Polymerization kinetics and reactivity of alternative initiators systems for use in light-activated dental resins

Objectives. The purpose of this study was to evaluate the reactivity and polymerization kinetics behavior of a model dental adhesive resin with water-soluble initiator systems. Methods. A monomer blend based on Bis-GMA, TEGDMA and HEMA was used as a model dental adhesive resin, which was polymerized using a thioxanthone type (QTX) as a photoinitiator. Binary and ternary photoinitiator systems were formulated using 1 mol% of each initiator. The co-initiators used in this study were ethyl 4-dimethylaminobenzoate (EDAB), diphenyliodonium hexafluorophosphate (DPIHFP), 1,3-diethyl-2-thiobarbituric acid (BARB), p-toluenesulfinic acid and sodium salt hydrate (SULF). Absorption spectra of the initiators were measured using a UV-Vis spectrophotometer, and the photon absorption energy (PAE) was calculated. The binary system camphorquinone (CQ)/amine was used as a reference group (control). Twelve groups were tested in triplicate. Fourier-transform infrared spectroscopy (FTIR) was used to investigate the polymerization reaction during the photoactivation period to obtain the degree of conversion (DC) and maximum polymerization rate (R-p(max)) profile of the model resin. Results. In the analyzed absorption profiles, the absorption spectrum of QTX is almost entirely localized in the UV region, whereas that of CQ is in the visible range. With respect to binary systems, CQ + EDAB exhibited higher DC and R-p(max) values. In formulations that contained ternary initiator systems, the group CQ + QTX + EDAB was the only one of the investigated experimental groups that exhibited an R-p(max) value greater than that of CQ + EDAB. The groups QTX + EDAB + DPIHFP and QTX + DPIHFP + SULF exhibited values similar to those of CQ + EDAB with respect to the final DC; however, they also exhibited lower reactivity. Significance. Water-soluble initiator systems should be considered as alternatives to the widely used CQ/amine system in dentin adhesive formulations. (C) 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A multidisciplinary approach to the functional and esthetic rehabilitation of amelogenesis imperfecta and open bite deformity: a case report

The treatment of amelogenesis imperfecta (AI) with an anterior open bite (AOB) is a challenge for the clinician and often requires a multidisciplinary team of specialists. Most often, patients suffering from these conditions are young and a good functional and esthetic long-term result must be aspired. This clinical report illustrates the orthodontic, maxillofacial, restorative, and prosthodontic rehabilitation of a 20-year-old woman with a hypoplastic form of AI and an AOB malocclusion, having received treatment for the last 6 years. It included adhesive resin composite restorations, orthodontical and maxillofacial surgery with a one-piece Le Fort I osteotomy, and a genioplasty. Subsequent prosthodontic therapy consisted of 28 all-ceramic crowns whereby a solid interdigitation, a canine guidance, and consistent and regular contacts between tooth crowns could be achieved to assure a good functional and esthetic oral situation. The tooth preparation techniques guaranteed minimally invasive treatment. The patient was affected very positively. CLINICAL SIGNIFICANCE: This article describes an interdisciplinary approach to the successful treatment of a patient with a hypoplastic form of amelogenesis imperfecta over a period of 6 years. It starts with a discussion of the conservative steps taken during adolescence and concludes with the final prosthetic rehabilitation with all-ceramic crowns after reaching adulthood.

Curing capability of halogen and LED light curing units in deep class II cavities in extracted human molars

Class II cavities were prepared in extracted lower molars filled and cured in three 2-mm increments using a metal matrix. Three composites (Spectrum TPH A4, Ceram X mono M7 and Tetric Ceram A4) were cured with both the SmartLite PS LED LCU and the Spectrum 800 continuous cure halogen LCU using curing cycles of 10, 20 and 40 seconds. Each increment was cured before adding the next. After a seven-day incubation period, the composite specimens were removed from the teeth, embedded in self-curing resin and ground to half the orofacial width. Knoop microhardness was determined 100, 200, 500, 1000, 1500, 2500, 3500, 4500 and 5500 microm from the occlusal surface at a distance of 150 microm and 1000 microm from the metal matrix. The total degree of polymerization of a composite specimen for any given curing time and curing light was determined by calculating the area under the hardness curve. Hardness values 150 microm from the metal matrix never reached maximum values and were generally lower than those 1000 microm from the matrix. The hardest composite was usually encountered between 200 microm and 1000 microm from the occlusal surface. For every composite-curing time combination, there was an increase in microhardness at the top of each increment (measurements at 500, 2500 and 4500 microm) and a decrease towards the bottom of each increment (measurements at 1500, 3500 and 5500 microm). Longer curing times were usually combined with harder composite samples. Spectrum TPH composite was the only composite showing a satisfactory degree of polymerization for all three curing times and both LCUs. Multiple linear regression showed that only the curing time (p < 0.001) and composite material (p < 0.001) had a significant association with the degree of polymerization. The degree of polymerization achieved by the LED LCU was not significantly different from that achieved by the halogen LCU (p = 0.54).

