Two-year Clinical Performance of Self-etching Adhesive Systems in Composite Restorations of Anterior Teeth

Objective: The aim of this study was to evaluate the two-year clinical performance of Class III, IV, and V composite restorations using a two-step etch-and-rinse adhesive system (2-ERA) and three one-step self-etching adhesive systems (1-SEAs).Material and Methods: Two hundred Class III, IV, and V composite restorations were placed into 50 patients. Each patient received four composite restorations (Amaris, Voco), and these restorations were bonded with one of three 1-SEAs (Futurabond M, Voco; Clearfil S3 Bond, Kuraray; and Optibond All-in-One, Kerr) or one 2-ERA (Adper Single Bond 2/3M ESPE). The four adhesive systems were evaluated at baseline and after 24 months using the following criteria: restoration retention, marginal integrity, marginal discoloration, caries occurrence, postoperative sensitivity and preservation of tooth vitality. After two years, 162 restorations were evaluated in 41 patients. Data were analyzed using the chi(2) test (p<0.05).Results: There were no statistically significant differences between the 2-ERA and the 1-SEAs regarding the evaluated parameters (p>0.05).Conclusion: The 1-SEAs showed good clinical performance at the end of 24 months.

Performance of a New One-step Multi-mode Adhesive on Etched vs Non-etched Enamel on Bond Strength and Interfacial Morphology

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of partially demineralized dentin beneath the hybrid layer on dentin-adhesive interface micromechanics

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Multi-step adhesive cementation versus one-step adhesive cementation: push-out bond strength between fiber post and root dentin before and after mechanical cycling

This study evaluated the effects of mechanical cycling on resin push-out bond strength to root dentin, using two strategies for fiber post cementation. Forty bovine roots were embedded in acrylic resin after root canal preparation using a custom drill of the fiber post system. The fiber posts were cemented into root canals using two different strategies (N = 20): a conventional adhesive approach using a three-step etch-and-rinse adhesive system combined with a conventional resin cement (ScotchBond Multi Purpose Plus + RelyX ARC ), or a simplified adhesive approach using a self-adhesive resin cement (RelyX U100). The core was built up with composite resin and half of the specimens from each cementation strategy were submitted to mechanical cycling (45 degree angle; 37 degrees C; 88 N; 4 Hz; 700,000 cycles). Each specimen was cross-sectioned and the disk specimens were pushed-out. The means from every group (n = 10) were statistically analyzed using a two-way ANOVA and a Tukey test (P = 0.05). The cementation strategy affected the push-out results (P < 0.001), while mechanical cycling did not (P = 0.3716). The simplified approach (a self-adhesive resin cement) had better bond performance despite the conditioning. The self-adhesive resin cement appears to be a good option for post cementation. Further trials are needed to confirm these results.

Effect of Resin Cement System and Root Region on the Push-out Bond Strength of a Translucent Fiber Post

Objectives: This study evaluated the bond strength of luting systems for bonding glass fiber posts to root canal dentin. The hypothesis tested was that there are no differences in bond strength of glass fiber posts luted with different cement systems.Methods: Forty bovine incisors were randomly assigned to five different resin cement groups (n=8). After endodontic treatment and crown removal, translucent glass fiber posts were bonded into the root canal using five different luting protocols (self-cured cement and etch-and-rinse adhesive system; dual-cured cement and etch-and-rinse adhesive system; self-cured cement and self-etch adhesive system; dual-cured cement and self-etch adhesive system; and dual-cured self-adhesive cement). Push-out bond strength was evaluated at three different radicular levels: cervical, middle, and apical. The interface between resinous cement and the post was observed using a stereoscopic microscope.Results: Analysis of variance showed a statistically significant difference among the cements (p<0.05) and the root canal thirds (p<0.05). The self-adhesive resinous cement had lower values of retention.Conclusions: The resin cements used with etch-and-rinse and self-etch adhesive systems seem to be adequate for glass fiber post cementation.

