Impact of dietary acids on the surface roughness and morphology of composite resins.

This in vitro study was performed to evaluate the surface roughness (Ra) and morphology by scanning electron microscopy (SEM) of composite resins that had been stored in acidic solutions typical of those present in the diet. Three composite resins (4 Seasons, Z250, and P90) were selected and divided into three groups (n = 7) according to the solutions tested: G1: distilled water; G2, Coca-cola, and G3: orange juice. The Ra test was repeated after immersion periods of 15, 90, and 180 days. The mean Ra values were subjected to LS means analysis and the Tukey-Kramer (P < 0.05). One test specimen of each composite resin was selected for SEM analysis after each period. The Ra data indicated that P90 had the lowest Ra values. 4 Seasons and Z250 had statistically similar roughness values for all the solutions and evaluation periods. With the exception of 180-day immersion in Coca-cola, 4 Seasons showed significantly higher values than Z250. SEM analysis showed that P90 was the composite resin most resistant to the actions of all acid solutions for the periods analyzed. Interaction between components of the solutions and the active components of other dietary items, as well as oral hygiene, may affect the chemical degradation of composite resins.

Effect of light absence or attenuation on biaxial flexural strength of dual-polymerized resin cements after short- and long-term storage.

OBJECTIVE: To evaluate whether biaxial flexural strength (BFS) of dual resin cements is affected by light absence or attenuation, storage time, or cements' chemical nature. MATERIALS AND METHODS: One hundred and twenty disk-shaped specimens were made from each cement (non-self-adhesive cement and self-adhesive cement) using Teflon molds on a controlled temperature surface (35°C). Specimens were polymerized as follows (N = 30): self-cured, directly light-cured, light-cured at a distance of 6 mm between the light tip and the specimen, and through a 6-mm thick composite resin barrier (indirectly light-cured). Each group was divided (N = 10) for storage purposes (15 minutes, 24 hours, and 6 months). Specimens were placed into a biaxial-flexure jig and a vertical load was applied until failure. The BFS values were subjected to generalized linear models statistical analysis and Weibull distributions (α = 0.05). RESULTS: After 15 minutes aging, neither material achieved enough polymerization to perform the BFS test when polymerized using the self-curing mode. The self-adhesive product demonstrated much lower variation in strength with storage time than did the non-self-curing cement. CONCLUSIONS: Attenuated/light-curing reduced BFS values only for 15-minutes storage period for both materials. Flexural strength of the self-adhesive cement was less affected by light absence/attenuation and storage time. CLINICAL SIGNIFICANCE: Biaxial flexural strength of a self-adhesive resin cement is less sensitive to variation in light application and storage time than is a non-self-adhesive cement.

Permeability of Dental Adhesives - A SEM Assessment.

OBJECTIVES: To morphologically evaluate the permeability of different commercial dental adhesives using scanning electron microscopy. METHODS: SEVEN ADHESIVE SYSTEMS WERE EVALUATED: one three-step system (Scotchbond Multi-Purpose - MP); one two-step self-etching primer system (Clearfil SE Bond - SE); three two-step etch-and-rinse systems (Single Bond 2 - SB; Excite - EX; One-Step - OS); and two single-step self-etching adhesives (Adper Prompt - AP; One-Up Bond F - OU). The mixture of primer and bond agents of the Clearfil SE Bond system (SE-PB) was also tested. The adhesives were poured into a brass mold (5.8 mm x 0.8 mm) and light-cured for 80 s at 650 mW/cm2. After a 24 h desiccation process, the specimens were immersed in a 50% ammoniac silver nitrate solution for tracer permeation. Afterwards, they were sectioned in ultra-fine slices, carbon-coated, and analyzed under backscattered electrons in a scanning electron microscopy. RESULTS: MP and SE showed slight and superficial tracer permeation. In EX, SB, and OS, permeation extended beyond the inner superficies of the specimens. SE-PB did not mix well, and most of the tracer was precipitated into the primer agent. In AP and OU, "water-trees" were observed all over the specimens. CONCLUSIONS: Different materials showed distinct permeability in aqueous solution. The extent of tracer permeation varied according to the composition of each material and it was more evident in the more hydrophilic and solvated ones.

