Desensitizing efficacy of a universal dentin adhesive containing mesoporous bioactive glass on dentin hypersensitivity: a randomized clinical trial with a split-mouth model.

This split-mouth blinded randomized controlled study compared the efficacy of a desensitizing agent with oxalate/resin polymer and a universal adhesive containing mesoporous bioactive glass (MBG) for dentin hypersensitivity (DH) relief, using Schiff sensitivity score (SSS) and visual analog scale (VAS). Split quadrants containing teeth with DH were treated with either MS Coat ONE or Hi-Bond Universal with MBG as the functional additive. Assessments at baseline, immediately post-application, and at 1- and 2-week follow-ups used standardized stimulus protocols (air, cold, and acid). The SSS difference was the primary outcome, while the VAS difference was the secondary outcome. A mixed linear effect model performed statistical analysis. Immediate DH reduction occurred in response to air stimuli, with a significant decrease in Group HB than in Group MS (p = 0.0178). Cold stimulus reduction exhibited a gradual cumulative effect, with consistently greater reductions in Group HB than in Group MS (p ≤ 0.0377). Both groups effectively managed acidic stimuli, with no significant differences (p > 0.05). The VAS scores decreased gradually over the follow-up period (p < 0.0001). This study highlights the differential efficacy of treatments for various DH triggers and recommends specific approaches based on different stimulus types. The universal adhesive containing MBG demonstrated DH relief potential, promising efficacy identical to or superior to that of a dedicated desensitizing agent. Further research exploring the long-term efficacy and underlying mechanisms is warranted. The universal adhesive containing MBG can be adopted as an in-office desensitizing agent for DH relief. The desensitizing efficacy of universal adhesive matches or surpasses dedicated agents for air and cold stimuli.

Effect of Phytic Acid Etching and Airborne-Particle Abrasion Treatment on the Resin Bond Strength.

Objective: This study aimed to evaluate the bond strength of a universal adhesive to dentin (µTBS) using different time periods of airborne particle abrasion (APA) and two types of acid etching. Methods: Seventy-two human third molars were divided into 9 groups (n=8) according to dentin pretreatment: APA duration (0, 5, or 10s) and acid etching (no acid - NA, 37% phosphoric acid - PhoA, or 1% phytic acid - PhyA). APA was performed at a 0.5 cm distance and air pressure of 60 psi using 50 µm aluminum oxide particles. Afterwards, two coats of Single Bond Universal adhesive (3M) were applied to the dentin surface. Composite blocks were built using the incremental technique, sectioned into 1×1 mm slices and subjected to microtensile bond strength (µTBS) testing. Fracture patterns and surface topography of each dentinal pretreatment were evaluated using a Scanning electron microscope (SEM). Bond strength data were analyzed using two-way ANOVA and Bonferroni post-hoc tests. Results: The group that received pretreatment with 5s APA and PhoA presented higher µTBS values among all groups, which was statistically different when compared with the PhoA, 10APA+PhoA, and 5APA+PhyA groups. PhyA did not significantly influence the bond strength of the air-abraded groups. Finally, adhesive failure was considered the predominant failure in all groups. Conclusion: Dentin pretreated by airborne particle abrasion using aluminum oxide demonstrated an increase in bond strength when abraded for 5 seconds and conditioned with phosphoric acid in a universal adhesive system.

Effect of photodynamic therapy with two photosensitizers on the microtensile bond strength of a universal adhesive to affected dentin.

BACKGROUND: This study aimed to evaluate the impact of photodynamic therapy (PDT) using two photosensitizers, methylene blue and indocyanine green, on the microtensile bond strength of a universal adhesive to caries-affected dentin. METHODS: The occlusal enamel of 60 third molars was cut to expose the inner one-third of the dentin. Artificial caries were induced through a pH cycling process. The samples were divided into three groups: M (Methylene blue+ diode laser), I (Indocyanine green agents+ diode laser irradiation), and control. Each group was further divided into two subgroups according to the adhesive protocol (self-etch, total-etch). After restoring with Gradia composite resin, teeth were sectioned and exposed to 5000 thermal cycles. Microtensile bond strength was measured using a universal testing machine. The data were subjected to two- and one-way ANOVA and paired comparisons were performed by the Tamhane and Tukey tests. RESULTS: The study found significant effects of the photosensitizer, etching pattern, and their interactions on the microtensile bond strength of composite resin to caries-affected dentin (P < 0.001). In the self-etching mode, PDT with indocyanine green exhibited significantly higher bond strength values compared to PDT with methylene blue (P = 0.001) and the control groups (P < 0.001). However, no significant differences were observed in the total-etch mode. (P = 0.54). CONCLUSIONS: The etching mode played a more significant role in the bond strength when using the universal adhesive alongside PDT with methylene blue and indocyanine green. Employing two photosensitizers in PDT during the self-etch mode significantly increased the bond strength values.

