Comparison of Three Different Orthodontic Adhesives Bonded to Metallic and Ceramic Brackets: SEM and SEM/EDX Analysis (In Vitro Study)

Objectives

To compare three different orthodontic adhesives (Transbond XT Light Cure Adhesive, Heliosit Orthodontic, Fuji Ortho LC) bonded to two types of orthodontic brackets: ceramic brackets (Fascination Roth 0.22) and metallic brackets (Topic Roth 0.22, Dentaurum).

Materials and methods

The study was performed on 18 human teeth (6 for each adhesive). The prepared teeth were divided into three groups according to the examination time. Subsequently, they were observed after 1, 2 and 3 weeks following bonding. After the experimental procedure, the teeth samples were cut in half along the longitudinal axis in the vestibulo-oral direction, fixed with conductive carbon cement, placed in a high-vacuum evaporator and then coated with carbon. One half of each sample was observed under a Field-emission gun scanning electron microscope (FEG-SEM Hitachi SU 8030, Japan), while on the second half of the samples qualitative (X-ray line-scans) and semi-quantitative point X-ray energy dispersive analyses (EDX) were performed with Thermo Noran (USA) NSS System 7, equipped with Ultra Dry detector (30 mm2 window).

Results

Transbond XT had an ideal bond with the enamel and the bracket base, with rare presence of microgaps and cracks in the enamel. Heliosit Orthodontic demonstrated a better bond relationship with the bracket base than the enamel, whereas in the latter the presence of microgaps in the bond was observed. The microphotographs of Fuji Ortho LC demonstrated many cracks inside the adhesive, and some of them continued to move forward into the enamel surface. Therefore, an impression of a very solid bond relationship with the enamel exists, with cracks being present in the enamel surface and never at the enamel-adhesive interface. Microgaps also appeared at the bracket-adhesive interface.

Conclusion

Transbond XT is a highly filled composite resin and is an ideal orthodontic adhesive in each aspect examined, with an ideal enamel-adhesive and bracket-adhesive interface. Heliosit Orthodontic provides better bracket-adhesive interface compared to the enamel. Fuji Ortho LC as a solid resin-modified GIC provides a better enamel-adhesive interface, compared to the bracket base.

Description and Durability of the Various Indirect Restoration Techniques in Molar-Incisor Hypomineralisation: A Systematic Review

Molar-incisor hypomineralisation (MIH) is a qualitative defect of the enamel structure. Indirect restorations may represent the most suitable therapeutic solutions for patients presenting MIH with tooth restorative procedures. This systematic review aims to determine the feasibility of indirect restorations.

MATERIALS AND METHODS

A systematic review has been performed and is reported following the PRISMA guidelines. It was performed on three databases (PubMed, Science Direct, and Google Scholar). Ten articles were included.

RESULTS

Only two articles reported the use of CAD/CAM technologies, whereas the other eight preferred conventional registration and handmade stratification for ceramics. All indirect bonded restorations made of composite resins or ceramics had significant success rates. A temporary material was placed in most of the articles. There was no clear consensus for tissue conditioning before bonding. Depending on the authors and the articles, the follow-up period extended from 2 months to 6 years.

CONCLUSIONS

The survival rate and the non-invasive procedures of indirect restorations are two main arguments that can help dental practitioners in daily practice. Development of CAD/ CAM technologies adds new perspectives in the registration, the design and production. However, more clinical trials are needed to confirm the conclusions.

The Effect of Bioglass Coating on Microshear Bond Strength of Resin Cement to Zirconia

Objectives: Durable bonding to zirconia is a challenging issue in dentistry. This study aimed to assess the effect of bioglass coating of zirconia on the microshear bond strength of resin cement to zirconia and to study the effect of thermocycling on this bond. Materials and Methods: This in-vitro experimental study was conducted on 60 yttria-stabilized tetragonal zirconia blocks in six groups (N=10) based on surface pretreatment and thermocycling. Surface pretreatments included no treatment control, alumina particle abrasion, and bioglass-coating of zirconia. Resin bonding was performed with Panavia F2.0 cements. Then, half of the specimens underwent a 24-hour incubation in 37°C water, while the other half were subjected to thermocycling (12000 cycles, 5-55°C, 60s for each batch) following the same incubation period. Subsequently, the microshear bond strength of the specimens was measured. Additionally, one block from each group was subjected to scanning electron microscopy and X-ray diffraction. The data were analyzed using Kruskal-Wallis and Mann-Whitney U tests. Results: There was a significant difference between the bond strength values of different groups (P<0.001). Alumina particle abrasion and bioglass coating equally increased the bond strength compared to the untreated control group (P<0.001). Thermocycling caused significant decreases in bond strength in all the groups (P<0.001); however, the bond strength value of the thermocycled bioglass-coated group was significantly higher than that reported for the thermocycled alumina particle abraded group (P=0.015). Conclusion: Despite the decrease in the bond strength values after thermocycling, the long-term efficacy of the bioglass coating of zirconia was promising.

