Effect of natural agents on the bond strength to eroded dentin

OBJECTIVE

This study evaluated the effect of bromelain and propolis extract on the bond strength (BS) of a universal adhesive system to eroded dentin.

MATERIALS AND METHODS

Sixty human molars with exposed dentin were halved, with one half protected by composite resin and the other subjected to erosive treatment followed by remineralization. After the erosive treatment, the composite resin was removed, and the teeth were randomly assigned to three groups (n = 20): Adhesive-Control System; Br-10%; Pr-16%. Following the treatments, composite resin blocks were built on the dentin surfaces and sticks of 0.9 mm2 were obtained and stored in distilled water at 37°C for 24 h and 6 months. After these periods, the sticks underwent bond strength testing and the data were analyzed using 2-way ANOVA, Bonferroni test, p < 0.05. Fracture patterns were observed using light microscope and scanning electron microscopy.

RESULTS

Irrespective of the substrate and aging duration, propolis demonstrated higher BS (p < 0.05) compared to the other treatments. Eroded dentin exhibited greater removal of the smear layer and dentinal tubules with a larger diameter than sound dentin, especially when treated with bromelain, resulting in the formation of resin tags.

CONCLUSIONS

Propolis consistently promoted the highest bond strength, irrespective of aging or substrate. Eroded dentin treated with propolis, or bromelain exhibited a higher prevalence of non-adhesive fractures and resin tag formation.

CLINICAL SIGNIFICANCE

Propolis shows promise for enhancing the longevity of adhesive restorations in eroded dentin due to its ability to promote high bond strength.

The Role of Duration of Chlorhexidine Gluconate 2% Application on the Shear Bond Strength of a Total Etch Bonding Agent: A Comparative Study

Introduction

Matrix metalloproteinases enzymes (MMPs) can degrade the hybrid layer which can cause failure of composite restorations. Chlorhexidine gluconate 2% can reduce MMPs activity and increase the bond strength of the resin to dentin.

Purpose

This study aims to determine the role of the duration of chlorhexidine gluconate 2% application on shear bond strength of a total-etch bonding agent.

Methods

A total of 36 freshly extracted maxillary premolars were removed occlusally by one-third of the crown using a carborundum disc until the dentin was exposed. Specimens were divided into four groups n(9). The dentin surfaces were etched for 5s. Group A is the control group. In group B, chlorhexidine gluconate 2% was applied for 30s. In group C, chlorhexidine gluconate 2% was applied for 60s. In group D, chlorhexidine gluconate 2% was applied for 90s. The universal adhesive was applied afterwards and then followed by composite to the dentin surface. All specimens were stored in artificial saliva at 37°C for 24 hours. The shear bond strength was tested using a universal testing machine.

Results

There was an increase in the shear bond strength of the bonding agent along with the additional application duration of chlorhexidine gluconate 2%. All groups gave higher MPa values than the control group. The shear bond strength in group A (control) was 12.64 MPa; Group B (30s of chlorhexidine) was 16.93 MPa; Group C (60s chlorhexidine) was 18.23 MPa; group D (90s of chlorhexidine) was 18.47MPa.

Conclusion

Duration of chlorhexidine gluconate 2% application affects the shear bond strength of the bonding agent with the total-etch system. The effective duration of chlorhexidine gluconate 2% for the restorative procedure is 60 seconds.

Effect of limonene associated with bioactive glass-ceramic on dentin/adhesive interface

This study evaluated the effect of pretreatment with limonene and/or biosilicate on the bond strength of a universal adhesive system in self-etch mode to dentin. Occlusal cavities were prepared in 80 human molars and the teeth were randomly allocated to one of four groups (n = 20), according to the pretreatment regimens applied before the adhesive. The pretreatments were (i) Control, no pretreatment, (ii) LIM, 0.5% limonene; (iii) Bio, 10% biosilicate; and (iv) LIMBio, LIM + Bio. After adhesive application and restoration, the specimens were sectioned into sticks, separated, and stored in distilled water at 37°C for 24 h or 6 months. Microtensile bond strength test was carried out and measurements were compared across pretreatment groups and storage times. Fracture patterns and adhesive interfaces were observed. Loss of dry mass was calculated (n = 10). There was no statistically significant difference in the bond strength between the groups and the most prevalent fracture pattern was the non-adhesive. LIM and LIMBio resulted in more open dentinal tubules. LIM and Bio, whether separate or combined, showed particles of those substances, which decreased in size and number after 6 months. All groups lost mass weight after treatment, with no statistically significant differences between them. Limonene and biosilicate pretreatment did not affect the bond strength to dentin of the universal adhesive system, but resulted in more non-adhesive fractures, even after 6 months.

Comparative Evaluation of Microleakage With Total-Etch, Universal (Self-Etch Mode), and Nano Adhesive Systems in Class V Composite Restorations: An In-Vitro Study

OBJECTIVES

The adhesion of bonding agents and their longevity are of interest to dentistry. Microleakage remains the major cause of composite restoration failures, which in turn depends on bonding between the restorative material and tooth substrate. The objective of this study is to evaluate and compare the microleakage with total-etch, universal, and nano adhesive systems in Class V composite restorations, utilizing a dye penetration method.

