Alternativas de tratamiento para pacientes jóvenes con pérdida de estructura dentaria. Parte 2: caso clínico / Treatment alternatives for young patients with loss of dental structure. Part 2: a clinical case

El objetivo de este artículo es presentar una alternativa de tratamiento rehabilitador para pacientes jóvenes con gran pérdida de estructura dental, vinculada a lesiones de origen no bacteriano. Se presenta el caso clínico de un paciente de sexo masculino, de 39 años de edad, que acudió a la Cátedra de Odontología Integral Adultos de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA) relatando síntomas compatibles con hipersensibilidad dentaria y fatiga de los músculos masticadores. Al mismo tiempo, manifestó disconformidad con el aspecto estético de su sonrisa. Teniendo en cuenta la gran pérdida de sustancia en sus piezas dentarias producida por hábitos parafuncionales (bruxismo), se realizó una rehabilitación oral adhesiva con cerámicas utilizando el protocolo de abordaje terapéutico sugerido por la Cátedra. En pacientes que presentan severos desgastes (AU)

Comparative Analysis of Shear Bond Strength of Steel and Ceramic Orthodontic Brackets Bonded with Six Different Orthodontic Adhesives / Análisis Comparativo de la Resistencia al Corte de Brackets de Ortodoncia de Acero y Cerámica Unidos con Seis Adhesivos de Ortodoncia Diferentes

ABSTRACT: Orthodontic accessories bonding in tooth enamel has been a critical step since the introduction of direct bonding techniques due to the importance of bracket stability. The aim of this study was to evaluate adhesion strength of different adhesive systems used for bracket bonding on dental surface. The present in vitro study was made from the analysis of shear strength of steel and ceramic brackets bonding with six different types of orthodontic adhesives. The brackets were bonded to 120 human extracted first premolar teeth with Orthocem®, Orthocem® + Ambar Universal® primer, Orthobond Plus®, Biofix®, Transbond XT®, Ortholink VLC®. Shear strength tests were performed on a universal testing machine EZ-Test-Shimadzu® and the data were analyzed using ANOVA test with Post-Hoc Bonferroni and 95 % statistical significance (p <0.05). Transbond XT® and Ortholink VLC® resin values showed greater shear resistance for steel brackets bonding and Transbond XT® and Orthobond Plus® adhesives showed better adhesion results for ceramic brackets bonding.

RESUMEN: La unión de accesorios de ortodoncia en el esmalte dental ha sido un paso crítico desde la introducción de las técnicas de unión directa debido a la importancia de la estabilidad del soporte. El objetivo de este estudio fue evaluar la fuerza de adhesión de diferentes sistemas adhesivos utilizados para la unión de brackets en la superficie dental. El presente estudio in vitro se realizó a partir del análisis de la resistencia al corte de brackets de acero y de cerámica unidos con seis tipos diferentes de adhesivos de ortodoncia. Los brackets se unieron a 120 primeros premolares extraídos con los adhesivos Orthocem®, Orthocem® + Ambar Universal® primer, Orthobond Plus®, Biofix®, Transbond XT®, Ortholink VLC®. Las pruebas de resistencia al corte se realizaron en una máquina de prueba universal EZ-Test-Shimadzu® y los datos se analizaron usando la prueba ANOVA con Bonferroni Post-Hoc y 95 % de significación estadística (p <0,05). Los valores de resina Transbond XT® y Ortholink VLC® mostraron una mayor resistencia al corte para la unión de brackets de acero y los adhesivos Transbond XT® y Orthobond Plus® mostraron mejores resultados de adhesión para la unión de brackets cerámicos.

Is it necessary to pre-treat Dentine before GIC Restorations? Evidence from an in Vitro Study / É necessário pré tratar a dentina antes das restaurações de CIV? Evidência de um estudo in vitro

ABSTRACT The aim of this study was to assess the influence of differentpretreatmentapproaches on glass ionomer cement (GIC)bond strength (BS) to dentine. Sixty bovine incisors wereallocated into six groups according to substrate - sound orcariesaffecteddentine; and substrate pretreatmentapproach -no conditioning (control), polyacrylic acid for 10 s andphosphoric acid for 7 s. Teeth in the cariesaffecteddentinegroup were previously submitted to cariogenic pHcyclingchallenge. After dentine pretreatment,according to experi mentalgroups, polyethylene tubes were placed on flat dentinesurfaces and filled with GIC. Teeth were stored in distilledwater for 24 h at 37 °C and then submitted to microshear test(0.5 mm/min). Failure pattern analysis was performed understereomicroscope (400x). Data were analysed using twowayANOVA and Tukey's test (α=5%). Statistically significantdifferences were found for the pretreatmentapproach,regardless of substrate (p<0.001). The polyacrylic acid groupand control group had similar BS values, and were both betterthan the phosphoric acid group. In general, GIC had betterbonding performance in sound dentine than in cariesaffecteddentine. In conclusion, dentine pretreatmentwith polyacrylicacid did not improve the performance of GIC restoration onclinically relevant substrates.

