12-months Clinical Evaluation of Fiber Reinforced Bulk Fill Resin Composite versus Incremental Packing of Nanohybrid Resin Composite in Restoration of Deep Proximal Lesions of Permanent Molars: A Randomized Controlled Trial.

Objective: The present clinical trial was conducted to evaluate the clinical performance of the biomimetic, bilayered structure utilizing a fiber reinforced bulk fill resin composite with a nanohybrid capping layer, compared to incremental packing of nanohybrid resin composite, in deep proximal cavities in permanent molars. Material and methods: A total of 36 deep proximal cavities in vital molars were restored either with a bilayered structure of fiber reinforced composite resin as a dentine substitute and a capping layer of nanohybrid composite resin (n=18) or conventional, nanohybrid composite resin incrementation (n=18). The restorations were assessed over a period of 12 months using the modified USPHS criteria. The criteria evaluated were: fracture and retention, marginal integrity, marginal discoloration, anatomic form, proximal contact, surface texture, radiographic evaluation, postoperative sensitivity and secondary caries. Results: There was no statistically or clinically significant difference between fiber-reinforced resin composite and conventional incremental resin composite. There was no risk for failure regarding all the evaluated modified USPHS criteria for both materials after 12 months (RR= 1(95% CI 0.0209 to 47.8503; P =1.0000)). Conclusion: The biomimetic approach utilizing a fiber reinforced resin composite dentine substitute showed a comparable clinical performance to nanohybrid resin composite incrementation. Bulk fill fiber reinforced resin composite is an efficient alternative in restoration of deep proximal cavities in posterior teeth. Further long-term studies are necessary to confirm these results.

Influence of Low-Level Laser Modification and Adhesive Application Mode on the Bonding Efficiency of Universal Adhesives to Er:YAG Laser-Ablated Dentin.

Introduction: Erbium laser ablation as a method of tooth preparation and conditioning has shown promising results. Although previous studies have adopted various combinations of different laser parameters and several dentin adhesive systems, very few have investigated combining high-level and low-level ER:YAG lasers with Universal adhesives. This study aimed to assess the impact of using low-energy irradiation on the surface micro-topography and shear bond strength (SBS) of universal adhesive (UA) to the erbium:yttrium-aluminum-garnet (Er:YAG) laser-ablated dentin substrate, bonded in etch-and-rinse or self-etch adhesive mode. Methods: Eighty-seven extracted molars were sectioned to expose flat occlusal dentin surface; 60 teeth were divided equally into three groups according to the surface treatment; bur-cutting (B), Er:YAG high-energy laser cutting (L1 - 200 mJ, 20 Hz, 50 µs pulse), or L1 followed by low-energy laser modification (L1 /L2 - 80 mJ, 10 Hz, 50 µs pulse). Then each group was equally divided into two groups (n=10) according to the mode of application of the universal adhesive; either etch-and-rinse (ER) or self-etching (SE). The samples were subjected to thermocycling (5000 cycle between 5°C and 55°C), and SBS was tested. Two-way ANOVA and Tukey post hoc test were used to analyze the results. The remaining 27 samples were used to investigate the effect of the treatment on the topography of the treated dentin surfaces using a scanning electron microscope (SEM). Results: B/SE recorded the highest SBS (25.48 ± 2.6 MPa) followed by B/ER (23.20 ± 6.8 MPa) and L1 /L2 /SE (22.94 ± 4.1 MPa) and with no statistically significant difference between these groups (P >0.05). The lowest SBS results (P <0.05) were recorded for L1/SE (12.22 ± 3 MPa). No statistical differences were found between the SBS of L1 /L2 /ER and L1 /ER groups or between the SBS of L1 /L2 / ER and L1 /L2 /SE groups. Conclusion: A subsequent treatment of the Er:YAG laser-ablated dentin with low-energy laser modification mode (LMM) enhances the SBS of the tested UA when applied in SE mode.

Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride: An in vitro study.