Can a Novel Device with Pure Dry Air Increase the Shear Bond Strength of Dental Composites to Dentin? An Experimental Study.

Modern conservative dentistry is taking the lead in daily clinical practice and is relying on adhesion. Whether it is a simple composite, ceramic inlays, onlays, veneers or crowns, the common factor for a successful outcome is a good bonding of these elements to dental structures. Thus, the purpose of this study was to evaluate the bond strength of resin composite to dentin when using a new device, the DENTIPURE KM™ (KM, Beirut, Lebanon), which provides a pure air flow, free of any contaminants and without humidity, when compared to other dental equipment. One hundred and eighty extracted human molars were equally divided into three groups according to the device used, the DENTIPURE KM™ (KM, Beirut, Lebanon), the KAVO™ (ESTETICA E30/E70/E80 Vision, KAVO, Biberach, Germany), or the ADEC™ (A-dec Performer 200, Newberg, OR, USA). The shear bond strength (SBS) was evaluated after 24 h of storage in distilled water on a universal testing machine. Statistical analysis was set with a level of significance at p ≤ 0.05. The results revealed that significantly different bond strength was imparted by the DENTIPURE KM™ device and the ADEC™ dental unit (p = 0.042). In conclusion, while the DENTIPURE KM™ device shows promise in providing contaminant-free air during bonding, its impact on dentin bond strength compared to devices like the KAVO™ appears minimal. Further research is needed to fully assess its potential in enhancing dentinal adhesion procedures.

Effect of universal adhesive pretreatments on the bond strength durability of conventional and adhesive resin cements to zirconia ceramic.

PURPOSE: This study aimed to evaluate the effect of pretreatment of three different universal adhesives (Single Bond Universal [SBU], All-Bond Universal [ABU], and Prime&Bond universal [PBU]) on the bonding durability of an adhesive (Panavia F 2.0, PF) and a conventional (Duo-Link, DL) resin cements to air-abraded zirconia. MATERIALS AND METHODS: Rectangular-shaped zirconia specimens were prepared. The chemical composition and surface energy parameters of the materials were studied by Fourier transform infrared spectroscopy and contact angle measurement, respectively. To evaluate resin bonding to the zirconia, all the bonding specimens were immersed in water for 24 h and the specimens to be aged were additionally thermocycled 10000 times before the shear bond strength (SBS) test. RESULTS: The materials showed different surface energy parameters, including the degree of hydrophilicity/hydrophobicity. While the DL/CON (no pretreatment) showed the lowest SBS and a significant decrease in the value after thermocycling (P < .001), the PF/CON obtained a higher SBS value than the DL/CON (P < .001) and no decrease even after thermocycling (P = .839). When the universal adhesives were used with DL, their SBS values were higher than the CON (P < .05), but the trend was adhesive-specific. In conjunction with PF, the PF/SBU produced the highest SBS followed by the PF/ABU (P = .002), showing no significant decrease after thermocycling (P > .05). The initial SBS of the PF/PBU was similar to the PF/CON (P = .999), but the value decreased after thermocycling (P < .001). CONCLUSION: The universal adhesive pretreatment did not necessarily show a synergistic effect on the bonding performance of an adhesive resin cement, whereas the pretreatment was beneficial to bond strength and durability of a conventional resin cement.

Clinical performance of posterior restorations using a universal adhesive over moist and dry dentin: A 36-month double-blind split-mouth randomized clinical trial.

