In-Vitro Evaluation of Dental Adhesive Bond Strength With Diode Laser Irradiation Before Photopolymerization.

AIM: In-vitro evaluation of shear bond strength, mode of failure, and adaptation of fifth-generation (etch-and-rinse), seventh-generation,and eighth-generation self-etch dental adhesives to human dentin with or without diode-laser irradiation before photopolymerization. MATERIALS AND METHODS: Seventy-two extracted human maxillary premolar teeth were collected. The buccal and lingual surfaces of teeth were grounded until dentin was exposed. Test areas of 4 mm diameter were created on both surfaces of teeth to standardize the area of treatment. The samples were then randomly allocated into three groups (n = 24): Group 1 Adper Single Bond 2 Etch-and-Rinse; Group 2 Tetric-N-Bond Universal Self-Etch; Group 3 Prime and Bond Universal Self-Etch dental adhesives were used. Buccal surfaces (sub-groups 'a') of all specimens were irradiated with diode laser before photopolymerization of the adhesive material, and palatal surfaces (sub-groups 'b') were directly photopolymerized without prior diode laser irradiation and restored with composite resin. All specimens were thermocycled. Four specimens from each group were then subjected to scanning electron microscopy (SEM) analysis to examine the adaptation of adhesive to dentin, and the remaining 60 specimens were evaluated for shear bond strength tests, modes of failure at the adhesive-dentin interface, and values were recorded, tabulated, and used for data analysis. A one-way ANOVA test and the Student's t-test were used for statistical analysis. A P value ≤ 0.05 was considered statistically significant. RESULTS: The mean shear bond strength for the groups was: Group 1a (13.96 MPa), 1b (14.95 MPa); Group 2a (10.06 MPa), 2b (10.30 MPa); Group 3a (12.03 MPa), and 3b (10.44 MPa). No statistically significant difference was seen among sub-groups 1a and 3a, 2a and 3a, 2b and 3b as P > 0.05. A significant difference was seen among sub-groups 1b and 3b (P<0.05), 1a and 2a, and 1b and 2b (P<0.01). CONCLUSION: Adper Single Bond 2 without diode-laser irradiation before photopolymerization showed the highest shear bond strength, followed by Adper Single Bond 2 irradiated with diode laser before photopolymerization, with the maximum adaptation of dental adhesive to dentin compared to other adhesives used either with or without diode-laser irradiation.

Does the Application of Additional Hydrophobic Resin to Universal Adhesives Increase Bonding Longevity of Eroded Dentin?

This paper evaluates the effect of an additional hydrophobic resin coat (extra HL) associated with universal adhesives on sound and eroded dentin and evaluated immediately or after 2 years of water storage to improve the microtensile bond strength (µTBS) and nanoleakage (NL) when compared to the use of universal adhesives only. Sixty-four molars were assigned to eight groups using the following combinations: 1. dentin substrate, including sound and eroded dentin; 2. treatment, including the control and extra HL and storage time (immediately and after two-years of storage). Two universal adhesives (Prime & Bond Active or Scotchbond Universal) were evaluated. Before restoration, half of the teeth were subjected to soft-drink erosion. Composite buildups were bonded; specimens were stored (37 °C/24 h), sectioned into resin−dentin bonded sticks and tested for microtensile bond strength and nanoleakage using SEM (immediately and after two-years of storage). Three-way ANOVA and Tukey's test (α = 0.05%) were used. In the immediate testing, the application of extra HL did not increase microtensile bond strength values compared with the control group in either substrate (p > 0.05). However, extra HL significantly decreased nanoleakage values when applied to eroded and sound dentin (p = 0.0001). After two years, the application of extra HL produced significantly higher microtensile bond strength and lower nanoleakage values than the control group for both adhesives (p = 0.0001). In all cases, sound dentin showed higher microtensile bond strength and lower nanoleakage values than eroded dentin (p = 0.000001). An extra HL increased the bond strength and reduced nanoleakage in eroded dentin after two-years of storage.

Extra Bonding Layer Compensates Universal Adhesive's Thin Film Thickness.