In vivo temperature measurement: tooth preparation and restoration with preheated resin composite.

STATEMENT OF THE PROBLEM: Composite preheating has shown to improve material physical properties in vitro, but no data exist on the use of this technique in vivo during placement. PURPOSE: The study aims to measure in vivo prepared tooth surface temperature during a restorative procedure using resin composite either at room temperature (23.6°C) or preheated to 54.7°C in a commercial compule heating device set to heat at 60°C. METHODS: Class I preparations (N=3) were made on a patient requiring multiple posterior restorations. A probe containing two thermocouples was used to record temperature values at the tooth pulpal floor and 2mm higher (top of the tooth preparation/restoration) after tooth preparation (prep), acid etching (etch), placement and curing of a bonding agent (BA), and during placement of composite used at room temperature (RT) or preheated in a commercial device (Calset(TM) , AdDent Inc., Danbury, CT, USA) set to 60°C. Data were compared with two-way analysis of variance, Tukey-Kramer post hoc test (α=0.05). RESULTS: No significant difference in pulpal floor temperature existed between prep (27.8°±1.3°C) and etch (26.3°±1.3°C), which were significantly lower than BA (30.5°±1.3°C) (p=0.0001). Immediate placement of preheated composite resulted in significantly higher pulpal floor (36.2°±1.9°C) (p=0.0025) and top composite temperatures (38.4°±2.2°C) (p=0.0034) than RT values (30.4°±2.2°C and 29.6°±0.9°C, respectively). CONCLUSIONS: In vivo use and placement of preheated resin composite resulted in temperature increase of 6° to 8°C than room temperature material. These values, however, were much lower than expected. CLINICAL SIGNIFICANCE: Although having many potential benefits, composite preheating may not be as clinically effective in delivering resin of predetermined temperature at the time of cure as laboratory experiments would suggest. Despite only moderate composite temperature increase over use of room temperature material, preheating still provides advantages in terms of ease of handling and placement.

Bond strength to high-crystalline content zirconia after different surface treatments.

The aim of this study was to evaluate the effect of primers, luting systems and aging on bond strength to zirconium oxide substrates. Eighteen zirconia discs (19.5 x 4 mm) were polished and treated (n = 3) either with a MDP primer (Md) or with a MDP and VBATDT primer (MV). In the control group (n = 3) no surface chemical treatment was performed. Zirconia specimens were cemented to prepolymerized composite discs utilizing resin cements - RelyX Unicem or Panavia 21 (RU and Pa, respectively). After 24 h, samples were sectioned for microtensile testing and returned to water at 37 degrees C for two different periods before being tested: 72 h or 60 days + thermocycling (5-55 degrees C/5000 cycles). Bond strength testing was performed at 1 mm/min. Values in MPa were analyzed through ANOVA and Tukey's Studentized Range (HSD) (p > 0.05). The application of MV primer resulted in the highest bond strength (22.77 MPa), statistically superior to Md primer (12.78 MPa), and control groups presented the lowest values (9.17 MPa). When luting systems were compared, RU promoted the highest bond strength (16.07 MPa) in comparison with Pa (13.75 MPa). The average bond strength decrease after aging (9.35 MPa) when compared with initial values (20.46 MPa). The results presented by this in vitro study suggest that a chemical surface treatment based on the MDP and VBATDT combination may improve bond strength between zirconia and luting system, without any previous mechanical treatment, depending on the luting system used. This chemical treatment may result in a reliable alternative to achieve adequate and durable bond strength.

Fluoride-containing adhesive: durability on dentin bonding.