OBJECTIVES: To evaluate the influence of dentin moisture on the clinical behavior of a universal adhesive on posterior teeth after 36 months of follow-up. METHODS: Forty-five patients participated in this study. Following a split-mouth design, three operators placed 90 Class I/Class II restorations over moist dentin (MD) or dry (DD) (n = 45) with resin composite (Filtek Bulk Fill) and a universal adhesive used in the etch-and-rinse mode (Single Bond Universal). Each restoration was evaluated according to the FDI and USPHS criteria (postoperative sensitivity, fracture and retention, marginal staining, marginal adaptation, and recurrence of caries) at baseline and after 6-, 12-, and 36 months. For statistical analysis, Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used. RESULTS: No significant difference between groups was observed in each FDI criterion after 36 months of clinical evaluation (p > 0.05). The retention rates (confidence interval 95 %) were 97.37 % (86.5 - 99.5) for both MD and DD without significant difference between them (p > 0.05). Eight restorations (MD = 4; DD = 4) showed minimal marginal staining defects (p > 0.05). Two restorations were lost (MD = 1; DD = 1). Fifteen restorations (MD = 8; DD = 7) presented minor marginal discrepancies according to the FDI criteria (p > 0.05). CONCLUSION: The clinical performance of the universal adhesive when applied in etch-and-rinse mode was not influenced by dentin moisture in posterior bulk-fill composite restorations. CLINICAL SIGNIFICANCE: The level of dentin moisture appears not to influence the clinical efficacy of a universal adhesive when applied using the etch-and-rinse technique in posterior composite resin restorations.

Influence of residues from bioceramic sealer on the bond interface with universal adhesive in different application modes.

This study evaluated the effect on adhesive layer thickness, bond strength, and adhesive failure pattern of the application of universal adhesive (Scotchbond Universal) using either manual or rotary brush in dentin previously impregnated with bioceramic sealer (Sealer Plus BC) using a manual brush, at 24 h and 1 year. Eighty-eight bovine crowns were divided into four groups (n = 22) according to the intervention: (i) use of bioceramic sealer and adhesive application using manual brush, (ii) use of bioceramic sealer and adhesive application using rotary brush, (iii) use of resin sealer and adhesive application using manual brush, and (iv) use of resin sealer and adhesive application using rotary brush. Subsequently, specimens were restored with a composite resin (Filtek Z-250). Adhesive layer thickness was evaluated using confocal microscopy. Bond strength was assessed using the microtensile bond strength test, and adhesive failure pattern was evaluated under a stereomicroscope. Data were analyzed using two-way ANOVA/Tukey tests. Specimens where a rotary brush had been used exhibited lower adhesive layer thickness. Specimens treated with resin sealer and using a manual brush showed lower bond strength values and a higher occurrence of adhesive failures at 24 h and 1 year than specimens treated with bioceramic sealer and using rotary brush for adhesive application.

Touch-cure activation by marketed universal resin luting cements of their associated primer to dentin.

PURPOSE: The aim of this study was to investigate the dentin shear bond strength (SBS) and bonding interface of three recently developed "universal" resin luting cements based on different modalities. METHODS: The dentin SBS and interfacial analysis of three recently launched "universal" resin luting cements, namely, G-Cem One, RelyX Universal and Panavia SA cement universal, were studied. All bonding protocols, including the previous use of their dedicated primer or universal adhesive in touch-cure mode or light-cure mode were performed. Variolink Esthetic LC used in conjunction with Scotchbond Universal Plus was used as a control group. For each group (n = 9), 10 specimens were tested for dentin SBS and two were examined by scanning electron microscopy. SBS were analyzed by two-way ANOVA followed by Dunnett's test. RESULTS: SBS values showed that the three "universal" resin luting cements tested exhibit different adhesive behaviors. G-Cem One with its touch-cure activated primer had a greater SBS to dentin (25.5 MPa) than that of the control group (22.1 MPa). CONCLUSION: "Universal" resin luting cements have variable efficacy when used in self-curing mode. The touch-curing mode is also of concern but may show high potential for some formulations.

Effects of Etching Time and Ethanol Wet Bonding on Bond Strength and Metalloproteinase Activity in Radicular Dentin.