Respuesta pulpar a materiales de restauración tipo resina

Las resinas compuestas y adhesivos dentales se utilizan ampliamente para la restauración de dientes con pulpas vitales. La preferencia en el uso de estas resinas compuestas podría estar atribuida a que son materiales con buenos resultados estéticos y se consideran materiales de restauración estables. Sin embargo se ha demostrado que son susceptibles a la degradación y liberación de la fracción de sus componentes y que cierta cantidad de los monómeros de su composición permanecen sin polimerizar por un largo periodo de tiempo, pudiendo estos filtrarse hacia el tejido pulpar y causar alteraciones de la actividad fisiológica de las células de la pulpa (DPCs) (1). Además, estudios in vitro han demostrado que los componentes de las resinas compuestas tienen potenciales tóxicos, generando respuestas inmediatas y a largo plazo luego de su aplicación. Identificar el potencial tóxico y deletéreo de los materiales de restauración sobre el tejido pulpar es de gran interés y relevancia clínica, por ello este estudio comprende en una revisión de la literatura acerca de la respuesta pulpar a los materiales de restauración tipo resina.

The adhesive system and root canal region do not influence the degree of conversion of dual resin cement

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

BOND STRENGTH DURABILITY of SELF-ETCHING ADHESIVES and RESIN CEMENTS TO DENTIN

Objectives: To evaluate the microtensile bond strength (mu TBS) of one-(Xeno III, Dentsply) and two-step (Tyrian-One Step Plus, Bisco) self-etching adhesive systems bonded to dentin and cemented to chemically cured (C&B Metabond) or light-cured paste of a dual-cure resin cement (Variolink II, Ivoclar) within a short (24 h) and long period of evaluation (90 days). Material and Methods: Forty recently extracted human molars had their roots removed and their occlusal dentin exposed and ground wet with 600-grit SiC paper. After application of one of the adhesives, the resin cement was applied to the bonded surface and a composite resin block was incrementally built up to a height of 5 mm (n = 10). The restored teeth were stored in distilled water at 37 C for 7 days. The teeth were then cut along two axes (x and y), producing beam-shaped specimens with 0.8 mm(2) cross-sectional area, which were subjected to mu TBS testing at a crosshead speed of 0.05 mm/min and stressed to failure after 24 h or 90 days of storage in water. The mu TBS data in MPa were subjected to three-way analysis of variance and Tukey's test (alpha = 0.05). Results: The interaction effect for all three factors was statistically significant (three-way ANOVA, p < 0.001). All eight experimental means (MPa) were compared by the Tukey's test (p < 0.05) and the following results were obtained: Tyrian-One Step Plus /C&B/24 h (22.4 +/- 7.3); Tyrian-One Step Plus /Variolink II/24 h (39.4 +/- 11.6); Xeno III/C&B/24 h (40.3 +/- 12.9); Xeno III/Variolink II/24 h (25.8 +/- 10.5); Tyrian-One Step Plus / C&B/90 d (22.1 +/- 12.8) Tyrian-One Step Plus/VariolinkII/90 d (24.2 +/- 14.2); Xeno III/C&B/90 d (27.0 +/- 13.5); Xeno III/Variolink II/90 d (33.0 +/- 8.9). Conclusions: Xeno III/Variolink II was the luting agent/adhesive combination that provided the most promising bond strength after 90 days of storage in water.

Length of resin tags in pit-and-fissure sealants: all-in-one self-etching adhesive vs phosphoric acid etching.

PURPOSE: To investigate the penetration (tags) of adhesive materials into enamel etched with phosphoric acid or treated with a self-etching adhesive, before application of a pit-and-fissure sealant. MATERIALS AND METHODS: The sample comprised six study groups with six specimens each. Before pit-and-fissure sealing with the materials Clinpro SealantTM (Groups I and II), Vitro Seal ALPHA (Groups III and IV) and Fuji II LC (Groups V and VI), the teeth in Groups I, III, and V were etched with 35% phosphoric acid for 30 seconds. Teeth in Groups II, IV, and VI received application of the self-etching adhesive Adper Prompt L-Pop. The treated teeth were sectioned buccolingually, ground to 100-microm thickness, decalcified, and analyzed by conventional light microscopy at 400x magnification. RESULTS: The teeth etched with phosphoric acid exhibited significantly greater penetration than specimens treated with self-etching adhesive. CLINICAL SIGNIFICANCE: When compared with enamel treated with a self-etching adhesive, the penetration (tags) of adhesive materials into enamel was greater when applied on enamel etched with phosphoric acid.

