Scanning electron microscopy observation of dentin bond interfaces in different types of resin luting cements

This study aimed to observe and compare the resin luting cement (RLC)/dentin interfaces of different types of RLC systems with scanning electron microscopy (SEM). This study evaluated six self-adhesive resin luting cement systems (SARLCs), four systems combining a SARLC with a tooth primer (SARLCPs), and six conventional resin luting cement systems (CVRLCs). Cured resin composite rods were bonded to bovine dentin using RLCs in different etching modes. The morphological features at the interfaces were observed using SEM. Although all RLCs in etch-&-rinse (ER) mode showed a clear hybrid layer, most SARLCs had a thinner and more porous hybrid layer than the SARLCPs and CVRLCs. All SARLCPs with primer and CVRLCs showed a thin high-density layer below the primer layer in both etching modes. CVRLCs and SARLCPs with primer treatment systems may be more versatile and reliable when compared to simplified RLC systems.

Comparing Various Resin Luting Cement Systems in Different Etching Modes Through Bond Durability and Morphological Features

OBJECTIVES

This study aimed to investigate bond performance of various resin luting cement (RLC) systems on enamel and dentin in different etching modes and to compare the RLC-tooth interface morphology using scanning electron microscopy (SEM).

METHODS AND MATERIALS

The self-adhesive RLC systems used in combination with universal adhesives were as follows: Scotchbond Universal Adhesive Plus + RelyX Universal (3M Oral Care) and Clearfil Universal Bond Quick ER + SA Luting Multi (Kuraray Noritake Dental). These RLC systems were also used alone as self-adhesive RLC systems without universal adhesives (self-adhesive mode). The conventional RLC systems for comparison materials were as follows: BeautiBond Xtream + ResiCem EX (Shofu) and Tooth Primer + Panavia V5 (Kuraray Noritake Dental). Twelve specimens were prepared for each group to measure shear bond strength (SBS) in different etching modes. A stainless-steel rod was used as a substitute for indirect restorations. Bonded specimens were allocated to baseline (stored for 24 hours) and artificially aged (thermocycling [TC] for 10,000 cycles) groups. Representative treated tooth surfaces and RLC-tooth interfaces were observed using SEM.

RESULTS

Three-way analysis of variance (ANOVA) revealed that all the factors (etching mode, storage period, and RLC system) had a significant influence on the enamel SBS values (p<0.05). Enamel SBS was significantly higher in etch-&-rinse (ER) mode than in self-etch (SE) mode, regardless of RLC system or storage period. Three-way ANOVA showed that all the factors had a significant influence on the dentin SBS values (p<0.001). Most RLC systems showed significantly higher dentin SBS in SE mode than in ER mode, regardless of storage period. However, the combination with Scotchbond Universal Adhesive Plus and RelyX Universal showed no significant difference in SBS values between etching modes at the baseline and showed a significantly higher SBS value in ER mode than in SE mode after TC.

CONCLUSIONS

The self-adhesive RLC systems with universal adhesives tended to show higher enamel and dentin bond performance than the self-adhesive RLC systems alone. The morphology of treated tooth surfaces and resin cement-tooth interfaces were dependent on the RLC system and etching mode used. The RLC systems with primer application showed a thin, high-density layer above the intact dentin in both etching modes, suggesting chemical interaction.

Bond durability of a two-step adhesive with a universal-adhesive-derived primer in different etching modes under different degradation conditions

This study investigated the enamel and dentin bond durability of a two-step adhesive system, using a universal adhesive-derived primer (G2-Bond Universal [GU]), and compared it with the two conventional, two-step, self-etch adhesive systems (Clearfil SE Bond 2 [CS] and OptiBond XTR [OX]) under thermal cycling (TC) and long-term water storage (WS). The shear bond strengths to bovine enamel and dentin were determined using the etch-and-rinse and self-etch modes. Twelve specimens per test group were prepared and further divided into the following subgroups: 1) subjected to TC, 2) long-term WS, and 3) WS for 24 h (baseline). The enamel and dentin bond durability of GU was superior to those of CS and OX in different etching modes and under different degradation conditions. The latest two-step adhesive system, which utilizes universal adhesives' benefits in its primer, might offer durable clinical bonding performances and can be widely used in a clinical setting.

Early Phase Enamel Bond Performance of a Two-step Adhesive Containing a Primer Derived from a Universal Adhesive

PURPOSE

To investigate the changes in the enamel bond performance of a two-step adhesive containing a primer derived from a universal adhesive in the early phase before 24 h and compare them to those of other adhesives. The Knoop hardness number (KHN) of the cured adhesive layers and resin composite was measured.

MATERIALS AND METHODS

A new two-step adhesive using universal adhesive technology, G2-Bond Universal, was tested. Two conventional two-step adhesives, Clearfil SE Bond 2 and OptiBond eXTRa, and an established universal adhesive, Scotchbond Universal Plus Adhesive, were used as comparison materials. Twelve specimens per group were used to measure the shear bond strength (SBS) to bovine enamel in different etching modes. The bonded specimens were stored in distilled water at 37°C for 5 min or 1, 6, 12, or 24 h before SBS testing. The KHN of the adhesive layer and resin composite was determined after the same storage periods as for SBS testing.

RESULTS

All adhesives exhibited increased SBS with prolonged storage periods, irrespective of the etching mode. The KHN of the adhesive layer and resin composite increased over time.

CONCLUSIONS

There were strong positive correlations between the SBS and KHN of the adhesive layer and resin composite. Phosphoric acid pre-etching of enamel effectively increases enamel bond performance. The two-step adhesive G2-Bond Universal demonstrated significantly higher bond strength in the early phase than the other adhesives in self-etch mode.

Effectiveness of Different Polishing Kits for Chairside CAD/CAM Provisional Restorative Materials

Objective: To investigate the efficacy of three specially designed polishing kits for provisional restorations made from three chairside computer-aided design and computer-aided manufacturing (CAD/CAM) provisional resin blocks.

Method: Ninety-six chairside CAD/CAM provisional restorations were milled out of three chairside CAD/CAM provisional resin blocks: (1) ArtBloc Temp (Merz Dental); (2) Telio CAD (Ivoclar Vivadent); and (3) Vita CAD-Temp (VITA Zahnfabrik). The provisional restorations for each material were allocated into the following groups: (1) milled restorations (no polish); (2) polished with CADMaster CAD/CAM Adjustment & Polishing Kit (CM, Shofu); (3) polished with KUT Ultimate Bisacryl (Temporaries) Polishing Kit (KU, Dental Savings Club); and (4) polished with K0330 PMMA Adjusting, Finishing & Polishing (KP, Brasseler USA). Optical profilometry and atomic force microscopy (AFM) were used to assess the surface roughness (Ra) of each provisional restoration at the microscale and nanoscale, respectively, and obtain topographical images. In addition, the milled and polished restorations were visually evaluated by 16 dentists.

Results: There was a strong positive correlation with Ra values between optical profilometry and AFM. Only KP significantly improved the surface roughness of CAD/CAM provisional restorations compared to the milled equivalent, regardless of material type or measurement modality (ie, lateral length scale). Although surface topography imaging with AFM revealed some shallow scratches, even for KP polished specimens, all KP polished restorations were categorized as clinically acceptable for provisional restorations in visual inspections from dentists.

Conclusion: Specially designed polishing kits for provisional restorations did not all improve the surface roughness of chairside CAD/CAM provisional restorations, regardless of the measurement method. KP was more consistently effective in polishing milled chairside CAD/CAM provisional restorations than CM and KU.