OBJECTIVES: To evaluate (1) the influence of fluoride-containing adhesive on microtensile bond strength (microTBS) and (2) in vitro secondary caries inhibition at the resin-dentin interface after 24 h and 3 months water-storage and (3) the degree of conversion of different adhesives after 24h 1 month. METHODS: Flat surfaces of human teeth were ground and randomly assigned to six groups: (SBMP-24) Scotchbond Multi-Purpose control [SBMP], 24 h; (SE-24) SBMP etch and primer+Clearfil SE Bond adhesive [SE], 24h; (PB-24) SBMP etch and primer+Clearfil Protect Bond adhesive [PB], 24h; (SBMP-3) SBMP, 3 months; (SE-3) SBMP+SE, 3 months; and (PB-3) SBMP+PB, 3 months. To evaluate the effect of the adhesive resin alone, all teeth were etched with 35% phosphoric acid and primed with SBMP primer prior to applying the adhesive resin. Bonded assemblies were prepared for microTBS and stored in distilled water at 37 degrees C for 24h and 3 months. Sections of restored teeth of each group were exposed to an acid challenge. The specimens were sectioned, polished, and then observed with polarized light microscopy (PLM). Also, the degree of conversion (DC) of the adhesives was measured using Fourier Transform-Infrared spectroscopy (FTIR) at 24 h and 1 month, after polymerization. RESULTS: microTBS values obtained in MPa (24h/3m) were: (MP) 61.5+/-10.5/52.9+/-8.9, (SE) 55.5+/-11.8/55.6+/-13, and (PB) 50.3+/-9.9/61.0+/-13.6. For interface analysis by PLM, an inhibition zone (IZ) adjacent to the hybrid layer was created only when the fluoride-containing adhesive (PB) was used. The DC in percentage (24 h, 1 month) were: (MP) 60.5+/-2.8/61.3+/-0.6, (SE) 69.6+/-1.3/70.7+/-0.05, and (PB) 53.1+/-0.4/58.3+/-1.6. SIGNIFICANCE: The fluoride-containing adhesive demonstrated significant increase of bond strength values after water-storage. This material was also able to create an acid inhibition zone in dentin. There was a significant increase of degree of conversion after 1 month only for PB.

Effect of curing mode on the polymerization characteristics of dual-cured resin cement systems.

OBJECTIVES: To evaluate the effects of different curing conditions on the degree of conversion (DC) of dual-cured cementing systems [combination of bonding agent (BA) and resin cement (RC)] using infrared spectroscopy. METHODS: Four fourth generation products [Scotchbond Multipurpose Plus/RelyX (3M ESPE), Optibond/Nexus 2 (Kerr), All Bond2/Duolink (Bisco), and Bond-It!/Lute-It! (Pentron)], and three fifth generation materials [Bond1/Lute-It! (Pentron), Prime&Bond NT Dual-Cure/Calibra (Dentsply), and Optibond Solo Dual Cure/Nexus 2 (Kerr)] were applied to the surface of a horizontal attenuated-total-reflectance unit, and were polymerized using one of four conditions: self-cure (SC), direct light exposure through glass slide (DLE, XL3000/3M ESPE) or through pre-cured resin discs (shades A2;A4/2mm thick/Z250/3M ESPE). Infrared spectra of the uncured cementing systems were recorded immediately after application to the ATR, after the system was light-cured or left to self-cure, and spectra were obtained 5 and 10 min later. DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios pre- and post-curing. Data (n=5) were analyzed by two-way repeated measures ANOVA and Tukey's test (p=0.05). RESULTS: Changes in aliphatic-to-aromatic peak ratios before and after placing RC onto the BA demonstrated that a combined layer was created. All groups exhibited higher DC after 10 min than after 5 min, except the DLE group of Bond-it!/Lute-it!. No significant differences in DC were observed among light-activated groups regardless of the resin disc shade in three of the four fourth generation cementing systems. The SC groups exhibited lower DC than the DLE groups for both fourth and fifth generation products either after 5 or 10 min. CONCLUSION: The chemistry of the bonding interface changed when RCs were applied to uncured BAs. The presence of an indirect restoration can decrease the DC of some cementing systems and the self-curing mode leads to lower DC than the light-activating one.

SEM observation of the bond integrity of fiber-reinforced composite posts cemented into root canals.