Direct pulp capping with a self-etching adhesive system: Histopathologic evaluation in dogs` teeth

Objective. This study evaluated histopathologically the response of pulp and periradicular tissues after pulp capping with an all-in-one self-etching adhesive system in dogs` teeth. Study design. Forty teeth of 4 dogs were assigned to 3 groups according to the pulp capping material: G1 (n = 20): self-etching adhesive system; G2 (n = 10): Ca(OH)(2); G3 (n = 10): zinc oxide-eugenol. The animals were killed 7 and 70 days after pulp capping. The pieces containing the pulp-capped teeth were removed and processed for histologic analysis. Results. At 7 days, no dentin bridge formation was observed; G1 and G3 exhibited inflammatory pulpal alterations, whereas G2 presented only mild inflammatory infiltrate in the pulp tissue adjacent to the capping material, the remainder being intact. At 70 days, no specimen in G1 or G3 presented dentin bridge formation. The remaining pulp tissue exhibited severe inflammatory alterations and areas of necrosis. In G2, all specimens showed dentin bridge formation and absence of inflammation and mineralized tissue resorption. No bacteria were identified using Brown and Brenn staining techniques in all 3 groups at any observation period. Conclusion. According to the conditions of this study, direct pulp capping with the self-etching adhesive system did not allow pulp tissue repair and failed histopathologically in 100% of the cases. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e34-e40)

Bond Strength of Fiber Posts in Different Root Thirds Using Resin Cement

Purpose: The aim of the study was to assess the in vitro bond strength (BS) of glass fiber posts (GF) and carbon fiber posts (CF) in the cervical, middle, and apical thirds of root canals cemented with RelyX-Unicem (RX) and Cement-Post (CP). Materials and Methods: Forty maxillary canines were divided into 4 groups (n = 10) according to the cement and post used: group 1: GF and RX; group 2: CF and RX; group 3: GF and CP; group 4: CF and CP. The push-out test was applied in the cervical, middle and apical thirds of each specimen to assess bond strength of the cement/post complex to the root canal wall. The data obtained were submitted to ANOVA (Bonferroni test, p < 0.05), and fracture analysis was done with SEM. Results: The GF posts presented the best results when cemented with RX and with CF (p < 0.05). RX presented the highest BS values for both GF and CF (p < 0.05). For all the groups, BS was higher in the cervical third, followed by the middle and apical thirds. Fracture analysis showed a predominance of cohesive fracture of posts for RX, and a predominance of adhesive fracture between dentin/cement, and mixed failure mode for CP. Conclusion: GF posts cemented with RX presented the highest BS values in all root thirds.

Short-term in situ/ex vivo study of the anticariogenic potential of a resin-modified glass-ionomer cement associated with adhesive systems

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hybrid layer thickness and resin tag length of a self-etching adhesive bonded to sound dentin

Objectives: the purpose of this study is to employ optical microscopy to measure the thickness of the hybrid layer and the penetration (tags) of an aggressive self-etching adhesive system into sound dentin.Methods: occtusat cavities were prepared in 40 extracted human posterior teeth. The prepared teeth were randomly assigned to four experimental groups with 10 specimens each. The self-etching adhesive system Adper Prompt L-Pop was applied to the dentin surface as follows: Group 1: cavosurface enamel was etched for 60 s and dentin for 20 s with 35% phosphoric acid get, immediately followed by application of the self -etching adhesive with a brush to the entire cavity for 15 s; Groups 2, 3, and 4: no pre-etching was performed, and the self -etching adhesive was applied to both enamel and dentin for 15, 30 and 45 s, respectively. After curing, the cavities were fitted with composite resin Fittek Z250. Afterwards, the teeth were decalcified and the restorations were carefully removed for later embedding in paraffin. The specimens were serially sectioned at 6 mu m of thickness and sequentially mounted in glass slides. These sections were stained with Brown and Brenn staining for posterior analysis and measurement of the hybrid layer and resin tags on a tight microscope with a micrometric ocular 40/075. The results were submitted to analysis of variance at the 5% level.Results: whenever there was significance, the Tukey test was applied at the 5% level. The specimens receiving application of acid etching before the selfetching. adhesive displayed a larger thickness of the hybrid layer; on the other hand, specimens receiving only application of the self -etching adhesive on dentin for 15, 30 and 45 s exhibited similar thickness of the hybrid layer. As regards the resin tags, no statistically significant differences could be found between the study groups.Conclusions: it could be concluded that the increase in the time of application of the self-etching adhesive Adper Prompt L-Pop did not significantly influence the formation and thickness of hybrid layer, as well as its penetration into the sound dentin surface. (c) 2005 Elsevier Ltd. All rights reserved.