(1) Background: The objective of this in vitro study was to evaluate the impact of different etching times and ethanol pre-treatments on the immediate bond strength of a hydrophilic multi-mode universal adhesive (Clearfil Universal Bond Quick, Kuraray, UBQ) and on the consequent gelatinolytic activity of metalloproteinases (MMPs) on radicular dentin. (2) Methods: Sixty single-root teeth were selected and divided into four groups according to the adhesive protocol applied for fiber post cementation: (G1) 15 s H3PO4 application + UBQ; (G2) 30 s H3PO4 application + UBQ; (G3) 15 s H3PO4 application + ethanol pre-treatment + UBQ; (G4) 30 s H3PO4 + ethanol pre-treatment + UBQ. After adhesive procedures, fiber posts were luted into the post space with a dual-curing cement (DC Core, Kuraray) and light-cured for 40 s. To perform the push-out test and nanoleakage analyses for both coronal end apical areas, 1 mm slices were prepared, following a 24 h storage period in artificial saliva. Additionally, an in situ zymographic assay was conducted to explore endogenous MMP activity within the radicular layer. Results were statistically analyzed with ANOVA and Tukey post hoc tests. Statistical significance was set at p < 0.05. (3) Result: ANOVA revealed a statistically significant difference in push-out bond strength related to the pre-treatment variable but did not highlight any significance of etching time. Specimens pre-treated with ethanol wet bond application showed higher bond strength (p < 0.01). In situ zymography quantification analyses revealed that all tested groups, independently of etching time end ethanol pre-treatment, activated MMP gelatinolytic activity. A significant increase in MMP activity was detected for the 30 s etching time. However, ETOH pre-treatment significantly reduced MMP activity within the adhesive interface (p < 0.01). (4) Conclusions: The tested adhesive showed similar results regardless of the etching time protocol. The gelatinolytic activity of MMPs was observed in all the groups. Further investigations and extended follow-ups are required to validate the results of the present study in vivo.

One-Year Evaluation of High-Power Rapid Curing on Dentin Bond Strength.

This study investigated the effect of 3 s light-curing with a high-power LED curing unit on the shear bond strength of bulk-fill composites. Four bulk-fill composites were bonded to dentin with a universal adhesive (Scotchbond Universal Plus): two materials designed for rapid curing (Tetric PowerFill and Tetric PowerFlow) and two controls (Filtek One Bulk Fill Restorative and SDR Plus Bulk Fill Flowable). The 4 mm composite layer was light-cured with Bluephase PowerCure for 20 s at 1000 mW/cm2 ("20 s") or for 3 s at 3000 mW/cm2 ("3 s"). The samples were stored at 37 °C in distilled water and tested after 1, 6 and 12 months. The samples polymerised in the "3 s" mode had statistically similar or higher bond strength than the samples cured in "20 s" mode, except for the Tetric PowerFlow (1 month) and SDR+ (6 month). The flowable materials Tetric PowerFlow and SDR Plus initially showed the highest values in the "3 s" and "20 s" groups, which decreased after 12 months. The bond strength was statistically similar for all materials and curing protocols after 12 months, except for Tetric PowerFill cured with the "3 s" protocol (21.22 ± 5.0 MPa), which showed the highest value. Tetric PowerFill showed the highest long-term bond strength. While "3 s" curing resulted in equal or better shear bond strength, its use can only be recommended for a material with an AFCT agent such as Tetric PowerFill.

The Impact of Silver Diamine Fluoride Only or Simultaneously With Potassium Iodide Treatment on the Bond Durability of Resin Composite Material on Primary Teeth.

We aim to evaluate the bond strength between resin composite and primary demineralized dentin, pretreated with silver diamine fluoride (SDF) and simultaneous SDF with potassium iodide (KI) after thermal aging. In this in vitro study, human carious-free primary molars were randomly assigned into three groups and prepared by exposing the superficial dentin. The primary dentin of each molar was demineralized. The first group (the control) received saline treatment before bond application. SDF was pretreated for the second group, whereas SDF and KI were used for the third. After that, the pretreated dentin was immediately built with resin composite bonded with a universal adhesive and kept wet for 24 hours. Then, the pretreated molars were prepared into beam specimens for microtensile bond strength (µTBS), 16 for each group, and subjected to thermal aging. Lastly, they were tested using a universal testing machine, and the resulting data were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's post hoc test. It was found that the SDF-KI group had a significant difference with both the control and SDF groups (p < 0.05), while the control and SDF groups showed no significant differences (p = 0.310). The SDF-KI group had the highest mean value of 11.73 ± 4.39 megapascal (MPa). In contrast, the control group had the lowest mean value of 9.31 ± 3.41 MPa. Post hoc pairwise comparison results showed that SDF-KI pretreatment had a significantly higher strength value than the control and SDF groups. Pretreatment of demineralized primary dentin with SDF-KI does not negatively affect the immediate loading of resin composite. However, under the limitation of this study, KI application after SDF pretreatment is recommended to enhance the bond's durability of resin composite to demineralized dentin.

