth structure and discuss factors that may affect bond strength measurement.

Data Collection

Relevant literature published between 1983 and 2018 was collected and reviewed from the PubMed database and Google scholar resources.

Review Results

Results of the current bond testing methods should be used to compare materials tested under the same laboratory settings, but they shouldn't be used to make direct inferences on their clinical behaviour. Shear and micro-shear tests, result in non-uniform stress distribution, stress concentration at the substrate area, and predominantly tensile stresses rather than shear stresses. Micro-tensile bond tests provide many advantages over the shear tests, although these methods are technique sensitive and labour intensive.

Conclusion

Bond strength testing methods should be well-standardized, but there are many factors that cannot be fully controlled which leads to variation and misinterpretation of the data about the bonding abilities of adhesives.

Clinical Significance

New adhesive materials should be subjected to a combination of testing protocols to properly assess their bonding effectiveness.

Application of Calcium Silicate Materials After Acid Etching May Preserve Resin-Dentin Bonds

INTRODUCTION

The aim of the present study was to evaluate the effect of the application of calcium silicate materials (CSMs), after acid etching, on the longevity of the hybrid layer and marginal adaptation of composite restorations.

METHODS AND MATERIALS

Eighty human permanent molars received an intrapulpal pressure of 15 cm H₂O. Sixty teeth received a mesial proximal slot preparation with the gingival margin extending 1 mm below the cemento-enamel junction. The samples were divided into two groups. Group 1 received restorations using two types of etch-and-rinse adhesives: ethanol based (Single Bond, 3M ESPE, St Paul, MN, USA) and acetone based (Prime & Bond NT, Dentsply, DeTrey GmbH, Germany). In group 2 samples, a commercially available CSM (ProRoot MTA) was allowed to set before grinding and placing into a distilled water solution. This solution was applied on the cavity floor after acid etching. The surface was washed after 30 seconds followed by application of adhesives and restorations as in group 1. The samples were stored in phosphate-buffered saline for six months, maintaining the intrapulpal pressure. An epoxy replica was made, and the marginal adaptation was evaluated using scanning electron microscopy. The percentage of continuous margin (CM) was recorded for each group. Another 20 samples were used for hybrid layer evaluation. The crowns were ground to expose dentin. Intrapulpal pressure was applied. The samples were divided into two groups and restored similar to samples restored for marginal adaptation evaluation. The samples were longitudinally cut in 1-mm slices. The slices were stored under 15 cm of phosphate-buffered saline to simulate the pulpal pressure. After six months, the adhesive interface was evaluated using a scanning electron microscope. Statistical analysis was done with two-way analysis of variance with Holm-Sidak's correction for multiple comparisons.

RESULTS

Application of CSMs improved the marginal adaptation values in both adhesive groups. In group 1, there were areas of incomplete penetration of resins along with evidence of partial degradation of resin tags. Samples receiving CSM application after acid etching demonstrated long and regular resin tags with very few signs of degradation.

CONCLUSIONS

Application of CSMs after acid etching can be a potential avenue in preserving the resin-dentin bonds.

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.

Degradation of Multimode Adhesive System Bond Strength to Artificial Caries-Affected Dentin Due to Water Storage

The purpose of this study was to evaluate the influence of water storage on bond strength of multimode adhesive systems to artificially induced caries-affected dentin. One hundred twelve sound bovine incisors were randomly assigned to 16 groups (n=7) according to the dentin condition (sound; SND, artificially induced caries-affected dentin; CAD, cariogenic challenge by pH cycling for 14 days); the adhesive system (SU, Scotchbond Universal Adhesive; AB, All-Bond Universal; PB, Prime & Bond Elect; SB, Adper Single Bond 2; and CS, Clearfil SE Bond), and the etching strategy (etch-and-rinse and self-etch). All adhesive systems were applied under manufacturer's instructions to flat dentin surfaces, and a composite block was built up on each dentin surface. After 24 hours of water storage, the specimens were sectioned into stick-shaped specimens (0.8 mm2) and submitted to a microtensile test immediately (24 hours) or after six months of water storage. Bond strength data (MPa) were analyzed using three-way repeated-measures analysis of variance and post hoc Tukey test (α=5%), considering each substrate separately (SND and CAD). The etching strategy did not influence the bond strength of multimode adhesives, irrespective of the dentin condition. Water storage only reduced significantly the bond strength to CAD. The degradation of bond strength due to water storage was more pronounced in CAD, regardless of the etching strategy.