PURPOSE: Universal adhesives (UAs) are applied in 2-step etch-and-rinse (2-E&R) or 1-step self-etch (1-SE) mode. This study investigated whether three UAs could benefit from a highly filled extra bonding layer (EBL), turning them into 3-E&R and 2-SE UAs, respectively, thus also compensating for the commonly thin film thickness of UAs. MATERIALS AND METHODS: Microtensile bond strength (µTBS) to bur-cut dentin of Clearfil Universal Bond Quick (C-UBq, Kuraray Noritake), G-Premio Bond (G-PrB, GC) and Prime&Bond Active (P&Ba, Dentsply Sirona), applied in E&R and SE mode without/with the adhesive resin (EBL) of OptiBond FL (Opti-FL_ar, Kerr), was compared to that of the 3-E&Ra OptiBond FL (Opti-FL; Kerr), which was also employed in 2-SE mode. As a cross reference, the SE primer of Clearfil SE Bond 2 (Kuraray Noritake) was combined with Opti-FL_ar (C-SE2/Opti-FL) and again applied in 2-SE and 3-E&R mode. µTBS was measured after 1 month of water storage (37°C) and additional 25,000 and 50,000 thermocycles (TC). All µTBS were statistically analyzed using three different linear mixed-effects models with specific contrasts (p < 0.05). RESULTS: Overall, the four parameters (adhesive, bonding mode, aging, EBL) significantly influenced µTBS. G-PrB and P&Ba benefited from EBL when applied in both E&R and SE bonding modes. In E&R mode, P&Ba generally revealed the highest µTBS; C-UBq presented an intermediate and G-PrB the lowest µTBS. No significant differences were found between different bonding modes. C-SE2/Opti-FL outperformed Opti-FL in 3-E&R and 2-SE_1 month/25k. CONCLUSION: The overall benefit of EBL on the 1-month and TC-aged bonding efficacy differed for the different UAs tested.

Mechanical and Chemical Changes in the Adhesive-Dentin Interface after Remineralization.

PURPOSE: To evaluate the remineralization effects of Bioglass 45S5 (BAG) on dentin composition, adhesive-dentin bond strength, as well as interface and diffusion zone thickness. MATERIALS AND METHODS: Dentin specimens were assigned to a control group (CG), in which the adhesive was applied following the manufacturer's instructions, and a remineralized group (RG), in which remineralization treatment was carried out by rubbing a remineralization solution (0.015 g of BAG with 1.35 ml of distilled water) on the etched dentin surface for 30 s before applying the adhesive. For bioactive analysis (n = 10), control and remineralized dentin were investigated using micro-Raman spectroscopy (mRS) and scanning electron microscopy (SEM). Stick specimens prepared with a three-step etch-and-rinse adhesive were submitted to a microtensile bond strength (µTBS) test (n = 10) after 24 h (24 h) and eight months (8 m). Micro-RS 3D-maps (n = 10) characterized the adhesive-dentin interface composition and diffusion zone thickness, and SEM images (n = 10) evaluated interface thickness. Data were analyzed using Student's t-test or two-way ANOVA and Tukey-Kramer's post-hoc test (α = 0.05). RESULTS: Remineralization treatment increased the mineral content of dentin. Mean µTBSs were statistically different at 24 h, with RG higher than CG; however, this difference was not significant at 8 m. When the adhesive was applied on remineralized dentin, its penetration was reduced, its physical interaction with phosphate was improved, and its degree of conversion increased. The diffusion zone in the CG did not differ from that of the RG, and interface thickness values of the CG did not differ from that of the RG. CONCLUSION: Remineralization treatment promoted mineral growth on the dentin surface, improved the interaction of dentin with adhesive monomers, and consequently resulted in higher immediate bond strengths.

Do Universal Adhesives Benefit from an Extra Bonding Layer?

PURPOSE: Universal adhesives use a combined primer/bonding resin applied either in 2-step etch-and-rinse (2-E&R) or 1-step self-etch (1-SE) mode. This study investigated whether three universal adhesives would benefit from an extra bonding layer (EBL), essentially making them 3-step E&R (3-E&R) and 2-SE adhesives, respectively. MATERIALS AND METHODS: Microtensile bond strengths (µTBSs) to bur-cut dentin of Clearfil Universal Bond Quick (C-UBq, Kuraray Noritake), G-Premio Bond (G-PrB, GC) and Prime&Bond Active (P&Ba, Dentsply Sirona) were compared to those of the 2-SEa Clearfil SE Bond 2 (C-SE2, Kuraray Noritake) which was also employed in 3-E&R mode. A split-tooth design was applied with each adhesive used in E&R and SE mode on each tooth, half without/with EBL (C-SE2 Bond). All adhesives were light cured after application of the final layer. The µTBS of one-third of the specimens was measured after 1-month water storage without thermocycling (TC), with the remaining two-thirds aged with 25,000 and 50,000 TCs. All µTBSs were statistically analyzed using a linear mixed-effects model with specific contrasts (p < 0.05). RESULTS: Overall, the four variables (adhesive, bonding mode, EBL, aging) significantly influenced µTBS. Solely G-PrB benefited from EBL when applied in SE mode. In E&R mode, P&Ba generally resulted in the highest µTBSs, C-UBq presented with intermediate and G-PrB with the lowest µTBSs, where the latter was significantly lower than the µTBSs recorded for C-SE2. In SE mode, P&Ba generally resulted in the highest µTBSs in 1- and 2-SE mode. Equally high µTBSs were recorded for G-PrB in 2-SE mode with EBL. Lower µTBSs were recorded for G-PrB in 1-SE mode and for C-UBq in 1- and 2-SE mode. CONCLUSION: The overall effect of EBL on immediate and aged bonding efficacy depended on the specific universal adhesive and its bonding mode.

