Effect of Conventional and Resin-modified Glass-Ionomer Liner on Dentin Adhesive Interface of Class I Cavity Walls After Thermocycling

Objective: The aim of this in vitro study was to analyze the effect of glass-ionomer cement as a liner on the dentin/resin adhesive interface of lateral walls of occlusal restorations after thermocycling.Materials and Methods: Occlusal cavities were prepared in 60 human molars, divided into six groups: no liner (1 and 4); glass-ionomer cement (GIC, Ketac Molar Easymix, 3M ESPE) (2 and 5); and resin-modified glass-ionomer cement (RMGIC, Vitrebond, 3M ESPE) (3 and 6). Resin composite (Filtek Z250, 3M ESPE) was placed after application of an adhesive system (Adper Single Bond 2, 3M ESPE) that was mixed with a fluorescent reagent (Rhodamine B) to allow confocal microscopy analysis. Specimens of groups 4, 5 and 6 were thermocycled (5 degrees C-55 degrees C) with a dwell time of 30 seconds for 5000 cycles. After this period, teeth were sectioned in approximately 0.8-mm slices. One slice of each tooth was randomly selected for confocal microscopy analysis. The other slices were sectioned into 0.8 nun x 0.8 mm beams, which were submitted to microtensile testing (MPa). Data were analyzed using two-way ANOVA and Tukey test (p < 0.05).Results: There was no detectedstatistical difference on bond strength among groups (alpha < 0.05). Confocal microscopy analysis showed a higher mean gap size in group 4(12.5 mu m) and a higher percentage of marginal gaps in the thermocycled groups. The RNIGIC liner groups showed the lowest percentage of marginal gaps.Conclusions: Lining with RMGIC resulted in less gap formation at the dentin/resin adhesive interface after artificial aging. RMGIC or GIC liners did not alter the microtensile bond strength of adhesive system/resin composite to dentin on the lateral walls of Class I restorations.

Does the Ultrasonic Cleaning Medium Affect the Adhesion of Resin Cement to Feldspathic Ceramic?

Purpose: To evaluate the effect of different cleaning media on the adhesion of resin cement to feldspathic ceramic after etching.Materials and Methods: The cementation surfaces of ceramic blocks (N = 20, n = 5 per group) were etched with 10% hydrofluoric acid (HF) gel for 20 s and rinsed for 60 s. They were then randomly assigned to 4 groups: G1: air-water spray+drying (control); G2: ultrasonic cleaning in distilled water for 4 min+drying; G3: ultrasonic cleaning in 99.5% acetone for 4 min+drying; G4: ultrasonic cleaning in 70% alcohol for 4 min+drying. The ceramic blocks were silanized and cemented (RelyX ARC) to the composite blocks. Subsequently, the microtensile bond strength test (mu TBS) was performed. In addition, EDS analysis was made to assess the elemental composition of the conditioned and cleaned ceramic surfaces.Results: A significantly higher mean mu TBS was obtained when specimens had been ultrasonically cleaned in distilled water (G2: 18.8 +/- 0.4 MPa) (p < 0.05) compared to other groups (G1: 16.6 +/- 0.5; G3: 16.1 +/- 0.9; G4: 15.8 +/- 1.4) (one-way ANOVA). EDS analysis indicated the presence of F- only in G1. Dissolved precipitates after HF etching were removed by ultrasonic cleaning.Conclusion: Cleaning the HF-etched ceramic surface ultrasonically in distilled water is recommended, instead of rinsing it with air-water spray only.

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).

