Bonding performance of self-etch adhesives to enamel bleached with different peroxide concentrations

Abstract The aim of this study was to evaluate the micro-shear bond strength (µSBS) of one and two steps self-etch adhesive systems after enamel bleaching with photo-activated bleaching systems of different hydrogen peroxide (HP) concentration. Occlusal enamel of forty intact human molars were flattened and assigned into four groups. GI Unbleached, GII, GIII, and GIV were bleached with Pyrenees (3.5% HP), GC TiON (20% HP), and Hi-Lite (35% HP) respectively. Enamel treatment with one and two steps self-etch adhesives (Clearfil S3 Bond- S3, and Clearfil SE Bond-SE) then micro-tubes were fixed on enamel and filled with AP-X composite (n=5). Bond was tested with the universal testing machine. Data were analyzed using two-way ANOVA and Tukey's tests at 5 % level of significance. The µSBS was significantly different between adhesives (F=154.46; p<0.05) and bleaching systems (F=77.33; p<0.05) with significant interaction. Specimens bonded with S3 shows a significantly lower μSBS than those bonded with SE (p<0.05) in all groups. For both adhesives the bleached groups demonstrate lower µSBS than unbleached except specimens bleached with Pyrenees and bonded with SE (p>0.05). A significant difference was observed between groups of the bleaching systems (p<0.05). Different peroxide concentrations photo-activated bleaching systems adversely affect μSBS of one and two steps self-etch adhesives. Low concentration system (Pyrenees) does not influence the bond strength of two steps adhesive.

Resumo O objetivo deste estudo foi avaliar a resistência ao cisalhamento (µSBS) de sistemas auto-adesivos de um e dois passos após clareamento do esmalte com sistemas de clareamento foto-ativados de diferentes concentrações de peróxido de hidrogênio (HP). O esmalte oclusal de quarenta molares humanos intactos foi aplainado e atribuído em quatro grupos. GI Unbleached, GII, GIII, e GIV foram branqueados com Pyrenees (3,5% HP), GC TiON (20% HP), e Hi-Lite (35% HP) respectivamente. Tratamento de esmalte com adesivos de um e dois passos auto-adesivos (Clearfil S3 Bond- S3, e Clearfil SE Bond-SE), depois os microtubos foram fixados no esmalte e preenchidos com composto AP-X (n=5). A resistência ao cisalhamento foi testada com a máquina universal de testes. Os dados foram analisados usando os testes de ANOVA e Tukey de duas vias a um nível de 5% de significância. O µSBS foi significativamente diferente entre adesivos (F=154,46; p<0,05) e sistemas de clareadores (F=77,33; p<0,05) com interação significativa. Os espécimes colados com S3 mostram um μSBS significativamente inferior aos colados com SE (p<0,05) em todos os grupos. Para ambos os adesivos, os grupos clareados demonstram µSBS inferiores aos não clareados exceto os espécimes clareados com Pyrenees e colados com SE (p>0,05). Foi observada uma diferença significativa entre os grupos dos sistemas de clareamento (p<0,05). Diferentes concentrações de peróxidos foto-ativados nos sistemas de clareamento afetam negativamente μSBS dos adesivos de uma e duas etapas de auto-colagem. O sistema de baixa concentração (Pyrenees) não influenciou a resistência ao cisalhamento do adesivo de duas etapas.

The effect of reduced glutathione on the toxicity of silver diamine fluoride in rat pulpal cells

Abstract Introduction Due to its ability to arrest untreated dental caries, silver diamine fluoride (SDF) has been advocated for indirect pulp capping procedures. However, the high concentrations of silver and fluoride in SDF raise concerns about its biocompatibility to pulpal tissues. Objectives This study aimed to investigate the effect of SDF on the viability, alkaline phosphatase (ALP) activity, and morphology of pulpal-like cells (RPC-C2A) and to evaluate the influence of reduced glutathione (GSH) on SDF-induced cytotoxicity and deposit formation on dentin. Methodology The cytotoxicity of diluted 38% SDF solutions (10-4 and 10-5), with or without the addition of 5 mM or 50 mM GSH, was evaluated at 6 and 24 hours. Cell viability was detected using WST-8 and the effect on ALP activity was performed using an ALP assay kit. Cell morphology was observed using a phase-contrast microscope. Scanning electron microscopy analysis was conducted to evaluate the effect of GSH incorporation or conditioning on SDF-induced deposit formation on dentin discs. Cytotoxicity data were analyzed by two-way analysis of variance (ANOVA) and Tukey post hoc tests (p<0.05). Results There were significant differences between the groups. The results demonstrated that all tested SDF dilutions caused a remarkable cytotoxic effect, while the addition of GSH prevented SDF-induced damage at 6-hour exposure time in the higher dilution of SDF. Dentin treated with plain SDF or GSH-incorporated SDF solution showed deposit formation with occluded dentinal tubules, unlike the other groups. Conclusion SDF severely disturbed the viability, mineralization-ability, and morphology of pulpal-like cells, while controlled concentrations of GSH had a short-term protective effect against SDF-induced damage. GSH showed an inhibitory effect on SDF-induced dentinal deposit formation. Further research is warranted to evaluate the effect of GSH on caries-arresting, anti-hypersensitivity, and antibacterial functions of SDF.

