Polymerization contraction stress in dentin adhesives bonded to dentin and enamel.

OBJECTIVE: In a previous study on of polymerization contraction stress determinations of adhesives bonded to dentin a continuous decline of stress was observed after the adhesives had been light-cured. The decline was ascribed to stress relief caused by diffusion into the adhesive layer of water and/or solvents, left in the impregnated dentin surface after drying and/or evaporation in the application procedure. The purpose of the present study was to test the hypothesis that the contraction stress of adhesives bonded to enamel will not decline after light-curing, based on the assumption that water and/or solvents are more efficiently removed from impregnated enamel surfaces in the drying and/or evaporation step. MATERIALS AND METHODS: Contraction stress was determined in a tensilometer for three total-etching adhesives Scotchbond multi-purpose, Single bond and One-step plus and four self-etching adhesives Clearfil SE Bond, Clearfil Protect Bond, AdheSE, and Xeno III. The adhesives were placed in a thin layer between a glass plate and a flat dentin or enamel surface pre-treated with phosphoric acid or self-etching primer and light-cured under constrained conditions. RESULTS: All adhesives bonded to enamel showed a stress decline, but significantly less than for dentin with the exception of two self-etching adhesives. The greatest decline was found for the total-etching adhesive systems bonded to dentin. The presence of hydrophobic monomers in the adhesives had a significant influence on the decline. SIGNIFICANCE: The experiments indicate that fluids are withdrawn from the resin impregnated tooth structures, which may result in small defects in the tooth-resin interfaces.

Effect of pre-etching enamel on fatigue of self-etch adhesive bonds.

OBJECTIVE: A previous study found that the shear bond strength (SBS) to bovine enamel for the self-etching adhesive Adper Prompt-L-Pop (PLP) was 75% of that found with the etch-and-rinse material SingleBond, while the comparative value for the shear fatigue limit (SFL) was only 58% at 10(5) load cycles. Resin penetration into the enamel surface was substantially less for PLP but it was not conclusive that this was the reason for the lower results cited above. The objective of this study was to determine if pre-etching enamel would substantially improve the SBS and SFL of the PLP adhesive over those found in the previous study. MATERIALS AND METHODS: All test methods were the same as for the previous study. SBS measurements were conducted for composite bonds to bovine enamel using a phosphoric acid pre-etch with the PLP adhesive (PLP-10) and for a conventional enamel-bonding adhesive (EB). Fatigue testing was done with the same test fixtures, load cycling at 2Hz up to a maximum of 10(5) cycles at four selected peak load values between 35 and 60% of the respective bond strengths. Fatigue limits were determined from the data obtained. SEM analysis of resin penetration of the enamel surface was carried out for each adhesive. RESULTS: A significantly greater SBS and SFL were found for EB (SBS: 30.4MPa; SFL: 15.6MPa) than for PLP-10 (SBS: 20.2MPa; SFL: 9.9MPa). Compared with previously found results, the pre-etching of enamel had no significant improvement in SBS and only slight improvement in SFL. Resin tag penetration of the enamel surface for PLP-10 was similar to that previously found for PLP alone, suggesting that the porosity created by phosphoric acid was effectively removed by the acidic PLP adhesive. SIGNIFICANCE: Unlike some self-etching adhesives reported in the literature, pre-etching enamel did not improve the performance of the Prompt-L-Pop adhesive.

Contraction stress and bond strength to dentinfor compatible and incompatible combinations of bonding systems and chemical and light-cured core build-up resin composites.