Comparative Evaluation of Application of Universal Bonding on the Microtensile Bond Strength of Light Cure and Dual Cure Composites Bonded to Dentin

Objectives: There is limited knowledge on the efficacy of universal adhesives when used in different etching modes. The aim of this study was to evaluate the microtensile bond strength (µTBS) to dentin using universal adhesives with light-cure and dual-cure composites. Materials and Methods: In this in vitro experimental study, the occlusal third of 60 caries-free human molars were removed and the exposed surfaces were treated and allocated to 10 groups (N=6). Two different bonding agents (Single Bond Universal, G-Premio) were used to bond 2 different composite resins (Z250 light-cure and CoreFlo DC dual-cure) to dentin, using etch-and-rinse (E&R) and self-etch (SE) modes. Single Bond 2 was applied in E&R mode on wet dentin to serve as control. The specimens were sectioned into 1×1 mm2 sticks with a precision saw. A microtensile testing machine was used to measure the µTBS of the specimens with a crosshead speed of 0.5 mm/min. Data were analyzed using three-way ANOVA and Bonferroni post-hoc test (α=0.05). Results: The Single Bond Universal group in SE mode with light-cure composite yielded the highest (39.24MPa), and the G-Premio SE group with dual-cure composite produced the lowest (13.65MPa) mean µTBS (P<0.05). The dominant failure mode was adhesive, in all groups. Conclusion: The bonding agent had a significant effect on µTBS of composite to dentin, but different composites and different etching modes were not significantly different in this respect.

Cracked Tooth Syndrome: Assessment, Prognosis and Predictable Management Strategies

Cracked tooth syndrome (CTS) is a common presentation in general practice. The diagnosis and management of teeth with CTS may be difficult due to the unknown extent of the crack. This article reviews the aetiology, diagnosis, management and prognosis of teeth with CTS. A thorough examination is required to effectively assess CTS. Intervention should aim to relieve symptoms and brace the remaining tooth structure effectively against further flexion. Restored teeth with CTS have a guarded prognosis due to the risk of further crack propagation, but the chances of survival at 5-years is acceptable (74.1-96.8%).

Comparison of the failure rate, bonding time and ARI score of two orthodontic bonding systems: Self-Etch Primer and Conventional Etching Primer: A systematic review and meta-analysis

OBJECTIVE

This study aimed to evaluate the failure incidence of brackets with at least six months follow-up between self-etch primer and conventional etch/primer, as well as to investigate the clinical duration of the bonding process and the amount of adhesive remnant index (ARI).

METHODS

Electronic search was conducted in databases including PubMed, Scopus, Web of Science, ProQuest, ClinicalTrials.gov, and ICTRP (International Clinical Trials Registry Platform). The electronic search targeted only randomized clinical trials and was limited from January 2000 to June 2021. Delphi list is used to evaluate the risk of bias and Stata Version14.2 software was used. This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded on the Ethics Committee of Research Institute of Dental Sciences, SBMU (IR.SBMU.DRC.REC.1398.240).

RESULTS

Out of 2288 extracted studies, 30 of them entered the full-text evaluation process. According to the inclusion criteria, 15 studies entered this systematic review. Containing 607 participants and 10,563 brackets/teeth. All the included studies were of randomized clinical trials (RCT) design with either parallel or split-mouth design. Comparing the two groups, the risk difference effect (RD)=0.007 CI 95% (-0.004,0.018) indicated a neglectable difference in the risk of bracket failure during treatment between the two groups. The index I²=53.9% indicated moderate heterogeneity in the results. Furthermore, the P-value=0.007 indicated statistical insignificance between the two interventions in terms of failure rate. The clinical duration of bonding time analysis were equal to SMD _Cohen=-2.67 CI95% (-3.49, -1.85), which indicated a statistically significant reduction in clinical process time, using the self-etch primer. Data synthesis for adhesive remnant index could not be conducted due to heterogeneity among included studies.

CONCLUSIONS

There was no difference between the self-etch primer and conventional etch/primer in bracket debonding at a medium level of evidence, However, there was statistically significant reduction in clinical bonding time using self-etch primer.

Cracked Tooth Syndrome: Assessment, Prognosis and Predictable Management Strategies

Cracked tooth syndrome (CTS) is a common presentation in general practice. The diagnosis and management of teeth with CTS may be difficult due to the unknown extent of the crack. This article reviews the aetiology, diagnosis, management and prognosis of teeth with CTS. A thorough examination is required to effectively assess CTS. Intervention should aim to relieve symptoms and brace the remaining tooth structure effectively against further flexion. Restored teeth with CTS have a guarded prognosis due to the risk of further crack propagation, but the chances of survival at 5-years is acceptable (74.1-96.8%).

Antimicrobial Efficacy of Silver Nanoparticles Incorporated in an Orthodontic Adhesive: An Animal Study

Objectives:

This study assessed the antimicrobial efficacy of silver nanoparticles (AgNPs) incorporated in Transbond XT orthodontic adhesive used in rats.

Materials and Methods:

Transbond XT orthodontic adhesive containing 0%, 1%, 5% and 10% AgNPs was experimentally produced. Twenty-eight male Wistar rats were randomly divided into four groups (n=7) of control (0% AgNPs), 1% AgNPs, 5% AgNPs and 10% AgNPs. After anesthetizing the rats, one drop (10 μm) of the adhesive was applied on the central incisor, and light-cured for 20 s. Transbond XT composite (1×1×1 mm) was also applied. Another 10-μm drop was applied over it, and light-cured for 40 s. Biofilm test was carried out, and the number of colony forming units (CFUs) of Streptococcus sanguinis (S. sanguinis), Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) in the saliva of rats was counted at baseline and 24 h after the application of adhesive. The data were analyzed using one-way ANOVA and Tukey’s test.

