Vertical ridge augmentation of atrophic posterior mandible with corticocancellous onlay symphysis graft versus sandwich technique: clinical and radiographic analysis

Alveolar ridge augmentation of atrophic posterior mandibular ridge represents a challenge in oral and maxillofacial surgery to restore aesthetic and function. The aim of the study was to compare the clinical and radiographic outcomes of bone formation in atrophic posterior mandibles augmented using onlay symphysis cortico-cancellous bone block with that augmented using sandwich bone augmentation technique (Inlay). Twelve patients were selected with missing mandibular posterior teeth. CBCT were done for all patients preoperatively to assess the residual bone height, ranged between 5 and 7 mm from the inferior alveolar nerve with adequate sufficient alveolar ridge width more than 4 mm. Patients required bone augmentation procedure with autologous onlay chin graft (group I) versus those used as inlay sandwich technique (group II). Clinical and radiographic analysis were done to analyses the newly formed bone and bone height. Percent of change in bone height was also calculated and revealed that group I was higher than group II, however, statistically insignificant differences between the two groups were found regarding the percentage of newly formed bone. Vertical ridge augmentation procedures using onlay chin graft took lesser time than the interpositional grafting with fixation technique, however, both techniques are promising for vertical ridge augmentation.

Alternating Layers of Morselized Allograft and Injectable Ceramic Bone Graft Substitute in Acetabular Reconstruction: A Novel 'Sandwich' Technique

Background

Impaction of morselized allograft is an appealing procedure for addressing the bone defects. However, concerns remain about its suitability for massive defects. We used a novel "sandwich" technique by impacting the morselized allograft in layers with an intervening layer of injectable bone graft substitute for restoring bone defects during acetabular reconstruction in total hip arthroplasties.

Methods

From August 2015 to June 2017, 17 revisions, 4 rerevisions, and 3 complex primary total hip arthroplasties were operated by this novel technique. Postoperatively, serial X-rays were evaluated at regular intervals. Clinical and functional outcomes were assessed by the Harris hip score. To examine if introducing an injectable bone substitute into allograft stock increased its load-bearing capability, simulated mechanical testing using Synbone samples was conducted in the laboratory.

Results

The mean Harris hip score significantly improved from 54.6 preoperatively to 86.8 at the latest follow-up. Graft incorporation was seen in all the cases. There was no evidence of component migration or loosening as compared to the X-rays at 3 weeks and 3 months in all the cases. With revision of component as end point, the survivorship was 100% at 82 months. The mechanical testing reported a higher capability of allograft samples when compared to those without bone substitutes.

Conclusions

Our data confirms that the use of the "sandwich" technique is a reliable option for major acetabular reconstruction. Early weight bearing is a significant value addition, and short-term results confirm good clinical and functional outcome. Longer follow-up is necessary to assess the status of the construct in the long term.

The sandwich technique to preserve the internal iliac artery during EVAR for ruptured abdominal aortic aneurysm with congenital anomalies

Congenital abnormalities of the iliac artery are uncommon and often discovered incidentally during the diagnosis or treatment of peripheral vascular diseases such as abdominal aortic aneurysm (AAA) and peripheral arterial diseases. The endovascular treatment of infrarenal AAA can be complicated by anatomic abnormalities in the iliac arteries, such as the absence of the common iliac artery (CIA) or overly short bilateral common iliac arteries. We present a case of a patient with a ruptured AAA and bilateral absence of the CIA, successfully treated by endovascular intervention combined with preservation of the internal iliac artery using the sandwich technique.

Laboratory "In-vitro" Evaluation of the Parallel Stent Graft Association for the Iliac Sandwich Technique

OBJECTIVES

The Iliac Sandwich is an off-label technique that uses parallel stent grafts to treat aortoiliac aneurysms. The purpose of this experimental study is to evaluate the conformability and juxtaposition of stent grafts combinations used in this technique through in-vitro mechanical evaluation, computed tomography (CT) analyses, and a controlled pulsatile flow system.

METHODS

The combinations of two Viabahn® ("V-V") or Viabahn® and Excluder® iliac extension ("V-E") were analysed using CT imaging with measurement of the gutter area by two independent analysts before and after balloon angioplasty. In a second phase, the parallel stent combinations were also evaluated using CT imaging after being implanted in the aortic aneurysm model with a pulsatile flow system with controlled temperature, viscosity, and density.

