Influence of Application Modes on Increasing Bond Strength Longevity of Self-etching and Universal Adhesive Systems to Enamel

The present study aimed to evaluate the influence of application mode on the short-term microshear bond strength longevity of self-etching and universal adhesive systems to enamel, the failure mode, and the resulting enamel surface micromorphology. Ninety enamel surfaces were obtained from sound third molars, planed, and randomly assigned to nine groups, according to the application mode and the adhesive system (n=10). There were three primer application modes: according to the manufacturer's recommended application time (control), using double the application time recommended for the primer and selective enamel etching. The adhesive systems used were: Clearfil SE Bond (Kuraray), FL-Bond II (SHOFU), and Futurabond U (Voco). At least two resin-bonded composite cylinders (Grandioso Light Flow, Voco) were placed on each enamel surface, and then evaluated for microshear bond strength at 24 hours and 180 days of storage in solution body fluid (SBF) at pH 7.4. Failure modes were evaluated with a stereoscopic microscope at 20× magnification. A micromorphological analysis of the enamel surface was performed under a scanning electron microscope at 5000× magnification before and after the treatments. Mixed models for repeated measures over time showed significant interaction among application modes, adhesive systems, and time periods (p=0.0331). The bond strength of FL-Bond II adhesive to enamel observed after performing selective enamel etching was significantly higher than that observed after applying the control treatment (p=0.0010) at both 24 hours and 180 days. However, no significant difference was observed between the application of this same adhesive at double the time recommended by the manufacturer and the other two application modes (p>0.05). There was also no significant difference in the microshear bond strength for the enamel treatments applied using Clearfil SE Bond and Futurabond U (p>0.05). A significant reduction in bond strength to enamel was observed at the 180-day storage time for all the adhesive systems when selective enamel etching was performed (p<0.0001). No significant association was observed between the adhesive system failure mode and the enamel treatments (p=0.1402 and p=0.7590 for 24 hours and 180 days, respectively). The most prevalent failure was the adhesive type.

The Classification and Selection of Adhesive Agents; an Overview for the General Dentist

Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords "adhesive agents", "classification", "dentin", "enamel", "universal", "self-etch", "etch-and-rinse", and "bonding". The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or "multi-mode" according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.

Comparative Study on Interface Fracture of 4th Generation 3-Steps Adhesive and 7th Generation Universal Adhesive

The purpose of this paper is to compare the fracture behavior of interfaces obtained using fourth-generation and universal dental adhesives. The study relies on optic and SEM to evaluate the dentin-adhesive-restoration material interface of the samples and also on FEA simulation of fracture behavior. Specimen fabrication relied on 20 extracted teeth, in which class I cavities were created according to a protocol established based on the rules of minimally invasive therapy. For the direct adhesive technique, the adhesives used were: three-step All Bond, three-batch A and one-step Clearfil Universal Bond Quick-batch B. The restoration was performed with the same composite for both adhesives: Gradia direct posterior. The simulation used a 3D reconstructed molar on which geometric operations were performed to obtain an assembly that replicated a physical specimen. Material properties were applied to each component based on the information found in the literature. A simplified model for crack propagation was constructed, and using the fracture mechanics tool in Ansys 2019, the stress intensity factors that act at the crack tip of the adhesive interface were obtained. Mechanical simulation and microscopic investigation showed us how the interface of the dentine-adhesive-filling material performed in cases of both dental adhesives and for a certain loading condition. Important differences were identified among the adhesives, the fourth generation being superior to the fourth generation especially due to the separate steps in which the tooth surface was prepared for adhesion.

A Study of the Peculiarities of the Formation of a Hybrid Interface Based on Polydopamine between Dental Tissues and Dental Composites, Using IR and Raman Microspectroscopy, at the Submicron Level

The creation of buffer (hybrid) layers that provide improved adhesion to two heterogeneous materials is a promising and high-priority research area in the field of dental materials science. In our work, using FTIR and Raman microspectroscopy at the submicron level in a system of dental composites/intact dental enamel, we assessed the molecular features of formation and chemically visualized the hybrid interface formed on the basis of a nature-like adhesive, polydopamine (PDA). It is shown that a homogeneous bioinspired PDA-hybrid interface with an increased content of O-Ca-O bonds can be created using traditional methods of dental tissue pretreatment (diamond micro drilling, acid etching), as well as the subsequent alkalinization procedure and the developed synthesis technology. The development of the proposed technology for accelerated deposition of PDA-hybrid layers, as well as the creation of self-assembled biomimetic nanocomposites with antibacterial properties, may in the future find clinical application for minimally invasive dental restoration procedures.

Noninvasive diagnostic method using optical coherence tomography detected a vulnerable dentin enamel junction created by phosphoric acid etching

To investigate the influence of phosphoric acid etching on the dentin enamel junction (DEJ) using optical coherence tomography (OCT). Human teeth were assigned to four groups: 1. control, no additional treatment (CT); 2. The primer of "SE Bond2" was applied (SE), 3. "Enamel Conditioner" was applied (EC), 4. "K-etchant syringe" was applied (KE). After treatment, the DEJ was observed using a laser microscope (CLSM), OCT, and scanning electron microscopy (SEM). Additionally, an ultimate tensile strength (UTS) test at the DEJ was performed. No cracks were observed by CLSM. In contrast, cracks were observed all samples by SEM. Additionally, OCT revealed a white line along the DEJ in all KE specimens and some EC specimens. The UTS test showed a significant difference between CT and KE. This study found that phosphoric acid etching may cause excessive demineralization and weaken the DEJ. This fragility was observed using a non-invasive diagnostic method using OCT.