OBJECTIVE: Recent studies have shown that adhesives containing acidic monomers combined with composites can adversely effect the polymerization reaction producing low bond strengths. This phenomenon may also occur in making composite build-ups, jeopardizing one of the key factors for a successful core build-up restoration. The aim of this study was to investigate the contraction stress development and bond strength to dentin of core build-up resin composites combined with adhesives of various acidities. In addition the hypothesis tested was that light irradiation through chemical-cured composites during curing does not influence contraction stress or bond strength to dentin. METHODS: The chemical-cured (Clearfil Core) and light-cured (Clearfil Photo Core) core build-up resin composites were combined with two light-cured adhesives, Clearfil SE Bond (pH=1.8) and One-Step Bond (pH=4.3) and two dual-cured adhesives, Clearfil Photo Bond (pH=2.5) and All-Bond 2 (pH=6.1). Contraction stress development (at C=3) was determined for a period of 30 min in a universal testing machine where the opposing bonding surfaces were glass and dentin. After the 30 min period, the specimens were loaded in tension to determine the bond strength to dentin. To test the hypothesis, the combinations of the chemical-cured composites with the four bonding systems were also light irradiated for 40s right at the start of curing. RESULTS: For all composite-adhesive combinations tested, the adhesion to dentin resisted the developing polymerization contraction stresses. Both, dentin as a substrate to bond at and the use of adhesives, were showed to play an important role in keeping the contraction stresses low. The chemical-cured composite (Clearfil Core) combined with the light-cured adhesive SE Bond (pH=1.8) showed for both contraction stress and bond strength significant lower values than the other combinations. The hypothesis was accepted for combinations of the chemical-cured composite with All-Bond 2 and One-Step Bond, but was not supported by combinations with Clearfil SE Bond or Clearfil Photo Bond, as a significant increase in contraction stress was found. The higher values found for bond strength were not significant. SIGNIFICANCE: Besides combinations of chemical-cured core build-up composites with light or dual-cured adhesives as recommended by the manufacturer, also combinations with adhesives of other manufacturers are compatible, provided that the pH is higher than approximately 4.3. Chemical-cured core build-up composites combined with light-cured adhesives with a pH as low as 1.8 lead to a significantly lower stress and bond strength compared to other combinations. Light irradiation during curing through a combination of a chemical-cured composite and a low pH adhesive reactivates polymerization.

Fatigue testing of enamel bonds with self-etch and total-etch adhesive systems.

OBJECTIVE: Etching of enamel by self-etching adhesive systems is not as pronounced as with phosphoric acid employed with most total-etch adhesive systems. This may result in differences in the effectiveness of the bonds for the two types of systems. The aim of this study was to compare two such systems by bond strength and fatigue testing. MATERIALS AND METHODS: Shear bond strengths for Single Bond (SB) and Adper Prompt-L-Pop (PLP) were obtained on bovine enamel surfaces. Fatigue measurements were made with the same test fixtures using cyclical loading at 2 Hz for a maximum of 10(5) cycles or until the bond failed. Four selected loads between 40 and 70% of the shear bond strength were tested for each adhesive and the number of cycles to failure was recorded. S-N curves were constructed from the data and fatigue stress limits were determined. The Mann-Whitney U-test and t-tests were used for statistical comparisons of the results. SEM analysis of resin tag formation into enamel surfaces was carried out. RESULTS: A significantly greater bond strength was found for SB (25.3 MPa) than for PLP (19.2). Sustainable stresses after 10(5) load cycles were substantially lower than the corresponding shear bond strengths and fatigue limits were found to be 8.4 MPa for PLP and 14.6 MPa for SB. The ratio of fatigue limit to bond strength was less for PLP (44%) than for SB (57%). Resin tag penetration into enamel was substantially less for PLP than for SB. SIGNIFICANCE: Fatigue testing in conjunction with bond strength testing can provide a better means for assessing the performance of adhesive systems used for bonding to enamel.

The effects of common errors on sealing ability of total-etch adhesives.

OBJECTIVES: This study evaluated the effect of errors commonly made in using total-etch adhesives, on the resulting bond strength, fluid movement and nanoleakage of resin dentin bonds. METHODS: Two total-etch adhesives were used for bonding to dentin according to the manufacturers' recommendations, with meticulous solvent evaporation (control), or with the introduction of common bonding errors-wet bonding without solvent evaporation (no evaporation), and dry bonding. RESULTS: The 24-hour bond strength of the control was significantly higher than the other groups (p <0.05). For all groups, the higher initial permeability declined significantly after 24 h. The fluid movement across bonded dentin was similar in the control and dry bonding for both adhesives, whereas significantly higher permeability (p<0.05) was recorded for the no evaporation groups even after 24 h. Extensive silver impregnation within hybrid layers was seen by TEM in the no evaporation and dry bonding specimens after 24 h. Dry bonding caused collapse of the collagen matrix and interfered with resin infiltration. In contrast, inadequate solvent evaporation and/or residual water during dentin bonding results in dilution or incomplete polymerization of the resin, leading to severe nanoleakage formation. SIGNIFICANCE: Increased permeability associated with incomplete solvent evaporation in total-etch adhesives may lead to poor bond strength.

Early and long-term wear of 'fast-set' conventional glass-ionomer cements.