Bond Strength of Two Resin Cements on Dentin Using Different Cementation Strategies

Purpose:This study evaluated the microtensile bond strength of two resin cements to dentin either with their corresponding self-etching adhesives or employing the three-step etch-and-rinse technique. The null hypothesis was that the etch-and-rinse adhesive system would generate higher bond strengths than the self-etching adhesives.Materials and Methods:Thirty-two human molars were randomly divided into four groups (N = 32, n = 8/per group): G1) ED Primer self-etching adhesive + Panavia F; G2) All-Bond 2 etch-and-rinse adhesive + Panavia F; G3) Multilink primer A/B self-etching adhesive + Multilink resin cement; G4) All-Bond 2 + Multilink. After cementation of composite resin blocks (5 x 5 x 4 mm), the specimens were stored in water (37 degrees C, 24 hours), and sectioned to obtain beams (+/- 1 mm2 of adhesive area) to be submitted to microtensile test. The data were analyzed using 2-way analysis of variance and Tukey's test (alpha = 0.05).Results:Although the cement type did not significantly affect the results (p = 0.35), a significant effect of the adhesive system (p = 0.0001) was found on the bond strength results. Interaction terms were not significant (p = 0.88751). The etch-and-rinse adhesive provided significantly higher bond strength values (MPa) with both resin cements (G2: 34.4 +/- 10.6; G4: 33.0 +/- 8.9) compared to the self-etching adhesive systems (G1: 19.8 +/- 6.6; G3: 17.8 +/- 7.2) (p < 0.0001). Pretest failures were more frequent in the groups where self-etching systems were used.Conclusion:Although the cement type did not affect the results, there was a significant effect of changing the bonding strategy. The use of the three-step etch-and-rinse adhesive resulted in significantly higher bond strength for both resin cements on dentin.CLINICAL SIGNIFICANCEDual polymerized resin cements tested could deliver higher bond strength to dentin in combination with etch-and-rinse adhesive systems as opposed to their use in combination with self-etching adhesives.(J Esthet Restor Dent 22:262-269, 2010).

Effect of Biomimetic Remineralization on the Dynamic Nanomechanical Properties of Dentin Hybrid Layers

The mineral and organic phases of mineralized dentin contribute co-operatively to its strength and toughness. This study tested the null hypothesis that there is no difference in nano-dynamic mechanical behavior (complex modulus-E*; loss modulus-E ''; storage modulus-E'; in GPa) of dentin hybrid layers (baseline: E*, 3.86 +/- 0.24; E '', 0.23 +/- 0.05; E', 3.85 +/- 0.24) created by an etch-and-rinse adhesive in the presence or absence of biomimetic remineralization after in vitro aging. Using scanning probe microscopy and nano-dynamic mechanical analysis, we demonstrated that biomimetic remineralization restored the nano-dynamic mechanical behavior of heavily remineralized, resin-sparse regions of dentin hybrid layers (E*, 19.73 +/- 3.85; E '', 8.75 +/- 3.97; E', 16.02 +/- 2.58) to those of the mineralized dentin base (E*, 19.20 +/- 2.42; E '', 6.57 +/- 1.96; E', 17.39 +/- 2.0) [p > 0.05]. Conversely, those resin-sparse, water-rich regions degraded in the absence of biomimetic remineralization, with significant decline [p < 0.05] in their complex and storage moduli (E*, 0.83 +/- 0.35; E '', 0.88 +/- 0.24; E', 0.62 +/- 0.32). Intrafibrillar apatite deposition preserves the integrity of resin-sparse regions of hybrid layers by restoring their nanomechanical properties to those exhibited by mineralized dentin.