RESUMO O objetivo deste estudo foi avaliar a influência de diferentesprétratamentosna resistência de união (RU) de cimentos deionômero de vidro (CIV) a dentina. Sessenta incisivos bovinosforam alocados em 6 grupos de acordo com o substrato -hígido ou cariado; e com a abordagem de prétratamento-sem condicionamento (controle), ácido poliacrílico por 10 s, eácido fosfórico por 7 s. Os dentes pertencentes aos grupos dedentina cariada foram previamente submetidos ao desafiocariogênico por meio da ciclagem de pH. Após o prétratamentoda dentina, de acordo com os grupos experimentais,tubos de polietileno foram colocados sobre superfícies planas dedentina e preenchidos com CIV. Os dentes foram armazenadosem água destilada por 24 h a 37°C e então submetidos ao testede microcisalhamento (0,5 mm/min). A análise do padrão defratura foi realizada em estereomicroscópio (400x). Os dadosobtidos foram analisados usando ANOVA de dois fatores e testede Tukey (α=5%). Diferença estatisticamente significante foiencontrada para as diferentes abordagens de prétratamento,independente do substrato (pp<0,001). Aplicação de ácidopoliacrílico resultou em valores de RU similares aos do grupocontrole. Entretanto, ambos os grupos mostraram um melhordesempenho quando comparado a aplicação de ácidofosfórico. De forma geral, CIV apresentou melho5 desempenhoadesivo em dentina sadia quando comparada a dentinacariada. Em conclusão, o prétratamentoem dentina comácido poliacrílico não melhora o desempenho das restauraçõesde CIV em substratos clinicamente relevantes.

Comparative effects of final canal irrigation with chitosan and EDTA

Abstract Chitosan is a natural, biocompatible chelating substance with potential for dental use. This study compared the effects of final canal irrigation with chitosan and EDTA on dentin microhardness, sealer dentin tubules penetration capacity, and push-out strength. Methodology: Fifty canine roots were distributed according to the final irrigation protocol (n=10): G1- 15% EDTA with conventional irrigation; G2- 15% EDTA with Endovac; G3- 0.2% chitosan with conventional irrigation; G4- 0.2% chitosan with Endovac; and G5- without irrigation. Specimens were obturated (AH Plus) and sectioned in 3 slices per root third. The first slice was used for microhardness and sealer penetration assessments under a laser confocal microscope. The second was utilized in a push-out strength test. The third slice was discarded. Data were analyzed using 2-way ANOVA and Tukey's post hoc test (α<0.05). Failure mode was determined at x40 magnification. Results: Microhardness reduction was more significant in groups G2 and G4 (p<0.05). Sealer penetration through dentin was significantly greater in group G2 (p<0.05). There was no significant difference between groups G1, G3, and G4 (p>0.05). In general, all experimental groups presented similar bond resistance (p>0.05) that significantly differed from the control (p<0.001). Mixed type failures were predominant. Conclusions: In general, 0.2% chitosan and 15% EDTA solutions act in a similar manner with regard to the variables studied. The use of Endovac potentiates the effect of these solutions.

Resin-dentin bond stability of etch-and-rinse adhesive systems with different concentrations of MMP inhibitor GM1489