Threats to adhesive/dentin interfacial integrity and next generation bio-enabled multifunctional adhesives.

Nearly 100 million of the 170 million composite and amalgam restorations placed annually in the United States are replacements for failed restorations. The primary reason both composite and amalgam restorations fail is recurrent decay, for which composite restorations experience a 2.0-3.5-fold increase compared to amalgam. Recurrent decay is a pernicious problem-the standard treatment is replacement of defective composites with larger restorations that will also fail, initiating a cycle of ever-larger restorations that can lead to root canals, and eventually, to tooth loss. Unlike amalgam, composite lacks the inherent capability to seal discrepancies at the restorative material/tooth interface. The low-viscosity adhesive that bonds the composite to the tooth is intended to seal the interface, but the adhesive degrades, which can breach the composite/tooth margin. Bacteria and bacterial by-products such as acids and enzymes infiltrate the marginal gaps and the composite's inability to increase the interfacial pH facilitates cariogenic and aciduric bacterial outgrowth. Together, these characteristics encourage recurrent decay, pulpal damage, and composite failure. This review article examines key biological and physicochemical interactions involved in the failure of composite restorations and discusses innovative strategies to mitigate the negative effects of pathogens at the adhesive/dentin interface. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2466-2475, 2019.

Engineered Peptide Repairs Defective Adhesive-Dentin Interface.

Failure of dental composite restorations is primarily due to recurrent decay at the tooth-composite interface. At this interface, the adhesive and its bond with dentin is the barrier between the restored tooth and the oral environment. In vivo degradation of the bond formed at the adhesive/dentin (a/d) interface follows a cascade of events leading to weakening of the composite restoration. Here, a peptide-based approach is developed to mineralize deficient dentin matrices at the a/d interface. Peptides that have an inherent capacity to self-assemble on dentin and to induce calcium-phosphate remineralization are anchored at the interface. Distribution of adhesive, collagen, and mineral is analyzed using micro-Raman spectroscopy and fluorescence microscopy. The analysis demonstrates remineralization of the deficient dentin matrices achieved throughout the interface with homogeneous distribution of mineral. The peptide-based remineralization demonstrated here can be an enabling technology to design integrated biomaterial-tissue interfaces.

A Mechanistic study of Plasma Treatment Effects on Demineralized Dentin Surfaces for Improved Adhesive/Dentin Interface Bonding.

Our previous work has shown that non-thermal plasma treatment of demineralized dentin significantly (p<0.05) improved adhesive/dentin bonding strength for dental composite restoration as compared with the untreated controls. This study is to achieve mechanistic understanding of the plasma treatment effects on dentin surface through investigating the plasma treated dentin surfaces and their interaction with adhesive monomer, 2-Hydroxyethyl methacrylate (HEMA). The plasma treated dentin surfaces from human third molars were evaluated by water contact angle measurements and scanning electron microscopy (SEM). It was found that plasma-treated dentin surface with subsequent HEMA immersion (Plasma/HEMA Treated) had much lower water contact angle compared with only plasma-treated (Plasma Treated) or only HEMA immersed (HEMA Treated) dentin surfaces. With prolong water droplet deposition time, water droplets spread out completely on the Plasma/HEMA Treated dentin surfaces. SEM images of Plasma/HEMA Treated dentin surfaces verified that dentin tubules were opened-up and filled with HEMA monomers. Extracted type I collagen fibrils, which was used as simulation of the exposed dentinal collagen fibrils after acid etching step, were plasma treated and analyzed with Fourier transform infrared spectroscopy (FT-IR) and circular dichroism (CD) spectra. FT-IR spectra of the Plasma/HEMA Treated collage fibrils showed broadened amide I peak at 1660 cm-1 and amide II at 1550 cm-1, which indicate secondary structure changes of the collagen fibrils. CD spectra indicated that 67.4% collagen helix structures were denatured after plasma treatment. These experimental results demonstrate that non-thermal argon plasma treatment was very effective in loosing collagen structure and enhancing adhesive monomer penetration, which are beneficial to thicker hybrid layer and longer resin tag formation, and consequently enhance adhesive/dentin interface bonding.