Results:

In presence of 5% and 10% AgNPs, S. sanguinis and L. acidophilus counts were significantly lower than those in the control and 1% AgNP groups (P<0.05). The S. mutans colony count was significantly lower in presence of all concentrations of AgNPs compared with the control group (P<0.05). The S. mutans colony count in 10% AgNP group was significantly lower than that in 1% and 5% AgNP groups (P<0.05).

Conclusion:

Silver nanoparticles have dose-dependent antimicrobial effects; 5% concentration is the minimum concentration of AGNPs with optimal antimicrobial efficacy against all strains evaluated in this study.

Effect of Cavity Disinfection with Chlorhexidine on Marginal Gap of Class V Composite Restorations Bonded with a Universal Adhesive Using Self-Etch and Etch-and-Rinse Bonding Strategy

Objectives:

This in-vitro study aimed to evaluate the effect of cavity disinfection with chlorhexidine (CHX) on marginal gaps of Class V composite resin restorations bonded with a universal adhesive using self-etch and etch-and-rinse bonding strategy.

Materials and Methods:

Sixty sound human premolars were randomly assigned to two groups (n=30): group 1 (CHX) and group 2 (no CHX). Each group was divided into two subgroups (n=15) according to the bonding strategy of the universal adhesive (self-etch or etch-and-rinse). Class V cavities were prepared on the buccal surfaces of the teeth. The occlusal and gingival margins of the cavities were placed in enamel and dentin, respectively. In the first and second subgroups of both groups, the All-Bond Universal adhesive was applied with self-etch and etch-and-rinse bonding strategy, respectively. After restoration and thermocycling, the samples were sectioned, and marginal gaps at the gingival margins were measured in micrometer (μm) under a stereomicroscope. Two-way analysis of variance (ANOVA) was used to compare marginal gaps between the groups and the subgroups.

Results:

The mean marginal gap size was significantly affected by cavity disinfection (P=0.001) and bonding strategy (P=0.002). However, the interaction effect of these two factors on the mean marginal gap size was not significant (P=0.79).

Conclusion:

The use of CHX resulted in larger marginal gaps at the gingival margins of Class V composite resin restorations. Irrespective of disinfection, the self-etch bonding strategy resulted in larger marginal gaps compared to the etch-and-rinse bonding strategy.

Effect of Different Application Techniques of Universal Bonding System on Microtensile Bond Strength of Bulk-Fill Composites to Primary and Permanent Dentin

Objectives

This study aimed to determine the microtensile bond strength (μTBS) of a bulk-fill composite to permanent and primary coronal dentin using a universal adhesive in self-etch and total-etch modes.

Materials and Methods

This in-vitro study was performed on 52 occlusal dentinal surfaces of human primary and permanent teeth. The crowns were cut to the gingival level. The 48 prepared dentin sections were randomly assigned to the following groups (n=13): A: Primary/Total-etch, B: Primary/Self-etch, C: Permanent/Total-etch, and D: Permanent/Self-etch. In groups A and C, after etching for 15 seconds, two layers of a universal bonding (Futurabond U) were applied and cured for 10 seconds. All samples were filled with a bulk-fill composite (x-trafil; VOCO) and cured for 40 seconds. The samples were cut to a bar-shaped dentin block with the dimensions of 1×1×1 mm³, and after 10,000 thermocycles, the μTBS test was accomplished at a crosshead speed of 1 mm/minute. The mean and standard deviation (SD) of μTBS were calculated, and the data were analyzed using two-way analysis of variance (ANOVA) and Fisher's exact test.

Results

The mean μTBS was as follows: A: 15.03±2.0279, B: 11.11±2.4423, C: 23.50±4.8165, and D: 16.26±6.3200 MPa. Futurabond U showed a higher μTBS in the total-etch mode (P<0.001). The permanent teeth had greater μTBS than the primary teeth (P<0.001). Similar percentages of failure modes were observed in the total-etch groups but in the self-etch groups, most failures were in the form of adhesive and mixed.

Conclusion

Greater μTBS was observed in the permanent teeth with the total-etch technique.

Shear Bond Strength of Brackets Bonded with Self-Etching Primers Compared to Conventional Acid-Etch Technique: A Randomized Clinical Trial

Objectives:

The purpose of this randomized clinical trial (RCT) was to compare the shear bond strength (SBS) of orthodontic brackets bonded to enamel with conventional acid-etch (AE) technique and self-etching primers (SEP).

Materials and Methods:

Twenty-two patients, requiring extraction of two bicuspids for orthodontic reasons, were recruited. In each individual, following blinding and allocation concealment, one intact premolar received conventional AE, whereas the contralateral premolar received SEP with a split-mouth design. Bonded brackets remained in the oral cavity for two months. Afterward, the teeth were extracted without debonding the brackets. SBS and adhesive remnant index (ARI) were measured using a Universal Instron machine and a stereomicroscope, respectively.