Influence of Application Methods of Self-etching Adhesive Systems on Adhesive Bond Strength to Dentin

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

Influence of Methods of Application of Self-etching Adhesive Systems on Adhesive Bond Strength to Enamel

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

Clinical performance of a self-etching adhesive at 18 months

Purpose: To test the null hypothesis that beveling and/or etching enamel would not affect the 18-month clinical performance of the self-etching adhesive Clearfil SE Bond (CSEB) in noncarious cervical lesions (NCCL). Methods: With Institutional Review Board approval, 34 patients were enrolled in this study. A total of 120 NCCL was selected and assigned to four groups: (1) CSEB was applied without any cavity preparation; (2) CSEB was applied after beveling enamel; (3) CSEB was applied after etching enamel for 15 seconds with 35% phosphoric acid; (4) CSEB was applied after beveling and etching enamel. A microfilled composite resin was used for all restorations. Resuts: At 6 months after initial placement, 120 restorations (a 100% recall rate) were evaluated. At 18 months, 87 restorations (a 72.5% recall rate) were available for evaluation. A survival rate of 100% was measured for all groups at both 6 and 18 months. Sensitivity to air decreased significantly only for Group 3 (no bevel+acid etch) from baseline to 18 months without statistical changes from 6 months to 18 months. None of the other parameters resulted in significant differences for any of the four groups. However, when data were pooled, both the overall marginal discoloration and the overall marginal adaptation were significantly worse at 18 months than at baseline, while sensitivity to air decreased significantly from baseline to 18 months. The 18-month survival rate of the self-etching adhesive Clearfil SE Bond was not improved by enamel bevel or by enamel etching. Both overall marginal adaptation and overall marginal discoloration were worse at 18 months than at baseline.

Localized mechanics of dentin self-etching adhesive system

The bond strength of composite resins (CRs) to dentin is influenced by the interfacial microstructure of the hybrid layer (HL) and the resin tags (TAG). The contemporary self-etching primer adhesive systems overcame the inconvenient of the etch-and-rinse protocol. Studies, however, have demonstrated that HL thickness and TAG length vary according to the wetting time and additional use of acid-etching prior to self-etching primers. This study investigated the localized stress distribution in the HL and the dentin/adhesive interface. Two HL thicknesses (3 or 6 mu m), two TAG lengths (13 or 17 mu m) and two loading conditions (perpendicular and oblique-25 degrees) were investigated by the finite element (FE) analysis. Five two-dimensional FE models (M) of a dentin specimen restored with CR (38 x 64 mu m) were constructed: M1 - no HL and no TAG; M2 - 3 mu m of HL and 13 mu m of TAG; M3 - 3 mu m of HL and 17 mu m of TAG; M4 - 6 mu m of HL and 13 mu m of TAG; and M5 - 6 mu m of HL and 17 mu m of TAG. Two distributed loadings (L) (20N) were applied on CR surface: L1 - perpendicular, and L2 - oblique (25 degrees). Fixed interfacial conditions were assigned on the border of the dentin specimen. Ansys 10.0 (Ansys (R), Houston, PA, USA) software was used to calculate the stress fields. The peak of von Mises (sigma(vM)) and maximum principal stress (sigma(max)) was higher in L2 than in L1. Microstructures (HL and TAG) had no effect on local stresses for L1. Decreasing HL decreased sigma(vM) and sigma(max) in all structures for L2, but the TAG length had influence only on the peributular dentin. The thickness of HL had more influence on the sigma(vM) and sigma(max) than TAG length. The peritubular dentin and its adjacent structures showed the highest sigma(vM) and sigma(max), mainly in the oblique loading.

Surface conditioning of a composite used for inlay/onlay restorations: Effect on mu TBS to resin cement

Purpose: To assess the effect of the composite surface conditioning on the microtensile bond strength of a resin cement to a composite used for inlay/onlay restorations.Materials and Methods: Forty-two blocks (6 x 6 x 4 mm) of a microfilled composite (Vita VMLC) were produced and divided into 3 groups (N = 14) by composite surface conditioning methods: Gr1 - etching with 37% phosphoric acid, washing, drying, silanization; Gr2 - air abrasion with 50-Im Al203 particles, silanization; Gr3 - chairside tribochemiCal silica coating (CoJet System), silanization. Single-Bond (one-step adhesive) was applied on the conditioned surfaces and the two resin blocks treated with the same method were cemented using RelyX ARC (dual-curing resin cement). The specimens were stored for 7 days in water at 37 degrees C and then sectioned to produce nontrimmed beam samples, which were submitted to microtensile bond strength testing (mu TBS). For statistical analysis (one-way ANOVA and Tukey's test, = 0.05), the means of the beam samples from each luted specimen were calculated (n = 7).Results: mu TBS values (MPa) of Gr2 (62.0 +/- 3.9a) and Gr3 (60.5 +/- 7.9a) were statistically similar to each other and higher than Gr1 (38.2 +/- 8.9b). The analysis of the fractured surfaces revealed that all failures occurred at the adhesive zone.Conclusion: Conditioning methods with 50-Im Al203 or tribochemical silica coating allowed bonding between resin and composite that was statistically similar and stronger than conditioning with acid etching.