Abstract Enzymatic degradation of the hybrid layer can be accelerated by the activation of dentin metalloproteinases (MMP) during the bonding procedure. MMP inhibitors may be used to contain this process. Objective To evaluate the degree of conversion (DC%), dentin bond strength (µTBS) (immediate and after 1 year of storage in water), and nanoleakage of an experimental (EXP) and a commercial (SB) adhesive system, containing different concentrations of the MMP inhibitor GM1489: 0, 1 µM, 5 µM and 10 µM. Methodology DC% was evaluated by FT-IR spectroscopy. Dentin bond strength was evaluated by µTBS test. Half of beams were submitted to the µTBS test after 24 h and the other half, after storage for 1 year. From each tooth and storage time, 2 beams were reserved for nanoleakage testing. Data were analyzed using ANOVA and Tukey's test to compare means (α=0.05). Results All adhesive systems maintained the µTBS after 1 year of storage. Groups with higher concentrations of inhibitor (5 µM and 10 µM) showed higher µTBS values than groups without inhibitor or with 1 µM. The nanoleakage values of all groups showed no increase after 1 year of storage and values were similar for SB and EXP groups, in both storage periods. The inhibitor did not affect the DC% of the EXP groups, but the SB5 and SB10 groups showed higher DC% values than those of SB0 and SB1. Conclusions The incorporation of GM1489 in the adhesive systems had no detrimental effect on DC%. The concentrations of 5 µM GM1489 for SB and 5 µM or 10 µM for EXP provided higher μTBS than groups without GM1489, in the evaluation after 1 year of storage; whereas the concentration of inhibitor did not affect adhesive systems nanoleakage.

Influence of alumina air-abrasion for highly translucent partially stabilized zirconia on flexural strength, surface properties, and bond strength of resin cement

Abstract Objective This study aims to evaluate the influence of different air-abrasion pressures and subsequent heat treatment on the flexural strength, surface roughness, and crystallographic phases of highly translucent partially stabilized zirconia (Y-PSZ), and on the tensile bond strength of resin cement to Y-PSZ. Methodology Fully sintered zirconia specimens were ground with SiC paper (control) and/or air-abraded with 50 µm particles of alumina at 0.1, 0.15, 0.2, or 0.3 MPa or left as-sintered. After air-abrasion at 0.2 MPa (0.2AB), additional specimens were then heated to 1500°C, and held for one hour at this temperature (0.2AB+HT1h). Flexural strength and surface roughness were evaluated. Crystalline phase identification was also carried out using X-ray diffraction. Bonded zirconia specimens with self-adhesive resin cement were stored in distilled water at 37°C for 24 h, either with or without aging (thermal cycling 4-60°C/20000). Results were analyzed statistically by ANOVA and Tukey-Kramer tests. Results The flexural strength decreased with the increase in air-abrasion pressure, while in contrast, the surface roughness increased. The lowest flexural strength and the highest roughness value were found for the 0.2AB and 0.3AB groups, respectively. All groups contained cubic-, tetragonal ( t )-, and rhombohedral ( r )-ZrO2 phases with the exception of the as-sintered group. Upon increasing the air-abrasion pressure, the relative amount of the r -ZrO2 phase increased, with a significant amount of r -ZrO2 phase being detected for the 0.2AB and 0.3AB groups. The 0.2AB+HT1h group exhibited a similar flexural strength and t -ZrO2 phase content as the as-sintered group. However, the 0.2AB group showed a significantly higher tensile bond strength (p<0.05) than the 0.2AB+HT1h group before and after aging. Conclusion Micromechanical retention by alumina air-abrasion at 0.2 MPa, in combination with chemical bonding of a resin to highly translucent Y-PSZ using a MDP-containing resin cement may enable durable bonding.

Microstructural and mechanical analysis of two CAD-CAM lithium disilicate glass-reinforced ceramics

Abstract The aim of this study was to analyze the structural, morphological and mechanical properties of two different lithium disilicate glass-reinforced ceramics for CAD-CAM systems (IPS e.max CAD and Rosetta SM). Five methodologies were used for both ceramics: microstructure (n = 2) was analyzed using x-ray diffraction (XRD); morphological properties (n = 2) were analyzed by scanning electron microscopy (SEM), with and without hydrofluoric etching; porosity (n = 3) was assessed using 3D micro-computed tomography (micro-CT); flexural strength was measured (n =1 0) using the three-point bending test; and bond strength was determined with self-adhesive resin cement (n = 10), using a microshear bond test. After performing all the tests, the data were analyzed using t-Student test and two-way ANOVA. All the tests used a significance level of α = 0.05. High peak positions corresponding to standard lithium metasilicate and lithium disilicate with similar intensities were observed for both ceramics in the XRD analysis. Morphological analysis showed that the crystalline structure of the two ceramics studied showed no statistical difference after acid etching. Additionally, no significant differences were recorded in the number or size of the pores for the ceramics evaluated. Moreover, no differences in flexural strength were found for the ceramic materials tested, or in the bond strength to ceramic substrates for the resin cements. Based on the study results, no significant differences were found between the two CAD-CAM lithium disilicate glass-reinforced ceramics tested, since they presented similar crystalline structures with comparable intensities, and similar total porosity, flexural strength and bond strength.