Results:

The mean SBS of the conventional AE and SEP groups was 9.53 and 9.20 MPa, respectively. Paired t-test showed no statistically significant difference between the two groups (P=0.096). Comparison of ARI between the two groups, using Wilcoxon test, indicated that significantly less adhesive remained on enamel with brackets bonded with SEP compared to brackets bonded with conventional AE (P<0.001) although the SBS was higher in the AE group.

Conclusion:

The present study indicated that although there is no significant difference in SBS between SEP and conventional AE for bonding orthodontic metal brackets, the amount of residual adhesive on the enamel surface is significantly less with SEP than with conventional AE.

(IRCT registration number: IRCT201705099086N3).

Effects of Calcium Hypochlorite and Sodium Hypochlorite, as Root Canal Irrigants, on the Bond Strength of Glass Fiber Posts Cemented with Self-Adhesive Resin Cement

Objectives:

Calcium hypochlorite (Ca(OCl)₂) is currently used as a root canal irrigant. The aim of this study was to compare the effects of calcium hypochlorite and sodium hypochlorite (NaOCl), as root canal irrigants, on the bond strength of posts cemented with a self-adhesive resin cement.

Materials and Methods:

In this in-vitro study, 40 maxillary central incisors with similar root lengths were decoronated. The teeth were randomly divided into five groups based on the irrigant used: Group 1: normal saline (control), Group 2: 2.5% sodium hypochlorite, Group 3: 5.25% sodium hypochlorite, Group 4: 2.5% calcium hypochlorite, and Group 5: 5% calcium hypochlorite. Root canal treatments were performed with Gates-Glidden drills and the irrigant corresponding to each group was used upon changing the file and for irrigating the post space. Then, glass fiber posts were cemented by BisCem self-adhesive cement. After applying 1,000 thermocycles at 5–55°C, three samples of the mid-section of each root were prepared: one for scanning electron microscopy (SEM), and the rest for push-out testing. Data were analyzed with SPSS 23 software using one-way analysis of variance and post-hoc Tukey’s test.

Results:

The highest and lowest mean bond strengths were recorded in groups 5 and 1, respectively. There was a significant difference between the 5% calcium hypochlorite group and the other groups (P<0.001). The difference between the other groups was not significant.

Conclusion:

The use of 5% calcium hypochlorite with self-adhesive cements increases the push-out bond strength of fiber posts to radicular dentin.

Pain perception of orthodontic treatment - A cross-sectional study

Objectives:

The objectives were to evaluate the intensity of pain perceived 24 hours following insertion of fixed orthodontic appliance components i-e separators, bands and brackets.

Methods:

This cross-sectional study conducted at a Dental College in Karachi (July 2017-March 2018) investigated the amount of pain perceived during different stages of fixed orthodontic treatment. The inclusion criteria were healthy individuals without systemic disease, age 13-26 years, fixed orthodontic treatment candidates having healthy permanent first molars. The exclusion criteria were missing permanent first molars, patients requiring brass wire separators instead of elastomeric separators and molar tubes instead of bands, ongoing or previous periodontal disease and syndromic patients. Pain intensity was assessed in ninety eight patients using a Numeric Rating scale (NRS) at baseline (T0) before insertion, and 24 hours after insertion (T1) of a component. This procedure was repeated six times, twice each for separators, bands and brackets. Scoring was done on the NRS from 0 to 10 where 0 indicated no pain and 10 indicated worst pain possible.

Results:

A significant difference in perceived pain was found between baseline and after 24 hours of placement of all components (P-value 0.000). Odds ratio indicated that males were at a greater risk to feel pain than females at baseline and after 24 hours of insertion of all components. Mann-Whitney U test showed that the most painful components at baseline were bands (Mean value=0.56) and after 24 hours were brackets (Mean value 6.25).

Conclusions:

Significant increase in pain was noted 24 hours after insertion of separators, bands and brackets. The most painful components were bands at baseline and brackets after 24 hours of insertion. There were no significant variations in pain perception based on age. However, males perceived higher pain than females both at baseline and after 24 hours.

Effect of Er:YAG and Er,Cr:YSGG Lasers on Ceramic Bracket Debonding from Composite Blocks

Objectives:

This study aimed to assess the effect of erbium-doped yttrium aluminum garnet (Er:YAG) and erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) lasers on the shear bond strength (SBS) of ceramic brackets debonding from the surface of composite blocks.

Materials and Methods:

Thirty-six composite blocks were fabricated using Filtek Z250 light-cure composite. Block surfaces were etched with 37% phosphoric acid for 30 seconds and then rinsed with water for 20 seconds and dried. Maxillary right central incisor ceramic orthodontic brackets were bonded to the surfaces of composite blocks using Transbond XT adhesive and were cured for 40 seconds. Twelve samples were irradiated with Er:YAG laser, while 12 samples were irradiated with Er,Cr:YSGG laser, and the brackets were then debonded using a universal testing machine. Twelve samples served as controls (debonding using the universal testing machine without using a laser). The adhesive remnant index (ARI) score and bracket or composite cracks were evaluated under a stereomicroscope. One-way analysis of variance (ANOVA) was used for the comparison of the three groups. Kruskal-Wallis test was used to compare the ARI scores.