Response of human pulps capped with a self-etching adhesive system

Objective: The aim of this study was to evaluate the human pulp response following direct pulp capping with a current self-etching bonding agent and calcium hydroxide (CH). Methods: Thirty-three sound human premolars had their pulp tissue mechanically exposed. Sterile distilled water was used to control the hemorrhage and exudation from the pulp exposure site. The pulps were capped with Clearfil Liner Bond 2 (CLB-2) or CH and the cavities were filled with a resin composite (Z-100) according to the manufacturer's instructions. After 5, 30 and 120-300 days, the teeth were extracted and processed for microscopic examination. Results: At short-term, CLB-2 elicited a mild to moderate inflammatory pulp response with dilated and congested blood vessels adjacent to pulp exposure site. With time, macrophages and giant cells engulfing globules and particulates of resinous material displaced into the pulp space were observed. This chronic inflammatory pulp response triggered by fragments of bonding agent displaced into the pulp space did not allow pulp repair interfering with the dentin bridging. On the other hand, pulps capped with CH exhibited an initial organization of elongated pulp cells underneath the coagulation necrosis. Pulp repair and complete dentin bridge formation was observed at long-term evaluation. Significance: The present study demonstrated that CH remains the pulp capping agent of choice for mechanically exposed human pulps. CLB-2 did not allow complete connective tissue repair adjacent to the pulp exposure site. Consequently, this bonding agent cannot be recommended for pulp therapy of sound human teeth. © 2001 Academy of Dental Materials. Published by Elsevier Science Ltd. All rights reserved.

Effect of ceramic surface treatment on the microtensile bond strength between a resin cement and an alumina-based ceramic

Purpose: The objective of this study was to test the following hypothesis: the silica coating on ceramic surface increases the bond strength of resin cement to a ceramic. Materials and Methods: In-Ceram Alumina blocks were made and the ceramic surface was treated: G1 - sandblasting with 110-μm aluminum oxide particles; G2 - Rocatec System: tribochemicai silica coating (Rocatec-Pre powder + Rocatec-Plus powder + Rocatec-Sil); G3 - CoJet System: silica coating (CoJet-Sand) + ESPE-Sil. The ceramic blocks were cemented to composite blocks with Panavia F resin cement (under a load of 750 g/1 min). The cemented blocks were stored in distilled water at 37°C for 7 days and sectioned along the x and y axes with a diamond disk. Samples with an adhesive area of ca 0.8 mm 2 (n = 45) were obtained. The samples were attached to an adapted device for the microtensile test, which was performed in a universal testing machine (EMIC) at a crosshead speed of 1 mm/min. Results: The obtained results were submitted to ANOVA and Tukey's test. Mean values of tensile strength (MPa) and standard deviation values were: (G1) 16.8 ± 3.2; (G2) 30.6 ± 4.5; (G3) 33.0 ± 5.0. G2 and 63 presented greater tensile strength than G1. There was no significant difference between G2 and G3. All the failures took place at the ceramic/resin cement interface. Conclusion: The silica coating (Rocatec or CoJet systems) of the ceramic surface increased the bond strength between the Panavia F resin cement and alumina-based ceramic.