BACKGROUND: Self-assembling peptide has been recently introduced to promote hard tissue regeneration for treating early non-cavitated carious lesions. This study investigates the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization combined with CPP-ACPF or fluoride. MATERIAL AND METHODS: Artificial enamel lesions were created on buccal surface of 60 specimens and were randomly assigned to six groups according to the remineralizing agent: G1-(Control, artificial saliva), G2-(Fluoride varnish), G3-(CPP-ACPF varnish), G4-(Self-assembling peptide), G5-(Self-assembling peptide+fluoride varnish), G6-(Self-assembling peptide+CPP-ACPF varnish). All products were applied according to manufacturer's instructions and specimens were stored in a daily renewed artificial saliva. Surface microhardness (SMH) and scanning electron microscope (SEM) were assessed at baseline, after demineralization, 1 week and 4 weeks storage. SMH values were analyzed using ANOVA and Tukey's post-hoc test. RESULTS: The highest statistically significant SMH values were found in G6 followed by G5, G4, G2 and G3 while the lowest values were found in G1. No statistically significant difference was found between G5 and G6. Also, no statistically significant difference was found between G2 and G3. SEM showed that G4, G5, G6 resulted in more pronounced remineralization, reversing the demineralized enamel fish scale pattern compared to G2 and G3 after 1 week and 4 week remineralization. CONCLUSIONS: Complementary effect was obtained after combining self-assembling peptide with CPP-ACPF or fluoride showing the highest remineralizing potential early after 1 week and even after 4 weeks compared to when each agent used alone. Added benefits can be obtained through combining self-assembling peptide with other remineralzing agents allowing faster and enhanced regeneration of non-cavitated caries lesions. Key words:Enamel regeneration, biomimetic remineralization, self-assembling peptide, CPP-ACPF, fluoride.

Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An in vitro study.

BACKGROUND: The biomimetic self-assembling peptide technology is a paradigm for dental hard tissue regeneration. AIM: To investigate the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization compared to casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and fluoride-based delivery systems. MATERIALS AND METHODS: Artificial enamel lesions were created on buccal surfaces of 40 extracted human molars. Specimens were randomly assigned to four groups (n = 10) according to the remineralizing agent used: G1 - control: artificial saliva, G2 - fluoride varnish, G3 - CPP-ACPF varnish, G4 - self-assembling peptide agent. All products were applied according to the manufacturer's instructions and the specimens were stored in daily renewed artificial saliva. Surface microhardness (SMH) was assessed at baseline, after demineralization, after 1 week and after 4 weeks storage. SMH values were analyzed using ANOVA and Tukey's post hoc test. RESULTS: Self-assembling peptide showed the highest statistically significant mean SMH followed by fluoride and CPP-ACPF while the lowest mean SMH was found in artificial saliva. However, no statistically significant difference was found between fluoride and CPP-ACPF. Higher statistically significant mean SMH was found after 4 weeks compared to 1 week remineralization in all groups. CONCLUSIONS: Self-assembling peptide confers the highest remineralizing efficacy compared to fluoride and CPP-ACPF, showing a promising, noninvasive regeneration potential. Furthermore, extended period of time helped attain more benefits from the remineralizing regimens applied.

The innovative applications of therapeutic nanostructures in dentistry.

Nanotechnology has paved multiple ways in preventing, reversing or restoring dental caries which is one of the major health care problems. Nanotechnology aided in processing variety of nanomaterials with innovative dental applications. Some showed antimicrobial effect helping in the preventive stage. Others have remineralizing potential intercepting early lesion progression as nanosized calcium phosphate, carbonate hydroxyapatite nanocrystals, nanoamorphous calcium phosphate and nanoparticulate bioactive glass particularly with provision of self-assembles protein that furnish essential role in biomimetic repair. The unique size of nanomaterials makes them fascinating carriers for dental products. Thus, it is recentlyclaimedthat fortifying the adhesives with nanomaterials that possess biological meritsdoes not only enhance the mechanical and physical properties of the adhesives, but also help to attain and maintain a durable adhesive joint and enhanced longevity. Accordingly, this review will focus on the current status and the future implications of nanotechnology in preventive and adhesive dentistry.

Assessment of post-contamination treatments affecting different bonding stages to dentin.