Results:

The mean SBS was 17.01±5.22 MPa with Er:YAG laser, 18.03±6.46 MPa with Er,Cr:YSGG laser, and 16.61±6.73 MPa in the control group; the difference of the three groups was not significant (P=0.835). The difference in the ARI scores and enamel and composite cracks was not significant either (P>0.05).

Conclusion:

This study did not show any reduction in the bond strength of ceramic bracket to composite blocks after Er:YAG and Er,Cr:YSGG laser irradiation.

In vivo optical coherence tomographic imaging to monitor gingival recovery and the adhesive interface in aesthetic oral rehabilitation: A case report

The available methods for veneer evaluation are limited to clinical and radiographic examinations, which may not allow the appropriate identification of failure. In this report, we demonstrate the use of optical coherence tomography (OCT) as a noninvasive diagnostic and follow-up method to evaluate gingival recovery and the adhesive interface in aesthetic oral rehabilitation involving periodontal plastic surgery and ceramic laminate veneers. OCT was efficient for evaluating both soft and hard tissues, as well as the quality of the adhesive interface. In conclusion, OCT was found to be a promising approach for the professional evaluation of aesthetic oral rehabilitation, as it was capable of generating images that enabled the analysis of gingival recovery and the adhesive interface.

Shear Bond Strength of Orthodontic Brackets to Composite Restorations Using Universal Adhesive

STATEMENT OF THE PROBLEM

The dental adhesives may have the potential to increase the bond strength of orthodontic brackets to composite resin and it would be highly desirable if adequate bracket-composite bond strength could be yielded by using these adhesives without the need for surface roughening.

PURPOSE

The purpose of this study was to measure the shear bond strength (SBS) of metal brackets to composite restorations by use of a universal adhesive compared with a conventional adhesive.

MATERIALS AND METHOD

In this in vitro, experimental study, 45 composite discs measuring 6 mm in diameter and 4 mm in thickness were fabricated and assigned to three groups (n=15). In the group 1, discs were etched with 37% phosphoric acid for 15 seconds and Scotchbond Universal was then applied. Discs were roughened by diamond bur in the group 2 and were subjected to the application of Scotchbond Universal. In the group 3, conventional adhesive (Single Bond 2) was applied after roughening the discs by diamond bur. Metal brackets were then bonded to discs and after thermocycling, the SBS was measured by an Instron machine. The mode of failure and adhesive remnant index (ARI) score were determined using stereomicroscope. Data were analyzed by SPSS version 18, one-way ANOVA, and the Kruskal Wallis test.

RESULTS

The surface roughening plus universal adhesive group showed the highest SBS (11.90 MPa) but according to one-way ANOVA, the difference in this regard among the three groups was not statistically significant (p= 0.94). Most samples showed ARI score of 4.

CONCLUSION

Universal adhesive can provide sufficient bond strength as high as that provided by conventional adhesives for orthodontic bracket bonding to composite restorations even in absence of surface roughening by bur.

Evaluation of the Effect of Propolis Nanoparticles on Antimicrobial Properties and Shear Bond Strength of Orthodontic Composite Bonded to Bovine Enamel

Objectives:

We aimed to investigate the effects of propolis nanoparticles (prpNPs) on antimicrobial property and shear bond strength (SBS) of orthodontic composite bonded to bovine enamel.

Materials and Methods:

Sixty bovine teeth were randomly divided into five groups (n=12). PrpNPs were prepared at concentrations of 0% (control), 1%, 2%, 5%, and 10% in Transbond XT composite to bond stainless steel brackets to the teeth. SBS between brackets and teeth was measured using a universal testing machine. After debonding, the adhesive remnant index (ARI) on bracket bases was measured. In the microbial test, composites with the aforementioned concentrations of prpNPs were cured in metal discs. The bacteria included Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis), and Lactobacillus acidophilus (L. acidophilus), and antimicrobial effects of prpNPs were investigated by anti-biofilm, disc agar diffusion and eluted component tests.

Results:

The 10% prpNPs group showed the lowest SBS. Colony growths of S. mutans and S. sanguinis at all concentrations (except for 1%) was significantly lower than the control group. L. acidophilus colony growth was significantly reduced at 5% and 10% concentrations. Growth inhibition zone developed at 2%, 5%, and 10% concentrations for S. mutans and S. sanguinis. The lowest numbers of S. mutans and S. sanguinis colonies at all concentrations were observed on day 15. L. acidophilus colonies decreased significantly at all concentrations (except for 1%) until day 30.

Conclusion:

Nano propolis has a significant antimicrobial effect at 2% and 5% concentrations, and the SBS is maintained within the acceptable clinical range.

Effect of Cyclic Loading on Shear Bond Strength of Orthodontic Brackets: An In Vitro Study

OBJECTIVES

In clinical conditions, orthodontic brackets are exposed to periodic stresses mainly induced by mastication and intraoral forces. The objective of the present study was to evaluate the effects of cyclic loading to simulate masticatory forces on shear bond strength (SBS) of metal brackets bonded to teeth using self-etch and total-etch bonding systems.