Evaluation of bulk-fill systems: microtensile bond strength and non-destructive imaging of marginal adaptation

Abstract The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey's post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett's T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.

Sodium hypochlorite effects on dentin bond strength and acid-base resistant zone formation by adhesive systems

Aim: To evaluate the effects of 10% NaOCl gel application on the dentin bond strengths and morphology of resin-dentin interfaces formed by three adhesives. Methods: Two etch-and-rinseadhesives (One-Step Plus, Bisco Inc. and Clearfil Photo Bond, Kuraray Noritake Dental) and oneself-etch adhesive (Clearfil SE Bond, Kuraray Noritake Dental) were applied on dentin accordingto the manufacturers’ instructions or after the treatment with 10% NaOCl (ED-Gel, Kuraray NoritakeDental) for 60 s. For interfacial analysis, specimens were subjected to acid-base challenge andobserved by SEM to identify the formation of the acid-base resistant zone (ABRZ). For microtensilebond strength, the same groups were investigated and the restored teeth were thermocycled(5,000 cycles) or not before testing. Bond strength data were subjected to two-way ANOVA andTukey’s test (p<0.05). Results: NaOCl application affected the bond strengths for One-Step Plusand Clearfil Photo Bond. Thermocycling reduced the bond strengths for Clearfil Photo Bond andClearfil SE Bond when used after NaOCl application and One-Step Plus when used asrecommended by manufacturer. ABRZ was observed adjacent to the hybrid layer for self-etchprimer. The etch-and-rinse systems showed external lesions after acid-base challenge and noABRZ formation when applied according to manufacturer’s instructions. Conclusions:10% NaOClchanged the morphology of the bonding interfaces and its use with etch-&-rinse adhesives reducedthe dentin bond strength. Formation of ABRZ was material-dependent and the interface morphologieswere different among the tested materials.

Effect of dentin desensitizers on resin cement bond strengths

Introduction: The crown preparation promotes the exposure of dentin tubules. Thus, to avoid post-operative sensitivity, the first approach involves the use of dentin adhesives, and the second one the use of dentin desensitizers. Objective: This study evaluated the effect of dentin desensitizers on microtensile bond strengths (μTBSs) of a resin cement to dentin. Material and methods: Twenty bovine teeth were prepared until obtaining flat dentin surfaces. A standardized smear layer was created (#600-grit SiC paper). The samples were randomly divided into the following four groups (n = 5): no treatment (Control), treatment with Gluma Desensitizer (Heraeus Kulzer), Super Seal (Phoenix Dental) and Teethmate Desensitizer (Kuraray Noritake Dental). The dentin surfaces were then treated with ED Primer II (Kuraray Noritake Dental). Twenty composite blocks, 4 mm thick (Estenia CeB, Kuraray Noritake Dental) were used. The composite surfaces were abraded with aluminum oxide (50 μm), and then silanized. The composite block was bonded to the dentin surface with a resin cement (Panavia F 2.0, Kuraray Noritake Dental) according to the manufacturer's instructions. After 24-hour storage (37ºC, 100% RH), the bonded samples were cut into beam-shaped microtensile specimens and loaded in tension until failure. Data were analyzed with one-way ANOVA and the Dunnett's test (α = 0.05). An SEM was used to examine the failure modes. Results: The μTBSs (MPa ± SD) were: 24.4 ± 3.2 (Control), 14.0 ± 5.6 (Gluma Desensitizer), 8.6 ± 4.7 (Super Seal), and 34.7 ± 4.6 (Teethmate Desensitizer), in which there were significant differences among the four groups (p < 0.05). The Teethmate Desensitizer group showed the highest μTBS, while the Super Seal group showed the lowest mean of μTBS to dentin. Conclusion: The efficacy of the desensitizers is material-dependent; Gluma Desensitizer and Super Seal decreased the μTBSs, however, Teethmate Desensitizer improved it.

Self-Etch Adhesive Systems: A Literature Review

This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

Este artigo apresenta o estado da arte de sistemas adesivos autocondicionantes. Quatro temas são apresentados nesta revisão: o histórico desta categoria de agentes de união, o mecanismo de adesão, as características/propriedades, e a formação da zona ácido-base resistente nas interfaces esmalte/dentina-adesivo. Além disso, as vantagens relativas aos sistemas de condicionamento total ( etch-and-rinse ) e as classificações dos sistemas adesivos autocondicionantes de acordo com o número de passos e acidez são abordados. Por fim, são discutidas questões como a durabilidade potencial e a importância clínica. Sistemas adesivos autocondicionantes são materiais promissores porque são fáceis de usar, unem-se quimicamente à estrutura do dente e preservam a hidroxiapatita dentinária, o que é importante para a durabilidade da ligação.