METHODS

Forty-five extracted premolars were included in the present study, and a Class V cavity on the facial surface of each tooth was prepared. The samples were divided into three groups of 15 teeth each depending on the bonding agents used, following which composite restoration was done. Specimens were thermocycled, and nail varnish was applied except around the restorations. Specimens were then immersed in 2% methylene blue for 24 hours and rinsed; sectioning was done and viewed under a stereomicroscope with 10X magnification.

RESULTS

The mean microleakage score was reported to be significantly higher in the universal adhesive system in the self-etch mode (3.60 ± 0.55) when compared with the total-etch adhesive system (2.40 ± 0.55) and least in the nano adhesive system (1.20+.45) (p value <.05).

CONCLUSION

The study findings revealed that nano adhesives showed lesser microleakage as compared to total-etch and universal adhesive systems.

CLINICAL SIGNIFICANCE

The study strengthens the findings that the nano adhesives have reduced microleakage, resulting in better marginal integrity and increased longevity of restoration. This study signifies that an eighth-generation bonding agent is reported to be better than the other bonding agents used in this study.

Selective adhesive luting: A novel technique for improving adhesion achieved by universal resin cements

OBJECTIVE

We aimed to introduce the concept of "Selective adhesive luting-SAL" which is explained through clinical steps and supported by preliminary laboratory evidence.

CLINICAL CONSIDERATIONS

Cementation with rubber dam is difficult to perform in case of short abutment teeth and/or subgingival crown margins. By means of universal resin cements/universal adhesive systems, which can be employed in self-adhesive as well as adhesive luting procedures, this paper presents a novel technique allowing clinicians to perform reliable cementation where rubber dam isolation is difficult. The SAL technique entails the application of a universal adhesive system only on easily accessible abutment surfaces, enabling simultaneous adhesive and self-adhesive luting in different portions of the abutment. The SAL clinical workflow is explained through prosthodontic rehabilitation of maxillary right central incisor affected by microdontia and restored with a lithium-disilicate crown. Furthermore, our laboratory microshear bond strength study supports the rationale behind SAL application demonstrating higher bond strength even when the adhesive resin is placed only on one portion of the cementation substrate.

CLINICAL SIGNIFICANCE

This article advocates the application of SAL technique in clinical situations where effective adhesive luting is uncertain, since it can improve the adhesion between the tooth and universal resin cements.

Clinical in-situ evaluation of the effect of rubber dam isolation on bond strength to enamel

OBJECTIVE

To evaluate the effect of rubber dam isolation on shear bond strength of two different adhesive systems to enamel.

MATERIALS AND METHODS

The mesial, distal, lingual, and vestibular enamel surfaces of thirty human third molars were prepared (total n = 120). A custom splint was made to fit a volunteer's maxilla, holding the specimens in place in the oral cavity. Four composite resin cylinders were bonded to each tooth with one of two bonding agents (OptiBond FL and Prime&Bond active) with or without rubber dam isolation. Shear bond strength was tested in a universal testing machine and failure modes were assessed. Significance level for statistical analyses was set at 5%.

RESULTS

All pairwise comparisons revealed statistical differences (p < 0.05). The highest mean shear bond strength values were obtained in rubber dam experimental groups, regardless of the adhesive system. Group OptiBond FL with rubber dam presented the highest mean bond strength values. Fracture modes for specimens bonded without rubber dam isolation were adhesive and cohesive within enamel, while rubber dam experimental groups revealed only cohesive fractures.

CONCLUSIONS

Absolute isolation with rubber dam increases bond strength to enamel, independent of the adhesive system. The three-step total-etch system OptiBond FL provided significantly higher bond strength values than Prime&Bond active under both experimental conditions.

CLINICAL SIGNIFICANCE

Rubber dam isolation has a significant effect on bond strengths to enamel, independent of the adhesive system. Its application is, therefore, advised whenever adhesive procedures are performed. A filled three-step etch-and-rinse adhesive performed superiorly, with or without rubber dam isolation, when bonding to enamel compared to an isopropanol-based universal adhesive.

Bonding strategy of a universal adhesive system containing chitosan: influence on dentin permeability, and effect on adhesive layer micromorphology

AIM

This study evaluated the influence of chitosan added to a universal adhesive system used in totaletch (TE) or self-etch (SE) mode on dentin permeability, and on the micromorphology of the adhesive layer.

MATERIALS AND METHOD

Dentin discs were obtained from human third molars and randomly distributed according to bonding strategy (TE or SE), and to whether or not 1% chitosan (C) was added to a universal adhesive system (Single Bond Universal/3M ESPE), to create the following groups (n=10): TE, TEC, SE, and SEC. Dentin permeability was measured at baseline and after application of dentin treatments. The surface of the adhesive layer (AL) and the dentin adjacent to the AL were examined under a scanning electron microscope.

RESULTS

There were no significant differences in permeability percentage between the groups with and without C (TE and SE versus TEC and SEC) (p>0.05; Mann Whitney test). Dentin permeability was lower when the adhesive system was applied in the SE mode, regardless of the addition of C. The micromorphology of the AL surface showed irregularities, and a greater degree of porosity, when the adhesive system was applied in the SE mode, regardless of chitosan addition. There was a greater depth of penetration of the adhesives into the dentin adjacent to the AL in both the TE and TEC groups. Chitosan added to the adhesive system did not influence dentin permeability.

