Dental Adhesives-Surface Modifications of Dentin Structure for Stable Bonding.

The latest advancements in dentin bonding have focused on strategies to impair degradation mechanisms in order to extend the longevity of bonded interfaces. Protease inhibitors can reduce collagen degradation within the hybrid layer (HL). Collagen cross-linkers allow better adhesive infiltration and also inhibit proteases activity. Particles added to adhesive can promote mineral precipitation within the HL, reducing nanoleakage and micropermeability, besides possible antimicrobial and enzymatic inhibition effects. Most of these approaches are still experimental, and aspects of the adhesive under the clinician's control are still determinant for the long-term stability of adhesive restorations.

Is dentin biomodification with collagen cross-linking agents effective for improving dentin adhesion? A systematic review and meta-analysis.

Objectives: The aim of this investigation was to evaluate the effectiveness of collagen cross-linking agents (CCLAs) used in combination with the adhesive technique in restorative procedures. Materials and Methods: In this systematic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An electronic search was performed using PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and DOSS, up to October 2020. The gray literature was also researched. Only randomized clinical trials were selected. Results: The selection process yielded 3 studies from the 838 retrieved. The addition of CCLAs in the retention of restorations increased the number of events. The postoperative sensitivity scores and marginal adaptation scores showed no significant difference between the CCLA and control groups, and the marginal pigmentation scores showed a significant increase in the CCLA group. There were no caries events in any group throughout the evaluation period. Conclusions: This systematic review showed that there is no clinical efficacy to justify the use of CCLAs in the protocols performed.

Influence of two carbodiimides on the bond strength of universal adhesives to dentin.

The pretreatment of dentin with cross-linking agents during bonding procedures has been proposed to improve the mechanical properties of the collagen in the hybrid layer and reduce the biodegradation of the adhesive interface. The aim of this study was to evaluate the influence of pretreatment with two carbodiimides on the dentin bond strength of universal adhesives, after thermocycling. Three universal adhesives in the self-etching mode were used (Single Bond Universal-SBU, Clearfil Universal-CLU and Ambar Universal-ABU). A self-etching adhesive system (Clearfil SE Bond-CSB) was used as control. Two carbodiimides, 1-ethyl-3-(3'-dimethylaminopropyl)-carbodiimide (EDC) and N,N'-dicyclohexylcarbodiimide (DCC), were applied for 1 min. The excess solution was removed with absorbent paper and the universal adhesives were applied. The specimens were stored for 24 h in distilled water at 37 °C or 10,000 thermal cycles (5-55 °C, 30 s) and then were prepared for microtensile bond strength test (n = 4 teeth, average of 21 sticks per group). Data were analyzed using three-way ANOVA and Tukey's (α = 5%). After 24 h, SBU and CSB had statistically similar bond strength values for the control groups (22.07 ± 9.03 and 19.82 ± 7.28 MPa), with EDC (30.21 ± 11.30 and 19.67 ± 5.36 MPa) and DCC (30.12 ± 13.43 and 19.82 ± 7.28 MPa) pretreatments (p > 0.05). The use of EDC (32.57 ± 9.60 MPa) and DCC (24.71 ± 9.87 MPa) showed statistically higher bond strength for CLU than for the control group (14.62 ± 6.16 MPa; p < 0.05). After thermocycling, the SBU, CLU, and CSB groups showed statistically similar bond strengths with the use of EDC (27.08 ± 8.44; 18.74 ± 5.41; and 24.55 ± 10.43 MPa) and without the use of cross linkers (20.06 ± 7.99; 22.55 ± 9.04; and 26.54 ± 10.13 MPa; p > 0.05). Groups tested after 24 h in distilled water presented higher bond strength than those submitted to thermocycling. It can be concluded that the use of cross linkers influenced the immediate bond strength of the universal adhesives, and this was dependent on the combination of the adhesive system and type of carbodiimide. The use of EDC increased the immediate bond strength of CLU. DCC increased the bond strength of ABU at 24 h, but the values were lower than those of the control group after aging for three out of the four adhesives.