Microtensile bond strength, 4-point bending and nanoleakage of resin-dentin interfaces: Effects of two matrix metalloproteinase inhibitors

Chronic degradation of hybrid layer collagen by matrix metalloproteinases (MMPs) jeopardizes resin-dentin interfacial integrity and limits the durability of dental restorations. The 4-point bending strength (BS) is a valid but uncommon method of testing the mechanical behavior of resin-dentin interfaces. The present study aims to analyze the influence of two matrix metalloproteinase inhibitors on microtensile bond strength (µTBS), BS and nanoleakage. A total of 48M were divided into three groups according to bonding procedure. Teeth were horizontally sectioned to produce a flat dentin surface. In the control group, etch-and-rinse Prime&Bond One (Dentsply) bonding was used; in the self-etch group, methacryloyloxydodecylpyridinium bromide (MDPB)-containing Clearfil SE Protect (Kuraray) was used; and in the benzalkonium chloride (BAC)-etch group, BAC-etchant (Bisco) was used. A Ceram.X-One (Dentsply) composite was built as three successive layers and was light-cured. Samples were sectioned to produce microrods that were randomly divided into two groups for analysis at baseline and after 6 months of water immersion (n = 32), plus one slab for nanoleakage analysis (n = 8) via scanning electron microscopy (SEM) and digital image analysis (Fiji). Data were analyzed using the Weibull distribution and a mixed-model ANOVA with a post hoc Tukey test. All groups showed deterioration of the initial bonds. The self-etch group had a worse baseline µTBS than the control but had the best BS after aging. BAC-etch did not improve bond stability of etch-and-rinse adhesive. The µTBS and BS test results after aging were moderately correlated. Mixed fractures prevailed with regard to µTBS, whereas adhesive fractures dominated with regard to BS. Nanoleakage was not eliminated in any group and increased after aging. MDPB self-etch resisted bond degradation better than etch-and-rinse adhesives, even after BAC-etching. Integrating BS in studies of µTBS and nanoleakage might provide more clinically relevant outcomes for predicting the performance of dental adhesives.

Effect of Metal Primers on Bond Strength of a Composite Resin to Nickel-Chrome Metal Alloy

Abstract This study evaluated the effects of three metal primers and one multi-mode adhesive system on the shear bond strength (SBS) of a flowable composite resin to nickel-chrome metal alloy (Ni-Cr). Ninety plates were cast from Ni-Cr and divided in nine groups (n=10). The surfaces were sandblasted with Al2O3 and primed with three adhesive primers: Alloy Primer (AP), Universal Primer (TP) and RelyX Ceramic Primer (CP), and a multi-mode adhesive (Scotchbond Universal, SU). The Adper Single Bond Plus (SB) and SU adhesives were also combined with adhesive primers. Control group did not have any surface treatment. The groups were: AP, AP+SB, AP+SU, TP+SB, TP+SU, CP+SB, CP+SU and SU. Composite cylinders were built on alloy surface. After 24 h, half the specimens were subjected to SBS and the other half to thermal cycling before testing. Data were analyzed by two-way ANOVA and Tukey’s test (a=0.05). Failure modes were assessed by SEM observation. Higher SBS were obtained with AP and TP combined with adhesives at 24 h and the lowest one for control group. Thermocycling reduced SBS for AP, CP+SU and SU. Combination between TP and SU resulted in the highest SBS after the thermocycling. TP groups showed all types of failures and high incidence of mixed failures. The use of AP and UP metal primers before application of SU and SB adhesive systems increased the SBS of composite to Ni-Cr. These combinations between metal primers and adhesives had the highest SBS after thermocycling.