CONCLUSIONS

The self-etch strategy led to lower dentin permeability, and to more irregularities on the surface of the adhesive layer.

Effect of the Adhesive System on the Properties of Fiberboard Panels Bonded with Hydrolysis Lignin and Phenol-Formaldehyde Resin

This study aimed to propose an alternative technological solution for manufacturing fiberboard panels using a modified hot-pressing regime and hydrolysis lignin as the main binder. The main novelty of the research is the optimized adhesive system composed of unmodified hydrolysis lignin and reduced phenol–formaldehyde (PF) resin content. The fiberboard panels were fabricated in the laboratory with a very low PF resin content, varying from 1% to 3.6%, and hydrolysis lignin addition levels varying from 7% to 10.8% (based on the dry wood fibers). A specific two-stage hot-pressing regime, including initial low pressure of 1.2 MPa and subsequent high pressure of 4 MPa, was applied. The effect of binder content and PF resin content in the adhesive system on the main properties of fiberboards (water absorption, thickness swelling, bending strength, modulus of elasticity, and internal bond strength) was investigated, and appropriate optimization was performed to define the optimal content of PF resin and hydrolysis lignin for complying with European standards. It was concluded that the proposed technology is suitable for manufacturing fiberboard panels fulfilling the strictest EN standard. Markedly, it was shown that for the production of this type of panels, the minimum total content of binders should be 10.6%, and the PF resin content should be at least 14% of the adhesive system.

Phenolic extract of Libidibia ferrea inhibits dentin endogenous enzymatic activity depending on the adhesive system strategy

This study evaluated the influence of Libidibia ferrea (Lf) extract used as dentin pretreatment on the resin-dentin bond strength stability and dentin endogenous enzymatic activity. The phytochemical profile (PP) of the Lf extract was evaluated by liquid chromatography; particle size, polydispersity index (PdI), and zeta potential (ZP) were evaluated by dynamic light scattering. The tested groups were ER-Scotchbond Universal (SBU) in the etch-and-rinse (ER) mode; ERLf-SBU in the ER mode + Lf after etching; SE- SBU in the self-etch (SE) mode; and LfSE-Lf before SBU in the SE mode. Sticks were obtained for microtensile bond strength tests and failure mode (24 hr and 12 months). The hybrid layer was evaluated using scanning electron microscopy. The endogenous enzymatic activity of the underlying dentin was analyzed by in situ zymography with the same treatments. The PP showed the presence of quercetin (2.6% w/w). Lf particles were considered large after the analysis of the PdI. The ZP remained stable over time. The ER and ERLf groups had lower bond strength after 12 months, but SE and LfSE remained stable. The predominant failure mode was adhesive for both times. ER and ERLf had longer resin tags and a thicker hybrid layer. The ER and LfSE groups showed higher enzymatic activity than the ERLf and SE groups after 12 months. The Lf extract may contribute to inhibit the dentin endogenous enzymatic activity when associated with an adhesive system in the ER mode.

The effect of immediate dentin sealing with chlorhexidine pretreatment on the shear bond strength of dual-cure adhesive cement

The purpose of this in vitro study was to evaluate the effect of immediate dentin sealing (IDS) with and without chlorhexidine (CHX) pretreatment on the shear bond strength (SBS) of dual-cure adhesive resin cement. Mid-coronal dentin surfaces were obtained from 75 human molars. They were randomly allocated into five groups in accordance to type of IDS [etch&rinse/ER (Adper Single Bond2) and universal/U adhesive systems (Single Bond Universal)] and presence of CHX application (n = 15): Group ER; Group ER + CHX; Group U; Group U + CHX; and Group C (no IDS). Dual-cure adhesive resin cements were bonded with a cylinder-shaped Teflon mold. The SBS was measured using a universal test machine. Fracture type was evaluated with stereomicroscope. The resin/dentin interfaces were examined with an environmental scanning electron microscope. Data were statistically analyzed with two-way analysis of variance and Bonferroni tests (p < .05). Regarding the IDS treatment groups with/without CHX, there were no significant differences in SBS (p > .05). Group U + CHX showed significantly higher SBS than Group C (p < .05). Regarding the presence of CHX, no significant differences in SBS were found (p > .05). The prevalent failure mode was the mixed type for most of the groups. Group C exhibited an intact and regular hybrid layer with no resin tag, whereas longer and clear resin-tag formation was visible for Group U + CHX. CHX pretreatment improved the bond strength between adhesive resin cement and dentin when IDS treatment was performed with a universal adhesive system.

Etching time and bonding of adhesive systems to dentin of primary teeth: A systematic review and meta-analysis

BACKGROUND

Due to the chemical and morphological differences between primary vs. permanent teeth, the time reduction of the acid etching or acidic primer can result in higher values of bond strength.

AIM

To assess through a systematic review and meta-analysis the influence of the reducing etching (acid etching or acidic primer) time on the bond strength of adhesive systems to primary dentin.

DESIGN

A systematic search was carried out in 3 databases: PubMed, Web of Science and Scopus. Studies that evaluated the effect of reducing the etching time on the bond strength of adhesive systems to primary dentin were included. Meta-analyses were performed using a random-effects model, with subgroups for etch-and-rinse and self-etching adhesives, with a significance level of P < .05. The risk of bias and heterogeneity between studies (Cochrane and I2 tests) were assessed.