Adhesive resistance of a copaiba oil-based dentin biomodifier

Abstract This study analyzed the effect of prior application of copaiba oil (CO) emulsions as a dentin cleaning substance on microleakage and microtensile adhesive strength. Twenty-five premolars and sixty-four molars were used for microleakage and microtensile assays. For the microleakage assays, specimens with standard class V cavities were divided (n = 5), according to the tested CO emulsions: CO10%X, CO10%Y, and CO10%Z, as well as chlorhexidine 2% (CHX) and distilled water (DW), as positive and negative controls, respectively. Restorations were performed using the Adper Single Bond® and/or Clearfil SE Bond® systems. Cervical, occlusal, distal and mesial sections were assessed for tracer penetration degree at the composite/tooth interface. For the microtensile assay, healthy molars were divided into sixteen groups, in which artificial caries were induced in half of the groups. Dentin surfaces were treated with CO10%X and CO10%Y, CHX and DW. Microtensile bond strength was measured by fixing each sample to the plate of a universal testing machine operated at a speed of 0.5 mm/minute until failure. Dentin treated with CO10%X showed a lower infiltration rate than dentin treated with the other CO emulsions, CHX2% and DW. According to the microtensile assay, both healthy and affected dentin treated with CO10%X and Adper Single Bond® adhesive system presented higher adhesive strength. CO emulsion, used as a dentin biomodifier, interfered positively in microleakage and improved adhesive strength after acid etching in the Adper Single Bond® adhesive system, or before applying the Clearfil SE Bond® self-etching system.

Does use of silane-containing universal adhesive eliminate the need for silane application in direct composite repair?

Abstract This in vitro study aimed to evaluate the effect of a silane-containing universal adhesive used with or without a silane agent on the repair bond strength between aged and new composites. Forty nanohybrid composite resin blocks were stored in distilled water for 14 d and thermo-cycled. Sandpaper ground, etched, and rinsed speciments were randomly assigned into four experimental groups: silane + two-step etch-and-rinse adhesive system, two-step etch-and-rinse adhesive system, silane + silane-containing universal adhesive system, and silane-containing universal adhesive system. Blocks were repaired using the same composite. After 24 h of water storage, the blocks were sectioned and bonded sticks were submitted to microtensile testing. Ten unaged, non-repaired composite blocks were used as a reference group to evaluate the cohesive strength of the composite. Two-way ANOVA and Tukey's tests were used to analyze average µTBS. One-way ANOVA and Dunnet post-hoc tests were used to compare the cohesive strength values and bond strength obtained in the repaired groups (α = 0.05). The µTBS values were higher for the silane-containing universal adhesive compared to the two-step etch-and-rinse adhesive system (p = 0.002). Silane application improved the repair bond strength (p = 0.03). The repair bond strength ranged from 39.3 to 65.8% of the cohesive strength of the reference group. Using universal silane-containing adhesive improved the repair bond strength of composite resin compared to two-step etch-and-rinse adhesive. However, it still required prior application of a silane agent for best direct composite resin repair outcomes.

Adhesive resistance of a copaiba oil-based dentin biomodifier

Abstract This study analyzed the effect of prior application of copaiba oil (CO) emulsions as a dentin cleaning substance on microleakage and microtensile adhesive strength. Twenty-five premolars and sixty-four molars were used for microleakage and microtensile assays. For the microleakage assays, specimens with standard class V cavities were divided (n = 5), according to the tested CO emulsions: CO10%X, CO10%Y, and CO10%Z, as well as chlorhexidine 2% (CHX) and distilled water (DW), as positive and negative controls, respectively. Restorations were performed using the Adper Single Bond® and/or Clearfil SE Bond® systems. Cervical, occlusal, distal and mesial sections were assessed for tracer penetration degree at the composite/tooth interface. For the microtensile assay, healthy molars were divided into sixteen groups, in which artificial caries were induced in half of the groups. Dentin surfaces were treated with CO10%X and CO10%Y, CHX and DW. Microtensile bond strength was measured by fixing each sample to the plate of a universal testing machine operated at a speed of 0.5 mm/minute until failure. Dentin treated with CO10%X showed a lower infiltration rate than dentin treated with the other CO emulsions, CHX2% and DW. According to the microtensile assay, both healthy and affected dentin treated with CO10%X and Adper Single Bond® adhesive system presented higher adhesive strength. CO emulsion, used as a dentin biomodifier, interfered positively in microleakage and improved adhesive strength after acid etching in the Adper Single Bond® adhesive system, or before applying the Clearfil SE Bond® self-etching system.

