The Effect of Varying Dentin Chroma and Enamel Thickness on the Color of A2 Double-layered Resin Composite.

OBJECTIVES: To evaluate chroma (C*) and overall color of double-layered (DL) resin composite (RC) restorations with various dentin shades and enamel thicknesses. METHODS: Enamel specimens were fabricated using custom-made molds to replicate VITA shade tabs with variant enamel thicknesses (0.5, 0.7, and 1.0 mm) (n=7) from two RC: Clearfil-Majesty (CM) shade (A2), and Vit-l-escence (VL), shade (pearl-neutral). Dentin specimens (shades A1, A2, and A3) were fabricated using custom molds corresponding to the enamel molds. Each enamel specimen was paired with three different dentin specimens. L*a*b* parameters were measured with VITA Easyshade-V. Color difference between DL specimens and the A2 VITA shade tab were calculated with the CIEDE2000 formula. Relationships among enamel thickness, ΔE00, C* of dentin layer, C* of DL, and change in chroma were assessed by Spearman rank correlations. ΔE00 was compared among groups using one-way analysis of variance with Tukey post-hoc adjustment for all possible pairwise group comparisons (experiment-wise α=0.05). RESULTS: There was no statistical difference among C* of DL specimens (p=0.65, 0.53) for CM and VL, respectively. Combinations of enamel thickness/ dentin shade had a significant difference in ΔE00 (p>0.05). No significant correlation was observed among enamel thickness and C* of dentin, and C* of the DL (p>0.05). Significant correlations were observed between ΔE00 of the VL DL and C* DL (r=-0.8, p<0.001); and ΔE00 of CM DL and enamel thickness (r=0.5, p<0.001). CONCLUSIONS: Enamel thickness did not affect C* of the dentin layer. Unlike VL RC, variations in dentin shades with CM produced a closer match to the A2 shade tab. Enamel is recommended to be 0.7 mm or less.

A Novel Enamel and Dentin Etching Protocol Using α-hydroxy Glycolic Acid: Surface Property, Etching Pattern, and Bond Strength Studies.

OBJECTIVES: To determine the use of α-hydroxy glycolic acid (GA) as a surface pretreatment for dental restorative applications. The etching pattern of GA pretreatment of dental hard tissues was assessed by surface microhardness and scanning electron microscopy (SEM). The effectiveness of GA surface etching on the enamel and dentin resin bond strengths was assessed using two etchant application modes (rubbing and no rubbing) and three adhesive systems (Single Bond [SB], One Step Plus [OSP], and Scotchbond Universal [SBU]). METHODS: Knoop microhardness measurements were carried out on polished enamel and dentin surfaces before and after treatment with 35% GA, 35% phosphoric acid (PA), or distilled water (control group) for 30 seconds. The microtensile bond strength test was carried out on enamel and dentin. Ultrastructural analysis of the surface and interfacial interaction was qualitatively accomplished using SEM. RESULTS: Etching with either PA or GA significantly decreased the enamel microhardness, with GA being significantly less aggressive than PA ( p<0.001), while both acids showed similar decreases in dentin microhardness ( p=0.810). SEM revealed similar etching patterns of GA and PA, while apparently a thinner hybrid layer was observed for GA groups. In dentin, the bond strengths were statistically similar between PA and GA groups, regardless of the etchant application mode ( p>0.05). However, rubbing of GA enhanced the bond strength to enamel. PA and GA significantly increased the SBU bond strength to enamel when compared to SB and OSP ( p<0.05). CONCLUSIONS: GA effectively etched enamel and dentin surfaces, resulting in bond strength values similar to those associated with traditional PA. GA is a suitable enamel and dentin surface etchant for adhesive restorative procedures.

Role of Proteolytic Enzyme Inhibitors on Carious and Eroded Dentin Associated With a Universal Bonding System.

OBJECTIVES: The aim of this study was to evaluate the effect of proteolytic inhibitors on the bond strength of a universal adhesive system (etch-and-rinse mode) applied to artificial carious and eroded dentin. METHODS: Ninety molars were prepared and randomly divided into three groups according to the substrate: N, no challenges; ACD, artificial carious dentin simulation and ERO, artificial erosion simulation with orange juice. All groups were redivided into three subgroups according to the dentin pretreatment: W, water; CHX, 2% digluconate chlorhexidine; and E-64 (trans-epoxysuccinyl-L-leucylamido-[4-guanidino] butane), 5 µM E-64 inhibitor. They constituted a total of nine groups (n=10): N-W, N-CHX, N-E64, ACD-W, ACD-CHX, ACD-E64, ERO-W, ERO-CHX, and ERO-E64. All specimens were restored with Adper Single Bond Universal/Filtek Z250. Beams (0.64 mm2) were obtained and subjected to the microtensile test (µTBS) in a universal testing machine at 0.5 mm/min. The failure mode of the interfaces was determined by optical microscopy (40× magnification). Data were statistically analyzed by three-way analysis of variance and Tukey tests (p<0.05). RESULTS: All individual factors (p<0.0001) and the interaction between substrate and treatment (p=0.0011) and between substrate and time (p=0.0003) were statistically significant. The caries substrate contributed negatively to bond strength. Chlorhexidine reduced bond strength for normal and eroded conditions. Only the normal substrate was negatively affected by time despite the pretreatment. CONCLUSIONS: The universal bonding system appears to be a promising bonding strategy for the maintenance of bond strength to affected dentin. E-64 did not affect bonding to the dentin in contrast to the use of chlorhexidine, which, when associated with the universal system, did affect the microtensile bond strength for artificial carious dentin.