THE EFFECT of IMMEDIATE DENTIN SEALING on THE MARGINAL ADAPTATION and BOND STRENGTHS of TOTAL-ETCH and SELF-ETCH ADHESIVES

Statement of problem. Sealing ability and bond strengths of total-etch and self-etch dentin adhesives used for immediate dentin sealing have not been assessed and established.Purpose. The purpose of this study was to determine the effectiveness of immediate dentin sealing (IDS) using total-etch or self-etch dentin adhesives on microleakage and microtensile bond strength.Material and methods. Twenty recently extracted molars were selected, and standard MOD inlay preparations were made with the gingival margins located below the cemento-enamel unction. The teeth were assigned to 4 experimental groups (n=5) according to the indirect composite restoration cementation technique used: (1) immediate dentin sealing with Adper Single Bond (TEBI); (2) conventional adhesive cementation technique using Adper Single Bond (TEAI); (3) immediate dentin sealing using Adper Prompt L-Pop (SEBI); or (4) conventional adhesive cementation technique using Adper Prompt L-Pop (SEAI). The restored teeth were thermal cycled 1,000 times between 5 degrees and 55 degrees C and then immersed in 50% ammoniacal silver nitrate. Three specimens per restoration were evaluated for microleakage, according to predefined scores, and submitted to Friedman's test (alpha-.05). The specimens were then sectioned to obtain 0.8 +/- 0.2-mm-thick sticks (with n ranging from 32 to 57 specimens) and submitted to microtensile bond strength (mu TBS) testing. The obtained data were submitted to 2-way ANOVA test (alpha=.05).Results. None of the experimental groups demonstrated complete elimination of marginal microleakage. There were significant differences in microleakage of the tested adhesives (P>.001). IDS microleakage scores were similar to those obtained using the conventional cementation technique (CCT) for both adhesives. The highest mean bond strengths were obtained with TEBI (51.1 MPa), whereas SEAI showed the lowest mean bond strengths (1.7 MPa). IDS resulted in significantly higher bond strengths than CCT (P<.001).Conclusions. Total-etch and self-etch adhesives have a significant effect on IDS. IDS resulted in high bond strengths for both adhesives; however, the microleakage was similar to that obtained with CCT (J Prosthet Dent 2009;102:1-9)

Marginal adaptation of Class 2 adhesive restorations

Objective: Control of microleakage represents a challenge for posterior composite restorations. The technique for composite placement may reduce microleakage. The null hypothesis of this in vitro study was that centripetal incremental insertion of composite resin would result in less microleakage than that obtained with the oblique incremental technique or bulk technique. Method and Materials: Standardized Class 2 preparations were made in 60 caries-free extracted third molars and randomly assigned to 3 groups ( n = 20): ( 1) oblique incremental insertion technique ( control), ( 2) centripetal incremental insertion technique, and ( 3) bulk insertion. The teeth were restored with a total-etch adhesive and micro-hybrid composite resin. The specimens were isolated with nail varnish except for a 2-mm-wide area around the restoration and then thermocycled ( 1,000 thermal cycles, 5 degrees C/ 55 degrees C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50% silver nitrate for 24 hours, followed by 8 hours of immersion in a photo-developing solution and subsequently evaluated for leakage. The microleakage scores ( 0 to 4) obtained from the occlusal and cervical walls were analyzed with median nonparametric tests ( P <.05). Results: The null hypothesis was rejected. All techniques attained statistically similar dentin microleakage scores ( P =.15). The centripetal insertion technique displayed significantly less microleakage than the oblique technique at the enamel margins ( P =.04). Conclusion: None of the techniques eliminated marginal microleakage in Class 2 preparations. However, in occlusal areas, the centripetal technique performed significantly better than the other techniques.