One-year clinical performance of self-etch adhesives in posterior restorations

Purpose: To evaluate the 1-year clinical performance of three self-etching adhesives (Adper Prompt L-Pop, Clearfil S-3 Bond, iBond) in posterior composite restorations using one etch&rinse adhesive (One-Step Plus) as control. Methods: Upon approval by the Institutional Review Board, 121 restorations were inserted in 38 subjects. The adhesives were applied as per manufacturers' instructions. Preparations were restored with a nanofilled resin composite (Filtek Supreme) and evaluated at baseline, 6 months, and 1 year. Statistical analyses included the Chi-square distribution with the McNemar non-parametric test (P< 0.05). Results: At 1 year, 111 restorations in 35 subjects were evaluated using the USPHS modified criteria. No significant changes were observed for the etch&rinse adhesive One-Step Plus. At 1 year the number of Alfa ratings decreased significantly for Clearfil S-3 Bond and for iBond in the categories color match, marginal staining, and marginal adaptation. For Adper Prompt L-Pop, marginal adaptation at 1 year was significantly worse than at baseline. Postoperative sensitivity to air improved significantly for Adper Prompt L-Pop, Clearfil S-3 Bond, and iBond. When the evaluation criteria were paired at 1 year, iBond resulted in a significantly lower number of Alfa ratings than any of the other adhesives for color match, marginal staining, and marginal adaptation. One-Step Plus resulted in a greater number of Alfa ratings for marginal adaptation than either Adper Prompt L-Pop or Clearfil S-3 Bond. Marginal adaptation was significantly better for Clearfil S-3 Bond than for Adper Prompt L-Pop. The post-operative sensitivity measured at 1 year for Adper Prompt L-Pop was statistically better than that for One-Step Plus.

An In Vitro Comparison of Different Cementation Strategies on the Pull-out Strength of a Glass Fiber Post

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

In vivo preservation of the hybrid layer by chlorhexidine

Host-derived proteases have been reported to degrade the collagen matrix of incompletely-resin-infiltrated dentin. This study tested the hypothesis that interfacial degradation of resin-dentin bonds may be prevented or delayed by the application of chlorhexidine (CHX), a matrix metalloproteinase inhibitor, to dentin after phosphoric acid-etching. Contralateral pairs of resin-bonded Class I restorations in non-carious third molars were kept under intra-oral function for 14 months. Preservation of resin-dentin bonds was assessed by microtensile bond strength tests and TEM examination. In vivo bond strength remained stable in the CHX-treated specimens, while bond strength decreased significantly in control teeth. Resin-infiltrated dentin in CHX-treated specimens exhibited normal structural integrity of the collagen network. Conversely, progressive disintegration of the fibrillar network was identified in control specimens. Auto-degradation of collagen matrices can occur in resin-infiltrated dentin, but may be prevented by the application of a synthetic protease inhibitor, such as chlorhexidine.

Cementation of fiber post: influence of the cement insertion techniques on the bond strength of the fiber post-root dentin and the quality of the cement layer.

The aim of this study was to assess the influence of resin cement insertion methods on the bond strength of a fiber post to root dentin and quality of the cement layer. Forty bovine single-roots (length =16 mm) were randomly allocated into four groups, according to the cement insertion methods (N.=10): Gr1- Lentulo drill #40, Gr2- Centrix syringe, Gr3- Explorer #5, Gr4- fiber post. The root canals were prepared at 12 mm, using preparation bur # 3 of a cylinder quartz-FRC post (Aesthet post-plus, Bisco). The fiber posts were cemented using a multi-step etch-and-rinse adhesive system (All Bond 2®, Bisco) and a dual-cured resin cement (Duolink, Bisco). Each root was cut into seven samples: four samples of 1.8 mm thickness for push-out testing, and three with 0.5 mm for cement layer quality analyzing. One-way ANOVA was used for the push-out test values and the One-Way Kruskal-Wallis (P<0.05) and Dunn (10%) tests for the cement layer analyzes. ANOVA showed that the cement layer quality was affected by the cement insertion methods (P=0.0044): Gr1 (3.8 ± 1.3a), Gr2 (3.2 ± 1.3a), Gr3 (5.2 ± 1.5a,b) and Gr4 (5.2 ± 1.5b) (Dunn test), whereas the bond strength (MPa) was not affected by cement insertion methods: G1 (4.2 ± 1.3), G2 (3.2 ± 1.8), G3 (4.5 ± 0.9), G4 (3.1 ± 1.3). The fiber posts should be cemented with the assistance of the lentulo drill or centrix syringe to promote the best cement layer results.