MATERIALS AND METHODS

Eighty-four caries- and crack-free bovine mandibular incisors were selected and randomly assigned to two groups based on the type of bonding system. After bonding, all samples were thermocycled (500 cycles) followed by cyclic loading of the half of the specimens in each group by applying 40 N load with 2 Hz frequency for 10,000 cycles. The SBS was measured using a universal testing machine. The adhesive remnant index (ARI) score was calculated subsequently. Data were analyzed using Kolmogorov-Smirnov test, two-way ANOVA and Mann-Whitney test.

RESULTS

The SBS was 10.09±3.78 MPa and 14.44±6.06 MPa for self-etch and total-etch bonding systems in cyclic loading group, respectively. The SBS was 9.43±5.3 MPa and 11.31±5.42 MPa in self-etch and total-etch groups without cyclic loading, respectively. Cyclic loading did not cause any significant difference in SBS (P>0.05). The ARI scores of the groups were significantly different (P<0.05).

CONCLUSIONS

The present results demonstrated that low masticatory forces at 10,000 cycles did not have a significant impact on bracket-adhesive SBS; however, they significantly changed the ARI score. Even though the total-etch bonding system yielded higher SBS than the self-etch system, the performance of both was clinically acceptable.

Effect of Different Irrigants Applied After Post Space Preparation on Push-Out Bond Strength of a Self-Etch Resin Cement

OBJECTIVES

The aim was to investigate the effect of intracanal irrigants and agents on the bond strength of intraradicular fiber posts to dentin.

MATERIALS AND METHODS

Root canals of 72 decoronated single-rooted premolars were cleaned, shaped, and obturated with gutta-percha and AH26. The specimens were incubated at 37°C and 100% humidity for seven days. Next, the coronal 10 mm of the canals were prepared to receive size 2 D.T. Light fiber post, and the specimens were randomly allocated into six groups according to the irrigants used after post space preparation: normal saline (control group), 5.25% sodium hypochlorite (NaOCl)/15 seconds, 17% ethylenediaminetetraacetic acid (EDTA)/60 seconds, 2% chlorhexidine (CHX)/5 minutes, MTAD/5 minutes, and acid-etching/15 seconds. All canals were rinsed with normal saline and dried. Fiber posts were cemented using Panavia F2.0. After 24 hours, two mid-root slices of 1mm thickness were obtained from each specimen. Push-out bond strength test was performed in a universal testing machine at 0.5mm/minute. The maximum applied load was recorded, and the bond strength was calculated in megapascal (MPa). Data were analyzed by one-way analysis of variance (ANOVA) and Tukey's test.

RESULTS

The mean shear bond strengths of etched (53.21±12.11 MPa), MTAD (52.47±14.75 MPa) and EDTA (49.08±10.19 MPa) groups were significantly higher than that of the control group (39.82±10.04 MPa). The difference was marginally significant for CHX group (49.8±13.57 MPa) and not significant for NaOCl group (47.15±17.64 MPa).

CONCLUSIONS

Etching or irrigating the root canals with MTAD or EDTA after post space preparation increases the bond strength of Panavia F2.0 to dentin.

Effect of Self-Adhesive and Separate Etch Adhesive Dual Cure Resin Cements on the Bond Strength of Fiber Post to Dentin at Different Parts of the Root

OBJECTIVES

Bonding of fiber posts to intracanal dentin is challenging in the clinical setting. This study aimed to compare the effect of self-adhesive and separate etch adhesive dual cure resin cements on the bond strength of fiber post to dentin at different parts of the root.

MATERIALS AND METHODS

This in-vitro experimental study was conducted on 20 single-rooted premolars. The teeth were decoronated at 1mm coronal to the cementoenamel junction (CEJ), and the roots underwent root canal treatment. Post space was prepared in the roots. Afterwards, the samples were randomly divided into two groups. In group 1, the fiber posts were cemented using Rely X Unicem cement, while in group 2, the fiber posts were cemented using Duo-Link cement, according to the manufacturer's instructions. The intracanal post in each root was sectioned into three segments of coronal, middle, and apical, and each cross-section was subjected to push-out bond strength test at a crosshead speed of 1mm/minute until failure. Push-out bond strength data were analyzed using independent t-test and repeated measures ANOVA.

RESULTS

The bond strength at the middle and coronal segments in separate etch adhesive cement group was higher than that in self-adhesive cement group. However, the bond strength at the apical segment was higher in self-adhesive cement group compared to that in the other group. Overall, the bond strength in separate etch adhesive cement group was significantly higher than that in self-adhesive cement group (P<0.001).

CONCLUSIONS

Bond strength of fiber post to intracanal dentin is higher after the use of separate etch adhesive cement compared to self-adhesive cement.

Deposition of Crystalline Hydroxyapatite Nanoparticles on Y-TZP Ceramic: A Potential Solution to Enhance Bonding Characteristics of Y-TZP Ceramics

OBJECTIVES

Many advantages have been attributed to dental zirconia ceramics in terms of mechanical and physical properties; however, the bonding ability of this material to dental structure and/or veneering ceramics has always been a matter of concern. On the other hand, hydroxyapatite (HA) shows excellent biocompatibility and good bonding ability to tooth structure, with mechanically unstable and brittle characteristics, that make it clinically unacceptable for use in high stress bearing areas. The main purpose of this study was to introduce two simple yet practical methods to deposit the crystalline HA nanoparticles on zirconia ceramics.