RESULTS

The "V-E" group had a better conformability when compared to the "V-V" group, ensuring smaller gutter areas (0.0064 cm² ± 0.01 vs. 0.0228 cm² ± 0.03, p < 0.001). Post dilatation with two non-compliant balloons resulted in enlargement of the gutter area (Area A, p 0.065; Area B, p 0.071). Conversely, post dilatation with a non-compliant balloon for the internal iliac component and a compliant balloon for the external iliac device reduced the gutter area (Area A, p 0.008; Area B, p 0.010).

CONCLUSION

The combination of Viabahn® and Excluder® iliac extension device ("V-E") had a smaller gutter area compared to two Viabahn® parallel stents for the Iliac Sandwich Technique. Post dilatation using a non-compliant balloon for the internal iliac device and a compliant balloon for the external iliac provided superior conformability and juxtaposition.

Sandwich graft technique outcomes in medium and large size nasal septal perforations

Introduction

Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used.

Objective

The aim of this study is to explain how we apply the sandwich graft technique that we use in medium and large nasal septal perforations as well as to present the results.

Methods

We retrospectively reviewed the patients who were operated with the sandwich graft technique between January 2014 to December 2018 and followed up for at least 6 months. The demographic data, symptom scores, examination, and surgical findings of the patients were taken from the hospital records. Surgical outcomes were presented according to both perforation etiologies (idiopathic or iatrogenic) and sizes (Group A: < 2 cm, Group B: ≥ 2 cm).

Results

We reviewed 52 cases and 56 surgeries. The average diameter of the perforations was 19.2 mm. The success rate after initial surgeries was 84.6% (44/52). After 4 revision surgeries, the perforation was closed in 88.5% of the cases (46/52). Success rates for Group A and Group B were 90.0% and 86.4%, respectively (p = 0.689). The success rates in idiopathic and iatrogenic cases were 93.3% and 86.5%, respectively (p = 0.659).

Conclusion

This study showed that the success rate of sandwich graft technique was higher in medium-sized perforations than large-sized ones and in idiopathic perforations compared to iatrogenic ones, but the latter rate was not statistically significant. This demonstrated that perforation size was not as important in the sandwich graft technique as in flap techniques.

Surface treatment of RMGIC to composite resin using different photosensitizers and lasers: A bond assessment of closed Sandwich restoration

AIM

The aim of present study was to assess and compare different conditioning methods (laser, PDT and conventional) on shear bond strength (SBS) of resin modified glass ionomer cement (RMGIC) bonded to composite (sandwich technique).

MATERIAL AND METHODS

Fifty specimens were prepared from RMGIC and were packed in a teflon mould placed on glass slab. Through each of the glass slab the cement was light cured for 20 s. Now samples were randomly allocated into five groups (n = 10) according to pre-treatment protocols. In group 1 RMGIC were conditioned with MBP using PDT, Samples in group 2 treated with Er,Cr:YSGG (ECYL), group 3 pre-treated with Nd:YAG laser (NYL), samples in group 4 surface conditioned with air abrasion (AA) and group 5 conditioned with 37 % phosphoric acid (PA). Specimens after conditioning were rinsed with distilled water. Adhesive Adper Single Bond 2 was applied on treated surface of RMGIC and cured. Teflon mold was utilized to hold the composite Filtek Z250 in an incremental technique. For SBS testing all specimens were placed under shear knife edge at 1 K N at a speed of 0.5mm2 until bond failure. Optical microscope was used to evaluate failure pattern at 10x magnification. The data of SBS in Megapascal were subjected to statistical test. Analysis of variance was followed by Post hoc test with level of significance at 5 %.

RESULT

The maximum SBS was found in group 5 RMGIC conditioned with 37 % PA (16.45 ± 0.32 MPa). Whereas, group 1 (MBP, PDT) demonstrated significantly lower bond integrity (9.82 ± 1.08 MPa) compared to all experimental groups. Bond integrity of RMGIC surface treated with MBP, PDT (9.82 ± 1.08 MPa), group 3 lased with NYL (11.47 ± 0.53 MPa) and samples in group 4 conditioned with AA (11.23 ± 0.47 MPa) were comparable (p > 0.05).