Effect of mold enclosure and chisel design on fatigue bond strength of dental adhesive systems

To examine the effect of mold enclosure and chisel design on macro shear fatigue bond strengths of dental adhesive systems. The fatigue bond strength testing was conducted with two commercially available dental adhesive systems, (1) OptiBond eXTRa and (2) Scotchbond Universal, for bonding a resin composite (Filtek Supreme Ultra) to both enamel and dentin using a mold enclosure and a non‐mold enclosure with a knife‐edge and two sized notched‐edge chisel assemblies for loading. As a loading reference for the fatigue testing, macro shear bond strengths of the adhesive systems to enamel and dentin were conducted using a mold enclosure and a knife‐edge chisel assembly. The shear bond strengths with the mold enclosure using knife‐edge chisel assembly did not exhibit a significant difference between the adhesive systems for either enamel or dentin. The fatigue bond strengths of bonded specimens demonstrated significant differences when comparing the mold enclosure and non‐mold enclosure, but not between knife‐edge and notched‐edge chisel assemblies. The fatigue bond strengths of dental adhesive systems demonstrated significantly higher values when using mold‐enclosed bonded specimens than a non‐mold enclosure, regardless of type of chisel assembly.

Influence of Different Application Methods on the Bonding Effectiveness of Universal Adhesives to Dentin in the Early Phase

PURPOSE

To investigate the changes in the dentin bond strengths of universal adhesives during the early phase and evaluate the effect of a double-layer adhesive application on the performance of the dentin bond.

MATERIALS AND METHODS

Three universal adhesives and a two-step self-etch adhesive were employed to ascertain the shear bond strengths (SBS) of specimens to bovine dentin with the use of the etch-and-rinse or self-etch mode. The specimens were further divided into two groups based on adhesive application in a single or a double layer. The bonded specimens were stored in distilled water at 37°C for 5 min or 1, 6, 12, or 24 h prior to SBS measurement and the adhesives' Knoop hardness number (KHN).

RESULTS

All the adhesives showed increased SBS with prolonged storage periods regardless of the adhesive layer (single or double) or etching mode. Most universal adhesives in the double adhesive layer groups showed significantly higher SBS than single adhesive layer groups for the same storage period. All the adhesives also showed increased KHN with increased storage period.

CONCLUSION

The SBS and KHN values of the adhesives increased with increasing storage duration over a 24-h period. Double adhesive layer application mediated increased dentin bond strength in the early phase.

Handling and Mechanical Properties of Low-viscosity Bulk-fill Resin Composites

This study aimed to evaluate the filler contents (FCs), flexural properties, depth of cure (DOC), wear resistance, and handling properties of different low-viscosity bulk-fill resin composites (LVBRCs) and to determine the correlations between the tested parameters. Six LVBRCs, Beautifil-Bulk (BBF), Bulk Base Hard (BBH), Bulk Base Medium (BBM), Filtek Bulk-Fill Flowable Restorative (FBF), G-ænial Bulk Injectable (GBI), and SDR flow+ Bulk-Fill Flowable (SDR) were used. The DOC and flexural property tests were conducted according to the ISO 4049 specifications. The flexural strength, elastic modulus, and resilience were determined in 12 specimens that were obtained from each of the 6 materials. Sliding-impact-wear testing was conducted by evaluating the wear facets of the specimens using a noncontact profilometer and by confocal laser scanning microscopy. The handling properties of the LVBRC was assessed via extrusion force and thread formation measurements. The DOC for the majority of the LVBRCs was approximately 4 mm. Although the FCs and mechanical properties were material dependent, some LVBRCs exhibited excellent flexural properties and wear resistance. The LVBRCs demonstrated a wide range of extrusion force and thread formation. Regarding the correlations between the tested parameters, extremely strong negative and positive correlations were observed for the DOC versus extrusion force, flexural strength versus elastic modulus, maximum depth versus volume loss, and maximum depth versus thread formation. In addition, strong correlations between FCs and DOC, resilience, wear resistance, and extrusion force were observed.

Evaluation of Polishing Systems for CAD/CAM Polymer-Infiltrated Ceramic-Network Restorations

OBJECTIVE

The purpose of this study was to evaluate the effectiveness of five different polishing systems on a computer-aided design and computer-aided manufacturing (CAD/CAM) polymer-infiltrated ceramic-network restoration with nanoscale assessment using atomic force microscopy (AFM) and visual assessment performed by dental school senior students and faculty members.

METHOD

Forty-eight full coverage crowns were milled out of polymer-infiltrated ceramic-network CAD/CAM blocks (Vita Enamic) for polishing with one company proprietary, two ceramic and two composite polishing systems. The prepared crowns were divided into six groups: (1) no polishing (control); (2) polishing with Vita Enamic Polishing Kit (VEna); (3) polishing with Shofu Porcelain Laminate Polishing Kit (SCer); (4) polishing with Brasseler Dialite Feather lite All- Ceramic Adjusting & Polishing System (BCer); (5) polishing with Shofu Composite Polishing Kit (SCom); and (6) polishing with Brasseler Composite Polishing Kit (BCom). The polished crown surface topography was observed, and surface roughness and area were measured with AFM. In addition, polished crowns were visually assessed by 15 senior dental students and 15 dental school faculty members.

RESULTS

All polishing treatments significantly reduced the surface roughness and area of the crown compared with the control. SCom and BCom showed significantly higher surface area than VEna, and the SCer and BCer groups were intermediate, showing no significant difference from either VEna or SCom and BCom. There were no significant differences in surface roughness between any of the systems. Dental students and faculty members classified the groups polished with VEna, SCer, and BCer groups as clinically acceptable, and they selected BCer group as the best polished restorations and the control group as the least polished restorations.

CONCLUSIONS

Ceramic and composite polishing systems produced similar polishing results as that observed using a company proprietary polishing system. However, effectiveness for polishing using a company proprietary and ceramic polishing system tends to be higher than composite polishing systems.

Bonding and wear properties of self-adhesive flowable restorative materials

The purpose of this study was to evaluate the bonding and wear properties of self-adhesive flowable restorative materials. Five self-adhesive flowable restorative materials were used. The study parameters were: (i) shear bond strengths; (ii) microleakage; (iii) occlusal wear; and (iv) qualitative evaluation of the bonding interface. The range of shear bond strengths of the materials was as follows: 7.4-12.2 MPa to ground enamel, 22.5-32.5 MPa to etched enamel, and 1.3-4.2 MPa to dentin. The microleakage scores of the materials did not show any statistically significant differences regardless of the presence or absence of etching. The wear facets on the materials showed 0.099-0.447 mm³ of volume loss and 148.6-365.3 µm maximum depth, with statistically significant differences between materials. Scanning electron microscopic images of the interfaces of the materials showed good adaptation regardless of substrate. The bonding and wear properties of self-adhesive flowable restorative materials were still limited and showed lower values than previously reported results for nanofilled composites with an adhesive system. Selective enamel etching can improve the bonding performance of these materials.

Bond durability of universal adhesives to intact enamel surface in different etching modes

This study aimed at determining the enamel bond durability of universal adhesives to intact enamel (IE) and ground enamel (GE) in different etching modes under thermal cycling (TC) and fatigue stresses. Two universal adhesives and a two-step self-etch adhesive were used. Enamel specimens were divided into four groups by treatment: (i) GE in etch-and-rinse, (ii) IE in etch-and-rinse, (iii) GE in self-etch, and (iv) IE in self-etch. Bonded specimens were subjected to TC, and then shear bond strengths (SBS) were conducted. SBS tests were also conducted after storage in 37°C water for 24 h (baseline). For shear fatigue strength (SFS) testing, bonded specimens were subjected to fatigue stress at a frequency of 10 Hz for 50,000 cycles. At baseline, all adhesives showed significantly higher SBS values with GE than IE in self-etch mode in contrast to in etch-and-rinse mode. After TC, the universal adhesives with IE showed lower SBS values than the baseline, regardless of the etching mode. Universal adhesives showed significantly lower SFS values with IE in etch-and-rinse, but not in self-etch mode. Phosphoric acid pre-etching or grinding of the aprismatic enamel may be helpful in establishing reliable initial and long-term bonds to enamel when using universal adhesives in self-etch mode.