How the repair bonding strength of hybrid ceramic CAD/CAM blocks is influenced by the use of surface treatments and universal adhesives.

We examined how different methods of surface treatment and different universal adhesives with or without extra silane affected the repair bonding strength of hybrid ceramic CAD/CAM restorations. Cerasmart specimens (n=320) were subjected to thermocycling and assigned to the following surface pretreatment protocols: control, diamond bur (DB), hydrofluoric acid (HF), and tribochemical silica coating (TSC). Half the specimens received a coating of silane, followed by application of the universal adhesives Futurabond M+ (FMU), Tokuyama Universal Bond (TUB), Single Bond Universal (SBU), or Clearfil Universal Bond Quick (CUQ) (n=10). A hybrid composite resin was used to simulate repair; then the specimens underwent further thermocycling. Shear bond strength (SBS) was determined and modes of failure were examined. The TSC-CUQ silane (-) group showed the highest SBS values. The best repairs were obtained when the surface was treated with TSC, with the exception of the DB-TUB silane (-) group. TUB increased SBS more than the other adhesives. Additional silane decreased SBS in the HF-TUB and TSC-CUQ groups, while increasing it in the TSC-TUB and DB-FMU groups (p<0.05).

Comparisons of ammonia- and water-based silver-containing solutions on dentin bonding and enzymatic activity: 1-yr evaluation.

OBJECTIVE: To evaluate the effects of an ammonia-based and a water-based silver-containing solutions on bonding performance and matrix-metalloproteinases (MMPs) activity of a universal adhesive to dentin after 1 year of artificial aging. METHODS: Mid-coronal dentin surfaces of 60 sound human molars were exposed and the following groups were formed according to the surface pre-treatment and etching mode of the universal adhesive (Zipbond Universal, SDI) (n = 10): G1) Zipbond in the self-etch mode (ZSE); G2) Riva Star (SDI) applied before ZSE; G3) Riva Star Aqua (SDI) applied before ZSE; G4) Zipbond in the etch-and-rinse mode (ZER); G5) Riva Star applied before ZER; G6) Riva Star Aqua applied before ZER. The specimens were sectioned and subjected to microtensile bond strength (µTBS) test at baseline (T0) and after 12 months (T12) of artificial storage. Scanning electron microscope (SEM) and energy dispersive spectroscopy analysis (EDS) were also conducted. Three additional molars per group were processed for the in situ zymography analysis at T0 and T12. Data were statistically analyzed (p < 0.05). RESULTS: Dentin pre-treatments and aging decreased bonding values, regardless of the etching mode (p < 0.05). No differences in µTBS were observed between the two silver-containing solutions, both at T0 and T12. Riva Star Aqua and etching significantly increased the MMPs activity, independent of the storage period (p < 0.05). SIGNIFICANCE: Dentin surface pre-treatment with silver-containing solutions negatively affects the bonding performances of resin composite restorations placed with a universal adhesive. However, the ammonia-based product Riva Star might show better stability in the long term, due to lower activation of MMPs.

Shear bond strength of universal adhesives to human enamel and dentin.

OBJECTIVE: The composition of universal adhesives is highly diverse. The purpose of this in vitro study was to compare the shear bond strength of a composite with five different universal adhesives to human enamel and dentin. MATERIALS AND METHODS: The shear bond strength of a composite (G-aenial Universal Injectable) to human enamel and dentin was tested in selective enamel etching mode before and after thermocyclic aging (10,000 cycles) using five different universal adhesive systems (Adhese Universal VivaPen, Clearfil Universal Bond Quick, G-Premio Bond, Prime&Bond active, and Scotchbond Universal Plus). Two-bottle systems (OptiBond FL and G2-Bond Universal) were used as control. Scanning electron microscopy was conducted of the bonding interface. RESULTS: Significant differences in shear bond strength values were found among the five evaluated universal adhesives. Lowest shear bond strength values were observed for 2-hydroxyethylmethacrylate (HEMA)-free systems. Thermocyclic aging did not significantly reduce shear bond strength values indicating that the initial bond remains stable. CONCLUSIONS: The clinical use of universal adhesives Adhese Universal VivaPen, Clearfil Universal Bond Quick, and Scotchbond Universal Plus can be encouraged as they provided comparable or even better shear bond strength values than the two-bottle controls. CLINICAL SIGNIFICANCE: Universal adhesives that were developed for the same indication and approved for clinical use demonstrated variety in shear bond strength values. When applied in the selective enamel etching mode, a stable bond can be expected from adhesives containing HEMA and monomers with phosphate groups.