CONCLUSION

ECYL has a potential to be used for conditioning of RMGIC prior to composite restoration (sandwich technique). MBP at 100 mg/L deteriorates SBS of composite to RMGIC.

From keyhole to sandwich: change in laparoscopic repair of parastomal hernias at a single centre

BACKGROUND

Nearly 50% of patients with an ostomy will develop a parastomal hernia (PSH). Its repair remains a surgical challenge. Both laparoscopic "modified Sugarbaker" (SB) and Keyhole (KH) repair are currently in use, frequently with unsatisfactory results.''Sandwich Repair'' (SR) may be an alternative to reduce recurrence rates. We present the change of our technique from KH to SR.

METHODS

We collected data from all consecutive laparoscopic PSH repairs at our institution from 2004 until now (from 2004 to 2013 treated with KH, from 2014 with SR) and compared the results of the two groups. Primary endpoint was recurrence rate at 1 year. Secondary outcomes were operative time, PO length of hospital stay (LOS), and short and long-term complications.

RESULTS

13 patients underwent SR. Main changes in surgical technique concerned primary defect closure, no stay sutures, use of glue for first mesh fixation, and partial lateral covering of the underlying mesh with a peritoneal flap. Early postoperative course after SR was uneventful and no recurrence at 1 year was recorded. In the KH group (19 patients), short-term complications occurred in two cases (10%), with one parietal hematoma and one case of intensive pain; we had four recurrences at 1 year (21%). LOS was shorter in the SR group (mean 4 days vs 6, p = 0.004). The KH group had 2 (10%) occurrences of chronic seroma and one bowel perforation (5%), while the SR group had one (8%) occurrence of chronic pain. Median follow-up was 26 months (range 13-78) for the SR group and 47 months (12-105) for the KH group.

CONCLUSION

SR is safe and effective in expert hands and provides promising preliminary results.

``Sandwich technique" with dual strut allograft in surgical treatment of femoral nonunion

OBJECTIVE

The treatment of femoral nonunion is challenging for both the surgeon and the patient. Strut allografts increase the bone stock, enhance fracture healing and increase stability by acting as a biological plate. In this study, we aimed to report the results of the sandwich technique with two-strut allograft in the treatment of oligotrophic or atrophic femoral nonunions.

METHODS

Medical records of the patients who were treated due to femoral nonunion in a single center were retrospectively reviewed. Twenty-one patients (10 males, 11 females) with a mean age of 49 (range: 21 to 79) years were included in the study. The left side was affected in 11 patients, whereas the right side was affected in ten. The patients had 11 femoral shaft fractures, seven proximal femoral fractures and three distal femoral fractures. The mean time from the previous operation to the nonunion surgery was 9.6 (range: 6 to 22) months.

RESULTS

Union was achieved in all patients after a mean period of 6.2 (range: 4 to 10) months. The mean follow-up time was 46.8 (range: 12 to 86) months. One patient had superficial surgical site infection in the autologous graft donor site.

CONCLUSION

The sandwich technique with two-strut allograft provides good results in the treatment of femoral nonunion. The technique can be used on any type of nonunion, at any segment of the femur and can be combined with different fixation techniques.

Report of five cases: sandwich repair for post infarction ventricular septal rupture with right ventricular approach

Background

Different techniques have been described to repair post myocardial infarction ventricular septal rupture (VSR), each method may result in residual shunting, bleeding, and suboptimal left ventricular (LV) performance secondary to change in LV geometry. The aim of this report is to describe early and mid-term results of sandwich technique through right ventricle in five consecutive patients.

Case presentation

Five consecutive patients (3 women and 2 men) with VSR (mean age 62.8 years, range 51-70) underwent surgical repair for postinfarction ventricular septal rupture by sandwich technique performed through right ventricle from August 2012 to April 2019 in our institute. Reconstruction of the septum was performed by two patches of 0.6 mm Gore-Tex on each side of the septal defect through right ventricular incision, according to the method described by Isoda et al. Coronary artery bypass grafting was performed in two patients.

The mean aortic clamp time was 90 min (range, 64 to 157 min). The mean extracorporeal circulation time was 146.6 min (range, 108 to 240 min). Postoperative intensive care unit (ICU) stay averaged 12 days (range, 4-40 days). There was no hospital mortality. No postoperative residual shunting was detected, and no patient needed re-operation for bleeding. Patients have been followed up for a mean of 24.4 months (range, 1 week to 7 years). There was one death seven days after discharge due to arrhythmia (40 days after surgery).