RESULTS

Eight studies were included in the systematic review and seven in the meta-analyses. The shortening etching time did not influence the immediate dentin bond strength for etch-and-rinse (Z = 0.07, P = .95) and self-etching adhesives (Z = 0.41, P = .69). After ageing, however, the shorting etching time improved the bond strength for etch-and-rinse adhesives (Z = 2.01, P = .04). All studies presented high bias risk.

CONCLUSIONS

Reducing the acid-etching time to primary dentin improves the long-term bond strength to this substrate.

Scanning electron microscopy comparison of the resin-dentin interface using different specimen preparation methods

Microscopy has been widely used to complement the data of studies related to dentin bonding; however, different specimen preparation methods may influence the analysis. Aiming to contribute to the reported scenario, this study evaluated the effect of two specimen-sectioning methods (cleavage and diamond disk cut) on the quality of the scanning electron microscopy (SEM) images. Four crowns of human molars were selected and had an area of approximately 6 mm² of dentin exposed. They were then divided into two groups according to the universal adhesive application: total and self-etching modes. Then, composite blocks were built up and the specimens were stored in deionized water to allow the postcuring. The specimens were further divided according to the sectioning method: cleavage or diamond disk cut. Four specimens were obtained from each tooth. They were desiccated, placed on aluminum stubs, sputter-coated with gold, and observed in a scanning electron microscope, with ×2000 of magnification. The quality of the SEM images were evaluated by two calibrated examiners and classified into four scores (1-4). Mann-Whitney test (p < .05) showed that the diamond disk provided significantly higher scores than cleavage, whereas no significant difference was observed when comparing the total-etching and self-etching modes of application. The diamond disk cut method is preferable to the cleavage method to ensure the quality of the SEM analysis in studies involving the resin-dentin interface.

[The results of evaluating the degree of influence of human blood plasma on the strength of adhesion of composite material to dentin (one-component adhesive system)]

OBJECTIVE

To study the dynamics of changes in the adhesion between the composite and dentin of the tooth when using different volumes of a single-component adhesive system in case of contamination of it with human blood plasma.

MATERIAL AND METHODS

To achieve this goal, the following were used: extracted human teeth, XP Bond one-component adhesive systems (DENTSPLY, Germany), Esthet X HD micrometric restoration material (DENTSPLY, Germany), and centrifuged blood plasma. The strength of the adhesive bond between the composite material and the hard tissues of the tooth was studied using a shear test machine Zwick Roell Z 010 («Zwick», Germany).

RESULTS

The use of a single-component adhesive system in an amount of 17.7 mg (1 drop from a dispenser) for treating open dentin makes it more resistant to contamination compared to using the same adhesive, but in an amount of 6.6 mg (the amount of adhesive that adsorbs a medium-sized dental take). A decrease in the adhesion force between the composite material and tooth hard tissues from 1.5 to 17.7% occurs when a single-component adhesive system weighing 17.7 mg of blood plasma simulating a dentinal fluid weighing from 0.2 to 2.0 mg enters. The ingestion of the same amount of blood plasma in a single-component adhesive system weighing 6.6 mg leads to a decrease in its adhesion from 4.3 to 43%.

An Insight into the Structural Diversity and Clinical Applicability of Polyurethanes in Biomedicine

Due to their mechanical properties, ranging from flexible to hard materials, polyurethanes (PUs) have been widely used in many industrial and biomedical applications. PUs’ characteristics, along with their biocompatibility, make them successful biomaterials for short and medium-duration applications. The morphology of PUs includes two structural phases: hard and soft segments. Their high mechanical resistance featuresare determined by the hard segment, while the elastomeric behaviour is established by the soft segment. The most important biomedical applications of PUs include antibacterial surfaces and catheters, blood oxygenators, dialysis devices, stents, cardiac valves, vascular prostheses, bioadhesives/surgical dressings/pressure-sensitive adhesives, drug delivery systems, tissue engineering scaffolds and electrospinning, nerve generation, pacemaker lead insulation and coatings for breast implants. The diversity of polyurethane properties, due to the ease of bulk and surface modification, plays a vital role in their applications.

Randomized clinical trial of different adhesion strategies in noncarious cervical lesion restorations: 1-year follow-up

OBJECTIVES

The purpose of the present prospective and randomized clinical trial was to evaluate the clinical performance of noncarious cervical lesions (NCCLs) restored with different adhesion strategies on the dental substrate.

METHOD AND MATERIALS

An adhesive restorative system (Single Bond Universal/ Z350XT) with and without selective enamel conditioning was evaluated, as well as a resin-modified glass-ionomer cement (Vitremer), with and without pretreatment with ethylenediaminetetraacetic acid (EDTA). Two operators placed a total of 200 restorations in 50 patients (four restorations per patient). Data from decayed, missing, and filled teeth (DMFT), visible plaque, and gingival bleeding were collected prior to the restorations and at each evaluation time. All restorations were evaluated using the modified United States Public Health Service (USPHS) evaluation system at baseline, and at 6 and 12 months. Data were analyzed by the Friedman, chi-square, Cochran, Wilcoxon, and multiple logistic regression analysis tests (P ≤ .05).