Influence of artificial aging in marginal adaptation of mixed class V cavities

The aim of this study was to investigate whether the artificial aging by thermal cycling had influenced the marginal adaptation of class V restorations with/without chlorhexidine application in the bond process. Twelve intact human third molars were used. Class V cavity preparations were performed on the buccal surface and the teeth received 35% phosphoric acid-etching procedure (Ultradent Products Inc., South Jordan, Utah, USA). Subsequently, the samples were divided in two groups: Untreated acid-etched dentin and chlorhexidine application as an adjunct in the bond process. The adhesive Single Bond 2 (3M ESPE, St. Paul, MN, USA) was used after 2% chlorhexidine application, and the restorations were performed with FiltekTM Z350 XT (3M ESPE) composite resin. The specimens were submitted to artificial aging by thermal cycling with 3,000 cycles. Analyzes were performed on scanning electron microscopy using replicas of marginal adaptation in percentage of continuous margin before and after the artificial aging. The data were analyzed by paired test and the results showed statistically significant differences in the percentage of continuous margin with/without chlorhexidine treatment before and after thermal cycling. This study concluded that the artificial aging by thermal cycling influenced the marginal adaptation of mixed class V composite restorations.

Marginal adaptation of class II cavities restored with bulk-fill composites

Objectives: To determine the marginal adaptation of bulk-fill composites in class II MO cavities.Methods: Standardized class II MO cavities with bevelled enamel margins were prepared in 40 extracted human molars. The teeth were randomly assigned to one of the five experimental groups (n = 8). The teeth were restored with two horizontal increments of composite (4 mm and 2 mm thickness). The experimental groups were (1st/2nd increment): Gr. A - Venus Bulk-Fill/Venus Diamond; Gr. B - Tetric EvoCeram BulkFill/Tetric EvoCeram; Gr. C - Surefil SDR/Ceram-X; Gr. D - SonicFill; Gr. E - Ceram-X/Ceram-X (control). After finishing procedures, impressions were made using a polyvinyl siloxane and epoxy resin replicas were obtained. Thermo-mechanical stressing was carried out 24 h after the restorative procedure. All specimens were submitted to 240,000 occlusal loading and simultaneous 600 thermal cycles in water at 5 degrees C and 50 degrees C. After loading, a new set of epoxy resin replicas was obtained. Scanning electron microscopy was carried out at 200x magnification. Results for the marginal adaptation were expressed as percentages of continuity relative to the exposed interface and analyzed by ANOVA and Duncan post hoc test (p < 0.05).Results: In enamel, no significant differences were detected before and after thermo-mechanical loading between groups. In dentine, the worst results were observed in Gr. A.Conclusion: By applying simple layering techniques, bulk-fill materials do not allow better marginal adaptation than a standard composite. Clinical significance: A new class of resin-base composite (bulk-fill) was recently launched on the market. The bulk-fill composites exhibited adequate marginal adaptation and similar to the results of the standard composite. (C) 2014 Elsevier Ltd. All rights reserved.

Marginal adaptation of Class V restorations with current generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with FiltekTM Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Effect of the Insertion and Polymerization Technique in Composite Resin Restorations: Analysis of Marginal Gap by Atomic Force Microscopy

This in vitro study evaluated the marginal gap at the composite tooth/resin interface in class V cavities under the influence of two insertion techniques and a curing system by means of atomic force microscopy (AFM). Forty enamel and dentin cavities were prepared on the buccal surface in bovine teeth with quadratic forms measuring 2 mm X 2 mm and depth of 1.5 mm. The teeth were then divided into four groups: group A, 10 cavities were restored in one increment, light cured by halogen light; group B, 10 cavities filled with bulk filling, light cured by the light emitting diodes (LED); group C, 10 cavities were restored by the incremental technique, light cured by halogen light; group D, 10 cavities were restored by the incremental technique, light cured by the LED. The teeth underwent the polishing procedure and were analyzed by AFM for tooth/restoration interface evaluation. The data were compared between groups using the nonparametric Kruskall-Wallis and Mann-Whitney tests (p < 0.05). The results showed a statistically significant difference between groups A and B and groups A and C. It was concluded that no insertion and polymerization technique was able to completely seal the cavity.