OBJECTIVES: To assess the effect of cleansing treatments following saliva and blood contamination at different bonding stages to dentin. MATERIALS AND METHODS: Labial surfaces of 168 permanent maxillary central incisors were ground flat exposing superficial dentin. Specimens were divided into: uncontaminated control (A), contamination after etching (B), contamination after adhesive application (C), contamination after adhesive polymerization (D). Groups were further subdivided according to cleansing treatments into: rinsing (B1, C1, D1), re-etching (B2, D3), sodium hypochlorite application (B3), ethyl alcohol application (C2), acetone application (C3), rinsing and rebonding (D2), re-etching and rebonding (D4). Composite microcylinders were bonded to treated substrates and shear loaded micro-shear bond strength (µSBS) until failure and treated surfaces were examined with scanning electron microscope. Debonded surfaces were classified as adhesive, cohesive or mixed failure. The data were analyzed using one-way ANOVA and Tukey's post hoc test. RESULTS: The µSBS values were ranked as follow; Group B: A > B3 > B2 > B1 > B, Group C: A > C3 > C2 > C1 > C, Group D: A > D4 > D1 = D2 ≥ D3. Debonded surfaces showed adhesive failure in Group B while cohesive failure in Groups C and D. CONCLUSIONS: Cleansing treatments differ according to bonding step; re-etching then rebonding suggested if etched substrate or polymerized adhesive were contaminated while acetone application decontaminated affected unpolymerized adhesive.

Is chlorhexidine-methacrylate as effective as chlorhexidine digluconate in preserving resin dentin interfaces?

OBJECTIVES: The aim of the current study was to evaluate the effect of 2% CHX and 2% CHX-methacrylate compared to the resin-dentin bonds created by a two-step etch-and-rinse adhesive system after 24h, 6min and 12min. METHODS: Microtensile bond strengths and interfacial nanoleakage within resin-dentin interfaces created by Adper Single Bond 2, with or without CHX or CHX-methacrylate pre-treatment for 30s on acid-etched dentin surfaces, were evaluated after 24h, 6min and 12min of storage in distilled water at 37°C. RESULTS: Twelve months of storage resulted in a significant decrease in microtensile bond strength in the control group, and significant increases in silver nanoleakage. In contrast, Single Bond 2+CHX, and to a greater extent CHX-methacrylate, significantly reduced the rate of deterioration of resin-dentin interfaces over the 12min water storage period, in terms of bond strength. CONCLUSIONS: Similar to Single Bond 2+CHX, Single Bond+CHX-methacrylates reduced the degradation of resin-bonded interfaces over a 12 month storage period. Thus it can be concluded that Single Bond 2+CHX-methacrylate may be important to improve durability of bonded interfaces and therefore, prolong the life span of adhesive restorations. CLINICAL SIGNIFICANCE: Although CHX primers have been shown to enhance the durability of etch-and-rinse adhesives, that protection is lost after 2h. The use of CHX-methacrylate should last much longer since it may copolymerize with adhesive monomers, unlike CHX.

Bonding of contemporary glass ionomer cements to different tooth substrates; microshear bond strength and scanning electron microscope study.

OBJECTIVE: This study was conducted to evaluate the microshear bond strength (µSBS) and ultramorphological characterization of glass ionomer (GI) cements; conventional GI cement (Fuji IX, CGI), resin modified GI (Fuji II LC, RMGI) and nano-ionomer (Ketac N100, NI) to enamel, dentin and cementum substrates. MATERIALS AND METHODS: Forty-five lower molars were sectioned above the cemento-enamel junction. The occlusal surfaces were ground flat to obtain enamel and dentin substrates, meanwhile the cervical one-third of the root portion were utilized to evaluate the bonding efficacy to cementum substrate. Each substrate received microcylinders from the three tested materials; which were applied according to manufacturer instructions. µSBS was assessed using a universal testing machine. The data were analyzed using two-way analysis of variance (ANOVA) and Tukey's post-hoc test. Modes of failure were examined using stereomicroscope at ×25 magnification. Interfacial analysis of the bonded specimens was carried out using environmental field emission scanning electron microscope. RESULTS: Two-way ANOVA revealed that materials, substrates and their interaction had a statistically significant effect on the mean µSBS values at P values; ˂0.0001, 0.0108 and 0.0037 respectively. RMGI showed statistically significant the highest µSBS values to all examined tooth substrates. CGI and RMGI show substrate independent bonding efficiency, meanwhile; NI showed higher µSBS values to dentin and cementum compared to enamel. CONCLUSION: Despite technological development of GI materials, mainly the nano-particles use, better results have not been achieved for both investigations, when compared to RMGI, independent of tooth substrate.