RESULTS

There was a gradual and significant increase in DMFT with a difference among the three evaluations (P ≤ .001). There was no difference for the Visible Plaque Index over time (P = .28); however, there was a significant reduction in the Gingival Bleeding Index between the baseline and the other evaluations (P ≤ .001). There was no statistically significant difference among groups and periods of evaluations (P > .05). Regarding logistic regression, the model as a whole was statistically significant (P = .034).

CONCLUSION

The four different adhesion strategies in the NCCL restorations presented similar clinical performance after 1 year of follow-up.

Does previous application of silver diammine fluoride influence the bond strength of glass ionomer cement and adhesive systems to dentin? Systematic review and meta-analysis

BACKGROUND

Silver diammine fluoride (SDF) applied before a restoration may prevent recurrent caries; therefore, its effect on the bonding of restorative materials is contradictory.

AIM

To assess through a systematic review and meta-analysis the influence of SDF on the bonding performance of adhesive materials to dentine.

DESIGN

A systematic search was carried out in PubMed, Web of Science, LILACS, and Scopus. Studies comparing bond strength of adhesive systems or glass ionomer cement to SDF-treated and -untreated (control) dentine were included. Global analysis comparing the bond strength data was performed, separately for adhesive systems and glass ionomer cement, using RevMan5.1, with a random-effect model, at a 5% significance level.

RESULTS

Eleven studies were included in the review and ten in the meta-analyses. Overall pooled effect for glass ionomer cement has shown no significant difference between the groups (Z = 0.47; P = .64). SDF treatment significantly impairs the bonding of adhesive systems to dentine (Z = 2.11; P = .03); this effect can be eliminated by the rinsing step (Z = 0.85; P = .40).

CONCLUSIONS

The previous application of SDF does not influence the dentine bond strength of glass ionomer cement, but compromises the bonding of adhesive systems.

Effect of Dentin Bonding Agents, Various Resin Composites and Curing Modes on Bond Strength to Human Dentin

This study investigated the influence of several dentin bonding agents, resin composites and curing modes on push-out bond strength to human dentin. 360 extracted caries-free third molars were prepared, cut into slices, embedded in epoxy resin and perforated centrally. One half of the specimens (180) were treated by using one-step adhesive systems and the other half (180) with multi-step adhesive systems. Subsequently, the cavities were filled with either universal, flowable or bulk-fill resin composite according to the manufactures’ product line and cured with either turbo or soft start program. After storage the push-out test was performed. The data was analyzed using Kolmogorov-Smirnov, three- and one-way ANOVA followed by the Scheffé post-hoc test, unpaired two-sample t-test (p < 0.05). The strongest influence on push-out bond strength was exerted by the resin composite type (partial eta squared η_P² = 0.505, p < 0.001), followed by the adhesive system (η_P² = 0.138, p < 0.001), while the choice of the curing intensity was not significant (p = 0.465). The effect of the binary or ternary combinations of the three parameters was significant for the combinations resin composite type coupled adhesive system (η_P² = 0.054, p < 0.001), only. The flowable resin composites showed predominantly mixed, while the universal and bulk-fill resin composite showed adhesive failure types. Cohesive failure types were not observed in any group. Multi-step adhesive systems are preferable to one-step adhesive systems due to their higher bond strength to dentin. Flowable resin composites showed the highest bond strength and should become more important as restoration material especially in cavity lining. The use of a soft start modus for polymerization of resin composites does not enhance the bond strength to dentin.

TiF4 Incorporated into a Self-etching Primer in Different Concentrations: Antimicrobial Properties and Effects on Demineralisation Inhibition Around the Restoration/Enamel-Dentin Interface

PURPOSE

To apply titanium tetrafluoride (TiF4) in an aqueous solution or incorporated into the primer of a self-etching adhesive (Clearfil SE Bond) as dentin pre-treatment and evaluate its antimicrobial effect, determine the minimum bactericidal concentraion (MBC) against Streptococcus mutans and Lactobacillus casei and analyse its potential to inhibit the development of carious lesions at the restoration interface.

MATERIALS AND METHODS

For MBC, an aqueous solution or primer with different concentrations (in %) of TiF4 were used (from 0.0 to 4.0). Also, 50 cavities were prepared at the enamel/dentin junction of third molars and received the following dentin pre-treatments (n = 10): Clearfil SE Bond (CL); aqueous solution of 2.5% TiF4 + CL (T2.5%); aqueous solution of 4% TiF4 + CL (T4%); 2.5% TiF4 incorporated into the primer (P2.5%); 4% TiF4 incorporated into the primer (P4%). Cavities were restored and submitted to pH cycling to create artificial caries lesions. Microhardness tests were performed after sectioning the restorations to assess the demineralisation at margins.

RESULTS

ANOVA and Tukey's tests showed that TiF4 in aqueous solution presented MBC against S. mutans and L. casei of over 2.0%. TiF4 in the primer of a self-etching adhesive presented MBC of over 1% for L. casei. For enamel, CL showed no significant differences in microhardness between the depths.

CONCLUSIONS

The aqueous solution had an antimicrobial effect against Streptococcus mutans and Lactobacillus casei of over 2.0%. Pretreatment with the aqueous solution or primer did not inhibit demineralisation at enamel or dentin restoration interfaces.