Conclusion

Sandwich technique through right ventricular approach is simple and extendable to all VSRs irrespective of their locations. Residual shunting and bleeding are negligible or zero. It may be considered as standard of repair for patient with post infarction ventricular septal rupture.

Shear bond strength and interface analysis between a resin composite and a recent high-viscous glass ionomer cement bonded with various adhesive systems

OBJECTIVE

This study investigated the shear bond strength (SBS) and interface between a resin composite and a new high-viscous glass ionomer cement (HV-GIC), a HV-GIC, a resin-modified glass ionomer cement (RM-GIC), a bulk-fill flowable composite, and a regular flowable composite bonded with various adhesive systems.

METHODS AND MATERIALS

A resin composite (Filtek Z350) was bonded to a new HV-GIC (EQUIA Forte Fil) using various adhesive systems, including a universal adhesive in self-etch and etch-and-rinse mode (Scotchbond Universal), a two-step etch-and-rinse adhesive (Scotchbond 1-XT), a one-step self-etch adhesive (Optibond All-in-one) tested also after silane application (Monobond Plus), and a coating material (EQUIA Forte Coat). The resin composite was also bonded to a HV-GIC (Fuji IX GP), a RM-GIC (Fuji II LC), a bulk-fill flowable composite (SDR), and a regular flowable composite (Tetric Evo Flow) with the universal adhesive in self-etch mode (Scotchbond Universal). Two-way ANOVA followed by Dunnett's post hoc test was used to investigate the difference in SBS. Failures were analyzed by chi-square test. Bonding interfaces were examined by environmental scanning electron microscopy (E-SEM).

RESULTS

SBS to EQUIA Forte Fil was significantly lower with Scotchbond 1-XT than with all other adhesive systems. By using Scotchbond Universal with the self-etch technique, the SBS to EQUIA Forte Fil was significantly higher than the SBS to Fuji IX GP and significantly lower than the SBS to Fuji II LC, SDR, and Tetric Evo Flow. E-SEM images showed an intimate contact at all interfaces examined.

CONCLUSION

EQUIA Forte Fil showed satisfactory SBS and interfaces with all adhesives tested.

CLINICAL RELEVANCE

Bonding between the resin composite and HV-GIC can be achieved using a universal adhesive in self-etch mode, an easy-to-use adhesive system.

Biological reconstruction of large osteochondral lesions of the talar dome with a modified "sandwich" technique-Midterm results

BACKGROUND

Surgical treatment for large osteochondral lesions of the talar dome (OLTD) must restore the convexity and curvature of the talus. Here, we present midterm results and describe the modified "sandwich" reconstruction procedure. Bone defects were restored using a biological inlay consists of autologous bone chips that were mixed with bone marrow concentrate and fibrin glue and covered with a xenogeneic collagen membrane infiltrated with bone marrow concentrate and stabilized by fibrin glue.

METHODS

Ten patients who were treated using a modified "sandwich" OLTD reconstruction were assessed after an average follow-up period of 46.4 (±18) months, using the clinical American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale (AOFAS) score and radiological magnetic resonance observation of cartilage repair tissue (MOCART) score.

RESULTS

The mean AOFAS score increased significantly from 58.3 (±8.5) points to 81.8 (±15.5) points as well the mean VAS score reduced significantly from 5.58 (±0.97) to 1.83 (±0.93) points. The average MOCART score was 69.5% (±16.7%) in the final follow-up.

CONCLUSIONS

The presented modified "sandwich" technique permanently recreates the convexity and curvature in large osteochondral lesions of the talar dome with a single step surgical procedure.

Sandwich technique using fibrin-coated collagen fleece for sellar reconstruction in large dural defects during transsphenoidal surgery

PURPOSE

Various surgical methods to prevent intraoperative and postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal approach (TSA) surgeries have been reported, but surgical techniques to address large dural defects have been less thoroughly investigated in the literature. The authors retrospectively evaluated the usefulness of the sandwich technique using fibrin-coated collagen fleece (TachoSil) to prevent intraoperative CSF leakage from large dural defects in TSA surgery.