OBJECTIVE: Fast setting high viscous glass-ionomer cements have been introduced to reach the set state sooner and to improve early mechanical properties. The aim of this study was to investigate whether 'fast-set' cements have improved the early three-body wear. METHOD: The three-body wear of four glass-ionomer cements was measured after 1, 4, 7, 30, 90, and 365 days. The chemical composition of the cements was determined with EDAX. The particle size of the powders was determined with a Mastersizer 2000. RESULTS: The three-body wear of Fuji IX Fast was only slightly less than that of 'regular-set' Fuji IX, but Ketac Molar Quick showed a higher wear compared to the regular-set Ketac Molar. The wear rate of all four glass-ionomer cements decreased over a period of 1 year and could be described by second order reaction kinetics and depended on polyalkenoic acid content, chemical composition, and the size of the glass particles. SIGNIFICANCE: Based on the results of this laboratory study on long-term wear, the glass-ionomer cements investigated may compete with composites, but the early wear characteristics should be further improved. Furthermore, a better understanding of the wear and reaction behavior of glass-ionomer cements is obtained.

Effect of conditioning time of self-etching primers on dentin bond strength of three adhesive resin cements.

OBJECTIVES: To evaluate the effect of increasing the dentin conditioning time with self-etching primers of different aggressiveness (pH) on the microtensile bond strength (muTBS) of three resin cements. MATERIALS AND METHODS: Pre-cured composite blocks were cemented with M-Bond, Bistite II DC, or Panavia F to flat occlusal dentin surfaces of human third molars, which were conditioned with M-Bond or Bistite II-primer for 30, 60 or 180 s or with Panavia-primer for 60 or 180 s. Each dentin-composite block assembly (four in each group) was longitudinally sectioned to obtain 1x1 mm microbars and tested for the muTBS. The morphology of the conditioned dentin surface and the hybrid layer was examined with SEM. RESULTS: Extending the primer conditioning time for Bistite II DC from 30 to 60 s significantly increased the muTBS (p<0.001) but did not further increase from 60 s to 180 s. For M-Bond there was only a significant increase from 30 to 180 s (p<0.05). For Panavia F the primer-conditioning time had no influence on the muTBS. SEM observations of conditioned dentin showed that the Bistite II DC and M-Bond self-etching primers with the lowest pH completely dissolved the dentin smear layer and plugs and formed well-defined hybrid layers. This was not found for Panavia F. SIGNIFICANCE: Dentin bond strength of resin cements using more aggressive self-etching primers is improved by increasing the conditioning time. To enable resin infiltration of highly filled resin cements, sufficient smear layer dissolution is necessary.

Influence of fatigue loading on the performance of adhesive and nonadhesive luting cements for cast post-and-core buildups in maxillary premolars.

PURPOSE: This study evaluated the influence of fatigue loading on the performance of an adhesive and a nonadhesive cement for cast post-and-core restorations in maxillary premolars. MATERIALS AND METHODS: The adhesive cement used was Panavia 21, a resin-based composite cement, and the nonadhesive cement was PhosphaCem/C, a zinc-oxy-phosphate cement. The coronal sections of single-rooted human maxillary premolars were removed at the level of the proximal CEJ. After endodontic treatment, a cast post and core was prepared for each tooth and cemented into the root canal with either Panavia 21 (n = 8) or PhosphaCem/C (n = 8). Half of the specimens from each cement group were exposed to fatigue loading almost perpendicular to the axial axis; the other half were used as controls. Three parallel transverse root sections were cut from each specimen and used for evaluation of the influence of fatigue loading. For each section, cement integrity was studied by SEM, and retention strength of the cemented post section was determined with a push-out test. RESULTS: For SEM evaluation and the push-out test, Panavia 21 proved significantly better than PhosphaCem/C. However, fatigue loading did not show any effect. CONCLUSION: Under the conditions of this study, fatiguing of cemented cast post-and-core restorations was not decisive as a single test to evaluate the quality of the cement.

In situ transformation of glass-ionomer into an enamel-like material.

PURPOSE: To assess the nature of clinically detectable alterations in glass-ionomer after long-term clinical service. METHODS: In addition to clinical macro pictures, SEM was carried out on replicas and on two sectioned primary molars SEM-EDAX analysis was performed to determine chemical transformation in the glass-ionomer. Also with SEM-EDAX, the composition was determined of a partially removed half-year old sealant. RESULTS: The clinically observed altered optical aspect and increased hardness could be related with surface structure changes as identified by SEM. The changed glass-ionomer showed a continuous integration with the adjacent enamel. The SEM-EDAX analysis revealed an increase of calcium and phosphorus in the surface layer, tentatively suggesting a sort of additional "mineralization" of the material. This phenomenon was only observed for restorations that had minimally 2-3 years in vivo dwell time.

The effect of adhesives with various degrees of hydrophilicity on resin ceramic bond durability.