Effect of incorporation of silane in the bonding agent on the repair potential of machinable esthetic blocks.

OBJECTIVE: To investigate the repair potential of CAD/CAM (computer-aided design/computer-aided manufacturing) ceramic and composite blocks using a silane-containing bonding agent with different repair protocols. MATERIALS AND METHODS: Twenty-four discs were constructed from CAD/CAM ceramic and composite blocks. The discs were divided into six groups according to surface pre-treatment employed; GI: Diamond stone roughening (SR), GII: SR+ silanization (SR+S), GIII: Hydrofluoric acid etching (HF), GIV: HF+ silanization (HF+S), GV: Silica coating (SC), GVI: SC+ silanization (SC+S). Silane-containing bonding agent (Single Bond Universal adhesive, 3M ESPE) was applied to the pre-treated discs. Prior to light curing, irises were cut from tygon tubes (internal diameter = 0.8 mm and height = 0.5 mm) and mounted on each treated surface. Nanofilled resin composite (Filtek Z350(XT), 3M ESPE) was packed into the cylinder lumen and light-cured (n = 10). The specimens were subjected to microshear bond strength testing (µ-SBS) using universal testing machine. Failure modes of the fractured specimens were analyzed using field emission scanning electron microscope (FESEM). Eight representative discs were prepared to analyze the effect of surface treatments on surface topography using FESEM. µ-SBS results were analyzed using ANOVA and Tukeys post-hoc test. RESULTS: Three-way ANOVA results showed that the materials, surface pre-treatment protocols, and silanization step had a statistically significant effect on the mean µ-SBS values at P ≤ 0.001. For ceramic discs, the groups were ranked; GIV (24.45 ± 7.35)> GVI ((20.18 ± 2.84)> GV (7.14 ± 14)= GII (6.72 ± 1.91)=GI (6.34 ± 2.21)=GIII (5.72 ± 2.18). For composite discs, groups were ranked; GI (24.98 ± 7.69)=GVI (24.84 ± 7.00) >GII (15.85 ± 5.29) =GV (14.65 ± 4.5)= GIV (14.24 ± 2.95)≥ GIII ((9.37 ± 2.78). CONCLUSION: The additional silanization step cannot be omitted if the repair protocol comprises of either hydrofluoric acid etching or silica coating for both CAD/CAM esthetic restorative materials. However, this step can be suppressed by using silane-containing adhesive with diamond stone roughened repair protocol.

The effect of cavity disinfectants on the micro-shear bond strength of dentin adhesives.

OBJECTIVES: This study was carried out to examine the effect of application of four different disinfecting agents on the micro-shear bond strength (µ-SBS) of an etch-and-rinse and self-etch adhesive systems. MATERIALS AND METHODS: One hundred flat dentin surfaces of human molars were produced by wet grinding the buccal surfaces. Specimens were randomly assigned to five groups according to the disinfectant used: Group I: Control (no disinfectant); Group II: 5.25% sodium hypochlorite based; Group III: 2% chlorhexidine based (Consepsis), Group IV: 0.1% benzalkoniumchloride based (Tubulicid red) and Group V: 3% doxycycline based (Biopure, MTAD). Specimens were bonded using either Adper Single Bond 2 or Clearfil S(3) Bond, which were employed according to the manufacturer's instructions. Resin composite microcylinders were bonded using Tygon(®) tubes for µ-SBS testing. The modes of failure were noted after visual examination using a binocular stereomicroscope at ×25 magnification. Failures were classified as adhesive, or mixed. µ-SBS results were analyzed using two-way ANOVA followed by Tukey's post-hoc test. RESULTS: Dentin disinfectants tested significantly negated the bonding of Adper Single bond 2 and the groups were ranked; Group I > Group V = Group IV > Group II = Group III, meanwhile they enhanced significantly the µ-SBS values upon using Clearfil S(3) Bond and were ranked; Group II > Group III = Group IV = Group V > Group I. Most failures were adhesive with the Adper single bond adhesive system. Mixed modes of failure were evident with Clearfil S(3) bond. CONCLUSIONS: The disinfectants tested should not be used with Adper Single Bond 2 when applied before the etching step, However they could be used safely prior to bonding with Clearfil S(3) Bond.