The effect of adhesive systems on the pullout strength of a fiberglass-reinforced composite post system in bovine teeth

Purpose: To evaluate the pullout strength of a glass fiber-reinforced composite post (glass FRC) cemented with three different adhesive systems and one resin cement. The null hypothesis was that pullout strengths yielded by the adhesive systems are similar. Materials and Methods: Thirty bovine teeth were selected. The size of the specimens was standardized at 16 mm by sectioning off the coronal portion and part of the root. The specimens were divided into three groups, according to the adhesive system, which were applied following the manufacturers' instructions: G1, ScotchBond Multi-Purpose Plus; G2, Single Bond; G3, Tyrian SPE/One-Step Plus. The glass FRCs (Reforpost) were etched with 37% H3PO4 for 1 min and silanized (Porcelain Primer). Thereafter, they were cemented with the dual resin cement En-Force. The specimens were stored for 24 h, attached to an adapted device, and submitted to the pullout test in a universal testing machine (1 mm/min). The data were submitted to the one-way ANOVA and Tukey's test (α = 0.05). Results: G1 (30.2 ± 5.8 Kgf) displayed the highest pullout strength (p < 0.001) when compared to G2 (18.6 ± 5.8 Kgf) and G3 (14.3 ± 5.8 Kgf), which were statistically similar. Analysis of the specimens revealed that all failures occurred between the adhesive system and the root dentin (pullout of the post cement), regardless of group. Conclusion: The multiple-bottle, total-etch adhesive system provided higher pullout strength of the glass FRC when compared to the single-bottle, total-etch, and single-step self-etching adhesive systems. The null hypothesis was rejected (p < 0.001).

Microtensile bond strength between a quartz fiber post and a resin cement: Effect of post surface conditioning

Purpose: To test the bond strength between a quartz-fiber-reinforced composite post (FRC) and a resin cement. The null hypothesis was that the bond strength can be increased by using a chairside tribochemical silica-coating system. Materials and Methods: Thirty quartz-FRCs (Light-Post) were divided into 3 groups according to the post surface treatment: G1) Conditioning with 32% phosphoric acid (1 min), applying a silane coupling agent; G2) etching with 10% hydrofluoric acid (1 min), silane application; G3) chairside tribochemical silica coating method (CoJet System): air abrasion with 30-μ SiO x-modified Al2O3 particles, silane application. Thereafter, the posts were cemented into a cylinder (5 mm diameter, 15 mm height) with a resin cement (Duo-Link). After cementation, the specimens were stored in distilled water (37°C/24 h) and sectioned along the x and y axes with a diamond wheel under cooling (Lab-cut 1010) to create nontrimmed bar specimens. Each specimen was attached with cyanoacrylate to an apparatus adapted for the microtensile test. Microtensile testing was conducted on a universal testing machine (1 mm/min). The data obtained were submitted to the one-way ANOVA and Tukey test (α = 0.05). Results: A significant influence of the conditioning methods was observed (p < 0.0001). The bond strength of G3 (15.14 ± 3.3) was significantly higher than the bond strengths of G1 (6.9 ± 2.3) and G2 (12.60 ± 2.8) (p = 0.000106 and p = 0.002631, respectively). Notwithstanding the groups, all the tested specimens showed adhesive failure between the resin cement and FRC. Conclusion: The chairside tribochemical system yielded the highest bond strength between resin cement and quartz-fiber post. The null hypothesis was accepted (p < 0.0001).

Bond strength of a resin cement to high-alumina and zirconia-reinforced ceramics: The effect of surface conditioning