Hydrofluoric acid concentration, time and use of phosphoric acid on the bond strength of feldspathic ceramics

Abstract The objective of this study was to evaluate the influence of hydrofluoric acid (HF) concentration, etching time, and application of phosphoric acid (PA) followed by neutralization with sodium bicarbonate on the bond strength between a feldspar ceramic and resin cement. Thus, 80 blocks (10 x 12 x 2 mm) of glass ceramic (VM - Vita Mark II - Vita Zahnfabrik) were made and randomly assigned to eight groups (n = 10) according to the factors: HF concentration (5 and 10%), etching time (60 and 120 s), and use of phosphoric acid (PA) (with and without). According to the experimental group, 37% PA (Condac, FGM) was applied after HF etching for 60s. Afterwards, samples were immersed in sodium bicarbonate for 1 min then in an ultrasonic bath in distilled water (5 min) for cleaning. After surface bonding treatment, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block. The samples were then stored in water (37ºC) for 90 days and submitted to the shear bond test (50 KgF, 1 mm/min). Failure analysis was performed by stereomicroscope and scanning electron microscopy. Data (MPa) were analyzed with 3-way ANOVA and Tukey's test. Only the factor "HF concentration" was significant (p = 0.02). Most failures were of cohesive in ceramic (40%) and mixed types (42.5%). The 10% HF resulted in higher shear bond strength value than the 5% HF. Surface cleaning with phosphoric acid followed by sodium bicarbonate and HF time (60 or 120 seconds) did not influence the resin bond strength to feldspar ceramic.

Efecto de la aplicación activa con aplicadores mejorados de un adhesivo universal / Effect of the active application of a universal adhesive with improved applicators

RESUMEN Introducción: La permeabilidad dentinaria es conocida como el paso de fluidos, iones, partículas, moléculas y bacterias a través de la dentina bajo ciertas condiciones. Objetivo: Determinar la influencia de la aplicación activa con un aplicador mejorado de un adhesivo dentinario sobre la conductancia hidráulica dentinaria humana, in vitro. Métodos: Estudio experimental in vitro en 40 terceros molares libres de caries, con indicación de exodoncia, provenientes de pacientes sanos entre 15 y 30 años, previo consentimiento informado. Posteriormente se limpiaron, desinfectaron y conservaron para ser incluidos en bloques de resina epóxica. Luego se realizaron cortes transversales y se obtuvieron discos dentinarios de 1,5 mm de espesor y 25 mm de diámetro. Se dividieron en dos grupos de 20 unidades cada uno, se sometieron a grabado con ácido ortofosfórico al 37 por ciento, y se lavaron y secaron. Sobre una balanza de precisión se les aplicó adhesivo dentinario fotopolimerizable, registrando la fuerza ejercida. En el grupo 1 se usó un microbrush en la aplicación y en el grupo 2 un aplicador mejorado diseñado especialmente. Posteriormente cada muestra fue sometida a una cámara de difusión para obtener la tasa de flujo y luego calcular la conductancia hidráulica, la cual otorga información acerca de la permeabilidad de la dentina. Resultados: los resultados obtenidos fueron levemente menores en el grupo 2, sin embargo, experimentaron una distribución normal. Conclusiones: no existen diferencias significativas, al ser analizados estadísticamente bajo diversas pruebas, en los valores de conductancia hidráulica. Tampoco se pudo establecer una relación inversa entre la fuerza de aplicación de un adhesivo en forma activa con un aplicador mejorado y la conductancia hidráulica, por lo cual no se aconseja el uso de dicho instrumento(AU)