Response of human pulps capped with different self-etch adhesive systems

The aim of this study was to evaluate the response of human pulps capped with a calcium hydroxide hard-setting cement or with two-step self-etch adhesive systems. Pulp exposures were performed on the occlusal floor, and the bleeding control was performed with saline solution. The exposed pulp tissue was capped with Clearfil LB 2V (2V) or Clearfil SE Bond (SE) and restored with a composite resin. In control group, the pulpal wound was capped with Ca(OH)(2) cement and restored with Clearfil LB 2V or Clearfil SE Bond + composite resin. After 30 and 90 days, the teeth were extracted, processed for hematoxylin and eosin, and categorized in a histological score system. The pulpal response was worse for groups capped with the self-etch adhesive systems (2V and SE) in both periods of evaluation, when compared to their respective control groups at 90 days (p < 0.05). For both self-etch systems evaluated, the pulp tissue exhibited moderate to severe inflammatory cell infiltrate involving the coronal pulp with chronic abscesses. Dentin bridging was observed in a few specimens. For the calcium hydroxide groups, almost all specimens showed dentin bridge formation, with few scattered inflammatory cells and normal tissue below the pulp exposure site. Calcium hydroxide should be used as the material of choice for pulp capping, and the use of two-step self-etch adhesives for human pulp capping is contraindicated.

Effect of adhesive system type and tooth region on the bond strength to dentin

Purpose: This study evaluated the bond strength of two etch-and-rinse adhesive systems (two- and three-step) and a self-etching system to Coronal and root canal dentin.Materials and Methods: The root canals of 30 human incisors and canines were instrumented and prepared with burs. The posts used for luting were duplicated with dual resin cement (Duo-link) inside Aestheti Plus #2 molds. Thus, three groups were formed (n = 10) according to the adhesive system employed: All-Bond 2 (TE3) + resin cement post (rcp) + Duo-link (DI); One-Step Plus (TE2) + rcp + DI; Tyrian/One-Step Plus (SE) + rcp + DI. Afterwards, 8 transverse sections (1.5 mm) were cut from 4 mm above the CEJ up to 4 mm short of the root canal apex, comprising coronal and root canal dentin. The sections were submitted to push-out testing in a universal testing machine EMIC (1 mm/min). Bond strength data were analyzed with two-way repeated measures ANOVA and Tukey's test (p < 0.05).Results: The relationship between the adhesives was not the same in the different regions (p < 0.05). Comparison of the means achieved with the adhesives in each region (Tukey; p < 0.05) revealed that TE3 (mean standard deviation: 5.22 +/- 1.70) was higher than TE2 (2.60 +/- 1.74) and SE (1.68 +/- 1.85).Conclusion: Under the experimental conditions, better bonding to dentin was achieved using the three-step etch-and-rinse system, especially in the coronal region. Therefore, the traditional etch-and-rinse three-step adhesive system seems to be the best choice for teeth needing adhesive endodontic restorations.

Bond strengths, degree of conversion of the cement and molecular structure of the adhesive-dentine joint in fibre post restorations

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of Self-Etching Adhesive Systems Used in the Dental Modelling Technique on the Cohesive Strength of Composite Resin

This study evaluated the cohesive strength of composite using self-etching adhesive systems (SE) in the lubrication of instruments between layers of composite. The specimens were made by using a Teflon (R) device. SE were used at the interface to lubricate the instruments: Group 1(G1) - control group, no lubricant was used; Group 2(G2) -Futurabond (R) M; Group 3(G3) - Optibond (R) All-In-One; Group 4(G4) - Clearfil (R) SE Bond; Group 5(G5) - Futurabond (R) NR; Group 6(G6) - Adper (R) SE Plus; Group 7(G7) - One Up Bond (R) F. Specimens were submitted to the tensile test to evaluate the cohesive strength. Data were submitted to the ANOVA and Tukey tests. ANOVA showed a value of p = 0.00. The average means (SD): G2 = 11.33(+/-3.44) a, G3 = 15.36(+/-4.06) ab, G4 = 18.9(+/-4.72) bc, G7 = 19.62(+/-4.46) bc, G5 = 21.02(+/-5.09) bc, G6 = 23.39(+/-4.17) cd, and G1 = 28.49(+/-2.89) d. All SE decreased the cohesive strength of the composite, except for Adper (R) SE Plus.