Influence of a Primer Resembling Universal Adhesive on the Bonding Effectiveness of an Experimental Two-step Self-etch Adhesive

Purpose: To investigate the effect of application of a primer resembling a universal adhesive with or without light irradiation followed by a hydrophobic bonding agent on bonding effectiveness, based on shear bond strength (SBS) and shear fatigue strength (SFS) tests. Materials and Methods: An experimental two-step self-etch adhesive (BZF) that comprises a primer resembling a universal adhesive (BZP) and a hydrophobic bonding agent (BZB) were used. The two-step self-etch adhesive, Clearfil SE Bond 2 (SE), served as a comparison. Three experiments were conducted. Experiment 1: (1) BZP alone without light irradiation (BZP w/o); (2) BZP alone with light irradiation (BZP w/); (3) BZP without light irradiation followed by BZB (BZPB w/o); (4) BZP with light irradiation followed by BZB (BZPB w/). Experiment 2: (1) BZPB w/o, (2) SE primer + BZ bonding agent (SEP + BZB), and (3) SE primer + SE bonding agent (SEPB). The bonded specimens of experiment 1 and 2 were subjected to SBS tests. Experiment 3: Bonded specimens following the same experimental protocol as experiment 2 were subjected to SFS tests. Results: BZPB showed significantly higher mean enamel and dentin SBS than did BZP. BZPB showed significantly higher SBS without light irradiation than with light irradiation to both substrates. The group of BZPB without light irradiation showed significantly higher SBS than the group of BZPB with light irradiation to both substrates. For experiments 2 and 3, although no significant differences were found in SBS among groups for enamel, SEP + BZB showed a significantly lower SBS and SFS than other groups for dentin. Conclusions: BZF showed bonding performance equivalent to that of the gold standard Clearfil SE Bond 2.

Comparison of different etch-and-rinse adhesive systems based on shear fatigue dentin bond strength and morphological features the interface

OBJECTIVES

The aim of this study was to investigate dentin bonding durability of different etch-and-rinse (ER) adhesive systems under fatigue stress and to compare morphological features of resin/dentin interfaces using SEM.

METHODS

Two three-step ER adhesives, a two-step ER adhesive, and a universal adhesive in ER mode were evaluated. Before application of either primer or adhesive, phosphoric acid etching of human dentin was completed. Fifteen bonded specimens for each adhesive system were stored in distilled water at 37 °C for 24 h, then subjected to a shear bond strength (SBS) test. Bonding durability was assessed from the perspective of biomechanical stress. 25 bonded specimens for each adhesive system were subjected to shear fatigue strength (SFS) testing with a repeated subcritical load at a frequency of 20 Hz for 50,000 cycles or until failure.

RESULTS

Mean SBS and SFS values ranged from 33.3 to 41.2 MPa, and from 18.3 to 20.3 MPa, respectively. Three-step adhesives showed higher SBS and SFS values than the other adhesive systems. Under SEM, resin tags in different adhesive systems showed similar features, but morphology below the hybrid layer was material dependent. The universal adhesive in ER mode showed an obvious thin, high-density reaction layer below the hybrid layer.

SIGNIFICANCE

Three-step adhesives showed higher dentin bond durability than the other ER adhesives; no significant differences in SFS were found between the universal adhesive in ER mode and the three-step ER adhesives. The results of this in vitro study indicate that some ER adhesives might establish chemical bonding with intact dentin below the hybrid layer in addition to micromechanical retention.

Effect of Layering Techniques on Polymerization Shrinkage Stress of High- and Low-viscosity Bulk-fill Resins

CLINICAL RELEVANCE

The use of layering techniques is still advisable with many bulk-fill resins and should be the default unless a particular resin is known to not need it.

SUMMARY

Objective: The purpose of this study was to investigate how layering techniques affect polymerization shrinkage stresses of high-and low-viscosity bulk-fill resins.Method: Six high-viscosity and six low-viscosity bulk-fill resins were evaluated. Aluminum blocks with a mesial-occlusal-distal (MOD) cavity were machined and randomly divided into groups for different filling techniques (bulk-fill vs horizontal layering vs oblique layering) and further subdivided according to type of resin (high- vs low-viscosity). The cuspal deflection resulting from the polymerization of bulk-fill resin bonded to a MOD cavity within an aluminum block was measured with a digimatic micrometer. Scanning electron microscopy analyses of tested resins were also conducted.Results: In the high-viscosity bulk-fill resins, cuspal deflection of the MOD cavity ranged from 11.2 to 18.2 μm with the bulk-filling technique, from 10.7 to 15.5 μm with the horizontal layering technique, and from 10.9 to 15.2 μm with the oblique layering technique. In the low-viscosity bulk-fill resins, cuspal deflection of the material ranged from 9.2 to 19.8 μm with the bulk-filling technique, from 8.2 to 15.7 μm with the horizontal layering technique, and from 8.4 to 16.4 μm with the oblique layering technique.Conclusion: Cuspal deflections for some high-and low-viscosity bulk-fill resins were significantly reduced by using layering techniques, but the resultant improvement of layering techniques was not applicable to all the bulk-fill resins used in this study.

Simulated Cuspal Deflection and Flexural Properties of Bulk-Fill and Conventional Flowable Resin Composites

CLINICAL RELEVANCE

Some bulk-fill flowable resin composites produce less cuspal deflection than a conventional incrementally filled flowable resin composites.

SUMMARY

Objective: This study investigated simulated cuspal deflection and flexural properties of bulk-fill and conventional flowable resin composites.Methods and Materials: Five bulk-fill and six conventional flowable resin composites were evaluated. Aluminium blocks with a mesio-occlusal-distal cavity were prepared and randomly divided into groups for each of the different measurement techniques and were further subdivided according to the type of flowable resin composite. The simulated cuspal deflection caused by the polymerization of resin composite within an aluminium block was measured using a highly accurate submicron digimatic micrometer or a confocal laser scanning microscope (CLSM). In addition, the flexural properties of tested resin composites were measured to investigate the relation between cuspal deflection and flexural properties, and the resin composites were observed using scanning electron microscopy.Results: Simulated cuspal deflection of some bulk-fill flowable resin composites was found to be significantly lower than or similar to those for conventional counterparts, regardless of the measurement method. There were statistically significant differences in flexural properties depending on the material, regardless of the type of flowable resin composite. Pearson correlation analysis did not reveal a statistically significant relationship between flexural properties and cuspal deflection.Conclusion: These results indicate that some bulk-fill flowable resin composites exhibit lower cuspal deflection with the bulk-filling technique than is shown by conventional flowable resin composites using the incremental filling technique. Simulated cuspal deflection can be measured using either a micrometer or CLSM, but this experiment failed to show a significant relationship between cuspal deflection and flexural properties of flowable resin composites.

Effect of double-layer application on the early enamel bond strength of universal adhesives

OBJECTIVES

The present study aimed to investigate the changes in the enamel bond strengths of universal adhesives in the early phase of specimen creation and evaluate the effect of double-layer application on enamel bond effectiveness using different etching modes.

METHOD

Four universal adhesives, namely Clearfil Universal Bond Quick, G-Premio Bond, Scotchbond Universal, and Tokuyama Universal Bond, were used. Clearfil SE Bond two-step self-etch adhesive system was used as a comparison. Fifteen specimens per group were used for determining the shear bond strength (SBS) to bovine enamel in the etch-and-rinse or self-etch mode. The adhesive was applied to specimens in accordance with the manufacturers' instructions (single-layer application), or the adhesive was applied twice (double-layer application). The bonded specimens were stored in distilled water at 37 °C for 5 min or 1, 6, 12, or 24 h before SBS testing. The flexural properties of the resin composite Clearfil AP-X were measured for the same storage periods.

RESULTS

All universal adhesives exhibited increased SBS values with prolonged storage periods regardless of the application technique or etching mode used. Double-layer application was associated with higher SBS values than single-layer application for most universal adhesives over the same storage period.

CONCLUSION

Phosphoric acid pre-etching and double-layer application of universal adhesives resulted in increased enamel bond strength in the early phase of specimen bonding.

CLINICAL RELEVANCE

Care should be taken when using universal adhesives in the self-etch mode for enamel bonding because the enamel adhesion is sensitive to the duration after filling.