ABSTRACT Introduction: Dentin permeability is defined as the passage of fluids, ions, particles, molecules and bacteria through the dentin under certain conditions. Objective: Determine the effect of the active application of a dentin adhesive with an improved applicator on human dentin hydraulic conductance in vitro. Methods: An in vitro experimental study was conducted of 40 caries-free third molars with an indication of exodontia from healthy patients aged 15-30 years, prior informed consent. The molars were cleaned, disinfected and preserved to be included in epoxy resin blocks. Cross-sectional cuts were then made to obtain dentin discs 1.5 mm thick and 25 mm in diameter. These were divided into two 20-unit groups, were subjected to etching with 37 percent orthophosphoric acid, and were washed and dried. On a precision scale photopolymerizable dentin adhesive was applied, recording the force exerted. Application was performed with a Microbrush applicator in Group 1 and with an improved dedicated applicator in Group 2. The samples were then placed in a diffusion chamber to determine flow rate and subsequently estimate hydraulic conductance, thus obtaining information about dentin permeability. Results: Results were slightly lower in Group 2, but they displayed normal distribution. Conclusions: Statistical analysis with various tests did not find any significant differences in hydraulic conductance values, nor could an inverse relation be established between the force of active application of an adhesive with an improved applicator and hydraulic conductance. Therefore, use of that instrument is not advised(AU)

Concepts and techniques to improve resin/resin bonding: literature review

The availability of new scientific information about the etiology, diagnosis and treatment of carious lesions and the introduction of reliable adhesive restorative materials substantially reduced the need of extensive tooth preparations. In order to achieve a successful procedure, an adequate bonding interface between old and new composite is required. The aim of this article is to review the concepts and techniques described in the literature for the improvement of resin-resin bonding. Bonding to dentin has been quite difficult to achieve. The difficulties are that dentin's histological structure and chemical composition are very different from those of the enamel. Bonding to dentin requires, besides acid conditioning and the adhesive required for enamel, a primer or dentin bonding agent, which is a hydrophilic, able to penetrate by infiltrating the microscopic spaces of the collagen mesh. The repairing of faulty restorations is a treatment option that has proven to be quite effective and safe, since it presents excellent results over time. For this purpose, different methods for surface treatment have been develo-ped, which has a great effect on the resistance of the reparation bonding. In order to achieve successful bonding between both resins, the following steps are recommended, including: surface roughening, acid etching, silane application, and bonding agent application

Effect of grape seed extract-containing phosphoric acid formulations on bonding to enamel and dentin

Abstract The aim was to evaluate the effect of 2% grape seed extract (GSE) containing phosphoric acid (PhA) on the bond strength to enamel and dentin. The control group was 37% PhA. The following three PhA formulations with 2% GSE and 20% ethanol were obtained: GSE5 = 5% PhA; GSE10 = 10% PhA; and GSE20 = 20% PhA. The enamel and dentin surfaces of molars were etched with the acid solutions, followed by Scotchbond Multi-Purpose adhesive and composite resin application. The tensile bond strength (TBS) test evaluated the bond to enamel after 24 h, and the microtensile bond strength (μTBS) test evaluated the bond to dentin after 24 h and 12-month water storage. Etched enamel and dentin were observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM), respectively. The TBS data were submitted to one-way ANOVA, while µTBS data were submitted to two-way ANOVA and Tukey's test (α = 0.05). The TBS (MPa) to enamel did not significantly differ among the control (48.1 ± 15.7), GSE5 (46.1 ± 9.6), GSE10 (49.8 ± 13.6) and GSE20 (44.1 ± 11.9) groups (p = 0.537). The µTBS (MPa) to dentin of the control (28.4 ± 14.4) and GSE20 (24.1 ± 8.1) groups were significantly higher than those of the GSE5 (16.8 ± 7.4) and GSE10 (17.5 ± 6.6) groups at 24 h (p < 0.006). After 12-month storage, only GSE5 (21.0 ± 7.8) and GSE10 (17.6 ± 8.0) did not show significantly decreased μTBS (p > 0.145). SEM micrographs showed a shallower enamel etching pattern for GSE5. AFM images showed the formation of collagenous globular structures for GSE5 and GSE10. The different acid solutions did not influence the TBS to enamel, and the µTBS to dentin was stable over time when dentin was etched with GSE5 and GSE10.