State of the Art of Dental Adhesive Systems

BACKGROUND

The large dependence on a dental substrate type to bond strength has leveraged the research on materials and techniques that perform different clinical behavior, promoting a stable bonding over time. Bonding to tooth structure has different clinical behaviors and is dependent on several factors.

OBJECTIVE

The aim of this paper is to reflect on the state of the art of adhesive systems after the emergence of Buonocore's experiments in current days.

METHODS

An electronic search was conducted on PubMed databases and supplemented with a manual study of relevant references.

RESULTS

The choice of the ideal adhesive system remains under discussion, housing a range of studies that highlight its potential characteristics, suggesting techniques that enable improvement to boost clinical outcomes.

CONCLUSION

It is important to know all different types of adhesive systems, as well as their indications and limitations. An attentive consideration of several factors is crucial to achieve clinical success on the restorative procedures.

Enamel shear bond strength of different primers combined with an orthodontic adhesive paste

AIM

The aim of this study was a comparison of shear bond strength (SBS) on tooth enamel of different primers combined with the adhesive paste Transbond XT.

MATERIALS AND METHODS

Forty bovine teeth were used in order to create 40 test blocks. The blocks were divided into four groups of 10 blocks each: group A - sample primer (SP); group B - Opal Seal (OS); group C - Transbond Plus SEP (TSEP); group D - Transbond XT Primer (TXT). After surface preparation and application of the primer, respectively, two stainless steel brackets were fixed on each tooth by using Transbond XT. Accordingly, 80 brackets were debonded (n=20). Shear bond strength and adhesive remnant index (ARI) scores were evaluated. Statistical analyses were performed by using the Student's t-test and Mann-Whitney U test.

RESULTS

All tested groups revealed high shear bond strength in a similar size range. There were no significant differences between the groups concerning shear bond strength. The ARI scores of group C showed significantly lower ARI scores (0 and 1) than that of group D. Apart from that there was no statistical difference.

CONCLUSION

In combination with the adhesive paste Transbond XT, all tested primers were suitable for fixing orthodontic brackets. The primers could be changed according to the clinical situation.

Bonding to Different PEEK Compositions: The Impact of Dental Light Curing Units

This study investigated the impact of different light curing units (LCUs) for the polymerization of adhesive system visio.link (VL) on the tensile bond strength (TBS) of different PEEK compositions. For TBS measurements, 216 PEEK specimens with varying amounts of TiO₂ (PEEK/0%, PEEK/20%, PEEK/>30%) were embedded, polished, air abraded (Al₂O₃, 50 µm, 0.4 MPa), conditioned using VL, and polymerized using either a halogen LCU (HAL-LCU) or a LED LCU (LED-LCU) for chairside or labside application, respectively. After thermocycling (5000×, 5/55 °C), TBS was measured, and fracture types were determined. Data was analyzed using a 2-way ANOVA followed by Tukey-HSD, Kruskal-Wallis H and Mann-Whitney U tests as well as a Chi²-test and a Ciba-Geigy table (p < 0.05). Globally, the light curing units, followed by PEEK composition, was shown to have the highest impact on TBS. The HAL-LCUs, compared to the LED-LCUs, resulted in a higher TBS for all PEEK compositions-without significant differences between chairside and labside units. Regarding the different PEEK compositions, PEEK/20%, compared to PEEK/0%, resulted in a higher TBS when both, HAL-LCUs or LED-LCUs were used for labside application. In comparison with PEEK/>30%, PEEK/20% resulted in a higher TBS after using HAL-LCU for labside application. No significant differences were found between PEEK/0% and PEEK/>30%. HAL-LCU with PEEK/20% for labside application showed a higher TBS than HAL-LCU with PEEK/20% for chairside application, whereas LED-LCU with PEEK/>30% for chairside application showed a higher TBS than LED-LCU with PEEK/>30% for labside application.

Bacterial microleakage of temporary filling materials used for endodontic access cavity sealing

Background/purpose

Providing a tight coronal seal is key for the success of endodontic treatment, therefore the study aimed to assess bacterial microleakage of materials used for short- and long-term temporization.

Materials and methods

One hundred and twenty-eight human upper-third molars were divided into six experimental groups (n = 20) and two control groups: negative (n = 4) and positive (n = 4). The standardized access cavities were prepared and filled with: (1) Cavit; (2) Fuji II LC; (3) Fuji IX; (4) Voco Clip; (5) AdheSE and Tetric EvoCeram; (6) Excite and Tetric EvoCeram. The crown of each tooth was sectioned to obtain 5.5-mm-high disks, which were assembled in a standard setup for bacterial microleakage studies using Streptococcus mutans. The monitoring lasted 90 days. Kaplan-Meier survival analysis was performed.

Results

The lowest amount of leaking samples was found in AdheSE and Tetric EvoCeram (31.3%), Cavit (33.3%), and Excite and Tetric EvoCeram groups (35.3%), followed by Fuji II LC (66.7%), Voco Clip (83.3%). and Fuji IX (88.2%) groups. According to the day of microleakage, materials could be classified in three groups with statistically significant differences (P < 0.05). In the first group were Cavit (70 days), AdheSE and Tetric EvoCeram (68 days), and Excite and Tetric EvoCeram (65 days), in the second group were Voco Clip (44 days) and Fuji II LC (43 days), and in the third group was Fuji IX (21 days).