OBJECTIVES: To test the null hypothesis that continuity of resin cement/dentin interfaces is not affected by location along the root canal walls or water storage for 3 months when bonding fiber posts into root canals. METHODS: Fiber posts were luted to bovine incisors using four resinous luting systems: Multilink, Variolink II, Enforce Dual and Enforce PV. After cementation, roots were longitudinally sectioned and epoxy resin replicas were prepared for SEM analysis (baseline). The original halves were immersed in solvent, replicated and evaluated. After 3 months water storage and a second solvent immersion, a new set of replicas were made and analyzed. The ratio (%) between the length (mm) of available bonding interface and the actual extension of bonded cement/dentin interface was calculated. RESULTS: Significant lower percent values of bond integrity were found for Multilink (8.25%) and Variolink II (10.08%) when compared to Enforce Dual (25.11%) and Enforce PV (27.0%) at baseline analysis. The same trend was observed after immersion in solvent, with no significant changes. However, bond integrity was significantly reduced after 3 months water storage and a second solvent immersion to values below 5% (Multilink=3.31%, Variolink=1.87%, Enforce Dual=1.20%, and Enforce PV=0.75%). The majority of gaps were depicted at the apical and middle thirds at baseline and after immersion in solvent. After 3 months, gaps were also detected at the cervical third. SIGNIFICANCE: Bond integrity at the cement/dentin interface was surprisingly low after cementation of fiber posts to root canals with all resin cements. That was not significantly altered after immersion in solvent, but was further compromised after 3 months water storage. Gaps were mainly seen at middle and apical thirds throughout the experiment and extended to the cervical third after water storage for 3 months. Bond integrity of fiber posts luted to root canals was affected both by location and water storage.

Effect of water storage and surface treatments on the tensile bond strength of IPS Empress 2 ceramic.

PURPOSE: The aim of this study was to evaluate the effect of water storage (24 hours and 1 year) on the tensile bond strength between the IPS Empress 2 ceramic and Variolink II resin cement under different superficial treatments. MATERIALS AND METHODS: One hundred and eighty disks with diameters of 5.3 mm at the top and 7.0 mm at the bottom, and a thickness of 2.5 mm were made, embedded in resin, and randomly divided into six groups: Groups 1 and 4 = 10% hydrofluoric acid for 20 seconds; Groups 2 and 5 = sandblasting for 5 seconds with 50 microm aluminum oxide; and Groups 3 and 6 = sandblasting for 5 seconds with 100 microm aluminum oxide. Silane was applied on the treated ceramic surfaces, and the disks were bonded into pairs with adhesive resin cement. The samples of Groups 1 to 3 were stored in distilled water at 37 degrees C for 24 hours, and Groups 4 to 6 were stored for 1 year. The samples were subjected to a tensile strength test in an Instron universal testing machine at a crosshead speed of 1.0 mm/min, until failure. The data were submitted to analysis of variance and Tukey's test (5%). RESULTS: The means of the tensile bond strength of Groups 1, 2, and 3 (15.54 +/- 4.53, 10.60 +/- 3.32, and 7.87 +/- 2.26 MPa) for 24-hour storage time were significantly higher than those observed for the 1-year storage (Groups 4, 5, and 6: 10.10 +/- 3.17, 6.34 +/- 1.06, and 2.60 +/- 0.41 MPa). The surface treatments with 10% hydrofluoric acid (15.54 +/- 4.53 and 10.10 +/- 3.17 MPa) showed statistically higher tensile bond strengths compared with sandblasting with 50 microm(10.60 +/- 3.32 and 6.34 +/- 1.06 MPa) and 100 microm (7.87 +/- 2.26 and 2.60 +/- 0.41 MPa) aluminum oxide for the storage time 24 hours and 1 year. CONCLUSIONS: Storage time significantly decreased the tensile bond strength for both ceramic surface treatments. The application of 10% hydrofluoric acid resulted in stronger tensile bond strength values than those achieved with aluminum oxide.

Effect of composite temperature on in vitro intrapulpal temperature rise.

