EDTA Conditioning Increases the Long-term Microtensile Bond Strength to Sclerotic Dentin Mediated by Self-etch Adhesives

Comparison between conventional and chemomechanical approaches for the removal of carious dentin: an in vitro study

The present study aimed to evaluate the efficiency, effectiveness, and biocompatibility of two agents used for the chemomechanical removal of carious dentin. Sixty extracted carious human teeth were treated with a conventional bur (CBG) or chemomechanical agents – Papacarie Duo (PG) and Brix 3000 (BG). Treatment efficiency and effectiveness were assessed by the working time for carious dentin removal and Knoop microhardness values, respectively. Human pulp fibroblasts (FP6) were used to evaluate cytotoxicity by incorporating MTT dye, and genotoxicity was evaluated with the micronuclei test. The carious tissue was removed in a shorter time with CBG (median = 54.0 seconds) than the time required for chemomechanical agents (p = 0.0001). However, the time was shorter for Brix 3000 (BG) than that for Papacarie Duo (PG), showing mean values of 85.0 and 110.5 seconds, respectively. Regarding microhardness testing, all approaches tested were effective (p < 0.05). The final mean microhardness values were 48.54 ± 16.31 KHN, 43.23 ± 13.26 KHN, and 47.63 ± 22.40 KHN for PG, BG, and CBG, respectively. PG decreased cell viability compared to that of BG, but it presented no genotoxicity. Brix 3000 may be a good option for chemomechanical dentin caries removal due to its reduced removal time and lower cytotoxicity compared to the other treatment options.

The microtensile bond strength test: Its historical background and application to bond testing

Microtensile bond strength (μTBS) test was introduced in 1994. Since then, it has been utilized profoundly across many bond strength testing laboratories, making it currently one of the most standard and versatile bond strength test. Although it is a static and strength-based method, together with the morphological and spectroscopic investigations, it has been contributing immensely in the advancement of dentin adhesive systems. μTBS test has a greater discriminative capability than the traditional macro-shear bond test. During the early stage of its development, the authors predicted that this testing method would enable evaluation of the adhesive performances of resins to excavated carious or sclerotic dentin and the regional bond strengths of various portions of the cavity. In addition, they also stated the possibility of comparing the long-term stability of resin adhesion at various portions of the cavity walls on teeth extracted at various times after insertion of bonded restorations. In this review, we discussed the historical background, inception and the application of the μTBS test and proposed directions for further improvement of this testing method.

A comparative study of the microtensile bond strength and microstructural differences between sclerotic and Normal dentine after surface pretreatment

Background

The resin bond strength of sclerotic dentine is significantly lower than that of the normal dentine, which paused a challenge for bonding procedures clinically. The aim of this study was to compare the effects of different surface pretreatments on the micro-tensile bond strength and microstructure between sclerotic dentine and normal dentine.

Methods

Eighty teeth that were collected, forty premolars with typical wedge-shaped defects visually graded as class III were assigned as the sclerotic dentine group (SD), the other forty normal premolars with artificial wedge-shaped defects were assigned as the normal dentine group (ND). Each group was randomly subdivided into eight subgroups according to the solution used: 35% phosphoric acid, 15% EDTA, 5% or 10% NaClO. Then the dentine surface was examined using a scanning electron microscope (SEM). The lesions were restored using self-etching adhesive and the subsequent resin composite. The teeth were sectioned into sticks for the micro-tensile bond strength analysis, and the data were analysed using the SPSS17.0 software package (α = 0.05).

Results

First, for the ND groups, after pretreatment using 35% phosphoric acid, and 35% phosphoric acid + 5% or 10% sodium hypochlorite, the bonding strengths of the normal dentine were higher than that of the other groups (P < 0.05). Second, for the SD groups, after pretreatment using 35% phosphoric acid, 15% EDTA, and 35% phosphoric acid + 5% or 10% sodium hypochlorite, the bonding strengths of the sclerotic dentine were higher than that of the other groups (P < 0.05). Third, the bond strengths of the sclerotic dentine were lower than that of the normal dentine without any pretreatment (P < 0.05). After pretreatment using 35% phosphoric acid + 5% or 10% sodium hypochlorite, the bonding strengths of the sclerotic dentine were higher than that of the normal dentine (P < 0.05). SEM observation showed that the appearances of dentine surface were changed after pretreatment using the above solutions, with the reduced smear layer, opened small groove and increased dentinal tubules.

Conclusion

Pretreatment of dentine using 35% phosphoric acid+ 5% or + 10% sodium hypochlorite changed the microstructure of the sclerotic dentine surface and subsequently increased the micro-tensile bond strength.