Conclusion

None of the tested materials were able to completely prevent bacterial microleakage. Adhesively bonded composites and Cavit offer better sealing compared with glass ionomer cements, resin modified glass ionomer cements, and composites without the use of an adhesive system.

Evaluation of the bond strength of different adhesive agents to a resin-modified calcium silicate material (TheraCal LC)

This study evaluated the bond strength of different adhesive agents to TheraCal LC and mineral trioxide aggregate (MTA) and examined the morphologic changes of these materials with different surface treatments. A total of 120 specimens, 60 of MTA Angelus (AMTA), and 60 of TheraCal LC, were prepared and divided into six subgroups according to the adhesive agent used; these agents included Scotchbond Multipurpose, Clearfil SE Bond, Clearfil Protect Bond, Clearfil S³ Bond, OptiBond All-in-One, and G-aenial Bond. After application of adhesive agents, Filtek Z250 composite resin was placed onto the specimens. Shear bond strengths were measured using a universal testing machine, followed by examination of the fractured surfaces. The surface changes of the specimens were observed using scanning electron microscopy. Data were compared by two-way analysis of variance. Although no significant differences were found among the bond strengths of different adhesives to AMTA (p = 0.69), a significant difference was found in terms of bond strengths of different adhesives to the TheraCal LC surface (p < 0.001). The total-etch adhesive system more strongly bonded to TheraCal LC compared to the bond with other adhesives. TheraCal LC bonded significantly more strongly than AMTA regardless of the adhesive agents tested. Resin-modified calcium silicate showed higher bond strength than AMTA in terms of the composite bond to these materials with different bonding systems. On the other hand, the highest shear bond-strength values were found for composite bonds with the combination of TheraCal LC and the total-etch adhesive system. SCANNING 38:403-411, 2016. © 2015 Wiley Periodicals, Inc.

Doxycycline as a matrix metalloproteinase inhibitor to prevent bond degradation: the effect of acid and neutral solutions on dentin bond strength

The aim of this in vitro study was to evaluate the pH effect of doxycycline solutions on the immediate dentin bond strength of a total-etch adhesive system. Twenty human molars were divided into 4 groups (n = 5) after acid etching according to surface treatment: 10% acidic doxycycline, 10% neutral doxycycline, 2% chlorhexidine, and control. Composite resin blocks were made and subjected to microtensile testing. Mean bond strength values were submitted to a 1-way analysis of variance and a Tukey test (α = 0.05). No statistically significant differences between the experimental groups were found (P = 0.093). The chlorhexidine group showed the highest number of pretesting failures. The application of either acidic or neutral doxycycline solution prior to the dentin adhesive did not influence the bond strength of the total-etch adhesive system evaluated.

Evaluation of the micro-shear bond strength of four adhesive systems to dentin with and without adhesive area limitation

The purpose of this study was to evaluate the bonding ability of four representative dentin-adhesive systems by applying the micro-shear bond strength (μ-SBS) test method and to evaluate the influence of adhesive area limitation on the bond strength. Two different adhesive application methods were used in the μ-SBS test (with and without adhesives area limitation), and four representative adhesive systems were used in this study. Each dentin surface was treated with one of the four representative adhesive systems, and with twenty samples per group (n=20), each of the four groups underwent a μ-SBS test. The results showed that the bond strength was significantly influenced by the adhesive application method (p<0.05), the adhesive type (p<0.05) and the interaction between the two factors (p<0.05). With regard to the four representative dentin-adhesive systems, 3-E&R has a much better bond quality compared to the other adhesive systems. Furthermore, the micro-shear bond strength test method of restricting the area of both the adhesive and the resin is more reliable for evaluating the bonding property of adhesives to dentin, and it is also adequate for comparing the different adhesives systems.

Effect of 180-Day Water Storage on Bonding Effectiveness of Self-Adhesive Systems to Occlusal and Proximal Dentin

PURPOSE

This study aimed to evaluate the microshear bond strength (μSBS) values of adhesive systems to occlusal and proximal dentin submitted to water storage aging.

MATERIALS AND METHODS

Occlusal and proximal dentin surfaces were obtained from 90 molars, polished with 600-grit SiC and divided according to the type of adhesive system: one total-etch and two self-etch. Starch tubing was used to perform 1 mm² cylindrical composite resin restorations. The specimens were aged in distilled water during different storage times: 24 hours, 3 months, and 6 months (n = 10). The specimens were submitted to μSBS test. The μSBS values in MPa were subject to three-way ANOVA and post hoc Tukey test (p < 0.05).

RESULTS

There was no statistical difference in the μSBS values among the storage times (p = 0.72); however, the dentin region (p < 0.01) and the adhesive system (p < 0.01) significantly affected the μSBS. The proximal surface (14.7 ± 3.3 MPa) presented higher μSBS values than the occlusal dentin (10.9 ± 4.1 MPa). The all-in-one adhesive system (GB) achieved the highest μSBS mean (17.0 ± 1.7 MPa).

CONCLUSION

Both material and dentin surface factors affected the composite-dentin bond strength; however, the water storage did not influence bonding effectiveness over time.

