Influence of the Use of Irrigation Solution Inhibitors in Improving Dentine Adhesion: A Systematic Review and Meta-Analysis.

INTRODUCTION: This systematic review examined the effect of neutralizing agents on bond strength after irrigation with sodium hypochlorite and their existing protocols in literature. METHODS: This present study adhered to the PRISMA guidelines and was registered at PROSPERO. Five electronic databases were searched (sept-2020/jan-2021) in English, Spanish, and Portuguese, without any restrictions on publication date. Cases reports, editorials and literature reviews were not included. The risk of bias was assessed using the Cochrane Collaboration tool. From the initial 7,147 studies, 2,745 were removed as duplicates and 4,382 were excluded after a title/abstract screen. RESULTS: Seventeen in vitro studies were included. The results showed that the higher the concentration of sodium hypochlorite, the lower the bond strength at dentine/restoration interface (p⟨0.01). Among the studies, sodium ascorbate was the most widely used neutralizer and showed the most significant results in increasing bond strength (p⟨0.01). The bond strength values were found to increase with longer application time of the neutralizing substances (p⟨0.01). CONCLUSIONS: The use of sodium ascorbate as a neutralizing agent can reverse the negative effects of the sodium hypochlorite and improve the bond strength between dentine and resin cement, however, it isn't possible to determine the best protocol for use.

Resin Bonding to a Hybrid Ceramic: Effects of Surface Treatments and Aging.

The aim of this study was to verify the effects of different surface treatments on the microtensile bond strength between resin cement and a hybrid ceramic. Thirty-two hybrid ceramic slices (8 × 10 × 3 mm) were produced and allocated among four groups according to the surface treatment: Cont = no treatment, HA = 10% hydrofluoric acid applied for 60 seconds, PA = 37% phosphoric acid applied for 60 seconds and CJ = air abrasion with silica particle coated alumina (Cojet Sand, 3M ESPE, 30 µm/2.8 bar). As a control group, eight blocks of feldspathic ceramic (8 × 10 × 3 mm) were etched by hydrofluoric acid for 60 seconds (VMII). After the surface treatments, the ceramic slices were silanized (except the Cont group) and adhesively cemented to composite resin blocks (8 × 10 × 3 mm ) with a load of 750 g (polymerized for 40 seconds each side). The cemented blocks were cut into beams (bonded surface area of ∼1 mm(2)). Half of the beams were aged (thermocycling of 5°C-55°C/6000 cycles + water storage at 37°C/60 days), and the other half were tested immediately after being cut. Data were analyzed by Kruskal-Wallis and Dunn tests (non-aged groups) and by one-way analysis of variance and Tukey test (aged groups; α=0.05%). The mode of failure was classified by stereomicroscopy. The surface treatment significantly affected the bond strength in each set of groups: non-aged (p=0.001) and aged (p=0.001). Before being aged, samples in the CJ, HA, and PA groups achieved the highest bond strength values. However, after being aged, only those in the HA group remained with the highest bond strength values. Adhesive failure was found most often. In conclusion, hydrofluoric acid etching should be used for surface conditioning of the studied hybrid ceramic.