Collagen cross-linking agents + dimethyl sulfoxide improving the adhesive properties of erosive lesion dentin

Abstract To investigate the effect of the dimethyl sulfoxide combined with cross-linking agents on microtensile bond strength, silver nitrate penetration and in situ degree of conversion analysis of adhesives to the erosive dentin treatment with Cola-based soft drink. One hundred and sixty-six molars were assigned to 20 groups: (1) Treatment: Sound dentin; Erosive dentin; Erosive dentin treated with primer of dimethyl sulfoxide; Erosive dentin treated with DMSO primer containing proanthocyanidin and rivoflavin; (2) Adhesive systems: iBond Universal and Scotchbond Universal; and (3) adhesive strategy: etch-and-rinse or self-etch strategy. After restoration, specimens were sectioned into sticks to be tested. The data from microtensile bond strength (MPa), silver nitrate penetration (%) and in situ degree of conversion (%) were analyzed by (three- and two-factor ANOVA; Tukey's test α=5%). The application of dimethyl sulfoxide combined of not with cross-linkers improved all properties evaluated when compared to only erosive dentin treatment with Cola-based soft drink. However, only when dimethyl sulfoxide was combined to cross-linkers, the values of the microtensile bond strength, silver nitrate penetration and in situ degree of conversion in erosive dentin treatment with Cola-based soft drink was similar to sound dentin, for both adhesives and adhesive strategies. The application of dimethyl sulfoxide combined with the collagen cross-linking agent contributed to increasing the bond strength and degree of conversion in erosive lesion dentin, at the same time that significantly reduction of nanoleakage in this substrate.

Resumo Este estudo investigou o efeito do dimetil sulfóxido combinado a agentes de reticulação de colágeno na resistência de união à microtração, infiltração de nitrato de prata e análise do grau de conversão por Micro-Raman de sistemas adesivos universais para a dentina erosionada por refrigerante a base de Cola. Cento e sessenta molares foram divididos em 20 grupos: (1) Tratamento: Dentina sadia; Dentina erosionada; Dentina erosionada tratada com primer de dimetil sulfóxido; Dentina erosionada tratada com primer contendo 6,5% de proantocianidina e; Dentina erosionada tratada com primer contendo 0,1% de rivoflavina; (2) Sistemas adesivos: iBond Universal e Scotchbond Universal; e (3) estratégia adesiva: estratégia condicionamento e lavagem ou autocondicionate. Após a restauração, os espécimes foram seccionados em palitos e testados. Os dados dos três testes foram analisados estatisticamente (ANOVA de 2 e 3 fatores e teste de Tukey; α = 5%). A aplicação de dimetil sulfóxido combinado ou não agentes de reticulação de colágeno melhorou todas as propriedades avaliadas quando comparado a dentina erosionada. Entretanto, apenas quando o dimetil sulfóxido foi combinado com agentes de reticulação de colágeno, os valores de adesão a dentina, infiltração de nitrato de prata e grau de conversão em dentina erosionada foi semelhante a dentina sadia, para os dois adesivos e estratégias adesivas. A aplicação de dimetil sulfóxido combinado com agentes de reticulação de colágeno contribuiu para aumentar a resistência de união e o grau de conversão dentro da camada híbrida na dentina erodida, ao mesmo tempo que reduziu significativamente a nanoinfiltração neste substrato.