Resistência de sistemas de união ao microcisalhamento de sistemas adesivos condiona-e-lava de 2 passos: efeito de diferentes tratamentos da superfície dentinária condicionada

Pós-graduação em Ciências Odontológicas - FOAR

Desempenho adesivo de sistemas de união à dentina aplicados in vivo e in vitro: efeito da pressão intrapulpar e profundidade dentinária

O objetivo do presente estudo foi investigar a influência da pressão intrapulpar e da profundidade dentinária sobre o desempenho adesivo de dois agentes de união à dentina, Single Bond (3M ESPE, St. Paul, MN, EUA) e Clearfil SE Bond (Kuraray, Tokyo, Japão), aplicados in vitro e in vivo. Quarenta e oito prémolares superiores hígidos foram selecionados e os pares pertencentes aos mesmos pacientes foram aleatoriamente distribuídos em 4 grupos experimentais de acordo com o sistema adesivo e a pressão intrapulpar, presente ou ausente. Dos dentes pertencentes ao mesmo par, um foi tratado in vivo e o outro in vitro. A ausência ou presença de pressão intra-pulpar foi determinada in vivo pelo uso de anestésicos locais com ou sem vasoconstritor, respectivamente. In vitro, os dentes foram mantidos sob pressão hidrostática de 15 cm de água por 24 horas. Cavidades de classe I foram preparadas e os sistemas adesivos aplicados de acordo com a recomendação dos fabricantes, seguidos da restauração incremental em resina composta. Para os dentes tratados in vitro, os mesmos procedimentos restauradores foram realizados após 6 meses de armazenagem em solução contendo timol 0,1%. Espécimes com área de secção transversal de 1 mm2 foram obtidos e submetidos ao ensaio mecânico de microtração. In vivo, ambos os sistemas adesivos apresentaram desempenho adesivo comparável, enquanto in vitro, o sistema Single Bond foi superior ao sistema Clearfil SE Bond. Esse último não foi influenciado por nenhuma das variáveis estabelecidas no estudo, ou seja, aplicação in vitro ou in vitro, presença de pressão intrapulpar e profundidade em dentina. O sistema Single Bond aplicado sob pressão intrapulpar positiva sofreu variação significante de resistência de união em função da profundidade da dentina, ou seja, em dentina profunda seu desempenho adesivo... (Resumo completo, clicar acesso eletrônico abaixo)

Seven-Year Clinical Performance of Resin Composite Versus Resin-Modified Glass lonomer Restorations in Noncarious Cervical Lesions

Purpose: The purpose of this study was to comparatively assess the seven-year clinical performance of a one-bottle etch-and-rinse adhesive with resin composite (RC) and resin-modified glass ionomer (RMGI) restorations in noncarious cervical lesions.Methods and Materials: One operator placed 70 restorations (35 restorations in each group) in 30 patients under rubber dam isolation without mechanical preparation. The restorations were directly assessed by two independent examiners, using modified US Public Health Service criteria at baseline and 6, 12, 24, 60, and 84 months. The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests. A difference was significant if p<0.05.Results: Twenty patients were available for recall after seven years (66.6%), and 25 RC and 26 RMGI restorations out of 70 restorations were evaluated. Excellent agreement was registered for all criteria between examiners (kappa >= 0.85). Alfa and bravo scores were classified as clinically acceptable. The McNemar test detected significant differences within RC restorations between baseline and seven-year evaluations for anatomic form, marginal integrity, and retention (p<0.05). For RMGI restorations, a significant difference was identified for marginal integrity (p<0.05). As to material comparison, the Fisher exact showed a better retention performance for RMGI restorations than for RC restorations (p<0.05). Twelve composite restorations were dislodged (52.0% retention) and three ionomer restorations were lost (88.5% retention). The cumulative success rate for RC and RMGI was 30% and 58.1%, respectively.Conclusions: After seven years of service, the clinical performance of RMGI restorations was superior to that of the adhesive system/resin composite restorations in this study.

Does the Method of Caries Induction Influence the Bond Strength to Dentin of Primary Teeth?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)