Influence of 38% silver diamine fluoride application on bond stability to enamel and dentin using universal adhesives in self-etch mode

In order to evaluate the influence of 38% silver diamine fluoride (SDF) application on enamel and dentin bond stability of universal adhesives in self-etch mode, a 38% SDF and three universal adhesives were used in this study. Initial shear bond strength (ISBS), fatigue bond strength (FBS), and shear bond strength of survivors (SBSS) to enamel and dentin of universal adhesives in self-etch mode, with and without SDF application, were determined. SDF was applied to the polished enamel or dentin surface for 1 min, water-rinsed and air-dried for comparison with controls. The universal adhesives were applied to the prepared samples and composite resin was bonded using a mold-enclosed method. Enamel bond stability of universal adhesives with SDF (ISBS: 14.7-20.4 MPa; FBS: 5.5-7.4 MPa and SBSS: 14.4-21.5 MPa) was significantly weaker than those without SDF (ISBS: 28.0-29.2 MPa; FBS: 12.1-15.6 MPa and SBSS: 28.4-34.4 MPa). Dentin bond stability with SDF (ISBS: 14.8-20.9 MPa; FBS: 7.1-8.2 MPa and SBSS: 17.3-21.8 MPa) was also significantly weaker than without SDF (ISBS: 19.3-36.1 MPa; FBS: 11.0-13.7 MPa and SBSS: 22.2-34.6 MPa). The results suggest that SDF application on enamel and dentin reduces the bond stability of universal adhesives in self-etch mode.

Comparison of occlusal wear between bulk-fill and conventional flowable resin composites

PURPOSE

To investigate the occlusal wear of bulk-fill and conventional flowable resin composites.

METHODS

Four bulk-fill flowable resin composites: (1) Filtek Bulk Fill Flowable Restorative (FB); (2) G-ænial Bulk Injectable (GB); (3) SDR Flow+ (SD); and (4) Tetric EvoFlow Bulk Fill (TB), and four conventional flowable resin composites: (1) Clearfil Majesty IC (CM); (2) Filtek Supreme Ultra Flow (FF); (3) G-ænial Universal Flow (GF); and (4) Herculite XRV Ultra Flow (HF) were evaluated. Localized wear was simulated using 400,000 cycles in a Leinfelder-Suzuki (Alabama) device with a stainless-steel ball bearing antagonist. Volume loss and maximum depth of wear facets were measured using a Proscan 2100 noncontact profilometer in conjunction with analyzing software. Scanning electron microscopy observations were also conducted on the wear specimens.

RESULTS

Simulated occlusal wear was significantly different (P< 0.05) among the materials tested. FF, GB and GF showed significantly less wear than the other tested resin composites. The rank order of volume loss and maximum depth was GF-GB-FF-FB-CM-HF-TB-SD.

CLINICAL SIGNIFICANCE

Bulk-fill flowable resin composites showed a much wider range of wear properties than conventional flowable resin composites. Some composites of each type may be suitable for use in occlusal contact areas of posterior restorations, but care must be taken when selecting such a resin.

In Vitro Wear Resistance of Self-Adhesive Restorative Materials

PURPOSE

To investigate simulated localized and generalized wear of self-adhesive restorative materials.

MATERIALS AND METHODS

Three commercially available restorative materials and one experimental material with self-adhesive properties were evaluated. The experimental material was tested in both light-cured and self-cured conditions. Activa (A), Fuji II LC (F), and Equia Forte (E) and the experimental material ASAR-MP4 (S) were investigated. Two kinds of wear were simulated in an Alabama wear machine. Localized wear was simulated with a stainless-steel ball bearing antagonist and generalized with a flat-ended stainless-steel cylinder antagonist. The wear challenge was carried out in an aqueous slurry of polymethyl methacrylate beads. Material volume loss was measured on polyvinyl siloxane replicates of each worn surface using a Proscan 2100 noncontact profilometer in conjunction with Proscan and AnSur 3D software.

RESULTS

There were significant differences (p < 0.05) among the materials for both generalized and localized wear. The experimental material in both curing modes exhibited significantly less localized wear than F and A and significantly less generalized wear than F and E.

CONCLUSION

Self-adhesive materials offer unique handling properties for direct placement of posterior restorations in permanent teeth. The experimental material ASAR-MP4 generated similar wear values to the other self-adhesive materials tested.

Enamel and Dentin Bond Durability of Self-Adhesive Restorative Materials

PURPOSE

To use shear bond strength (SBS) and shear fatigue strength (SFS) testing to determine the durability of adhesion of self-adhesive restorative materials compared to composite resin bonded with a universal adhesive.

MATERIALS AND METHODS

A universal adhesive, Prime & Bond Active, was used in self-etch mode to bond Z-100 composite resin to enamel and dentin. Three commercially available restorative materials and one experimental material with self-adhesive properties, Activa (A), Fuji II LC(F), and Equia Forte (E) and ASAR-MP4 (S) were also bonded to enamel and dentin. The SBS and SFS were determined for all materials. A staircase method was used to determine the SFS with 10 Hz frequency for 50,000 cycles or until failure occurred.

RESULTS

On enamel, S generated similar values to the adhesive/composite materials and higher values than F, E, and A. On dentin, the composite/universal adhesive showed significantly higher SBS and SFS than the self-adhesive materials. S, F, and E generated higher values than A on dentin.

CONCLUSION

SBS and SFS values to enamel were similar for all materials tested except Activa which generated lower enamel values. On dentin surfaces, the self-adhesive materials generated similar SBS and SFS, with the exception of Activa. Those values were lower than that generated with composite resin and a universal adhesive.

Implant therapy with ultratranslucent monolithic zirconia restorations in the esthetic zone: a case report

Esthetic problems in maxillary central incisors are often difficult to treat with dental implants. It is necessary to preserve the interdental papillae, or regenerate them if they are absent, and minimize the risk of loss of hard or soft tissue. This task may be made easier by the recent introduction of ultratranslucent zirconia, which can be used with custom zirconia abutments to mutually enhance the effectiveness of both materials. This case report describes implant therapy with ultratranslucent monolithic zirconia restorations in the esthetic zone. In this approach, adequate pink esthetics can be achieved by delayed titanium implant placement in conjunction with guided bone regeneration. Ultratranslucent monolithic zirconia restorations with custom zirconia abutments provide predictable esthetic results.

Comparison of dentin bond durability of a universal adhesive and two etch-and-rinse adhesive systems

OBJECTIVE

This study aimed to compare dentin bond durability under different degradation conditions between two etch-and-rinse (ER) systems and a universal adhesive in ER mode.

METHOD

This study used a universal adhesive [Scotchbond Universal (SU)], a three-step ER adhesive [Scotchbond Multi-Purpose Plus (SM)], and a two-step ER adhesive [Single Bond Plus (SB)]. A phosphoric acid-etching agent was applied to bovine dentin prior to the application of either a primer or the adhesive. After acid etching, bonding procedures were conducted. The specimens were divided into three group classes: (1) subjected to 10,000, 30,000, or 50,000 thermal cycles (TC); (2) stored in distilled water at 37 °C for 6 months or 1 year (WS); and (3) stored in distilled water for 24 h (baseline). Shear bond strength (SBS) tests were conducted.

RESULTS

SB showed a higher baseline SBS than the other adhesives. Defining the baseline SBS value for each adhesive system as 100%, TC groups ranged from 56.1 to 70.3% for SM, from 98.4 to 103.7% for SB, and from 120.3 to 126.7% for SU. WS groups ranged from 66.2 to 71.4% for SM, from 98.1 to 103.3% for SB, and from 102.5 to 118.1% for SU.

CONCLUSIONS

Although SB showed relatively stable dentin bond performance under all degradation conditions, SM showed decreased dentin SBS with prolonged degradation. SU did not show any significant decrease in SBS from the baseline under any degradation condition.

CLINICAL RELEVANCE

The universal adhesive showed comparable adhesive performance with the two-step ER adhesive.