Purpose: The aim of this study was to evaluate the effect of two surface conditioning methods on the microtensile bond strength of a resin cement to three high-strength core ceramics: high alumina-based (In-Ceram Alumina, Procera AllCeram) and zirconia-reinforced alumina-based (In-Ceram Zirconia) ceramics. Materials and Methods: Ten blocks (5 ×6 × 8 mm) of In-Ceram Alumina (AL), In-Ceram Zirconia (ZR), and Procera (PR) ceramics were fabricated according to each manufacturer's instructions and duplicated in composite. The specimens were assigned to one of the two following treatment conditions: (1) airborne particle abrasion with 110-μm Al2O3 particles + silanization, (2) silica coating with 30 μm SiOx particles (CoJet, 3M ESPE) + silanization. Each ceramic block was duplicated in composite resin (W3D-Master, Wilcos, Petrópolis, RJ, Brazil) using a mold made out of silicon impression material. Composite resin layers were incrementally condensed into the mold to fill up the mold and each layer was light polymerized for 40 s. The composite blocks were bonded to the surface-conditioned ceramic blocks using a resin cement system (Panavia F, Kuraray, Okayama, Japan). One composite resin block was fabricated for each ceramic block. The ceramic-composite was stored at 37°C in distilled water for 7 days prior to bond tests. The blocks were cut under water cooling to produce bar specimens (n = 30) with a bonding area of approximately 0.6 mm2. The bond strength tests were performed in a universal testing machine (crosshead speed: 1 mm/min). Bond strength values were statistically analyzed using two-way ANOVA and Tukey's test (≤ 0.05). Results: Silica coating with silanization increased the bond strength significantly for all three high-strength ceramics (18.5 to 31.2 MPa) compared to that of airborne particle abrasion with 110-μm Al2O3 (12.7-17.3 MPa) (ANOVA, p < 0.05). PR exhibited the lowest bond strengths after both Al2O3 and silica coating (12.7 and 18.5 MPa, respectively). Conclusion: Conditioning the high-strength ceramic surfaces with silica coating and silanization provided higher bond strengths of the resin cement than with airborne particle abrasion with 110-μm Al2O3 and silanization.

Does the thickness of the resin cement affect the bond strength of a fiber post to the root dentin?

This study aimed to evaluate the influence of cement thickness on the bond strength of a fiber-reinforced composite (FRC) post system to the root dentin. Eighteen single-rooted human teeth were decoronated (length: 16 mm), the canals were prepared, and the specimens were randomly allocated to 2 groups (n = 9): group 1 (low cement thickness), in which size 3 FRC posts were cemented using adhesive plus resin cement; and group 2 (high cement thickness), in which size 1 FRC posts were cemented as in group 1. Specimens were sectioned, producing 5 samples (thickness: 1.5 mm). For cement thickness evaluation, photographs of the samples were taken using an optical microscope, and the images were analyzed. Each sample was tested in push-out, and data were statistically analyzed. Bond strengths of groups 1 and 2 did not show significant differences (P = .558), but the cement thicknesses for these groups were significantly different (P < .0001). The increase in cement thickness did not significantly affect the bond strength (r2 = 0.1389, P = .936). Increased cement thickness surrounding the FRC post did not impair the bond strength.

Bond strength of adhesive systems to human tooth enamel

The purpose of this study was to evaluate in vitro three adhesive systems: a total etching single-component system (G1 Prime & Bond 2.1), a self-etching primer (G2 Clearfil SE Bond), and a self-etching adhesive (G3 One Up Bond F), through shear bond strength to enamel of human teeth, evaluating the type of fracture through stereomicroscopy, following the ISO guidance on adhesive testing. Thirty sound premolars were bisected mesiodistally and the buccal and lingual surfaces were embedded in acrylic resin, polished up to 600-grit sandpapers, and randomly assigned to three experimental groups (n = 20). Composite resin cylinders were added to the tested surfaces. The specimens were kept in distilled water (37°C/24 h), thermocycled for 500 cycles (5°C-55°C) and submitted to shear testing at a crosshead speed of 0.5 mm/min. The type of fracture was analyzed under stereomicroscopy and the data were submitted to Anova, Tukey and Chi-squared (5%) statistical analyses. The mean adhesive strengths were G1: 18.13 ± 6.49 MPa, (55% of resin cohesive fractures); G2: 17.12 ± 5.80 MPa (90% of adhesive fractures); and G3: 10.47 ± 3.14 MPa (85% of adhesive fractures). In terms of bond strength, there were no significant differences between G1 and G2, and G3 was significantly different from the other groups. G1 presented a different type of fracture from that of G2 and G3. In conclusion, although the total etching and self-etching systems presented similar shear bond strength values, the types of fracture presented by them were different, which can have clinical implications.