Bond strengths of various resin cements to different ceramics

Abstract This study evaluates the shear bond strength (SBS) of various resin cements to different ceramics. Composite resin cylinders of Z100 were fabricated and cemented to disks of feldspathic ceramic (Creation), leucite-reinforced feldspathic ceramic (Empress I), and densely sintered aluminum oxide ceramic (Procera AllCeram) using five resin cements: Panavia F (PAN), RelyX ARC (ARC), RelyX Unicem (RXU), RelyX Veneer, and Variolink II. SBS was measured after three days of water storage (baseline) and after artificial aging (180 days of water storage along with 12,000 thermal cycles). Failure mode of fractured specimens also was evaluated. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests (α=0.05). RXU showed 1) the lowest baseline median SBS to feldspathic ceramic, which was not statistically different from PAN; 2) the lowest median baseline SBS to leucite-reinforced feldspathic and densely sintered aluminum-oxide ceramics. All cements performed similarly after aging, except for ARC (median 0.0 MPa) and PAN (median 16.2 MPa) in the densely sintered aluminum-oxide ceramic group. Resin cements perform differently when bonded to different ceramic substrates. While all test resin cements worked similarly in the long-term to feldspathic and leucite-reinforced feldspathic ceramics, only the MDP-containing resin cement provided durable bonds to densely sintered aluminum-oxide ceramic.

Six-month performance of restorations produced with the ethanol-wet-bonding technique: a randomized trial

Abstract This double-blind randomized controlled clinical trial evaluated the effectiveness of dentin pretreatment with 100% ethanol (EWBT - ethanol wet bonding technique) and different adhesive protocols in noncarious cervical lesions (NCCL) after 6 months. Patients presenting at least one NCCL were included. NCCLs (n=148) were randomly assigned to 4 groups: NE (Non-EWBT + three-step etch-and-rinse (Scotchbond Multi Purpose, 3M ESPE [MP]), E (EWBT + MP); EB (EWBT + [Bond - third step of MP]), and EU (EWBT + universal adhesive (Single Bond Universal, 3M ESPE). Conventional acid-etching (Condac 37%, FGM) and nanohybrid resin composite (Z350, 3M ESPE) were used. Trained and calibrated examiners (Kappa = 0.61) evaluated the restorations at baseline (7 days) and 6-month recall using the USPHS modified criteria. Data were subjected to Chi square (α = 0.05). Differences in the success rate were found for the treatments (p = 0.003). EB presented the lowest success rate compared with the other groups (p < 0.02). No significant differences were detected among NE, E, and EU (p > 0.49). The survival rates were 97.23%, 97.30%, 78.95%, and 97.30% for NE, E, EB, and EU, respectively. Regarding postoperative sensitivity, a significant reduction was found for groups E (p = 0.027) and EU (p < 0.01) after 6 months. After 6 months, EWBT associated to the hydrophobic adhesive system had the highest failure rate.

Effect of peracetic acid used as single irrigant on the smear layer, adhesion, and penetrability of AH Plus

Abstract The aim of this study was to evaluate the effect of peracetic acid (PAA) as a single irrigant on the smear layer, on the intraradicular dentinal bond strength, and on the penetrability of an epoxy-based resin sealer into the dentinal tubules. A total of 120 roots were distributed into 4 groups according to the irrigant used in root canal preparation: 1% PAA (PAA); 2.5% NaOCl followed by final irrigation with 17% EDTA and 2.5% NaOCl (NaOCl-EDTA-NaOCl); 2.5% NaOCl (NaOCl); and saline solution (SS). The smear layer was evaluated using scanning electron microscopy. The bond strength of an epoxy-based resin sealer (AH Plus) to root dentin was evaluated by the push-out test and penetrability of the sealer into dentinal tubules was observed by confocal laser microscopy. The results were analyzed by the Kruskal-Wallis and the Dunn post-test (α = 0.05). The use of 1% PAA as single root canal irrigant provided smear layer removal and improved the penetrability and bond strength of AH Plus to root dentin in a manner similar to that of the NaOCl-EDTA-NaOCl group (p > 0.05). The NaOCl and SS groups had higher values of smear layer and lower values of sealer penetrability and dentin bond strength than the PAA and NaOCl-EDTA-NaOCl groups (p < 0.05). Thus, 1% PAA has the potential to be used as a single irrigant in root canals.