The Effects of Aluminablasting on Bond Durability Between Universal Adhesives and Tooth Substrate

The aim of this study was to determine the effect of aluminablasting on the bond durability of universal adhesives and adherent surface characteristics. Adhese Universal (Ivoclar Vivadent), All-Bond Universal (Bisco), Bondmer Lightless (Tokuyama Dental), G-Premio Bond (GC), and Scotchbond Universal (3M ESPE) were used in self-etch mode. The prepared bovine enamel and dentin specimens were divided into two groups based on whether they received an aluminablasting prior to application of the universal adhesives. The resin composite bonded specimens were stored in distilled water at 37°C for 24 hours, following which the shear bond strength (SBS) of half of the specimens was measured (24-hour group). The other half was subjected to 30,000 thermal cycles between 5 and 55°C before SBS measurement (TC group). Surface roughness (Ra) and surface free energy (SFE) of the adherent surfaces were also measured, and scanning electron microscopy observation and scanning electron microscopy/energy-dispersive X-ray analysis were carried out. Most of the adhesives did not show any significant differences in enamel SBS values between the two pretreatment groups, regardless of the storage condition. However, the dentin SBS values were significantly lower in specimens that underwent aluminablasting compared with those that did not, irrespective of their storage conditions. Significantly higher Ra and SFE values were observed in the enamel and dentin of specimens that underwent aluminablasting. Although aluminablasting increased the Ra and SFE values of enamel and dentin, its effect on the SBS value was dependent on the tooth substrate. In addition to C, O, Na, Mg, P, and Ca, the element Al was detected in the enamel and dentin of samples that had undergone aluminablasting. These results suggest that although aluminablasting of the tooth surface is thought to be effective for modification of the adherent surface, it may not enhance enamel bond performance and may also adversely affect the dentin bond effectiveness of the universal adhesives.

Effects of Finishing and Polishing Methods on the Surface Roughness and Surface Free Energy of Bulk-fill Resin Composites

The purpose of this study was to determine the influence of finishing and polishing methods on surface properties of bulk-fill resin composites through surface roughness (Ra) and surface free energy (SFE) measurements, and scanning electron microscopy (SEM) observations. Three bulk-fill resin composites, Tetric EvoCeram Bulk Fill (TB), Filtek Bulk Fill (FB), and Filtek Bulk Fill Flowable Restorative (FF), and two conventional resin composites, Clearfil AP-X (AP) and Estelite ∑ Quick (EQ) were used. Seventy cured specimens of each resin composite were prepared and divided into seven groups of 10 specimens. Ra, SFE measurements, and SEM observations were conducted after finishing and polishing procedures. Three groups of specimens were finished with a fine grit diamond bur (FDB), and three with a tungsten carbide bur (CBB). After finishing, one group from each type of finishing was polished with aluminum oxide flexible disks (SSD) and one group from each type of finishing was polished with diamond particles embedded in a silicone point (CMP). A baseline group of samples that were neither finished nor polished after removing the translucent strips from the surface was examined. Although the baseline group showed significantly lower Ra values than the other groups, most resin composites showed lower Ra values with CBB+SSD than with the other finishing and polishing groups. Among the tested resin composites, EQ showed significantly lower Ra values than the other resin composites, regardless of the finishing and polishing methods. On the other hand, AP showed significantly higher Ra values than the other resin composites in all finishing and polishing groups, apart from FB with FDB. For the finished specimens, most resin composites showed higher SFE values with CBB than with FDB. For the polished specimens, all the tested resin composites with CMP showed lower γ_S values than those with SSD, regardless of the finishing method. The baseline groups of TB and FB showed significantly lower SFE values than the other finished and polished groups. In the SEM observations, all the examined resin composites showed rougher surfaces after finishing with FDB than with CBB. However, when comparing the different polishing methods (CMP and SSD), surface smoothness appeared to be material dependent.

SEM observation of novel characteristic of the dentin bond interfaces of universal adhesives

OBJECTIVE

The aim of this study was to observe the resin/dentin interfaces of universal adhesives by using scanning electron microscopy (SEM), and to compare their morphologies with conventional etch & rinse (ER) and self-etch (SE) adhesive systems.

METHODS

Two three-step and one two-step ER adhesives and two two-step and two single-step SE adhesives were used for comparison with seven universal adhesives in ER mode and SE mode, respectively. Bonded surfaces with bovine teeth were longitudinally sectioned and mirror-polished. Half of the samples were treated with HCl and NaOCl solutions. The interfaces were subjected to argon ion beam etching and then observed by scanning electron microscopy.

RESULTS

The thickness of the adhesive layer (AL) of most of the seven universal adhesives and single-step SE adhesives was similar. Universal adhesives in SE mode formed a hybrid smear layer as a high-density zone between the AL and dentin. The thickness of the hybrid layer (HL) of the universal adhesives in ER mode was ∼1-2μm, with a high-density zone (reaction layer [RL]) below the HL.

CONCLUSION

The morphological features of most universal adhesives in SE mode and single-step SE adhesives are similar. Although resin-dentin interfaces of universal adhesives in ER mode resemble those of ER adhesives, universal adhesives have a distinctive feature, an RL.

SIGNIFICANCE

The RL might be a sign of chemical bonding even when using universal adhesives in ER mode.

Etch-and-rinse vs self-etch mode for dentin bonding effectiveness of universal adhesives

In this study, dentin bond fatigue resistance and interfacial science characteristics of universal adhesives through etch-and-rinse and self-etch modes were investigated. Resin composite was bonded to human dentin with four universal adhesives, namely, Adhese Universal, All-Bond Universal, G-Premio Bond, and Scotchbond Universal Adhesive. The initial bond strengths, bond fatigue strengths, and interfacial science characteristics of the universal adhesives with dentin through etch-and-rinse and self-etch modes were determined. Bond fatigue resistance (initial bond strength and bond fatigue strength) of universal adhesives in etch-and-rinse mode showed no significant difference in contrast to that in self-etch mode and was material-dependent regardless of the etching mode. Although phosphoric acid conditioning of dentin did not have a strong impact on the bond fatigue resistance, surface free energy and parameters of dentin were significantly decreased by etching and by application of universal adhesives regardless of etching mode. Changes in γ_S and γ_S^h for when universal adhesive was applied to etched and ground dentin were significantly different depending on the adhesive. The results suggest that bonding performance of universal adhesives was effective in both etching modes; however, bonding mechanisms may be different for each.

Influence of different curing modes on flexural properties, fracture toughness, and wear behavior of dual-cure provisional resin-based composites

We investigated the influence of different curing modes on the mechanical properties and wear behavior of dual-cure provisional resin-based composites (DCPRs). Three DCPRs and a self-curing bis-acryl provisional resin-based composite were used. Flexural strength (σ_F), elastic modulus (E), resilience (R), and fracture toughness (K_IC) were measured. The specimens were fabricated with and without light irradiation, stored in distilled water at 37°C for 24 h, and subjected to 5,000 or 10,000 thermal cycles. For sliding impact wear testing, 12 specimens were prepared with and without light irradiation. The maximum facet depth and volume loss were determined using a noncontact profilometer. Some of the mechanical properties and wear behavior of DCPRs are affected by light irradiation. This study indicated that proper light irradiation is important in polymerization process of the DCPRs to enhance the wear resistance and some mechanical properties.