Influence of dentin pretreatment on bond strength of universal adhesives

Objective: The purpose of the present study was to compare bond strength of different universal adhesives under three different testing conditions: when no pretreatment was applied, after 37% phosphoric acid etching and after glycine application. Materials and methods: One hundred and fifty bovine permanent mandibular incisors were used as a substitute for human teeth. Five different universal adhesives were tested: Futurabond M+, Scotchbond Universal, Clearfil Universal Bond, G-Premio BOND, Peak Universal Bond. The adhesive systems were applied following each manufacturer's instructions. The teeth were randomly assigned to three different dentin surface pretreatments: no pretreatment agent (control), 37% phosphoric acid etching, glycine pretreatment. The specimens were placed in a universal testing machine in order to measure and compare bond strength values. Results: The Kruskal-Wallis analysis of variance and the Mann-Whitney test were applied to assess significant differences among the groups. Dentin pretreatments provided different bond strength values for the adhesives tested, while similar values were registered in groups without dentin pretreatment. Conclusions: In the present report, dentin surface pretreatment did not provide significant differences in shear bond strength values of almost all groups. Acid pretreatment lowered bond strength values of Futurabond and Peak Universal Adhesives, whereas glycine pretreatment increased bond strength values of G Praemio Bond adhesive system.

Influence of Different Dentin Substrate (Caries-Affected, Caries-Infected, Sound) on Long-Term μTBS

Abstract The aim of this study was to evaluate the μTBS in different dentin substrates and water-storage periods. Twenty-four dentin blocks obtained from sound third molars were randomly divided into 3 groups: Sound dentin (Sd), Caries-affected dentin (Ca) and Caries-infected dentin (Ci). Dentin blocks from Ca and Ci groups were subjected to artificial caries development (S. mutans biofilm). The softest carious tissue was removed using spherical drills under visual inspection with Caries Detector solution (Ca group). It was considered as Ci (softer and deeply red stained dentin) and Ca (harder and slightly red stained dentin). The Adper Single Bond 2 adhesive system was applied and Z350 composite blocks were built in all groups. Teeth were stored in deionized water for 24 h at 37 ºC and sectioned into beams (1.0 mm2 section area). The beams from each tooth were randomly divided into three storages periods: 24 h, 6 months or 1 year. Specimens were submitted to µTBS using EZ test machine at a crosshead speed of 1.0 mm/min. Failure mode was examined by SEM. Data from µTBS were submitted to split plot two-way ANOVA and Tukey’s HSD tests (a=0.05). The µTBS (MPa) of Sd (41.2) was significantly higher than Ca (32.4) and Ci (27.2), regardless of storage. Ca and Ci after 6 months and 1 year, presented similar µTBS. Mixed and adhesive failures predominated in all groups. The highest µTBS values (48.1±9.1) were found for Sd at 24 h storage. Storage of specimens decreased the µTBS values for all conditions.

Effect of Storage Time on Bond Strength Performance of Multimode Adhesives to Indirect Resin Composite and Lithium Disilicate Glass Ceramic

Purpose: To investigate the bond strength performance of multimode adhesives (MMAs) to indirect resin composite and lithium disilicate glass ceramic after 24 hours or one year of water storage.

Methods and Materials: Thirty flat and polished plates of indirect resin composite (Epricord) and thirty lithium disilicate glass ceramic plates (IPS e.max Press) were prepared. Surfaces were pretreated using sandblasting (indirect resin composite) or hydrofluoric acid (glass-based ceramic). Specimens were bonded with one of two MMAs (Scotchbond Universal [SBU] or All-Bond Universal [ABU]) or ceramic primer and hydrophobic bonding (RelyX Ceramic Primer and Adper Scotchbond Multi-Purpose Bond) as a control (n=10). Resin cement cylinders (0.75 mm in diameter × 0.5 mm in height) were bonded to both substrate surfaces using the respective adhesives. After 24 hours or one year of water storage, bonding performance was measured by microshear bond strength (MSBS) testing. Results were analyzed using three-way ANOVA with Bonferroni post hoc tests (α=0.05).

Results: For indirect resin composite, significantly higher MSBS values were found for ABU after 24 hours (ABU &gt; SBU = control); however, no significant difference among the adhesives was observed after one year (p&gt;0.05). For glass-based ceramic, significantly different bond strengths were observed among the adhesives after 24 hours (control = ABU &gt; SBU) and one year (control &gt; SBU = ABU; p&lt;0.05).

Conclusions: Both MMAs tested can be considered effective alternatives for bonding to sandblasted indirect resin composite after aging, as they showed similar bond performance to that of the control group. However, separate bottles of silane bonding resin showed higher MSBS values and more durable bonding for etched glass–based ceramic.