Microtensile bond strength of root canal dentin treated with adhesive and fiber-reinforced post systems

Abstract Nowadays, demand for esthetic restorations has risen considerably; thus, nonmetal esthetic posts made of either high-strength ceramics or reinforced resins, such as fiber-reinforced resin posts, have become more and more popular. Important characteristics of fiber-reinforced posts involve a modulus of elasticity similar to dentin and their ability to be cemented by an adhesive technique. A total of 36 maxillary incisors were divided into four groups. In this study, four adhesively luted fiber-reinforced (glass fiber, quartz glass fiber, zirconia glass fiber and woven polyethylene fiber ribbon) post systems were used. Post spaces were prepared by employing drills according to the protocol established for each group, and each post was adhesively luted with one of three adhesive systems. Three segments per root apical to the cementoenamel junction (CEJ) were obtained by sectioning the root under distilled water with a carbon spare saw. The samples (total of 108 sections) were 2.0±0.1 mm in thickness and they were stored individually in black film canisters with sterile distilled water. In order to determine the bond strength, the bonding area of each specimen was measured, and specimens were attached to a device to test microtensile strength at a speed of 1 mm/min. The analyses revealed no statistically significant differences between the adhesive systems and fiber-reinforced posts. (P> 0.05). However, the coronal portion of the root dentin had the highest bond strength. Adhesive systems used along with fiber-reinforced resin posts demonstrated reliable bonding.

Effect of hydrofluoric acid concentration and etching time on resin-bond strength to different glass ceramics

Abstract: The objective of this study was to evaluate the effect of the hydrofluoridric acid (HF) concentration and time of acid conditioning on bond strength of three glass ceramics to a resin cement. Thus, fifty blocks (10 mm x 5 mm x 2 mm) of each ceramic (LDCAD: IPS e.max CAD; LCAD: IPS Empress CAD and LDHP: IPS e.max Press) were made and embedded in acrylic resin. The surfaces were polished with sandpaper (#600, 800, 1000, and 1200 grits) and blocks were randomly divided into 15 groups (n = 10) according to the following factors: Concentration of HF (10% and 5%), conditioning time (20 s and 60 s) and ceramic (LDCAD, LDHP, and L). After conditioning, silane (Prosil / FGM) was applied and after 2 min, cylinders (Ø = 2 mm; h = 2 mm) of dual resin cement (AllCem / FGM) were made in the center of each block using a Teflon strip as matrix and light cured for 40 s (1,200 mW/cm2). Then, the samples were thermocycled (10,000 cycles, 5/55°C, 30s) and submitted to the shear bond test (50 KgF, 0.5 mm/min). The data (MPa) were analyzed with 3-way ANOVA and Tukey's test (5%). Failure analysis was performed using a stereomicroscope (20x) and a scanning electron microscope (SEM). ANOVA revealed that the "concentration" factor (p = 0.01) and the interaction "acid concentration X ceramic" (p = 0.009) had a significant effect, however, the "ceramic" (p = 0.897) and "conditioning time" (p = 0.260) factors did not influence the results. The LDHP10%60s (10.98 MPa)aA* group presented significantly higher bond strength than LDHP10%20s (6.57 MPa)bA, LCAD5%20s (6,90 ±3,5)aB and LDHP5%60s (5.66 ± 2,9MPa)aA* groups (Tukey). Failure analysis revealed that 100% of specimens had mixed failure. In conclusion, etching with 5% HF for 20 seconds is recommended for lithium disilicate and leucite-reinforced CAD/CAM ceramics. However, for pressed lithium disilicate ceramic, 10% HF for 60 s showed significantly higher bond strength to resin cement.

Surface morphologic evaluation of orthodontic bonding systems under conditions of cariogenic challenge

Abstract: Orthodontic bonding systems are submitted to demineralization and remineralization dynamics that might compromise their surface smoothness, and favor biofilm aggregation and caries development. The aim of the present study was to evaluate the effects of a cariogenic challenge model (in vitro pH-cycling model) on the surface roughness and topography of 3 bonding materials: Transbond™ XT (XT), Transbond™ Plus Color Change (PLUS) and Fuji Ortho™ LC (FUJI), by means of Atomic Force Microscopy (AFM). Six specimens with standardized dimensions and surface smoothness were fabricated per group, and the materials were manipulated in accordance with the manufacturers' instructions. No polishing was necessary. AFM tests were performed before and after pH-cycling, taking 3 readouts per specimen. The roughness results (Ra) were obtained at nanometric levels (nm) and surface records were acquired in two- and three-dimensional images of height and lock-in phase of the material components. The surfaces of all groups analyzed in the study were morphologically altered, presenting images suggestive of matrix degradation and loss of matrix-load integrity. FUJI presented the greatest increase in surface roughness, followed by XT and PLUS, respectively (p≤0.001). Nevertheless, the roughness values found did not present sufficient degradation to harbor bacteria. The surface roughness of all tested materials was increased by pH-cycling. The use of materials capable of resisting degradation in the oral environment is recommended, in order to conserve their integrity and of the surrounding tissues.