Influence of Application Time on Dentin Bond Performance in Different Etching Modes of Universal Adhesives

We attempted to determine the effect of universal adhesive application time on dentin bond performance in different etching modes based on shear bond strength (SBS) tests and surface free energy (SFE) measurements. The five universal adhesives used were Adhese Universal (AU), Clearfil Universal Bond Quick (CQ), G-Premio Bond (GP), Scotchbond Universal (SU), and Tokuyama Universal Bond (TU). Bovine dentin specimens were divided into four groups of 10 for each adhesive. SBS and SFE were determined after applying the following surface treatments: 1) self-etch (SE) mode with immediate air blowing after adhesive application (IA treatment), 2) SE mode with prolonged application time (PA treatment), 3) etch-and-rinse (ER) mode with IA treatment, and 4) ER mode with PA treatment. Bonded specimens were subjected to SBS testing. The SFE of adhesive-treated dentin surfaces was measured after rinsing with acetone and water. Three-way analysis of variance revealed that dentin SBS values (p<0.001) were significantly influenced by the factors of adhesive type and application duration, but the factor of pre-etching was not significant (p=0.985). The manufacturer's instructions require longer application times for AU and SU, which showed significantly lower SBS values in IA than in PA treatment in both etching modes. However, the difference in the other adhesives was not significant between the IA and PA treatments in either etching mode. The total SFE (γ_S) was dependent on the adhesive and etching mode. The γ_S value of the initial group (SiC paper ground group) at baseline was 69.5 (mN·m^-1) and that of the pre-etching group at baseline was 30.6 (mN·m^-1). For all the adhesives, γ_S in SE mode showed significantly higher values than in ER mode, regardless of the application time. In SE mode, almost all universal adhesives tested showed lower γ_S values in PA treatment than in IA treatment. For ER mode, all the adhesives showed significantly higher γ_S values than those of the pre-etching baseline, regardless of the application time. Most adhesives did not show any significant differences in γ_S values between IA and PA treatments, regardless of etching mode.

Comparisons of ISO depth of cure for a resin composite in stainless-steel and natural-tooth molds

The purpose of this study was to compare the depth of cure (DOC) of a resin-based composite (RBC) using the ISO DOC protocol with stainless-steel and molar-tooth molds (4 mm cylindrical cavity). The tooth mold included testing with and without the occlusal surface being covered with black tape around the cavity opening. The RBC was cured with either halogen (HAL) or light-emitting diode (LED) light. The results showed that specimens made in the non-taped tooth mold had DOCs that were significantly greater (28%-35%) than those in the stainless-steel mold. The taped tooth mold also produced significantly greater DOCs, but only by 6%-8%. Knoop hardness (KNH) measurements along the central axis of the RBC specimens showed that depths for 80% of maximum hardness were substantially greater than those determined by the ISO DOC protocol but were limited to the center and quickly dropped below 80% in a lateral direction. The KHN mapping for each of the three molds found that the ISO DOCs could validate a KHN of ≥80% across the RBC to the periphery, only for the non-taped tooth mold. This was due to light incident on the tooth surrounding the RBC being scattered into the RBC.

Depth of cure of high-viscosity bulk-fill and conventional resin composites using varying irradiance exposures with a light-emitting diode curing unit

The purpose of this study was to determine the depth of cure (DOC) of three resin-based composites (RBCs) using varying irradiance exposures with a corded light-emitting diode curing unit. DOCs for Filtek Z250, TPH Spectra, and Tetric EvoCeram Bulk Fill were determined using the International Organization for Standardization (ISO) Standard 4049. The RBCs were light-polymerized using three different power modes and manufacturer-recommended curing times. Irradiance was determined using a spectrometer sensor and the total energy density was calculated for each power mode and concomitant polymerization time. The DOC data were analyzed with a two-way analysis of variance and Tukey's post hoc test. Tetric EvoCeram Bulk Fill produced significantly greater DOCs than TPH and Z250 (P < 0.05) for all three power mode settings. Overall, the DOC of Tetric EvoCeram Bulk Fill was greater than those of TPH and Z250 at all power settings, but the individual RBCs did not show a significant DOC difference among the three power settings (P > 0.05).

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.

Immediate enamel bond strength of universal adhesives to unground and ground surfaces in different etching modes

The purpose of this study was to determine the immediate bond effectiveness of universal adhesives to unground and ground enamel surfaces in different etching modes, through shear bond strength (SBS) tests and scanning electron microscopy observations. Three universal adhesives, a conventional two-step self-etch adhesive, and a conventional single-step self-etch adhesive were compared. Human enamel specimens from lower anterior teeth were divided into four groups and subjected to the following treatments: (i) unground enamel in self-etch mode; (ii) ground enamel in self-etch mode; (iii) unground enamel in etch-&-rinse mode; and (iv) ground enamel in etch-&-rinse mode. Bonded assemblies were subjected to SBS testing. All the adhesives showed significantly higher SBS values in etch-&-rinse mode than in self-etch mode, regardless of whether enamel was unground or ground. The influence of the enamel surface condition on SBS was different in different etching modes. Without pre-etching, all tested materials showed lower SBS values in unground enamel than in ground enamel. In etch-&-rinse mode, no significant differences in SBS values were observed between unground enamel and ground enamel for any of the adhesives tested. Phosphoric acid pre-etching before application of self-etch adhesives to an unground enamel surface is essential to enhance initial enamel bond effectiveness.

The role of spatial frequency analysis in correlating atomic force microscopy and optical profilometry with self-etch adhesive enamel bond fatigue durability

The purpose of this study was to: (a) evaluate the role of enamel surface roughness on bond fatigue durability and (b) evaluate statistical differences in roughness values based on measurement technique, including the use of spatial filtering for optical profilometry (OP). OptiBond XTR (Kerr Corp), Prime & Bond elect (DENTSPLY Caulk), Scotchbond Universal (3 M Oral Care), and XTR pre-etched with Ultra-Etch phosphoric acid (35%) (Ultradent) self-etch adhesives were used to treat enamel. A flat ground enamel surface was included as a control. Atomic force microscopy (AFM) and OP were used to measure the surface topography of each enamel surface following the application of adhesives. AFM, OP, and filtered OP (FOP) roughness values, where FOP was designed to only include the lateral spatial resolution consistent with AFM roughness values, were collected. Spatial resolution filtering with OriginPro was used to compare line scans from the two imaging techniques and generate the FOP group. These micro- versus nanoscale lateral roughness values were correlated with shear bond and shear fatigue strengths of the adhesives bonded to enamel. Roughness values showed differences based on measurement technique and strong correlations with bond and fatigue strength. The filtered OP group demonstrated the importance of careful usage and reporting of atomic force microscopy and OP metrics in adhesive dentistry. Best practices for surface roughness analysis were also discussed.

Effect of Active Application on Bond Durability of Universal Adhesives

The purpose of this study was to determine the effect of different adhesive application methods and etching modes on the dentin bond durability of universal adhesives under thermal cycling (TC). All-Bond Universal (Bisco), Adhese Universal (Ivoclar Vivadent), and Scotchbond Universal (3M ESPE) were used as adhesives. In total, 600 bovine teeth with exposed dentin were divided into 12 groups according to the type of adhesive and subjected to the following bonding procedures: 1) etch-and-rinse mode with active application; 2) etch-and-rinse mode with inactive application; 3) self-etch mode with active application; and 4) self-etch mode with inactive application. Bonded specimens were stored in distilled water at 37°C for 24 hours and then subjected to 5000, 10,000, 30,000, or 50,000 TC between 5°C and 55°C before shear bond strength (SBS) testing, creating a division into a total of five different storage conditions. Baseline specimens were stored in distilled water at 37°C for 24 hours. The SBS test was performed at a cross-head speed of 1.0 mm/min. Three-way analysis of variance revealed that all the factors of application mode, adhesive, and thermal cycle period significantly influenced the SBS values (p&lt;0.001), regardless of the etching mode. In the baseline groups, all of the tested adhesives with active application had higher SBS values than those with inactive application, regardless of etching mode. In the TC groups, significantly lower SBS values were observed at 50,000 TC with inactive application compared to those with active application, regardless of the etching mode. From the scanning electron microscopy observation of demineralized and deproteinized resin/dentin interfaces, dense resin tags longer than 50 μm were observed in the etch-and-rinse with active application group. On the other hand, the resin tags in self-etch mode were sparse, thin, and much shorter than those in etch-and-rinse mode. Comparing the penetration status of the resin tags with active and inactive application in self-etch mode, the resin tag penetration with inactive application was much lower than that with active application. Active application is effective in enhancing the dentin bond durability of universal adhesives. When using universal adhesives with different etching modes, practitioners should select the optimal etching mode and appropriate application method in accordance with the cavity conditions.