Influence of different curing modes on the bonding effectiveness of self-adhesive resin luting cements in combination with universal adhesives.

OBJECTIVES: This study aimed to investigate the immediate dentin bond performance and bond durability of self-adhesive resin luting cements (RLCs) in combination with universal adhesives in different curing modes. METHODS: Two self-adhesive RLCs were used with universal adhesives as primers. They were also used alone as self-adhesive RLCs. Two multiple-step RLC systems were used as comparison materials. To measure the shear bond strength (SBS) in different curing modes, 12 specimens were prepared for each group. Stainless-steel rods were bonded to bovine dentin, and the bonded specimens were assigned to the baseline group (stored for 24 h) and artificially aged group (thermal cycling [TC], 10,000 cycles). After each storage period, the SBS of the bonded specimens was measured. The Knoop hardness number (KHN) of the cured RLCs was measured with or without primer application in different curing modes at 24 h and after 10,000 TC. The representative RLC/dentin interfaces were observed using scanning electron microscopy (SEM). RESULTS: Dentin SBS was significantly influenced by the RLC system but not by the curing mode. Self-adhesive RLCs alone showed significantly lower SBS values than self-adhesive RLCs with primer regardless of the curing mode or storage period. The storage period, curing mode, and RLC system significantly influenced the KHN. SIGNIFICANCE: The use of universal adhesives as a primer may help enhance the immediate dentin bond performance and bond durability of self-adhesive RLCs.

Dentin adhesion of bulk-fill composites and universal adhesives in class I-cavities with high C-factor.

OBJECTIVES: The aim of this study was to compare the dentin adhesion of bulk-fill composites in high C-factor class I-cavities before and after thermocycling to a control group using incremental layering technique. METHODS: A standardized class I-cavity was prepared into 195 human molars, then different universal adhesives were applied either in self-etch or etch & rinse mode, and the cavity was filled according to each materials application protocol. The material combinations used were a conventional layered composite as control, the respective bulk-fill product, two other bulk-fill composites made by different manufacturers, with one of them being tested using two different polymerization times. Furthermore, one thermoviscous bulk-fill composite and one self-adhesive restorative were examined of which the latter can only be applied in self-etch mode. In each group the dentin adhesion to the cavity bottom was measured using microtensile bond strength test initially (24 h water storage) and after thermocycling. All results were statistically analyzed using STATA 17.0. RESULTS: The statistical analysis showed significant differences between the control and the experimental groups (p < 0.001). The highest mean bond strength before (14.8 ± 10.7 MPa) and after aging (14.2 ± 11.5 MPa) was measured for the etch & rinse-control group. Among the bulk-fill groups, the etch & rinse technique consistently showed higher bond strengths. Bond strength of groups with shortened polymerization did not exceed 2.1 MPa. The bond strength of the self-adhesive restoration material was low before and after thermocycling (2.7 MPa/ 0.0 MPa). Groups with low bond strength values showed a high number of pre-testing-failures. CONCLUSIONS: Bulk-fill materials used in high C-factor class I-cavities showed lower bond strength during self-etch application. The same applies for a shortened polymerization regime, which cannot be recommended for high C-factor cavities. CLINICAL SIGNIFICANCE: Today, a large variety of materials and application techniques can be used when placing an adhesive restoration. Whether new instead of established procedures should be applied in high C-factor cavities has to be critically assessed, as they are a demanding scenario for adhesive restorations.

Microtensile Bond Strength of Self-Etch Adhesives on Dentin Treated with Chlorhexidine.