Effect of adhesive system and application strategy on reduction of dentin permeability

This study evaluated the effect of adhesive systems and application strategies on dentin hydraulic conductance (HC). The buccal enamel was removed from bovine incisors to simulate laminate cavity preparations. After removing the roots and the coronal pulp, the buccal dentin was treated with EDTA solution (0.5 M) for 5 minutes, rinsed, ultrasonicated for 12 minutes and connected to a permeability device. HC of the specimens was measured at 10 psi (n = 5). Permeability was measured before and after bonding procedures using G-Bond (GB), Clearfil Tri-S Bond (CTS), Hybrid Coat (HY), Bond Force (BF), Adper Easy Bond (AEB) Silorane (SI), Clearfil SE Bond (CSE) and Adper Scotchbond Multi-Purpose (SMP) adhesives systems, which were applied following three strategies: 1) according to the manufacturers' instructions; 2) two coats of all-in-one self-etching adhesives (GB, CTS, HY, BF, AEB) or priming step plus two coats of bonding resin for the other systems (SI, CSE and SMP); and 3) a thin layer of a flowable composite applied over one coat of all-in-one self-etching adhesives or primed surface for SI, CSE and SMP adhesives. No significant difference was observed among the application modes concerning their ability to reduce HC. None of the adhesives showed complete sealing (100%) of the bovine tooth dentin. SI exhibited lower HC than SMP, however, they were not significantly different from the other systems. The results suggest that all systems tested result in an HC reduction of more than 90%. The wet bonding technique seemed to be more sensitive for dentin sealing.

Avaliação da resistência de união à dentina de um compósito indireto fixado com diferentes técnicas e cimentos resinosos / Evaluation of bond strength of an indirect composite luting fixed by different techniques and resin cements to dentin

O objetivo deste estudo foi avaliar a resistência de união (RU) em dentina utilizando diferentes técnicas de fixação de restaurações indiretas de compósito e cimentos resinosos. Molares humanos foram utilizados para obtenção de superfícies dentinárias oclusais planificadas a meia distância da polpa dental. Os dentes foram divididos em seis grupos experimentais, de acordo com as técnicas de cimentação (IF: instruções do fabricante; AC: adesivo + cimento; AFC: adesivo + resina Flow + cimento) e os materiais cimentantes (PF: Panavia F; RX: RelyX Unicem). Blocos de compósito indireto Estenia foram cimentados de acordo com o grupo experimental e os dentes restaurados foram armazenados em água a 37ºC por 24 horas. Os espécimes foram preparados a partir das restaurações para o ensaio de microtração. A RU foi calculada e expressa em MPa (mega pascal). Os foram analisados pela ANOVA (2 fatores) e teste de Tukey (p<0,05). Os valores médios de RU foram: PF/IF; 17,7 (4,2); PF/AC: 20,9 (8,2); PF/AFC: 25,9 (4,5); RX/IF:8,6 (4,5); RX/AC: 23,0 (7,7) e RX/AFC: 24,2 (4,8). O compósito fixado com os agentes cimentantes pode apresentar melhores resultados, em termos de RU, à dentina com a aplicação de um adesivo ou através da combinação do adesivo com uma resina flow antes da cimentação.

Bond strength of a resin cement to dentin using the resin coating technique

The aim of this study was to evaluate the bond strength of a resin cement to dentin using different adhesive systems (AS) in the presence or absence of a low-viscosity composite liner (Protect Liner F - PLF) applied over the bonded dentin. The adhesive systems selected were: AdheSE/Vivadent (AD); Clearfil Protect Bond/Kuraray (CP); One-Up Bond F/Tokuyama (OU); Single Bond/3M ESPE (SB); Tyrian SPE/One-Step Plus/Bisco (TY); Xeno III/Dentsply (XE) and Unifil Bond/GC (UN). After removing the labial and lingual enamel surfaces of bovine incisors, dentin fragments were prepared and randomly divided into 15 groups (n = 8). The dentin substrates were bonded with the AS and the PLF was applied or not before application of the resin cement (Panavia F, Kuraray). In the control group, the ED Primer (ED) and the resin cement without PLF were used. The AS, PLF and resin cement tested were used according to the manufacturers' instructions, and all treated dentin surfaces were temporized. After water storage for one week, three cylinders of resin cement were applied to each bonded dentin surface, using tygon tubing molds. The specimens were subjected to micro-shear testing and the data were statistically analyzed (two-way ANOVA, Tukey and Dunnett tests, p < 0.05). The observed mean shear bond strengths in MPa were: ED: 20.2 ± 2.3; AD: 30.3 ± 6.5; CP: 25.3 ± 4.4; OU: 28.3 ± 6.6; SB: 25.6 ± 6.9; TY: 24.5 ± 2.5; XE: 17.3 ± 3.4; UN: 28.4 ± 6.2; AD+PLF: 32.8 ± 4.1; CP+PLF: 29.9 ± 3.9; OU+PLF: 34.1 ± 4.1; SB+PLF: 29.5 ± 8.2; TY+PLF: 29.2 ± 3.9; XE+PLF: 32.8 ± 6.7; UN+PLF: 32.2 ± 4.5. The bond strength of the resin cement to dentin using the tested AS was increased when the low-viscosity composite liner was applied.