Surface moisture influence on etch-and-rinse universal adhesive bonding

PURPOSE

To evaluate whether surface moisture would influence the bonding effectiveness of universal adhesives in etch-and-rinse mode.

METHODS

All-Bond Universal (AB), G-Premio Bond (GP) Prime&Bond Active (PB) and Scotchbond Universal Adhesive (SU) were evaluated. Shear bond strengths after 24 hours and 10,000 thermal cycles of universal adhesives to moist and dry enamel and dentin in etch-and-rinse mode were determined. Scanning electron microscopy observations of the adhesive interfaces were conducted.

RESULTS

The bond durability of universal adhesive to dentin in etch-and-rinse mode was influenced by the surface moisture, unlike bond durability to enamel. The bond durability of AB and GP, but not PB and SU, to dentin in etch-and-rinse mode was different depending on the surface moisture. Surface moisture did not influence the thicknesses of the adhesive or hybrid layer of resin-dentin interfaces, but the length of resin tags in the moist group was longer than in the dry group.

CLINICAL SIGNIFICANCE

Some universal adhesives, with the addition of specific components and optimization of water content, can achieve stable bonds regardless of surface moisture, but the surface moisture of dentin, although not enamel, is still a significant factor for universal adhesive bonding in etch-and rinse mode.

Influence of Application Time and Etching Mode of Universal Adhesives on Enamel Adhesion

PURPOSE

To investigate the influence of application time and etching mode of universal adhesives on enamel adhesion.

MATERIALS AND METHODS

Five universal adhesives, Adhese Universal, Bondmer Lightless, Clearfil Universal Bond Quick, G-Premio Bond, and Scotchbond Universal, were used. Bovine incisors were prepared and divided into four groups of ten teeth each. SBS, Ra, and SFE were determined after the following procedures: 1. self-etch mode with immediate air blowing after application (IA); 2. self-etch mode with prolonged application time (PA); 3. etch-and-rinse mode with IA; 4. etch-and-rinse mode with PA. After 24-h water storage, the bonded assemblies were subjected to shear bond strength (SBS) tests. For surface roughness (Ra) and surface free energy (SFE) measurements, the adhesives were simply applied to the enamel and rinsed with acetone and water before the measurements were carried out.

RESULTS

Significantly higher SBS and Ra values were obtained with etch-and-rinse mode than with self-etch mode regardless of the application time or type of adhesive. Although most adhesives showed decreased SFE values with increased application time in self-etch mode, SFE values in etch-and-rinse mode were dependent on the adhesive type and application time.

CONCLUSIONS

Etching mode, application time, and type of adhesive significantly influenced the SBS, Ra, and SFE values.

Effect of Reduced Universal Adhesive Application Time on Enamel Bond Fatigue and Surface Morphology

Objective:

The purpose of this study was to evaluate the effect of reduced application times of universal adhesives on enamel bond fatigue and surface morphology of the treated enamel with constant force atomic force microscopy (AFM).

Methods:

Four universal adhesives—Adhese Universal (AU), Clearfil Universal Bond Quick (CU), G-Premio Bond (GP), and Scotchbond Universal Adhesive (SU)—were evaluated in a laboratory for their ability to adhesively bond resin composite to enamel. Shear bond strengths were initially determined using 15 specimens per test group for each adhesive. Shear fatigue strengths were then determined using 20 specimens per test group for each the adhesives. The fatigue specimens were loaded using a sine wave at a frequency of 20 Hz for 50,000 cycles or until failure occurred. AFM observations, surface Ra roughness measurements, and geometric surface area evaluations of enamel surface treated with the adhesive agents were also conducted.

Results:

A strong relationship was found between the initial shear bond strength and shear fatigue strength for enamel surface Ra roughness but not for geometric surface area. The initial shear bond strength and shear fatigue strength of CU and GP were not influenced by different application times, unlike those of AU and SU. While the surface area of enamel treated with the adhesive agents was not significantly influenced by different application times and type of adhesive, surface Ra roughness of the enamel in the AU and SU groups significantly increased with increasing application time, unlike CU and GP.

Conclusions:

The results of this study suggest that universal adhesives, used with reduced application times, have adequate Ra surface roughness to provide sufficient resistance to enamel bond fatigue at application times from &lt;1 second to 20 seconds, while the geometric surface area of adhesive-treated enamel did not show any significant changes at these different application times.

Reconsideration of Enamel Etching Protocols for Universal Adhesives: Effect of Etching Method and Etching Time

PURPOSE

To evaluate whether different etching methods with reduced etching times would improve the enamel bonding efficacy of universal adhesives.

MATERIALS AND METHODS

Three enamel etching methods were evaluated - 1. phosphoric acid ester monomer etching (PPM); 2. phosphoric acid etching (PPA); and 3. polyalkenoic acid etching (PLA) - as were three universal adhesives: 1. BeautiBond Universal (BU); 2. Prime&Bond elect (PE); and 3. Scotchbond Universal Adhesive (SU). The shear bond strengths of the universal adhesives to ground enamel and ground enamel etched for 1, 5, 10, and 15 s with different etching methods were determined after 24 h and 10,000 thermal cycles. Surface roughness average (Ra) and surface area ratio (surface area:planar area) were measured using a confocal laser scanning microscope. Field-emission scanning electron microscope (FE-SEM) observations of enamel with different etching protocols were also conducted.

RESULTS

The bond strengths of universal adhesives to enamel subjected to PPA etching with maximum times of 1-15 s and PLA etching for 15 s were significantly higher than those to ground enamel. The bond strength to enamel subjected to PPM etching did not increase and was similar to that for ground enamel. PPA and PLA etching were effective at increasing the Ra and surface area ratio of enamel. Although both values were significantly higher than those of ground enamel, those subjected to PPA etching were significantly higher than those which underwent PLA etching. In addition, the Ra and surface area of enamel subjected to PPM etching were similar to those of ground enamel, regardless of the etching time.

CONCLUSIONS

Phosphoric acid etching for <1-15 s and polyalkenoic-acid etching for 15 s both improve the bonding of universal adhesives, the Ra, and the surface area ratio of enamel. However, phosphoric acid ester monomer etching was not effective, regardless of the etching time.

3D printed coping for intraoral evaluation: a clinical report

The clinical report describes a three-dimensional (3D) printed coping for intraoral evaluation before milling final anterior restorations. The use of printed copings allows restorations for complex and esthetically important restorations to be thoroughly tested at relatively low cost without introducing large delays into the fabrication process.

Influence of surface wetness on bonding effectiveness of universal adhesives in etch-and-rinse mode

The purpose of this study was to evaluate whether surface wetness would influence the bonding effectiveness of universal adhesives in etch-and-rinse mode. All-Bond Universal (AB), G-Premio Bond (GP), Prime & Bond Active (PB), and Scotchbond Universal Adhesive (SU) were evaluated. Initial bond strengths and bond-fatigue strengths of universal adhesives to both wet and dry enamel and dentin in etch-and-rinse mode were determined. Scanning electron microscopy observations of the adhesive interfaces were also conducted. The bond-fatigue durability of universal adhesive to enamel in etch-and-rinse mode was influenced by the surface wetness, unlike that to dentin. The bond fatigue durability of AB and GP to dentin in etch-and-rinse mode was different depending on the surface wetness, unlike that of PB and SU. The thicknesses of the adhesive or hybrid layer of resin-dentin interfaces were not influenced by the surface wetness, but the length of resin tags in the wet group was longer than in the dry group. Some universal adhesives with the addition of specific components and optimization of water content can achieve stable bonds regardless of surface wetness, but the surface wetness of dentin is still a significant factor for universal adhesive bonding in etch-and rinse mode, unlike that of enamel.

Simulated cuspal deflection and flexural properties of high viscosity bulk-fill and conventional resin composites

OBJECTIVES

The purpose of this study was to investigate the simulated cuspal deflection and flexural properties of high viscosity bulk-fill and conventional resin composites.