Remineralizing efficacy of different calcium-phosphate and fluoride based delivery vehicles on artificial caries like enamel lesions.

OBJECTIVES: To assess enamel remineralization of different calcium-phosphate and fluoride delivery systems. METHODS: Artificial caries lesions were created on 115 extracted human molars. Specimens were assigned according to remineralizing agent into five groups: G1: Control (artificial saliva), G2: Clinpro™ white varnish, G3: Relief, G4: Tooth Mousse Plus, G5: Vanish™XT. Surface micro-hardness (SMH), surface roughness (Ra) and surface topography by scanning electron microscope (SEM) were evaluated at baseline, after demineralization, after 2 and 4 weeks remineralization and after acid challenge. RESULTS: Demineralized enamel showed the lowest SMH. By 2 weeks remineralization, SMH were ranked as follows: G2 (282.14±6.82)>G3 (269.37±7.25)>G5 (263.00±6.49)=G4 (251.83±8.26)>G1 (226.5±9.34). However, 4 weeks remineralization showed the following: G2 (304.09±6.65)>G3 (293.1±5.24)=G4 (285±7.29)>G5 (272.43±4.89)>G1 (233.33±9.12). By exposure to acid challenge, groups presented order of: G2 (279.71±5.99)=G3 (275.51±5.59)>G4 (262.29±6.65)>G5 (245.43±6.43)>G1 (190.27±8). Surface roughness showed the following mattress after 2 weeks remineralization: G1 (0.2488±0.0016)=G2 (0.2487±0.0007)=G3 (0.2476±0.0006)>G4 (0.2442±0.0004)>G5 (0.2396±0.0009). After 4 weeks remineralization: G1 (0.2469±0.0017)>G4 (0.244±0.0004)>G5 (0.2413±0.0008)=G3 (0.2405±0.0007)=G2 (0.2399±0.0006). After acid challenge; G1 (0.2582±0.0027)>G5 (0.2556±0.0007)>G4 (0.2484±0.0009)>G3 (0.2463±0.0007)>G2 (0.2443±0.0004). SEM revealed mineralized coating on the surfaces which resists dissolution by acid challenge at variable degrees according to remineralization regimen applied. CONCLUSIONS: Remineralizing agents containing different calcium-phosphate formulas and fluoride have increased remineralization potential compared to artificial saliva. Clinpro™ varnish presented the highest remineralization tendency with greatest resistance for acid challenge. CLINICAL SIGNIFICANCE: This in vitro study imitated the application of different calcium phosphorous and fluoride based delivery vehicles to enamel tooth surfaces in the mouth. The new therapeutic techniques based on different calcium phosphate formulas containing fluoride provide a new avenue for remineralization of non-cavitated and early carious lesions.

Effect of EDTA and phosphoric Acid pretreatment on the bonding effectiveness of self-etch adhesives to ground enamel.

OBJECTIVES: This in vitro study determined the effect of enamel pretreatment with phosphoric acid and ethylenediaminetetraacetic acid (EDTA) on the bond strength of strong, intermediary strong, and mild self-etching adhesive systems. METHODS: Ninety sound human premolars were used. Resin composite cylinders were bonded to flat ground enamel surfaces using three self-etching adhesive systems: strong Adper Prompt L-Pop (pH=0.9-1.0), intermediary strong AdheSE (pH=1.6-1.7), and mild Frog (pH=2). Adhesive systems were applied either according to manufacturer instructions (control) or after pretreatment with either phosphoric acid or EDTA (n=10). After 24 hours, shear bond strength was tested using a universal testing machine at a cross-head speed of 0.5 mm/minute. Ultra-morphological characterization of the surface topography and resin/enamel interfaces as well as representative fractured enamel specimens were examined using scanning electron microscopy (SEM). RESULTS: Neither surface pretreatment statistically increased the mean shear bond strength values of either the strong or the intermediary strong self-etching adhesive systems. However, phosphoric acid pretreatment significantly increased the mean shear bond strength values of the mild self-etching adhesive system. SEM examination of enamel surface topography showed that phosphoric acid pretreatment deepened the same etching pattern of the strong and intermediary strong adhesive systems but converted the irregular etching pattern of the mild self-etching adhesive system to a regular etching pattern. SEM examination of the resin/enamel interface revealed that deepening of the etching pattern was consistent with increase in the length of resin tags. EDTA pretreatment had a negligible effect on ultra-morphological features. CONCLUSIONS: Use of phosphoric acid pretreatment can be beneficial with mild self-etching adhesive systems for bonding to enamel.