OBJECTIVES: To measure in vitro intrapulpal temperature when placing and restoring with either room-temperature or pre-heated (54 and 60 degrees C) composite. METHODS: A K-type thermocouple was placed in the pulpal chamber of an extracted, human bifurcated upper premolar which had a Class V preparation (1 mm remaining dentin thickness) on the facial surface. Tooth roots were immersed in a thermostatically controlled water bath and perfused with water at 1.25 microl/min to simulate physiological circulation in the pulp chamber. The thermocouple was connected to an analog-to-digital converter. The preparation was filled using composite either at room-temperature, or pre-heated to 54 or 60 degrees C with a commercial compule heater (Calset), using standard clinical procedures by one person while continuously monitoring intrapulpal temperature (n=5). Temperature rise over baseline values were determined at various stages during the restoration process: composite placement, contouring, prior to light-curing, and immediately after light-curing (20s, Optilux 501). At each measurement interval, intrapulpal temperature values were compared using ANOVA and the Tukey-Kramer post hoc test (alpha=0.05). RESULTS: Significant differences were found in intrapulpal temperature when comparing pre-heated and room-temperature composite treatments with respect to baseline among the stages of the restorative process. However, the extent of this increase with heated composite was only 0.8 degrees C. A 5 degrees C intrapulpal temperature rise was seen for all groups during photopolymerization. SIGNIFICANCE: Use of pre-heated composite only mildly increased intrapulpal temperature values when compared to composite delivered at room-temperature in an in vitro test environment. The largest temperature change occurred with application of the curing light.

Marginal adaptation and microtensile bond strength of composite indirect restorations bonded to dentin treated with adhesive and low-viscosity composite.

OBJECTIVES: This study evaluated the marginal adaptation of composite indirect restorations bonded with dual curing resin cement after different strategies to seal dentin. Different bonding techniques associated or not with a low-viscosity composite resin (LVCR) were utilized. In addition, the bond strength between composite resin and pre-sealed dentin was evaluated in the buccal and pulpal walls of class I cavities, prepared for indirect restorations. METHODS: Thirty-three freshly extracted human molars were used for this study, divided into three groups (n=11) representing different techniques to seal dentin-(Group 1) Conventional technique: the adhesive system was applied and polymerized just before the cementation of the indirect restoration; (Group 2) Dual bonding technique: a first layer of the adhesive system was applied and polymerized just after preparation, and a second layer just before the final cementation; (Group 3) Resin coating technique: a LVCR was applied and polymerized after the first layer of the adhesive system, and before the impression. A further application of the adhesive system was performed before the placement of the restoration. The restorations were polished and a solution of acid red propylene-glycol was dropped on each specimen's occlusal surface for 10 s. The dye penetrations were captured under stereoscopic lens and the images were transferred to a computer with a measurement program, in order to determine the extension of the dye penetration. The microtensile bond strength test (muTBS) was applied on pulpal (P) and buccal (B) walls of the restorations for Groups 1-3. The subgroups for muTBS were: Group 1P (n=13); Group 1B (n=7); Group 2P (n=6); Group 2B (n=14); Group 3P (n=14); Group 3B (n=15). All specimens were sectioned to obtain an area of 0.8 mm2. The specimens were mounted on a microtensile device and fractured using a universal testing machine at a cross-head speed of 1mm/min. Failure modes were analyzed by SEM. One-way ANOVA and multiple-comparison Tukey's test were used for statistical analysis of the marginal adaptation scores and muTBS test. Non-parametrical Kruskal-Wallis test was used for failure mode analysis. RESULTS: Group 3 showed a significantly higher mean value of marginal dye penetration (45.59) when compared to Groups 1 (8.44) and 2 (18.92). For pulpal walls, Group 1P showed significantly higher mean muTBS (25.93+/-2.27) when compared to Groups 2P (14.71+/-1.78) and 3P (16.07+/-2.81). There was no statistical difference between Groups 2P and 3P. For buccal walls, Group 2B presented significantly higher mean muTBS (23.29+/-1.42), and Group 1B the lowest mean values (11.37+/-1.14). The failure mode analysis presented a considerable variation, according to the treatment and to the wall. SIGNIFICANCE: The results of this study indicated that a previous sealing of dentin using the adhesive system, followed by a second application just before the cementation, is an effective alternative technique, since it maintains the marginal adaptation of indirect composite resin restorations, and improves the bond strength at the interface on buccal walls, which are the most critical regions for the long-term durability of these procedures.

Water sorption/solubility of dental adhesive resins.