Influencia de los inhibidores de las metaloproteinasas, agentes reticuladores y remineralización biomimética en la longevidad de la unión adhesiva: parte 3: agentes reticuladores / Metalloproteinase inhibitors, cross-linking agents and biomimetic remineralization influence in the adhesive bond longevity: part 3: cross-linking agents

Las propiedades mecánicas del colágeno se deben a agentes intrínsecos de entrecruzamiento [Al-Ammar et al, 2009]. El aumento en el número de enlaces de la molécula de colágeno mejora su estabilidad e integridad, colaborando con el mantenimiento de propiedades adecuadas de la unión adhesiva a lo largo del tiempo [Bedran-Russo et al, 2009; Breschi et al, 2008]. Existen varios enfoques que permiten modificar el sustrato dentinario mediante la promoción de la formación de enlaces exógenos, con el objetivo de aumentar la resistencia de la red de colágeno [Bedran-Russo et al, 2007; Bedran-Russo et al, 2008]. Estos enfoques se dividen en métodos mecánicos [Bedran-Russo et al, 2007; Bedran-Russo et al, 2008; Castellan et al, 2010; Han et al, 2003] y método fotoxidativo [Cova et al, 2011]. Dentro de los primeros, los agentes reticuladores de origen natural son capaces de estabilizar el colágeno de la dentina [Bedran-Russo et al, 2007] sin afectar la resistencia de la unión adhesiva y sin generar toxicidad. Sin embargo, el uso de estos agentes por sí solo no permite asegurar la estabilidad de la unión adhesiva a lo largo del tiempo; porque como es sabido, la longevidad de dicha unión no depende únicamente de las características del sustrato, sino también de propiedades inherentes al sistema adhesivo por un lado, y de la presencia de humedad por otro.

The mechanical properties of collagen are due to intrinsic crosslinking agents [Al-Ammar et al, 2009]. The increase in the number of links of the collagen molecule improves its stability and integrity, collaborating with the maintenance of adequate adhesive bonding properties over time [Bedran-Russo et al, 2009; Breschi et al, 2008]. There are several approaches for modifying the dentin substrate by promoting the formation of exogenous links, in order to increase the strength of the collagen network [Bedran-Russo et al, 2007; Bedran-Russo et al, 2008]. These approaches are divided into mechanical methods [Bedran-Russo et al, 2007; Bedran-Russo et al, 2008; Castellan et al, 2010; Han et al, 2003] and foto oxidating method [Cova et al, 2011]. Within the first, the naturally occurring crosslinking agents are capable of stabilizing the dentin collagen [Bedran-Russo et al, 2007] without affecting the strength of the adhesive bond and without generating any toxicity. However, the use of these agents alone does not ensure the stability of the adhesive bond over time; because as it is known, the longevity of such binding does not only depend on the substrate’s characteristics, but also on the adhesive system’s properties on one side, and the presence of moisture on the other

Impact and flexural strength, and fracture morphology of acrylic resins with impact modifiers.

OBJECTIVES: This study evaluated the impact and flexural strength and analyzed the fracture behavior of acrylic resins. METHODS: Eighteen rectangular specimens were fabricated of Lucitone 550, QC 20 (both unreinforced acrylic resins), Impact 1500 (extra strength impact), Impact 2000 (high impact) according to the manufacturers' instructions. The impact strength was evaluated in notched specimens (50x6x4mm) and flexural strength in unotched (64x10x3.3mm), using three-point bending test, as well as, stress at yield, Young modulus and displacement at yield. Fragments from mechanical tests were observed by SEM. Data from impact strength, stress at yield and displacement at yield were analyzed by 1-way ANOVA and Tukey test (alpha=0.05). Young modulus values were analyzed by One-way ANOVA and Dunnett T3 multiple comparisons test (alpha=0.05). RESULTS: Mean values of impact strength and stress at yield values were higher (P<.005) for Impact 2000 while Young modulus was higher (P<.05) for Lucitone 550; Impact 1500 and Impact 2000 showed significant values (P<.05) in the displacement at yield. Impact fractures of the all acrylic resins were brittle. Bending fractures of Lucitone 550 and Impact 2000 were brittle, QC 20 fractures were ductile and Impact 1500 showed brittle (75%) and ductile (25%) fractures. CONCLUSION: Within the limitations of this study, the Impact 2000 showed improved mechanical properties with high capacity of stress absorption and energy dissipation before the fracture.