Geckos significantly alter foot orientation to facilitate adhesion during downhill locomotion

Geckos employ their adhesive system when moving up an incline, but the directionality of the system may limit function on downhill surfaces. Here, we use a generalist gecko to test whether limb modulation occurs on downhill slopes to allow geckos to take advantage of their adhesive system. We examined three-dimensional limb kinematics for geckos moving up and down a 45° slope. Remarkably, the hind limbs were rotated posteriorly on declines, resulting in digit III of the pes facing a more posterior direction (opposite to the direction of travel). No significant changes in limb orientation were found in any other condition. This pes rotation leads to a dramatic shift in foot function that facilitates the use of the adhesive system as a brake/stabilizer during downhill locomotion and, although this rotation is not unique to geckos, it is significant for the deployment of adhesion. Adhesion is not just advantageous for uphill locomotion but can be employed to help deal with the effects of gravity during downhill locomotion, highlighting the incredible multi-functionality of this key innovation.

MMP Inhibitors on Dentin Stability: A Systematic Review and Meta-analysis

The aim of this study was to systematically review the literature for in vitro and ex vivo studies that evaluated the effect of matrix metalloproteinase (MMP) inhibitors during the adhesive procedure on the immediate and long-term resin-dentin bond strength. The search was conducted in 6 databases with no publication year or language limits, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. From 1,336 potentially eligible studies, 48 were selected for full-text analysis, and 30 were included for review, with 17 considered in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooled effect estimates were expressed as the weighted mean difference between groups. The most used MMP inhibitor was chlorhexidine (CHX). Immediate bond strength results showed no difference between 2% CHX and control; however, a difference was found between 0.2% CHX and control at baseline. After aging, CHX presented higher bond strength values compared to control groups (p < .05). However, this was not observed for longer periods of aging. High heterogeneity was found in some comparisons, especially for the water storage aging subgroup. Subgroup analyses showed that self-etching and etch-and-rinse adhesives are benefited by the CHX use. From the studies included, only 1 presented low risk of bias, while the others showed medium or high risk of bias. The use of MMP inhibitors did not affect the immediate bond strength overall, while it influenced the aged bond strength. Aging procedures influenced bond strength values of the dentin adhesion stability.

Cytotoxicity of adhesive systems of different hydrophilicities on cultured odontoblast-like cells

This study evaluated the cytotoxicity of experimental adhesive systems (EASs) on odontoblast-like cells. Paper discs (n = 132) were impregnated with 10 µL of each EAS-R1, R2, R3, R4, and R5 (in an ascending order of hydrophilicity), followed by photoactivation. R1 and R2 are nonsolvated hydrophobic blends, R3 represents a simplified etch-and-rinse adhesive system, and R4 and R5 represent simplified self-etch adhesive systems. Discs were immersed in Dulbecco's modified Eagle's medium for 24 h to obtain eluates applied on MDPC-23 cell cultures. No material was applied on discs used as control (R0). Cell viability [3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay], total protein (TP) production, alkaline phosphatase (ALP) activity, type of cell death, and degree of monomer conversion Fourier transform infrared (%DC-FTIR) were evaluated. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests (α = 0.05). Considering R0 (control) as having 100% of cell viability, R1, R2, R3, R4, and R5 reduced the metabolic activity of cells by 36.4, 3.1, 0.2, 21.5, and 65.7%, respectively, but only R1 and R5 differed from R0. Comparing with R0, lower TP production was observed for R1, R4, and R5, while ALP activity decreased for R1 and R5. Necrotic cell death was predominant for all EASs, but only R1, R4, and R5 differed from R0. Only R5 presented a different apoptotic cell death ratio from R0. R1 presented the lowest %DC (ca. 37%), whereas R4 and R5 presented the highest (ca. 56%). In conclusion, R2 and R3 were not toxic to the MDPC-23 cells, suggesting that the degree of hydrophilicity or %DC of the EASs alone were not responsible for their cytopathic effects.

Influence of previous acid etching on interface morphology and bond strength of self-etching adhesive to cavosurface enamel

OBJECTIVES

The aim of this study was to evaluate the (1) bond strength of a etch-and-rinse and self-etching adhesive systems to cavosurface enamel, (2) influence of the previous acid etching with phosphoric acid 35% to the self-etching adhesive application on bond strength values, and (3) analysis of the cavosurface enamel morphology submitted to different types of conditioning, with the use of a scanning electronic microscope (SEM).

METHODS

Twenty four human third molars were sectioned on mesio-distal direction, resulting in two slices. The specimens were ground flat with 600-grit aluminum oxide papers, and were randomly divided into three groups: Group 1 (etch-and-rinse adhesive system (control group)), Group 2 (self-etching adhesive), and Group 3 (self-etching adhesive with previous 35% phosphoric acid-etching for 15 s). Four cylinders (0.75 mm of diameter, 1 mm height) were confectioned prior to the microshear test. Four samples for each group were prepared according the cavosurface enamel treatment and were analyzed in an SEM.

RESULTS

Group 3 had the highest values on bond strength to cavosurface enamel compared to the other two groups, which presented statistically similar values. The performance of acid etching before the application of the self-etching adhesive results in an etching pattern that is different than the other groups, favoring the adhesion to the cavosurface enamel.

CONCLUSIONS

Acid etching increases the bond strength values of the self-etching adhesive to cavosurface enamel, promoting a conditioning pattern that favors the adhesion to this substrate.