The influence of cervical finish line, internal relief, and cement type on the cervical adaptation of metal crowns

Objective: the aim of this investigation was to evaluate the cervical adaptation of metal crowns under several conditions, namely (1) variations in the cervical finish line of the preparation, (2) application of internal relief inside the crowns, and (3) cementation using different luting materials. Method and Materials: One hundred eighty stainless-steel master dies were prepared simulating full crown preparations: 60 in chamfer (CH), 60 in 135-degree shoulder (OB), and 60 in rounded shoulder (OR). The finish lines were machined at approximate dimensions of a molar tooth preparation (height: 5.5 mm; cervical diameter: 8 mm; occlusal diameter: 6.4 mm; taper degree: 6; and cervical finish line width: 0.8 mm). One hundred eighty corresponding copings with the same finish lines were fabricated. A 30-mu m internal relief was machined 0.5 mm above the cervical finish line in 90 of these copings. The fit of the die and the coping was measured from all specimens (L0) prior to cementation using an optical microscope. After manipulation of the 3 types of cements (zinc phosphate, glass-ionomer, and resin cement), the coping was luted on the corresponding standard master die under 5-kgf loading for 4 minutes. Vertical discrepancy was again measured (L1), and the difference between L1 and L0 indicated the cervical adaptation. Results: Significant influence of the finish line, cement type, and internal relief was observed on the cervical adaptation (P < .001). The CH type of cervical finish line resulted in the best cervical adaptation of the metal crowns regardless of the cement type either with or without internal relief (36.6 +/- 3 to 100.8 +/- 4 mu m) (3-way analysis of variance and Tukey's test, alpha = .05). The use of glass-ionomer cement resulted in the least cervical discrepancy (36.6 +/- 3 to 115 +/- 4 mu m) than those of other cements (45.2 +/- 4 to 130.3 +/- 2 mu m) in all conditions. Conclusion: the best cervical adaptation was achieved with the chamfer type of finish line. The internal relief improved the marginal adaptation significantly, and the glass-ionomer cement led to the best cervical adaptation, followed by zinc phosphate and resin cement.

Marginal fit of nickel-chromium copings before and after internal adjustments with duplicated stone dies and disclosing agent.

STATEMENT OF PROBLEM: Despite careful procedures, master stone dies may be damaged during laboratory procedures. The dentist routinely adjusts castings because the marginal fit of casting is not as accurate as on the dies. PURPOSE: This study evaluated the technique of internal adjustment of castings with use of duplicated stone dies and a disclosing agent to improve marginal fit discrepancy. MATERIAL AND METHODS: Thirty-two nickel-chromium copings were fabricated and simulated standard clinical and laboratory procedures with 2 variables: tooth preparation convergence angles of 6 and 18 degrees, with or without internal relief. Master stone dies and their duplicates were selected for coping construction and internal adjustment, respectively. A specimen positioning device was coupled with a Toolmakers microscope to allow reproducibility of measurements. Each coping was evaluated at 8 locations of its marginal perimeter, before and after internal adjustment. RESULTS: Marginal fit discrepancy of copings were significantly reduced with an internal adjustment technique (mean > 52%) for all experimental groups. Tooth preparations with greater convergence and internally relieved castings recorded a better marginal fit. CONCLUSION: The casting internal adjustment technique with use of duplicated stone dies and a disclosing agent substantially reduced marginal fit discrepancy.

Evaluation of marginal microleakage in Class II cavities: Effect of microhybrid, flowable, and compactable resins