Influence of different tooth etchants on bur-cut and uncut enamel

This study aimed to evaluate the effect of pre-etching for two-step self-etch adhesive bonding to bur-cut and uncut enamel. Bur-cut and uncut enamel surfaces were assigned to surface treatments of no etchant (CT), Enamel Conditioner (EC; Shofu, Kyoto, Japan), or K-etchant syringe (KE; Kuraray Noritake Dental, Tokyo, Japan). The bonded samples were thermal cycled and evaluated by microshear bond strength (μSBS). The adhesive interface after acid-base challenge and the conditioned enamel surfaces were morphologically analyzed using scanning electron microscopy (SEM). For bur-cut enamel, EC and KE pre-etching significantly improved μSBS. For uncut enamel, KE showed higher μSBS than EC. SEM observation revealed that only KE removed the prismless layer of the uncut enamel surface. EC could improve enamel bonding and appears to be a substitute for phosphoric acid, especially for bur-cut enamel. However, uncut enamel could not be effectively conditioned by EC with a lower bond strength than KE.

Development of a Hybrid Biomimetic Enamel-Biocomposite Interface and a Study of Its Molecular Features Using Synchrotron Submicron ATR-FTIR Microspectroscopy and Multivariate Analysis Techniques

Using a biomimetic strategy and bioinspired materials, our work proposed a new technological approach to create a hybrid transitional layer between enamel and dental biocomposite. For this purpose, an amino acid booster conditioner based on a set of polar amino acids (lysine, arginine, hyaluronic acid), calcium alkali, and a modified adhesive based on BisGMA and nanocrystalline carbonate-substituted hydroxyapatite are used during dental enamel restoration. The molecular properties of the hybrid interface formed using the proposed strategy were understood using methods of multivariate statistical analysis of spectral information collected using the technique of synchrotron infrared microspectroscopy. The results obtained indicate the possibility of forming a bonding that mimics the properties of natural tissue with controlled molecular properties in the hybrid layer. The diffusion of the amino acid booster conditioner component, the calcium alkali, and the modified adhesive with nanocrystalline carbonate-substituted hydroxyapatite in the hybrid interface region creates a structure that should stabilize the reconstituted crystalline enamel layer. The developed technology can form the basis for an individualized, personalized approach to dental enamel restorations.

Ultrastructural characterisation of young and aged dental enamel by atomic force microscopy

Recent advances in atomic force microscopy (AFM) have allowed the characterisation of dental-associated biomaterials and biological surfaces with high-resolution. In this context, the topography of dental enamel - the hardest mineralised tissue in the body - has been explored with AFM-based approaches at the micro-scale. With age, teeth are known to suffer changes that can impact their structural stability and function; however, changes in enamel structure because of ageing have not yet been explored with nanoscale resolution. Therefore, the aim of this exploratory work was to optimise an approach to characterise the ultrastructure of dental enamel and determine potential differences in topography, hydroxyapatite (HA) crystal size, and surface roughness at the nanoscale associated to ageing. For this, a total of six teeth were collected from human donors from which enamel specimens were prepared. By employing intermittent contact (AC mode) imaging, HA crystals were characterised in both transversal and longitudinal orientation (respect to surface plane) with high-resolution in environmental conditions. The external enamel surface displayed the presence of a pellicle-like coating on its surface, that was not observable on cleaned specimens. Acid-etching exposed crystals that were imaged and morphologically characterised in high-resolution at the nanoscale in both the external and internal regions of enamel in older and younger specimens. Our results demonstrated important individual variations in HA crystal width and roughness parameters across the analysed specimens; however, an increase in surface roughness and decrease in HA width was observed for the pooled older external enamel group compared to younger specimens. Overall, high-resolution AFM was an effective approach for the qualitative and quantitative characterisation of human dental enamel ultrastructure. Future work should focus on exploring the ageing of dental enamel with increased sample sizes to compensate for individual differences as well as other potential confounding factors such as behavioural habits and mechanical forces. Lay abstract: Currently, advanced microscopy techniques such as atomic force microscopy (AFM) can be used to characterise surfaces relevant to dentistry with great detail. Among these surfaces of interest, dental enamel - the hardest mineralised tissue in the body- is important as it protects the deeper areas of the tooth from harmful stimuli such as sudden temperature changes, bacterial penetration, and chemical attack. Also, dental enamel is an important surface for the adhesion of some types of dental restorations; thus, its structure and organisation is highly relevant for both dental scientists and clinicians. With age, teeth are known to suffer changes that can impact their structural stability and function; however, changes in enamel structure as a result of ageing have not yet been explored with nanoscale resolution. It is necessary to develop and optimise AFM-based techniques in order to process specimens from dental samples across different age groups for ageing-associated nanoscale studies in the future. Therefore, the aim of this investigation was to optimise an approach to characterise the ultrastructure of dental enamel and determine potential differences in enamel topography, hydroxyapatite (HA) crystal size, and surface roughness at the nanoscale associated to ageing. For this, human enamel specimens obtained from a total of six teeth were collected and analysed with AFM, and HA crystals were characterised in both transversal and longitudinal orientation with high-resolution in environmental conditions. Upon AFM observation, sound superficial enamel displayed the presence of a pellicle-like coating on its surface, that was not observable after specimens were cleaned. Furthermore, acid-etching exposed HA crystals that were imaged and morphologically characterised in high-resolution at the nanoscale across different regions of enamel in older and younger specimens. We observed important individual variations in HA crystal width and roughness parameters across the analysed specimens and groups, suggesting individual as well as age-associated differences. Overall, high-resolution AFM was an effective approach for the qualitative and quantitative characterisation of human dental enamel ultrastructure at the nanometer range with minimal sample preparation. This proof-of-concept work can pave the way for future studies employing increased sample sizes to compensate for individual differences and population level factors. This article is protected by copyright. All rights reserved.