OBJECTIVES: To investigate the role of different acid surface-treatments and hydrophilic and hydrophobic bonding agents on resin ceramic bond durability. METHODS: Two resin cements, Tetric Flow and Nexus 2, were applied to CAD/CAM Cerec Vitablocs with six bonding strategies: (1) HF-etching and silanization, (2) HF-etching, silanization and application of a hydrophilic bonding agent, (3) HF-etching, silanization and application of a hydrophobic bonding agent, (4) H3PO4-treatment and silanization, (5) H3PO4-treatment, silanization and application of a hydrophilic bonding agent, and (6) H3PO4-treatment, silanization and application of a hydrophobic bonding agent. The hydrophilic agents were Syntac Single-Component and OptiBond Solo Plus. The hydrophobic agent was Visio Bond. After 1d water storage at 37 degrees C, 1 mm2 microbars were cut for the microtensile bond strength test (microTBS test). The microbars were subjected to a tensile load using a modified testing device immediately after trimming and after 7 and 28d water storage. The fractured specimens were examined with a stereomicroscope and scanning eslectron microscopy to determine the failure mode. RESULTS: HF-etching resulted in significantly higher microTBS than H3PO4-treatments (p < 0.001) The 1d microTBS with hydrophilic bonding agents was significantly higher than with the hydrophobic bonding agent (p < 0.001) but decreased with time after water storage ( p < 0.001) while bonds with the hydrophobic bonding agent remained stable. The percentages of adhesive failures after 1, 7, and 28d were 60, 86, and 94, respectively. SIGNIFICANCE: Bonding agents that contain hydrophilic monomers have a negative influence on the resin ceramic bond durability.

Effect of dentin perfusion on the sealing ability and microtensile bond strengths of a total-etch versus an all-in-one adhesive.

OBJECTIVES: To test the null hypothesis that perfusion of dentin has no effect on the sealing or bond strength in Class V resin composite restorations using a two-step total-etch (Scotchbond 1), or a one-step self-etch (all-in-one) (Prompt L-Pop) adhesive. METHODS: Dentin permeability in Class V cavity preparations cut into extracted human third molars was measured in a fluid transport setup. Resin composites were placed using either Scotchbond 1, or Prompt L-Pop with or without dentin perfusion at 1.47 kPa. Permeability was re-measured, and the reduction in permeability was calculated as a percentage of the initial value. Additionally, microtensile bond strength (microTBS) to dentin was measured. RESULTS: Whereas the ability of Scotchbond 1 to seal dentin was significantly decreased due to dentin perfusion (p = 0.00025), that of Prompt L-Pop was not affected (p = 0.099). Scotchbond 1 produced significantly less dentinal seal than Prompt L-Pop only in the restorations carried out with perfusion (p = 0.0003), in the absence of perfusion, however, the difference was not significant (p = 0.343). Dentin perfusion significantly decreased the microTBS of Scotchbond 1 to dentin (p = 0.001). Due to excessive premature failure during sectioning, microTBS test could not be performed with Prompt L-Pop. SIGNIFICANCE: Dentinal fluid flow may have detrimental effects on the sealing ability of dental adhesives depending on the type of adhesive used. Studies aiming to rank adhesives in relation to their sealing ability in vitro should not disregard dentin perfusion.

Microtensile bond strength testing of luting cements to prefabricated CAD/CAM ceramic and composite blocks.

OBJECTIVES: To investigate the Microtensile bond strength (microTBS) and failure mode of resin cements bonded to composite and ceramic CAD/CAM blocks following various surface treatments. METHODS: Paradigm composite blocks and Cerec Vitablocs received three surface treatments following the control treatment of surface grinding with 600 SiC grit. (1) Application of adhesive resin (Adh), (2) etching with hydrofluoric acid and silanization (HF+S) or (3) combination of the previous two treatments (HF+S+Adh). Three resin cements (Tetric Flow, Nexus 2, RelyX ARC) were applied to these surfaces and built-up in layers. After 24 h water storage at 37 degrees C, the non-trimming version of microTBS test was used to produce 1 mm(2) microbars. The Microbars were subjected to a tensile load using a modified testing device. The broken specimens were examined with a stereomicroscope and SEM to determine the failure mode. RESULTS: All control and adhesive treated groups of the ceramic substrate showed premature debonding during cutting. The overall mean microTBS for the three resin cements bonded to ceramic following HF+S and HF+S+Adh surface treatment, was 27 and 29.2 MPa and for the resin cements bonded to composite substrate was 42.3 and 54.2 MPa, respectively. The mode of failure was 98% adhesive with composite as a substrate and 68% mixed failures with ceramic as a substrate. CLINICAL SIGNIFICANCE: CAD/CAM restorations fabricated from processed composite blocks may have advantage over the ceramic blocks with regard to the higher bond strength with resin cements.