Objective: The goal of the present study was to evaluate the microleakage on the cementum/dentin and enamel surfaces in Class II restorations, using different kinds of resin composite (microhybrid, flowable, and compactable). Method and materials: Forty human caries-free molars were extracted and selected. Eighty Class II standardized cavities were made in the cervical wall at the cementoenamel junction (CEJ) and at the mesial and distal surfaces. The teeth were divided into four groups: G1 - adhesive system + microhybrid resin composite Z100; G2 - adhesive system + compactable resin composite Prodigy Condensable; G3 - adhesive system + flowable resin composite Revolution + Z100 resin composite; G4 - adhesive system + Revolution fluid resin + compactable resin composite Prodigy Condensable. The adhesive system used in this study was Scotchbond Multi-Purpose Plus. The specimens were thermocycled in baths of 5°C and 55°C for 1,000 cycles and immersed in 50% silver nitrate solution. The specimens then were sectioned and evaluated on degree of dye penetration. Results: The results were evaluated using the nonparametric Kruskall-Wallis test, which showed a statistically significant difference between groups G1 and G4, G2 and G4, and G3 and G4. Conclusions: None of the materials was able to eliminate the marginal microleakage at the cervical wall; the application of a low-viscosity resin composite combined with a compactable resin composite significantly decreased the microleakage.

SEM analysis of internal adaptation of adhesive restorations after contamination with saliva

Purpose: This study tested the null hypothesis that different treatments of saliva-contaminated substrate would not affect microgap formation at the dentin walls of bonded restorations. Materials and Methods: Forty freshly extracted human molars received standardized Class V preparations on buccal and lingual surfaces. The specimens were assigned to four experimental groups (n = 20): [G1] no contamination (control group), [G2] saliva contamination (10 s) after etching followed by 5 s air stream; [G3] saliva contamination after etching and rinsed for 10 s; and [G4] re-etching for 10 s after saliva contamination. All specimens were restored with a one-bottle adhesive (Single Bond, 3M ESPE) and microhybrid composite resin (Filtek Z250, 3M ESPE) according to the manufacturer's instructions. The specimens were thermocycled, sectioned through the center of the restoration, and then processed for SEM. Microgaps were measured at the axial wall at 1500X magnification. The data were submitted to Kruskal-Wallis nonparametric statistical analysis at p < 0.05. Results: The data revealed that different groups resulted in a statistically significant difference (p < 0.01) in gap formation. Air drying [G2] and rinsing [G3] the saliva-contaminated dentin resulted in similar microgap values (p > 0.05). However, re-etching the dentin after saliva contamination [G4] increased microgap formation (p < 0.05) when compared with the groups G1 and G2. Although air drying and rinsing produced results comparable to noncontaminated dentin, the presence of microgaps was not completely eliminated. Conclusion: Contaminated saliva did not prevent hybrid layer formation; however, it did reduce the adaptation of the restorative material to bonded surfaces.

Scanning electron microscope analysis of internal adaptation of materials used for pulp protection under composite resin restorations

Purpose: The aim of this study was to evaluate the interfacial microgap with different materials used for pulp protection. The null hypothesis tested was that the combination of calcium hydroxide, resin-modified glass ionomer, and dentin adhesive used as pulp protection in composite restorations would not result in a greater axial gap than that obtained with hybridization only. Materials and Methods: Standardized Class V preparations were performed in buccal and lingual surfaces of 60 caries-free, extracted human third molars. The prepared teeth were randomly assessed in six groups: (1) Single Bond (SB) (3M ESPE, St. Paul, MN, USA); (2) Life (LF) (Kerr Co., Romulus, MI, USA) + SB; (3) LF + Vitrebond (VT) (3M ESPE) + SB; (4) VT + SB; (5) SB + VT; (6) SB + VT + SB. They were restored with microhybrid composite resin Filtek Z250 (3M ESPE), according to the manufacturer's instructions. However, to groups 5 and 6, the dentin bonding adhesive was applied prior to the resin-modified glass ionomer. The specimens were then thermocycled, cross-sectioned through the center of the restoration, fixed, and processed for scanning electron microscopy. The specimens were mounted on stubs and sputter coated. The internal adaptation of the materials to the axial wall was analyzed under SEM with × 1,000 magnification. Results: The data obtained were analyzed with nonparametric tests (Kruskal-Wallis, p ≤ .05). The null hypothesis was rejected. Calcium hydroxide and resin-modified glass ionomer applied alone or in conjunction with each other (p < .001) resulted in statistically wider microgaps than occurred when the dentin was only hybridized prior to the restoration. ©2005 BC Decker Inc.