AIM: To evaluate the microtensile bond strength of self-etching adhesive systems in dentin treated with 2% chlorhexidine digluconate (CHX). MATERIALS AND METHODS: The occlusal surfaces of 20 human molars were removed and divided into eight groups: 1A, Clearfil SE adhesive (SE) with self-etching technique (TS); 1B, SE with TS and previous application of CHX; 2A, Scotchbond Universal (SBU) adhesive with TS; 2B, SBU adhesive with TS and previous application of CHX; 1C, SE with total-etching technique (TT); 1D, SE with TT and previous application of CHX; 2C, SBU with TT; 2D SBU with TT and previous application of CHX. Composite resin (5mm) was applied on the hybridized surface. Samples were subjected to microtensile test and evaluated on Scanning Electron Microscope (SEM) and with energy-dispersive X-ray (EDX). RESULTS: Low values of bond strength were observed in groups 1A (39,77±11,56) and 2A (40,84±12,49) comparing with 1B (22,86±5,18) and 2B (27,02±5,58). TS group presented adhesive type remover fracture while TT groups presented cohesive at the top of hybrid layer. EDX revealed the presence of CHX crystals for TS, which was not found in the TT. CONCLUSION: The previous application of chlorhexidine on dentin decreased the bond strength of adhesive systems on self-etching technique.

Prolonged polymerization of a universal adhesive in non-carious cervical lesions: 36-month double-blind randomized clinical trial.

OBJECTIVE: To evaluate the effect of prolonged (P) polymerization time of a universal adhesive system applied in etch-and-rinse (ER) or self-etch (SE) strategies on the clinical performance of restorations in non-carious cervical lesions (NCCLs), after 36 months of clinical service. METHODS: A total of 140 restorations were randomly placed in 35 subjects according to the polymerization time groups: ER (10 s); ER-P (40 s); SE (10 s); and SE-P (40 s) at 1,200 mW/cm2. Composite resin was placed incrementally. The restorations were evaluated immediately and after 6, 12, 18, and 36 months using the FDI criteria. Data were analyzed using the Kaplan-Meier survival test for retention loss, and the Kruskal-Wallis' test for secondary outcomes (α = 0.05). RESULTS: After 36 months, 19 restorations were lost: ER 6, ER-P 2, SE 9, SE-P 2. The retention rates were 82.3% for ER; 94.1 % for ER-P; 73.5 % for SE; and 94.1 % for SE-P, with a significant difference between ER vs. ER-P and SE vs. SE-P, as well as ER vs. SE-P and ER-P vs. SE (p < 0.0001). Minor defects were observed in 18 restorations for the marginal staining criteria: ER 5, ER-P 2, SE 8, SE-P 3; and in 33 restorations for the marginal adaptation criteria: ER 11, ER-P 4, SE 12, and SE-P 6 (p > 0.05). No restorations showed recurrence of caries or postoperative sensitivity. CONCLUSIONS: A prolonged polymerization time of 40 s improves the clinical performance of the universal adhesive for both adhesive strategies evaluated, even after 36 months. CLINICAL SIGNIFICANCE: Prolonging the polymerization time of a universal adhesive from 10 to 40 s has been shown to improve its clinical performance when used in NCCLs.

Temperature rise in photopolymerized adhesively-bonded resin composite: A thermography study.