OBJECTIVES: This study evaluated the water sorption, solubility and kinetics of water diffusion in commercial and experimental resins that are formulated to be used as dentin and enamel bonding agents. METHODS: Four commercial adhesives were selected along with their solvent-monomer combination: the bonding resins were of Adper Scotchbond Multi-Purpose (MP) and Clearfil SE Bond (SE) systems, and the "one-bottle" systems, Adper Single Bond (SB) and Excite (EX). Five experimental methacrylate-based resins of known hydrophilicities (R1, R2, R3, R4 and R5) were used as reference materials. Specimen disks were prepared by dispensing the uncured resin into a mould (5.8mm x 0.8mm). After desiccation, the cured specimens were weighed and then stored in distilled water for evaluation of the water diffusion kinetics over a 28-day period. RESULTS: Resin composition and hydrophilicity (ranked by their Hoy's solubility parameters) influenced water sorption, solubility and water diffusion in both commercial and experimental dental resins. The most hydrophilic experimental resin, R5, showed the highest water sorption, solubility and water diffusion coefficient. Among the commercial adhesives, the solvated systems, SB and EX, showed water sorption, solubility and water diffusion coefficients significantly greater than those observed for the non-solvated systems, MP and SE (p<0.05). In general, the extent and rate of water sorption increased with the hydrophilicity of the resin blends. SIGNIFICANCE: The extensive amount of water sorption in the current hydrophilic dental resins is a cause of concern. This may affect the mechanical stability of these resins and favor the rapid and catastrophic degradation of resin-dentin bonds.

Ultramorphological analysis of resin-dentin interfaces produced with water-based single-step and two-step adhesives: nanoleakage expression.

This study evaluated the nanoleakage patterns in bonded interfaces using two single-step, self-etching adhesives (Adper Prompt-AD, and One-up Bond F-OB), two two-step, self-etching primers (Clearfil SE Bond-CF, and Unifil Bond-UB), and one two-step, total-etch adhesive (Single Bond-SB). Dentin surfaces were bonded with the adhesive systems and stored in water at 37 degrees C for 1 week and 6 months. After storage periods, teeth were sectioned into 0.8 mm-thick slabs, coated with nail varnish except for the bonded interfaces, and immersed in ammoniacal AgNO(3) for 24 h. After immersion in photodeveloping solution, bonded sections were prepared and observed under a SEM using the backscattered electron mode. Undemineralized, unstained, epoxy resin-embedded sections were prepared for TEM. Nanoleakage patterns were qualitatively compared between periods. Nanoleakage was observed in all bonded specimens at both periods. CF and UB presented silver deposits predominantly restricted to the thin (0.5 microm) hybrid layer (HL) at both periods. Although no evident differences were observed in the nanoleakage pattern of UB at 7 days and 6 months, CF presented enlarged areas of silver impregnation after 6 months. SB presented accumulation of silver particles mostly within the HL at 7 days, which was intensified after 6 months. AD and OB presented massive silver accumulation within the HL and the overlying adhesive layer. No evident differences were noticed between storage periods. Silver impregnation increased for all adhesive systems from 7 days to 6 months, except for UB.

Influence of activation mode of dual-cured resin composite cores and low-viscosity composite liners on bond strength to dentin treated with self-etching adhesives.

PURPOSE: The objective of this study was to investigate the effect of light- or chemical initiation on the polymerization reaction of dual-cured composite core buildup materials (CM) with respect to their shear bond strength to dentin treated with self-etching adhesives (SE), in the presence or absence of a low-viscosity composite liner (LI). MATERIALS AND METHODS: Two SEs (Clearfil SE Bond and Unifil Core Bond), their respective CMs (DC Core Paste and Unifil Core), and a LI (Protect Liner F) were tested. After removing the labial enamel surfaces of 8 bovine incisors, each flat dentin surface was sectioned into 4 pieces with similar surface areas (30 mm2). The dentin surfaces were wet abraded with 600-grit SiC paper and randomly divided into 8 groups. Experimental groups comprised the use of a SE and its respective CM with or without an intermediate application of the LI and with or without CM light activation. Three cylinders of CM (0.5 mm high and 0.75 mm in diameter) were applied to each bonded dentin surface (n = 12), using a tygon tubing mold. After water storage for 24 h, specimens were subjected to microshear testing. Data were statistically analyzed by two-way ANOVA and Tukey's test (5%). RESULTS: For both SEs, LI application and CM light activation showed significantly higher bond strengths than the groups in which an intermediate LI was not used or the CMs were only chemically cured. CONCLUSION: The bond strength of CM to dentin using SE is reduced if the LI and light activation are not employed.