MATERIALS AND METHODS

zirconia blocks were treated with HA via two different deposition methods namely thermal coating and air abrasion. Specimens were analyzed by scanning electron microscopy, energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD).

RESULTS

In both groups, the deposition techniques used were successfully accomplished, while the substrate showed no structural change. However, thermal coating group showed a uniform deposition of crystalline HA but in air abrasion method, there were dispersed thin islands of HA.

CONCLUSIONS

Thermal coating method has the potential to significantly alter the surface characteristics of zirconia. The simple yet practical nature of the proposed method may be able to shift the bonding paradigm of dental zirconia ceramics. This latter subject needs to be addressed in future investigations.

Effect of Different Surface Treatments on Microtensile Bond Strength of Composite Resin to Normal and Fluorotic Enamel After Microabrasion

OBJECTIVES

This study aimed to determine the effect of surface treatments such as tooth reduction and extending the etching time on microtensile bond strength (μTBS) of composite resin to normal and fluorotic enamel after microabrasion.

MATERIALS AND METHODS

Fifty non-carious anterior teeth were classified into two groups of normal and fluorotic (n=25) using Thylstrup and Fejerskov index (TFI=4-6). Teeth in each group were treated with five modalities as follows and restored with OptiBond FL and Z350 composite resin: 1-Etching (30 seconds), bonding, filling (B); 2-Tooth reduction (0.3mm), etching, bonding, filling (R-B); 3-Microabrasion (120 seconds), etching, bonding, filling (MB); 4- Microabrasion, tooth reduction, etching, bonding, filling (M-R-B); and 5- Microabrasion, etching (60 seconds), bonding, filling (M-2E-B). Ten experimental groups (n=5) were designed; 150 rectangular samples (10 in each group) with a cross-sectional area of 1×1mm² were prepared for μTBS test. Failure mode was determined under a stereomicroscope and one specimen was selected from each group for scanning electron microscopy (SEM) analysis. Data were analyzed using two-way ANOVA and Tukey's test.

RESULTS

The μTBS to normal enamel was higher than to fluorotic enamel in all groups except for group (R-B). The Maximum and minimum μTBS were noted in the group (normal, reduction, bonding) and (fluorosed, microabrasion, bonding), respectively. Tooth reduction increased μTBS more effectively than extended etching time after microabrasion.

CONCLUSIONS

Fluorosis may reduce μTBS of composite resin to enamel. Microabrasion reduced the bond strength. Tooth reduction and extended etching time increased μTBS of composite resin to both normal and fluorotic enamel.

A Comparative Evaluation of Microleakage of Two Low-Shrinkage Composites with a Conventional Resin Composite: an In Vitro Assessment

STATEMENT OF THE PROBLEM

Polymerization shrinkage stress in composite restorations may lead to microleakage. Clinical methods such as using low-shrinkage composites have been suggested to overcome this problem; however, there are controversies about their efficiency in decreasing the microleakage.

PURPOSE

This in vitro study was conducted to compare the microleakage of two low-shrinkage resin composites with a conventional one.

MATERIALS AND METHOD

Fifty class V cavities of 2.5×3×2 mm (depth× length× width) were prepared in the buccal surfaces of intact bovine incisor teeth with the incisal margin on the enamel and gingival margin on the cementum. The teeth were randomly divided into 5 groups. In group 1, Clearfil APX (conventional) with SE Bond was used in 2 layers (Kuraray; Japan). In group 2, GC Kalore (low -shrinkage) with GC UniFil Bond was applied in one layer (GC Company). In group 3, the material of group 2 was applied in two layers. In group 4, FiltekP90 (low -shrinkage) with P90 System adhesive was applied in one layer (3M ESPE). In group 5, the materials of group 4 were applied in two layers. The samples were thermocycled and immersed in 0.5% fuchsin solution for 24h. The restorations were sectioned in buccolingual direction. Then they were evaluated for microleakage by using a stereomicroscope and scored as 0, 1, 2, and 3 and then Kruskal-Wallis test was used (p< 0.05).

RESULTS

The groups were not significantly different regarding the microleakage in the coronal and cervical margins (p< 0.423 and p< 0.212, respectively); however, the Filtek P90 yielded the best results. In all groups, except group 5 (p= 0.018), the cervical margins had greater microleakage than the coronal margins.

CONCLUSION

The results suggested that low-shrinkage resin composites may not reduce the marginal microleakage. The proper use of conventional resin composites may offer comparable clinical results.

Effect of the type of endodontic sealer on the bond strength between fiber post and root wall dentin

OBJECTIVES

An important factor that interferes with the bonding between the root canal wall and resin cement is the root canal sealer remnant. There is controversy about the effect of eugenol-containing sealers on the bond strength between resin cements and fiber post. The aim of this study was to evaluate the effect of the type of endodontic sealer on the bond strength of FRC posts cemented with resin cement to the root canal wall.