Avaliação da microinfltração coronária de três materiais utilizados na restauração provisória da cavidade endodôntica: estudo in vitro. / Coronal leakage of three materials used for temporary restoration of endodontic access cavities: an in vitro study

O objetivo deste trabalho foi avaliar a capacidade seladora de um material restaurador provisório, Villevie, e de uma resina composta, Tetric Ceram, associada a dois tipos de sistema adesivos, XENO III e Single Bond. Quarenta incisivos inferiores unirradiculares foram distribuídos em três grupos de dez dentes cada e cinco dentes para cada grupo controle, positivo e negativo. Os espécimes, após a cirurgia de acesso, foram preparados por meio de sistema de instrumentação rotatória e irrigados com água destilada e deionizada. A porção externa dos dentes foi impermeabilizada até 2 mm aquém da margem externa da cirurgia de acesso. Colocou-se no interior do canal radicular um cone de papel seguido de uma pensa de algodão impregnados com solução alcoólica de dimetilglioxima 1%. A cavidade endodôntica foi selada de acordo com os seguintes grupos: GA- sistema adesivo autocondicionante XENO III + resina composta; GB- sistema adesivo Single Bond + resina composta; e GC- selador provisório. Os espécimes foram imersos em recipientes contendo solução de sulfato de níquel 5% e submetidos à ciclagem térmica por 72h. Os testes de Kruskal-Wallis e Dunn foram utilizados para análise dos resultados com nível de 5% de signifcância. O menor nível de microinfltração foi observado no grupo do restaurador provisório (GC), com diferença estatística signifcante em relação aos demais grupos (P<0,001). Os grupos A e B mostraram-se semelhantes ao controle positivo (P>0,05), com os maiores índices de microinfltração. Concluiu-se que nenhum dos materiais avaliados foi capaz de impedir a microinfltração coronária.

The purpose of this study was to evaluate the sealing capacity of a temporary restorative material (Villevie) and a composite resin, Tetric Ceram, associated with two adhesive systems (XENO III and Single Bond). Forty single-rooted mandibular incisors were distributed into three experimental groups of 10 teeth each, and two control groups (positive and negative) of 5 teeth each. After preparation of the access cavities, the canals were instrumented with a rotary system and irrigated with distilled deionized water. The external surfaces of the teeth were rendered water-proof up to 2 mm from the external margins of the access cavities. A paper point and a coton mesh impregnated with an alcoholic 1% dimethylglyoxime were placed inside the root canals, and the endodontic access cavities were sealed according to the following groups: GA- XENO III self-etch adhesive system + composite resin; GB- Single Bond etch-and-rinse adhesive system + composite resin; and GC- temporary restorative material. The specimens were immersed in receptacles containing a 5% nickel sulfate solution and subjected to a thermal cycling regimen during 72 h. The Kruskal-Wallis and Dunn's tests were used for statistical analysis of the results at 5% signifcance level. The group restored with the temporary restorative material (GC) presented statistically signifcant less coronal leakage than the other groups (p<0.001). GA and GB were statistically similar to the positive control (p>0.05), showing the highest levels of coronal leakage. None of the tested materials was able to prevent the occurrence of coronal leakage.

Effect of deproteinization and tubular occlusion on microtensile bond strength and marginal microleakage of resin composite restorations

Dentin adhesion procedure presents limitations, especially regarding to lifetime stability of formed hybrid layer. Alternative procedures have been studied in order to improve adhesion to dentin. OBJECTIVE: The aim of this study was to evaluate in vitro the influence of deproteinization or dentin tubular occlusion, as well as the combination of both techniques, on microtensile bond strength (µTBS) and marginal microleakage of composite resin restorations. MATERIAL AND METHODS: Extracted erupted human third molars were randomly divided into 4 groups. Dentin surfaces were treated with one of the following procedures: (A) 35 percent phosphoric acid gel (PA) + adhesive system (AS); (B) PA + 10 percent NaOCl + AS; (C) PA + oxalate + AS and (D) PA + oxalate + 10 percent NaOCl + AS. Bond strength data were analyzed statistically by two-way ANOVA and Tukey's test. The microleakage scores were analyzed using Kruskal-Wallis and Mann-Whitney non-parametric tests. Significance level was set at 0.05 for all analyses. RESULTS: µTBS data presented statistically lower values for groups D and B, ranking data as A>C>B>D. The use of oxalic acid resulted in microleakage reduction along the tooth/restoration interface, being significant when used alone. On the other hand, the use of 10 percent NaOCl alone or in combination with oxalic acid, resulted in increased microleakage. CONCLUSIONS: Dentin deproteinization with 10 percent NaOCl or in combination with oxalate significantly compromised both the adhesive bond strength and the microleakage at interface. Tubular occlusion prior to adhesive system application seems to be a useful technique to reduce marginal microleakage.