OBJECTIVES: To assess visually and quantitatively the contributions of the adhesive layer photopolymerization and the subsequent resin composite increment to spatio-temporal maps of temperature at five different cavity locations, subjected to two irradiance curing protocols: standard and ultra-high. METHODS: Caries-free molars were used to obtain 40, 2 mm thick dentin slices, randomly assigned to groups (n = 5). These slices were incorporated within 3D-printed model cavites, 4 mm deep, restored with Adhese® Universal bonding agent and 2 mm thick Tetric® Powerfill resin composite, and photocured sequentially, as follows: G1: control-empty cavity; G2: adhesive layer; G3 composite layer with no adhesive; and G4 composite layer with adhesive. The main four groups were subdivided based on two curing protocols, exposed either to standard 10 s (1.2 W/cm2) or Ultra high 3 s (3 W/cm2) irradiance modes using a Bluephase PowerCure LCU. Temperature maps were obtained, via a thermal imaging camera, and numerically analyzed at 5 locations. The data were analyzed using two-way ANOVA followed by multiple one-way ANOVA, independent t-tests and Tukey post-hoc tests (α = 0.05). Tmax, ΔT, Tint (integrated area under the curve) and time-to-reach-maximum-temperature were evaluated. RESULTS: Two-way ANOVA showed that there was no significant interaction between light-curing time and location on the measured parameters (p > 0.05), except for the time-to-reach-maximum-temperature (p < 0.05). Curing the adhesive layer alone with the 10 s protocol resulted in a significantly increased pulpal roof temperature compared to 3 s cure (p < 0.05). Independent T-tests between G3 and G4, between 3 s and 10 s, confirmed that the adhesive agent caused no significant increases (p > 0.05) on the measured parameters. The ultra-high light-curing protocol significantly increased ΔT in composite compared to 10 s curing (p < 0.05). SIGNIFICANCE: When the adhesive layer was photocured alone in a cavity, with a 2 mm thick dentin floor, the exothermal release of energy resulted in higher temperatures with a 10 s curing protocol, compared to a 3 s high irradiance. But when subsequently photocuring a 2 mm layer of composite, the resultant temperatures generated at pulpal roof location from the two curing protocols were similar and therefore there was no increased hazard to the dental pulp from the immediately prior adhesive photopolymerization, cured via the ultra-high irradiation protocol.

Evaluación de la fuerza de unión de sistemas adhesivos universales previa aplicación de clorhexidina al 2 %

Introducción: La influencia de la clorhexidina sobre la fuerza de unión de los sistemas adhesivos es aún muy controversial. Objetivo: Determinar la fuerza de unión de dos adhesivos universales en dentina previa aplicación de la clorhexidina al 2 % en tiempos de aplicación diferentes. Métodos: Se empleó treinta incisivos y se desgastó la superficie vestibular para exponer la dentina. Posteriormente, se dividió aleatoriamente en seis grupos (n = 5). Se emplearon los adhesivos Single Bond Universal (SBU) y All-Bond Universal (ABU) con/sin clorhexidina. Grupo SBU-0: Single Bond Universal; Grupo SBU-30: clorhexidina por 30 segundos + Single Bond Universal; Grupo SBU-60: clorhexidina por 60 segundos + Single Bond Universal; Grupo ABU-0: All-Bond Universal; Grupo ABU-30: clorhexidina por 30 segundos + All-Bond Universal y Grupo ABU-60: clorhexidina por 60 segundos + All-Bond Universal. La resistencia adhesiva se analizó mediante ANOVA mixto de dos factores y post hoc de Tukey (p < 0,05). Resultados: La fuerza de unión para el grupo SBU-60 aumentó significativamente respecto al grupo control (p = 0,032). Igualmente, para los grupos ABU-30 y ABU-60, la fuerza de unión aumentó significativamente respecto al grupo control (p = 0,001) y (p = 0,000), respectivamente. Conclusión: La aplicación previa de clorhexidina al 2 % durante 60 segundos aumenta la fuerza de unión de los sistemas adhesivos Single Bond Universal y All-Bond Universal.

Introduction: The influence of chlorhexidine on the bond strength of adhesive systems is still very controversial. Objective: To determine the bond strength of two universal adhesives on dentin after application of 2% chlorhexidine at different application times. Methods: Thirty incisors were used and the vestibular surface was abraded to expose the dentin. Subsequently, they were randomly divided into six groups (n = 5). Single Bond Universal (SBU) and All-Bond Universal (ABU) adhesives with/without chlorhexidine were used. Group SBU-0: Single Bond Universal; Group SBU-30: chlorhexidine for 30 seconds + Single Bond Universal; Group SBU-60: chlorhexidine for 60 seconds + Single Bond Universal; Group ABU-0: All-Bond Universal; Group ABU-30: chlorhexidine for 30 seconds + All-Bond Universal and Group ABU-60: chlorhexidine for 60 seconds + All-Bond Universal. Adhesive strength was analyzed by two-factor mixed ANOVA and Tukey's post hoc (p < 0.05). Results: The bond strength for the SBU-60 group increased significantly with respect to the control group (p = 0.032). Similarly, for the ABU-30 and ABU-60 groups, the bond strength increased significantly with respect to the control group (p = 0.001) and (p = 0.000), respectively. Conclusion: Pre-application of 2% chlorhexidine for 60 seconds increases the bond strength of Single Bond Universal and All-Bond Universal adhesive systems.