MATERIALS AND METHODS

In this in vitro study, 20 extracted mandibular first premolars were endodontically treated and divided into two groups according to the endodontic sealer used (n=10): G1: AH26 (Resin based); and G2: Endofill (Eugenol-based). After preparing post space, adhesive resin cement (Panavia F 2.0) was used for cementation of the fiber post to the root canal dentin. Three 3 mm thick slices were obtained from each root. The push-out test was performed with a cross-head speed of 1 mm/minute. Two-way ANOVA and Tukey post hoc tests were used for analyzing data (α=0.05).

RESULTS

The two-way ANOVA showed that different root canal sealers (P=0.037) had significant effects on bond strength (BS), but root canal regions (P=0.811) and interaction between root canal sealers and root canal regions (P=0.258) had no significant effects on BS. Maximum and minimum mean values were observed in the AH26 group, the apical region and the Endofill group in the apical region, respectively. Post Hoc Tukey test revealed that there were no significant differences between different root canal regions in both cements (P>0.05).

CONCLUSION

The region of root canal had no effect on the bond strength of cemented fiber posts to the root canal. Eugenol-based sealers (Endofill) significantly reduced the bond strength between fiber posts luted with resin cement to the root canal.

Comparison of the Shear Bond Strength of Resin Modified Glass Ionomer to Enamel in Bur-Prepared or Lased Teeth (Er:YAG)

OBJECTIVE

The purpose of this study was to evaluate the effect of Er:YAG laser on the shear bond strength of resin modified glass ionomer (RMGI) to enamel.

MATERIALS AND METHODS

Twenty extracted caries-free human premolars were selected. The teeth were embedded in acrylic resin. The buccal surfaces of each sample were ground to plane enamel with carbonated disc. The teeth were randomly divided in two groups. In the first group, the surfaces were treated by Er:YAG laser (350mJ/10Hz). The second group was prepared by carbide bur. Fuji IX RMGI was adhered to surfaces of the samples in both groups in rod shape. The shear bond strength of samples was measured by a universal testing machine. The results of the two groups were analyzed by T- test.

RESULTS

The means and standard deviations of shear bond strength of the laser-treated group and the bur-treated group were 6.75 ± 1.99 and 4.41 ± 1.62 Mpa, respectively. There is significant difference in the shear bond strength of RMGI between the two groups (P-value=0.01).

CONCLUSION

The laser group showed better results. Er:YAG laser can be an alternative technology in restorative dentistry.

Influence of surface modification techniques on shear bond strength between different zirconia cores and veneering ceramics

PURPOSE

Veneering porcelain might be delaminated from underlying zirconia-based ceramics. The aim of this study was the evaluation of the effect of different surface treatments and type of zirconia (white or colored) on shear bond strength (SBS) of zirconia core and its veneering porcelain.

MATERIALS AND METHODS

Eighty zirconia disks (40 white and 40 colored; 10 mm in diameter and 4 mm thick) were treated with three different mechanical surface conditioning methods (Sandblasting with 110 µm Al₂O₃ particle, grinding, sandblasting and liner application). One group had received no treatment. These disks were veneered with 3 mm thick and 5 mm diameter Cercon Ceram Kiss porcelain and SBS test was conducted (cross-head speed = 1 mm/min). Two and one way ANOVA, Tukey's HSD Past hoc, and T-test were selected to analyzed the data (α=0.05).

RESULTS

In this study, the factor of different types of zirconia ceramics (P=.462) had no significant effect on SBS, but the factors of different surface modification techniques (P=.005) and interaction effect (P=.018) had a significant effect on SBS. Within colored zirconia group, there were no significant differences in mean SBS among the four surface treatment subgroups (P=0.183). Within white zirconia group, "Ground group" exhibited a significantly lower SBS value than "as milled" or control (P=0.001) and liner (P=.05) groups.

CONCLUSION

Type of zirconia did not have any effect on bond strength between zirconia core and veneer ceramic. Surface treatment had different effects on the SBS of the different zirconia types and grinding dramatically decreased the SBS of white zirconia-porcelain.

Tensile bond strength of metal bracket bonding to glazed ceramic surfaces with different surface conditionings

OBJECTIVE

The objective of this study was to compare the tensile bond strength of metal brackets bonding to glazed ceramic surfaces using three various surface treatments.

MATERIALS AND METHODS

Forty two glazed ceramic disks were assigned to three groups. In the first and second groups the specimens were etched with 9.5% hydrofluoric acid (HFA). Subsequently in first group, ceramic primer and adhesive were applied, but in second group a bonding agent alone was used. In third group, specimens were treated with 35% phosphoric acid followed by ceramic primer and adhesive application. Brackets were bonded with light cure composites. The specimens were stored in distilled water in the room temperature for 24 hours and thermocycled 500 times between 5°C and 55°C. The universal testing machine was used to test the tensile bond strength and the adhesive remenant index scores between three groups was evaluated. The data were subjected to one-way ANOVA, Tukey and Kruskal-Wallis tests respectively.

RESULTS

The tensile bond strength was 3.69±0.52 MPa forfirst group, 2.69±0.91 MPa for second group and 3.60±0.41 MPa for third group. Group II specimens showed tensile strength values significantly different from other groups (P<0.01).

CONCLUSION

In spite of limitations in laboratory studies it may be concluded that in application of Scotch bond multipurpose plus adhesive, phosphoric acid can be used instead of HFA for bonding brackets to the glazed ceramic restorations with enough tensile bond strength.