Bonding strategies to pulp chamber dentin treated with different endodontic irrigants: microshear bond strength testing and SEM analysis.

PURPOSE: To evaluate the effect of 6 irrigant regimens on the microshear bond strength of different adhesives to pulp chamber dentin and to determine their interfacial morphology by SEM. MATERIALS AND METHODS: Forty-three human molars were split into halves and ground to provide flat pulp chamber dentin. Eighty-five halves were used. The specimens were assigned to 6 groups according to the irrigant regimen used. Group I (n=10) was irrigated with distilled water (control). The remaining 5 groups (n=15 each) were irrigated with 5.25% NaOCl followed by either 5.25% NaOCl, 17% EDTA, benzalkonium chloride (Tubilcid Plus) or MTAD (Biopure), either rinsed or not. Irrigated specimens were bonded using Clearfil S3 Bond or Adper Single Bond 2, which was employed with or without etching. Resin composite cylinders were bonded using tygon tubes for microshear bond strength testing. Data were analyzed using two-way ANOVA followed by Tukey's post-hoc test. Representative specimens of each group were prepared from 17 further molars for interfacial SEM examination. RESULTS: The different irrigant regimens used did not significantly alter the microshear bond strength values using either of the bonding systems, except NaOCl, which significantly reduced the microshear bond strength values with Adper Single Bond 2. Bonding irrigated specimens directly using the Adper Single Bond 2 without prior etching provided significantly reduced values. CONCLUSION: The irrigant regimens examined could be used safely prior to bonding except for the NaOCl, which should be negated if it is to be followed by Adper Single Bond 2, and the etching step cannot be omitted if an etch-and-rinse adhesive system is the adhesive of choice.

Effect of the number of applications of acetone-based adhesives on microtensile bond strength and the hybrid layer.

PURPOSE: The current study was carried out to evaluate the effect of doubling the adhesive layers of three acetone-based adhesives on the microtensile bond strength and ultra morphological characterization of the resin dentin interface using SEM. MATERIALS AND METHODS: A total of 27 caries-free human molars were used. Superficial flat dentin surfaces were obtained by wet grinding the buccal surfaces. Three adhesive systems Prime & Bond NT (G1), XENO IV (GII) and G BOND (GIII) were used according to three different protocols: (A) according to the manufacturer's instructions, (B) doubling the adhesive layers and light curing and (C): doubling the adhesive layers with intermediate curing between each layer. Resin composite buildups were made using TPH Spectrum resin composite on the bonded surfaces in 1 mm light cured increments for 40 seconds each. The bonded teeth were sectioned to obtain sticks for microtensile testing. The testing was conducted using a universal testing machine at a crosshead speed of 1 mm/minute. The microtensile bond strength means and standard deviations were calculated and the data were statistically analyzed using Two-way Analysis of Variance (ANOVA) and Tukey's post-hoc tests (p < or = 0.05). Ultra morphological characterization of the resin-dentin interface and representative fractured dentin specimens were examined using SEM. RESULTS: When applied according to the manufacturer's instructions, Prime & Bond NT (total etch adhesive) showed significantly high microtensile bond strength with a mean value +/- SD of 35 +/- 12.7 MPa followed by XENO IV (21.2 +/- 9.4 MPa), while G BOND presented a significantly lower mean value (10.9 +/- 2.9 MPa). Doubling the adhesive layers significantly reduced the mean strength of the total etch adhesive system; in contrast, it significantly increased the bond strength of both self-etch adhesives. The relatively thicker adhesive layer was seen with the total-etch adhesive when the application was doubled, while the hybrid layer appeared thicker with self-etch adhesives. CONCLUSIONS: Doubling the adhesive layer applications significantly improved the bond strength of the two self-etch adhesives (XENO IV and G BOND); however, it had a negative effect on the bond strength of the total-etch adhesive (Prime & Bond NT).