METHODS

Seven high viscosity bulk-fill resin composites and eight conventional resin composites were used. Aluminum blocks (10 mm x 8 mm x 15 mm) with a mesio-occlusal-distal (MOD) cavity [4 (W) mm x 8 (L) mm x 4 (D) mm] were prepared and randomly divided into groups for different measurement techniques [micrometer vs CSLM] and further subdivided according to type of resin composite (high viscosity bulk-fill vs conventional resin composite). The simulated cuspal deflection resulting from the polymerization of resin composite bonded to a precisely machined MOD cavity within an aluminum block was measured with either a novel highly accurate submicron digimatic micrometer (MDH-25 M, Mitsutoyo, Tokyo, Japan) or a confocal laser scanning microscope (CLSM, VK-9710, Keyence, Tokyo, Japan) cuspal measurement method. In addition, flexural properties of tested resin composites were measured to investigate the relationship between simulated cuspal deflection and flexural properties. Scanning electron microscopy observation of tested resin composites was also conducted.

RESULTS

The simulated cuspal deflection of high viscosity bulk-fill resin composites was similar to that of conventional resin composites, regardless of measurement method. There were no statistically significant differences (p > 0.05) between the micrometer and CLSM cuspal measurement methods. There were statistically significant differences (p < 0.05) in flexural strength and elastic modulus depending on the material, regardless of the type of resin composite. Pearson correlation analysis did not show any statistically significant (p < 0.05) relationship between flexural properties and cuspal deflection.

CONCLUSIONS

The results of this study indicate that high viscosity bulk-fill resin composites show similar cuspal deflection with bulk-filling techniques, to those shown by conventional resin composites with incremental filling techniques. Simulated cuspal deflection can be measured using either a micrometer or CLSM, but this experiment failed to show any relationship between the flexural properties and simulated cuspal deflection of resin composites.

SIGNIFICANCE

High viscosity bulk-fill resin composites produce the same level of cuspal deflection as a conventional incrementally filled resin composite.

Influence of Thermal Stress on Simulated Localized and Generalized Wear of Nanofilled Resin Composites

Objective:

This study investigated the influence of thermal stress on the simulated localized and generalized wear of nanofilled resin composites.

Methods:

Six nanofilled resin composites were evaluated and then subjected to a wear challenge of 400,000 cycles in a Leinfelder-Suzuki (Alabama) wear simulation device after 24 hours of water storage (24-hour group) and 24 hours of water storage and 10,000 thermal cycles (TC group). Simulated localized wear was generated using a stainless-steel ball bearing, and simulated generalized wear was generated using a flat-ended stainless-steel cylinder. Wear testing was accomplished in a water slurry of polymethyl methacrylate beads. Simulated localized and generalized wear was determined using a noncontact profilometer (Proscan 2100) in conjunction with Proscan and AnSur 3D software.

Results:

Wear was significantly different (p&lt;0.05) among the resin composites for both simulated localized and generalized wear of either the 24-hour group or the TC group. The simulated localized wear of the TC group was significantly greater than that of the 24-hour group; however, the simulated generalized wear of most of the resin composites of the TC group was not significantly different from that of the 24-hour group.

Conclusion:

The simulated localized and generalized wear of nanofilled resin composites is material dependent. The simulated localized wear of nanofilled resin composites appears to be influenced by thermal stress, whereas this effect is not as apparent in simulated generalized wear testing.

Relationship Between Simulated Gap Wear and Generalized Wear of Resin Luting Cements

OBJECTIVE

The relationship between the simulated gap wear and generalized wear of resin luting cements was investigated.

METHODS

Five resin luting cements, G-Cem LinkForce (GL), Multilink Automix (MA), NX3 Nexus, Panavia V5 (PV), and RelyX Ultimate were evaluated and subsequently subjected to a wear challenge in a Leinfelder-Suzuki (Alabama) wear simulation device. Half of the specimens from each resin luting cement were photo-cured for 40 seconds and the other half were not photo-cured. The simulated gap and generalized wear were generated using a flat-ended stainless steel antagonist. Wear testing was performed in a water slurry of polymethyl methacrylate beads, and the simulated gap and generalized wear were determined using a noncontact profilometer (Proscan 2100) in conjunction with the Proscan and AnSur 3D software.

RESULTS

A strong relationship was found between the gap wear and generalized wear simulation models. The simulated gap wear and generalized wear of the resin luting cements followed similar trends in terms of both volume loss and mean depth of wear facets with each curing method. Unlike the simulated gap wear and generalized wear of GL and PV, those of MA, NX, and RU were influenced by the curing method.

CONCLUSION

The results of this study indicate that simulated gap wear of resin luting cements is very similar to simulated generalized wear. In most cases, dual curing appears to ensure greater wear resistance of resin luting cements than chemical curing alone. The wear resistance of some resin luting cements appears to be material dependent and is not influenced by the curing method.

Wear of resin composites: Current insights into underlying mechanisms, evaluation methods and influential factors

The application of resin composites in dentistry has become increasingly widespread due to the increased aesthetic demands of patients, improvements in the formulation of resin composites, and the ability of these materials to bond to tooth structures, together with concerns about dental amalgam fillings. As resistance to wear is an important factor in determining the clinical success of resin composite restoratives, this review article defines what constitutes wear and describes the major underlying phenomena involved in this process. Insights are further included on both in vivo and in vitro tests used to determine the wear resistance of resin composite and the relationships between these tests. The discussion focuses on factors that contribute to the wear of resin composite. Finally, future perspectives are included on both clinical and laboratory tests and on the development of resin composite restorations.

Relationship between mechanical properties and bond durability of short fiber-reinforced resin composite with universal adhesive

The purpose of this study was to determine the relationship between mechanical properties and bond durability of short fiber-reinforced resin composite with universal adhesive. As controls, micro-hybrid and nano-hybrid resin composites were tested. The universal adhesives used were Scotchbond Universal, Adhese Universal, and G-Premio Bond. The fracture toughness and flexural properties of resin composites, and shear bond strength and shear fatigue strength of universal adhesive with resin composite using both total-etch and self-etch modes were determined. In the results, short fiber-reinforced resin composite showed significantly higher fracture toughness than did micro-hybrid and nano-hybrid resin composites. The flexural strength and modulus of short fiber-reinforced and nano-hybrid resin composites were significantly lower than were those of micro-hybrid resin composites. Regardless of etching mode, the shear bond strength of universal adhesives with short fiber-reinforced resin composite did not show any significant differences from micro-hybrid and nano-hybrid resin composites. The shear fatigue strength of universal adhesives with short fiber-reinforced resin composite and micro-hybrid resin composites were significantly higher than that of nano-hybrid resin composites. The results of this study suggest that the mechanical properties of short fiber-reinforced resin composite improve their bond durability with universal adhesive.

Simulated localized wear of resin luting cements for universal adhesive systems with different curing mode

This study evaluated the simulated localized wear of resin luting cements for universal adhesive systems using different curing modes. Five resin luting cements for universal adhesive systems were evaluated and subsequently subjected to wear challenge in a Leinfelder-Suzuki wear simulation device. Overall, 20 specimens from each resin luting cement were photo-cured for 40 s (dual-cure group), and 20 specimens of each material were not photo-cured (chemical-cure group). Simulated localized wear was generated using a stainless steel ball-bearing antagonist in water slurry of polymethylmethacrylate beads. In addition, scanning electron microscopy (SEM) observations of resin luting cements and wear facets were conducted. Significant differences in simulated wear and SEM observations of wear facets were evident among the materials in the dual- and chemical-cure groups. The simulated wear and SEM observations of wear facets of G-CEM LinkForce and Panavia V5 were not influenced by the curing mode. SEM observations of resin luting cements were material dependent. In most cases, dual curing appears to ensure greater wear resistance of resin luting cements than chemical curing alone. The wear resistance of some resin luting cements appears to be material dependent and is not influenced by the curing mode.