METHODS

In total, 101 cases of intraoperative CSF leaks were observed among 465 patients who underwent TSA surgery at a single university hospital between 2002 and 2014. Among them, cases with Grade 3 intraoperative CSF leakages and large diaphragmatic/dural defects were reconstructed via the sandwich technique using TachoSil or via the conventional technique using simple intrasellar packing with fat or synthetic materials, and these cases were enrolled in this study.

RESULTS

A total of 28 cases with Grade 3 intraoperative CSF leakages were identified and analyzed. The sandwich technique using TachoSil was applied in 13 cases, and the conventional technique was applied in 15 cases. The postoperative CSF leakage was significantly decreased by the sandwich technique as compared to the conventional technique (retrospectively, 0 cases vs. 4 cases (30.8%); P=0.044).

CONCLUSION

The sandwich technique using TachoSil can effectively prevent CSF leakage in cases with large dural defects during TSA surgery.

Iatrogenic Supravalvular Aortic Stenosis

We describe a case of hemolytic anemia and proximal anastomotic site stenosis following emergency repair of a Type A aortic dissection. This rare complication led to a reoperation to correct the iatrogenic aortic stenosis and cure the consequent hemolysis. A "sandwich" technique (with two Teflon strips on the outside and inside of the aortic wall) was used in the initial repair to reinforce the suture line and prevent bleeding from the aortic anastomoses. At the time of reoperation, the inner Teflon strip at the proximal aortic anastomosis was found to have inverted into the aortic lumen, as suggested by the preoperative magnetic resonance imaging. Surgical treatment consisted of resecting the portion of inner Teflon that had turned in and tacking the remaining part back onto the aortic wall. The observed hemolysis was likely due to the turbulent flow associated with the supra-aortic stenosis and the collision of red cells with the internal Teflon strip. The patient made an uncomplicated recovery with no further hemolysis and was discharged on postoperative day 8.

Comparison between clinical and audiological results of tympanoplasty with modified sandwich technique and underlay technique

INTRODUCTION

Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.

OBJECTIVE

To describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.

METHODS

A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results.

RESULTS

Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4±1.7dB while in Group B; it was 22.5±3.5dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.

CONCLUSION

Double layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.

Laparoscopic repair for recurrent parastomal hernia of an end stoma using the sandwich technique while preserving an ileal conduit: A case report

•

This is a quite rare case report of laparoscopic repair for recurrent parastomal hernia in a patient with an ileal conduit.

•

Laparoscopic sandwich technique is to combine the keyhole and Sugarbaker techniques.

•

Laparoscopic sandwich technique can be useful for parastomal hernia.

Introduction

Parastomal hernia is a common complication following stoma creation. The surgical approaches included local repair by suture, stoma relocation and mesh-based techniques; but none has been able to provide satisfactory results.

Presentation of case

A 60-year-old asian female was referred complaining of abdominal pain and constipation caused by recurrent parastomal hernia of an end stoma. She had undergone total cystectomy with creation of an ileal conduit at the age of 53 years, and laparoscopic sigmoid colostomy at the age of 55 years. Parastomal hernia of an end stoma had developed postoperatively, and she had undergone recreation of colostomy at the same place with fasciorrhaphy at the age of 59 years, but parastomal hernia recurred 6 months later because of split fascia sutures. Laparoscopic repair for recurrent parastomal hernia was conducted using the sandwich technique while preserving an ileal conduit. The patient has been followed postoperatively for more than 3 years without any sign of recurrence.

Discussion

Although further cases are required to get definitive conclusions, we suppose that the laparoscopic sandwich technique can be useful for parastomal hernia.

Conclusion

We herein report a case of recurrent parastomal hernia treated laparoscopically while preserving an ileal conduit using the sandwich technique which combines the keyhole and Sugarbaker techniques. This is a quite rare case report of laparoscopic repair for recurrent parastomal hernia in a patient with an ileal conduit.

Grynfelt-Lesshaft hernia a case report and review of the literature

INTRODUCTION

Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life.

CASE REPORT

A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type "A" lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO(®) mesh fixed with PDS(®) II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication.

DISCUSSION

Primary (spontaneous) lumbar hernias represent 50-60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH.

CONCLUSION

The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.

Simultaneous determination of iron (II) and ascorbic acid in pharmaceuticas based on flow sandwich technique

The simple and easy performed flow system based on sandwich technique has been developed for the simultaneous separate determination of iron (II) and ascorbic acid in pharmaceuticals. The implementation of sandwich technique assumed the injection of sample solution between two selective reagents and allowed the carrying out in reaction coil two chemical reactions simultaneously: iron (II) with 1,10-phenanthroline and ascorbic acid with sodium 2,6-dichlorophenolindophenol. For achieving of excellent repeatability and considerable reagent saving the various parameters such as flow rate, sample and reagent volumes, reaction coil length were also optimized. The limits of detection (LODs) obtained by using the developed flow sandwich-type approach were 0.2 mg L(-1) for iron (II) and 0.7 mg L(-1) for ascorbic acid. The suggested approach was validated according to the following parameters: linearity and sensitivity, precision, recoveries and accuracy. The sampling frequency was 41 h(-1).

Comparative study to evaluate shear bond strength of RMGIC to composite resin using different adhesive systems

Aim:

The aim of the study is to compare and evaluate the role of new dental adhesives to bond composite to the resinmodified glass inomer cement (RMGIC).

Materials and Methods:

Thirty specimens were prepared on acrylic blocks, with wells prepared in it by drilling holes, to retain the RMGIC. The specimens were randomly divided into three groups of ten specimens each. In Group a thin layer of selfetch adhesive (3M ESPE) was applied between the RMGIC and the composite resin FILTEK P60 (3M SPE). In Group II, total etch adhesive (Adeper Scotch bond 2, 3M ESPE) was applied, and in Group III, there was no application of any adhesive between RMGIC and the composite resin. After curing all the specimens, the shear bond strength was measured using an Instron universal testing machine.

Results:

The results were drawn and tabulated using ANOVA-fishers and Dunnet D statistical tests.The maximum shear bond strength values were recorded in Group I specimens with self-etch adhesive showing a mean value of 2.74 when compared to the Group II adhesive (Total etch) showing a mean shear strength of value 1.89, where no adhesive was used, showed a minimum mean shear bond strength of 1.42. There was a great and significant difference between Group I and Group II (P value 0.05) whereas, both Group I and Group II showed a vast and significant difference from Group III (P value = 0–001).

Conclusion:

Hence, this present study concludes that application of self-etch adhesive (3M ESPE, U.S.A) in between RMGIC and composite resin increases the shear bond strength between RMGIC and the resin composites, as compared to the total-etch type adhesive (Adeper Scotch bond 2,3M ESPE, U.S.A) as well as without application of the adhesive agent.

Comparison of the shear bond strength of RMGIC to a resin composite using different adhesive systems: An in vitro study

Aim:

This study evaluated and compared the role of newer dental adhesives to bond composite resin to the resin modified glass ionomer (RMGIC) liner.

Materials and Methods:

Thirty-six specimens were prepared on acrylic blocks, with wells prepared in it by drilling holes, to retain the RMGIC. The specimens were randomly divided into three groups of 12 specimens each. In group I, a thin layer of an adhesive, which was a Total-etch type (Adper Single bond-2), was applied between RMGIC and the composite resin. Ingroup II, a Self-Etch adhesive (Adper prompt-L pop) was applied, and in group III there was no application of any adhesive between RMGIC and the composite resin. After curing all the specimens, the shear bond strength was measured using an Instron universal testing machine.

Results:

The results were drawn and tabulated using ANOVA-fishers and Tukey’s statistical tests. The maximum shear bond strength values were recorded in group II specimens with the self-etch adhesive (Adper prompt-L pop), showing a mean value of 5.826 when compared to the group I adhesive-Total-etch type with a mean shear bond strength of 4.6380, while group III specimens, where no adhesive was used, showed a minimum mean shear bond strength of 2.8385. There was a great and significant difference between group I and group II (P value 0.003), whereas, both group I and group II showed a vast and significant difference from group III (P value 0 – 001).

Conclusion:

Hence, this present study concludes that application of Self-Etch adhesive (Adper prompt-L pop) in between RMGIC and composite resin increases the shear bond strength between RMGIC and the resin composites, as compared to the Total-etch type adhesives (Adper Single Bond 2), as well as, without application of the adhesive agent.